Deksmedetomidin ve fentanil propofol enjeksiyon ağrısını gideriyor

Öz

We performed this study to compare the effects of intravenous dexmedetomidine and fentanyl on propofof injection pain. We conducted a prospective, randomized and double blind study of 120 adult unpremedicated patients (18-65 years of age) scheduled to undergo elective surgery under general anesthesia. The patients were allocated randomly into three groups (n=40): fentanyl (F), dexmedetomidine (D), and Control (C). Ten ml of the study solution was injected over 10 seconds. One minute after the administration of fentanyl (1 ug/ kg) or dexmedetomidine (0,15 ug/ kg) or placebo, propofol 2,5 mg/ kg was Infused at a rate of 20 ml/ min. Injection pain was assessed using a four - point verbal rating scale. The incidence of propofol-associated injection pain were 65% (26) for group C, 27% (16) for group F, and 25% (10) for group D. The incidence of pain were less in the"fentanyl, and especially in the dexmedetomidine groups than control group (p< 0.05). Severe pain in groups were D

Anahtar Kelimeler

• Dexmedetomidine,Fentanyl,Propofol,Injections,Anesthesia, Intravenous,Premedication,Pain,Hemodynamics,Analgesics

Deksmedetomidin and fentanyl attenuatethe propofol injection pain

Öz

Bu çalışmayı, venöz yol ile verilen deksmedetomidin ve fentanilin propofol enjeksiyon ağrısı üzerine olan etkisini karşılaştırmak üzere gerçekleştirdik. Genel anestezi altında elektif cerrahi geçirecek olan, premedikasyon yapılmamış (18-65 yaş), yetişkin hasta ile bir prospektif, randomize ve çift kör çalışma planladık. Hastalar gelişigüzel 3 gruba ayrıldı (n=40)- Fentanil (F), deksmedetomidin (D) ve Kontrol (C). 10 mililitrelik çalışma solüsyonu sabit 10 saniye içinde enjekte edildi. Fentanil (1 ug/ kg) ya da deksmedetomidin (0.15 ug/ kg) ya da plasebo verildikten 60 saniye sonra propofol 2,5 mg/kg 20 ml/ dakika hızla infuze edildi Enjeksiyon ağrısı four-point sözel skalası kullanılarak değerlendirildi Propofol ilişkili enjeksiyon ağrısının oranları grup C için. %65 (26), F grubu için: %27 (16) ve grup D için %25 (10) idi. Ağrı oranı fentanil ve özellikle de deksmedetomidin grubunda kontrol grubuna göre daha azdı (p< 0.05). Gruplardakı şiddetli ağrı, D

Anahtar Kelimeler

• Deksmedetodimin,Fentanil,Propofol,Enjeksiyonlar,Anestezi, ven içi,Premedikasyon,Ağrı,Hemodinamikler,Analjezikler

Kaynakça

1. 1.Angst MS, Mackey SC, Zupfer GH. Reduction of propofol injection pain with a double lumen i.v. set. J Clin Anesth. 1197;9:462-6
2. 2.Scott RP, Saunders DA, Norman J. Propofol: clinical strategies for preventing the pain of injection. Anaesthesia. 1988;43:492-4
3. 3.Doenicke AW, Roizen MF, Rau 1 Reducing pain during propofol injection: the role of the solvent. Anesth Analg. 1996;82:472-4
4. 4.King SY, Davis FM, Wells JE. Lidocaine for the prevention of pain due to injection of propofol. Anesth Analg. 1992;74:246-9
5. 5.Cheong MA, Kim KS, Choi WJ. Ephedrine reduces the pain from propofol injection. Anesth Analg. 2002;95:1293-6
6. 6.Barbi E, Marchetti F, Gerarduzzi T. Pretreatment with intravenous ketamine reduces propofol injection pain. Paediatr Anaesth. 2003; 13:764-8
7. 7.Fujii Y, Nakayama M. A lidocaine/metoclopramide combination decreases pain on injection of propofol. Can J Anaesth. 2005;52:474-7
8. 8.Agarwal A, Ansari MF, Gupta D. Pretreatment with thiopental for prevention of pain associated with propofol injection. Anesth Analg. 2004;98:683-6

9. 9.Huang YW, Buerkle H, Lee TH. Effect of pretreatment with ketorolac on propofol injection pain. Acta Anaesthesiol. Scand. 2002;46:1021-4
10. lO.Picard P, Tramer MR. Prevention of pain on injection with propofol: a quantitative systematic review. Anesth Analg. 2000;90:963-9
11. ll.Lilley EM, Isert PR, Carasso ML, Kennedy RA. The effect of the addition of lignocaine on propofol emulsion stability. Anaesthesia. 1996;51:815-8
12. 12.Pang WW, Mok MS, Huang S, Hwang MH. The analgesic effect of fentanyl, morphine, meperidine, and lidocaine in the peripheral veins: a comparative study. Anesth Analg. 1998;86:382-6
13. 13.Kamibayashi T, Maze M. Clinical uses of alpha2 -adrenergic agonists. Anesthesiology. 2000;93:1345-9
14. 14.Turan A, Memis D, Kaya G, Karamanlioglu B. The prevention of pain from injection of propofol by dexmedetomidine and comparison with lidocaine. Can J Anaesth. 2005;52:548-9
15. 15.Cameron E, Johnston G, Crofts S, Morton NS. The minimum effective dose of lignocaine to prevent injection pain due to propofol in children. Anaesthesia. 1992;47:604-6
16. 16.Tan CH, Onsiong MK. Pain on injection of propofol: Anaesthesia. 1998;53:468-76
17. 17.Smith I, White PF, Nathanson M, Gouldson R. Propofol. An update on its clinical use. Anesthesiology. 1994;81:1005-43
18. 18.Coderre TJ, Katz J, Vaccarino AL, Melzack R. Contribution of central neuroplasticity to pathological pain: review of clinical and experimental evidence. Pain. 1993;52:259-85
19. 19.McCrirrick A, Hunter S. Pain on injection of propofol: the effect of injectate temperature. Anaesthesia. 1990;45:443-4
20. 20.Nathanson MH, Gajraj NM, Russell JA. Prevention of pain on injection of propofol: a comparison of lidocaine with alfentanil. Anesth Analg. 1996;82:469-71
21. 21.Kobayashi Y, Kamada Y, Kumagai A. Pain-free injection of propofol. Masui. 1998;47:835-8
22. 22.Bekker A, Sturaitis MK. Dexmedetomidine for neurological surgery. Neurosurgery. 2005;57:l-10
23. 23.Khan ZP, Ferguson CN, Jones RM. alpha-2 and imidazoline receptor agonists. Their pharmacology and therapeutic role. Anaesthesia. 1999;54:146-65
24. 24.Ayoglu H, Altunkaya H, Ozer Y. Does dexmedetomidine reduce the injection pain due to propofol and rocuronium? Eur 3 Anaesthesiol. 2007;24:541-5
25. 25.Bahar M, McAteer E, Dundee JW, Briggs LP. Aspirin in the prevention of painful intravenous injection of disoprofoh(ICI35,868) and diazepam (Valium). Anaesthesia. 1982;37:847-8
26. 26.Helmers JH, Kraaijenhagen RJ, Leeuwen L, Zuurmond WW. Reduction of pain on injection caused by propofol. Can J Anaesth. 1990;37:267-8
27. 27.Basaranoglu G, Erden V, Delatioglu H. Reduction of pain on injection of propofol: a comparison of fentanyl with remifentanil. Anesth Analg. 2002;94:1040-1
28. 28.Dalle C, Schneider M, Clergue F. inhibition of the I(h) current in isolated peripheral nerve: a novel mode of peripheral antinociception? Muscle Nerve. 2001;24:254-61
29. 29. James MK, Feldman PL, Schuster SV. Opioid receptor activity of GI87084B, a novel ultra-short acting analgesic, in isolated tissues. J Pharmacol Exp Ther. 1991;259:712-8
30. 30.Newcombe GN. The effect, on injection pain, of adding lignocaine to propofol. Anaesth Intensive Care. 1990; 18:105-7