ABSTRACT
Injection pain of propofol remains a common clinical problem. Previous studies demonstrated that propofol injection pain was alleviated by applying nitroglycerin ointment to the skin of injection site, which inspires us to test whether venous vasodilation induced by fluid preload could alleviate the pain. Different types or volumes of fluid preload were compared. 200 ASA I-II adult patients were randomly assigned to five groups of 40 each. A 20 G cannula was established on the dorsum or wrist of the hand. When fluid preload given with Plasma-Lyte A 100 mL (P100 group), 250 mL (P250 group), 500 mL (P500 group), 0.9% saline 500 mL (N500 group) or Gelofusine 500 mL (G500 group) was completed within 30 min, respectively, Propofol (0.5 mg/kg, 1%) was injected at a rate of 0.5 mL/s. A blind investigator assessed the pain using a four-point scale. Incidence of pain in P100, P250, and P500 groups was 87.5%, 57.5% and 35%, respectively (P<0.05). The median pain intensity score was significantly lower in P500 group than that in P250 and P100 groups (P<0.05 and P<0.01, respectively). Comparison of the effect of different types of solution preload indicated that the highest incidence of pain was in N500 group (62.5%) (N500 vs. P500, P=0.014; N500 vs. G500, P=0.007). The median pain intensity score in N500 group was higher than that in P500 group (P<0.05) and G500 group (P<0.05). There was no significant difference between P500 and G500 groups. It is suggested that Plasma-Lyte A or Gelofusine preload with 500 mL before propofol injection is effective in alleviating propofol-induced pain.
Subject(s)
Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Electrolytes , Therapeutic Uses , Injections, Intravenous , Methods , Pain , Drug Therapy , Plasma Substitutes , Therapeutic Uses , Polygeline , Therapeutic Uses , PropofolABSTRACT
Objective To compare the effects of the two kinds of crystalloid solutions on glycometabolism in type 2 diabetic patients during the operation for the sclestion of the most suitable crystalloid solution. Methods In the forty scheduled gastrointestinal operation patients,there were twenty (D-group) type 2 diabetic patients and the others (N-group) were non-diabetic patients. Each of the two groups were randomly divided into two groups according to infusing different crystalloid solutions: lactated Ringer’s solution (L group), Plasma Lyte A (A group).So the patients were divided into D-L group,D-A group,N-Lgroup,N-A group.The blood glucose concentration,the blood lactate concentration and artery blood gas analysis before operation (T0) and at the end of operation(T1)were measured . Results The blood glucose concentrations had significant increase at the end of operations,and the blood glucose concentrations of D group were higher than that of N group at T0 and T1.The lactate concentrations before operation were normal in all the patients, but the lactate concentrations were over the normal limits after infusing lactated Ringer’s solution and remained normal after infusing Plasma Lyte A.The lactate concentrations had significant increase in the other three groups except N-A group. Conclusion Plasma Lyte A is the more safe and efficient crystalloid solution for diabetic patients during the operation.