目的 比较预注射利多卡因和局部加温缓解罗库溴铵注射痛效果。 方法 选取2011年3月－8月择期行腹腔镜下胆囊切除术的150例患者，按照完全随机的方法分为利多卡因组（L组）、局部加温组（W组）、对照组（C组）,每组各50例患者。W组患者在留置针部位用Bair Hugger以40 °C加温1 min；L组患者用橡胶止血带在静脉近端加压直至静脉输液停止走行，推注1%利多卡因2 mL，1 min后松开止血带。随后3组患者均在2 s内静脉推注1 mL罗库溴铵注射液（含罗库溴铵10 mg）。观察在注射罗库溴铵前预先注射利多卡因及局部加温缓解注射痛的效果。 结果 罗库溴铵注射痛的发生率在W组、L组、C组中分别为62%、34%、82%。C组的疼痛发生率最高（P＜0.05）；W组的疼痛率高于L组（P＜0.05）；与W、L组相比，C组的重度疼痛率最高（P＜0.05）；L组的中、重度疼痛率低于W组（P＜0.05）。 结论 预注射利多卡因和局部加温均能有效缓解罗库溴铵引起的注射痛，预注射利多卡因对于缓解罗库溴铵引起的注射痛更为有效。
【摘要】 目的 比较利多卡因不同剂量预处理对罗库溴铵注射痛的影响。 方法 120例行全身麻醉择期手术的患者按照完全随机的方法分为利多卡因10 mg 3 mL预处理组（A组），利多卡因25 mg 3 mL预处理组（B组），利多卡因50 mg 3 mL预处理组（C组），生理盐水3 mL预处理组（D组）。观察不同剂量的利多卡因预处理对罗库溴铵注射痛的影响。 结果 A、B、C和D组注射罗库溴铵的疼痛发生率分别为53%、27%、3%和90%。与生理盐水预处理组相比，利多卡因预处理组能明显减轻罗库溴铵引起的注射痛（Plt;0.01）；剂量越大，效果越明显。 结论 利多卡因10、25、50 mg预处理均能显著降低罗库溴铵注射时引起的疼痛，以50 mg利多卡因更为有效。【Abstract】 Objective To compare the effects of different doses of lidocaine pretreatment on the pain from injection with rocuronium. Methods One hundred and twenty patients of general anesthesia had undergone elective surgery, were randomly divided into lidocaine 10 mg 3 mL pretreated group (group A), lidocaine 25 mg 3 mL pretreated group (group B), lidocaine 50 mg 3 mL pretreated group (group C) and saline 3 mL pretreated group (group D). The effects of different doses of lidocaine pretreatment on injection pain of rocuronium were observed. Results The pain incidence from injection with rocuronium in A, B, C, D groups were 53%, 27%, 3% and 90% respectively. The higher dose of lidocaine, the more obvious effect. Conclusion Lidocaine pretreatment with 10, 25, 50 mg can reduce the severity of pain from injection with rocuronium, and lidocaine 50 mg is the most effective.
摘要:目的: 在风湿性心脏病患者瓣膜置换术中,评价罗库溴铵在麻醉诱导期间对患者心肌氧供和氧耗平衡的影响。 方法 :选择86例在中低温体循环下行瓣膜置换术的患者,采用随机双盲法分配成罗库溴铵组(n=42例)和维库溴铵组(n=41例)。给予咪唑安定(005～01 mg/kg)及芬太尼(10～15μg/kg)及等效剂量的罗库溴铵06 mg/kg或维库溴铵01 mg/kg(Org. Comp)进行麻醉诱导。监测麻醉诱导前至插管后10分钟(1次/1分)期间两组患者心肌氧供和氧耗的变化。 结果 :与基础值相比,罗库溴铵组患者在插管后5分钟期间心率增加了174%～135%,动脉收缩压增加了1694%～143%,平均动脉压增加了151%～132%。同期心率收缩压乘积增加了2267%～1396% (〖WTBX〗P lt;005)。心率和动脉血压在插管后1～7分钟期间明显高于同期的维库溴铵组患者(〖WTBX〗P lt;005)。 结论 :在ASA ⅢⅣ级、心功ⅡⅢ级风心病瓣膜病变患者进行瓣膜置换术中, 06 mg/kg罗库溴铵有潜在增加患者心肌耗氧量的作用。Abstract: Objective: To evaluate the effects of rocuronium on myocardial oxygen supplydemand in patients with rheumatic heart disease (RHD) during induction. Methods : 86 patients of either sex (ASA status ⅢⅣ; New York Heart Association classes ⅡⅢ) scheduled for valve replacement surgery were included in this randomized clinical trial (RCT). SwanGanz catheter was placed via right internal jugular vein before the induction of anaesthesia. Anaesthesia was induced with midazolam 00501mg.kg-1 and fentanyl 1015 μg·kg-1. The patients were randomized to receive either rocuronium 06 mg·kg-1 (group R, 〖WTBX〗n= 42) or vecuronium 01 mg·kg-1 (group V, 〖WTBX〗n= 41) to facilitate tracheal intubation when bispectral index (BIS) value dropped to 60 All data were recorded at the time before anaesthesia (Tb), loss of consciousness (Ts), administration of muscle relaxant (Tm), 1 min after administration of muscle relaxant (T1), when trainoffour stimulation (TOF) reached 0 (T2) and 1,2,3,4,5,7,10 min after tracheal intubation (T39).〖WTHZ〗Results : Heart rate (HR) increased by 174%135%, systemic arterial systolic pressure (SAP) increased by 1694%143%, mean arterial systolic pressure (MAP) increased by 151%132% and product of heart rate and arterial systolic pressure(RPP) increased 2267%1396% respectively during 5 minutes after intubation as compared with baseline in group R, which were significantly higher than those in group V during 5 minutes after intubation (〖WTBX〗P lt;005). Conclusion : An intubation dose of rocuronium should be used cautiously in patients with rheumatic heart disease (ASA status ⅢⅣ; NYHA classes IIⅢ).
ObjectiveTo systematically evaluate the efficacy of different interventions in preventing rocuroniuminduced injection pain or withdrawal movements, so as to provide references for preventing adverse reactions induced by rocuronium injection in clinical practice. MethodsWe electronically searched PubMed, EMbase, The Cochrane Library (Issue 3, 2014), CBM, and CNKI databases to collect randomized controlled trials (RCTs) about the prevention of rocuronium-induced injection pain or withdrawal movements from inception to March 2014. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of included studies. Then, meta-analysis was performed using RevMan 5.2.8 software. ResultsA total of 43 RCTs involving 6 034 patients were include. The results of meta-analysis showed that compared with the placebo/blank group, lidocaine pretreatment with venous occlusion (RR=0.37, 95%CI 0.29 to 0.48, P<0.000 01), opioid drug pretreatment with venous occlusion (RR=0.77, 95%CI 0.68 to 0.87, P<0.000 1), lidocaine pretreatment with venous injection (RR=0.51, 95%CI 0.44 to 0.59, P<0.000 01), opioid drug pretreatment with venous injection (OR=0.03, 95%CI 0.02 to 0.05, P<0.000 01), ketamine pretreatment with venous injection (RR=0.36, 95%CI 0.23 to 0.54, P<0.000 01), mixing sodium bicarbonate (NaHCO3) with rocuronium (OR=0.02, 95%CI 0.01 to 0.04, P<0.000 01) and local heating (RR=0.74, 95%CI 0.63 to 0.88, P=0.000 6) were all effective in decreasing the incidence of rocuronium-induced injection pain or withdrawal movements. ConclusionThe intravenous injection of opioid drugs was effective in preventing rocuronium-induced injection pain or withdrawal movements, while local heating needs further research. Due to the limited quantity and quality of the induced studies, the above conclusion still needs to be verified by more high quality studies.
ObjectivesTo systematically review the prophylactic efficacy of lidocaine administrated intravenously in advance on rocuronium associated injection pain/withdrawal movement in patients under general anesthesia.MethodsPubMed, The Cochrane Library, Web of Science, EMbase, CNKI, WanFang Data and VIP databases were electronically searched to collect relevant randomized controlled trials (RCTs) on pretreatment with lidocaine intravenously to prevent injection pain /withdraw movement from rocuronium from inception to September 30th, 2018. Two reviewers independently screened literature, extracted data and assessed risk of bias of included studies; then, meta-analysis was performed by using RevMan 5.3 software.ResultsA total of 30 RCTs involving 2 518 patients were included. The results of meta-analysis showed that, compared to the control group, pretreating with intravenous lidocaine could significantly reduced the occurrence of total pain/withdrawal movement associated with rocuronium injection (RR=0.43, 95%CI 0.36 to 0.51, P<0.000 01), and whether with (RR=0.39, 95%CI 0.29 to 0.52, P<0.000 01) or without (RR=0.45, 95%CI 0.36 to 0.57, P<0.000 01) occluding the vein, intravenous lidocaine could prevent pain/withdrawal movement associated with rocuronium injection. In addition, the incidence of lidocaine group igniting moderate (RR=0.38, 95%CI 0.31 to 0.46, P<0.000 01) or severe (RR=0.23, 95%CI 0.18 to 0.30, P<0.000 01) pain/ withdrawal movement were less likely to occur. However, there was no difference between the lidocaine and control group in the incidence of mild injection pain/withdrawal movement induced by rocuronium (RR=0.89, 95%CI 0.75 to 1.06, P=0.19).ConclusionsCurrent evidence shows that pre-intravenous lidocaine can reduce the occurrence of injection pain/withdrawal movement associated with rocuronium injection patients, especially in the prevention of moderate and severe injection pain/withdrawal movement.