EBRU KELSAKA, Sibel BARIŞ, Şebnem TEPE, Binnur SARIHASAN, Bengi ŞENER, Ayla TÜR

Propofol enjeksiyon ağrısının önlenmesinde ondansetron ve lidokainin karşılaştırılması

Bu çalışma, propofol enjeksiyon ağrısının önlenmesinde ondansetron ve lidokainin etkilerini karşılaştırmak amacıyla yapıldı. Çalışmaya alınan 75 erişkin olgu randomize olarak 25'şer kişilik üç gruba ayrıldı. Oh kola turnike uygulanarak Grup I'deki olgulara 2 cc (4 mg) ondansetron, Grup H'dekilere 2 cc (%2) lidokain ve Grup IU'deki olgulara ise 2 cc SF (%0.9) iv. verildi. 30 sn sonra turnike gevşetildi. 2.5 mg/kg total propofol dozunun önce 1/4'ü 4 sn içinde verildi. Ağrı şiddeti ve kol çekme tepkilerine bakıldı. Sonra propofolün kalan 3/4'ü verildi. Ondansetron ve lidokain uygulananlarda propofol enjeksiyon ağrısı plaseboya göre (sırasıyla %48, 36 ve 96) anlamlı derecede azdı (p

Anahtar Kelimeler:

Anestezikler, lokal, Enjeksiyonlar, Lidokain, Ağrı, ameliyat sonrası, Propofol, Ondansetron, Ameliyat sonrası bulantı ve kusma

Comparison of ondansetron and lidocaine in preventing of propofol injection pain

This study was examined to compare the efficiency of propofol injection pain prevention with the effect of ondansetron and lidocaine. The study were included 75 adult patients were divided into three groups (n=25). The turniquet was applied on the forearm. Patients in Group I received 2 cc (4 mg) ondansetron, in Group II received 2 cc (2%) lidocaine and in Group III received 2 cc of iv 0.9% saline. After 30 seconds, turniquet was released. One fourth of total dose (2.5 mg/kg) was injected in 4 sec. Then the intensity of pain and arm withdrawn was observed. Than three fourth of propofol was given. Pretreatment with ondansetron and lidocaine significantly reduced the incidence of propofol pain comparing with the placebo (48%, 36 and 96 respectively) (p<0.05). There was not difference between ondansetron and lidocaine. We decided that ondansetron and lidocaine were more successful than placebo in relieving pain. Ondansetron which is used on preventing postoperative nause and vomiting may be alternative to lidocaine on the preventing the injection pain of propofol and we realized that two goals could be verified with the same injection.

Keywords:

Anesthetics, Local, Injections, Lidocaine, Pain, Postoperative, Propofol, Ondansetron, Postoperative Nausea and Vomiting,

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1. Esener ZK. İntravenöz Anestezikler. 'Klinik Aneste- zi'den, 2 nd. İstanbul, Logos Yayıncılık, 1997; 102-104. 2. King SY, Davis FM, Wells JE, et al. Lidocaine for the prevention of pain due to injection of propofol. Anesth Analg 1992; 74: 246-249. Ye JH, Mui WC, Ren J, et al. Ondansetron exhibits the properties of a local anesthetic. Anesth Analg 1997; 85: 1116-1121. 4 Tan CH, Onsiong MK. Pain on injection of propofol. Anaesthesia 1998; 53: 468-76. 5. Klement W, Arndt JO. pain on intravenous injection of some anaesthetic agents is evoked by the unphysi- ological osmolality or pH of their formulations. Br J Anaesth 1991; 66: 189-195. 6. Scott RBE, Saunders DA, Norman J. Propofol: clinical strategies for preventing pain on injection. Anaesthe¬ sia 1988; 43: 492-494. 7. Başar H, Sayın M, Ketene A, ve ark. Propofol ve eto- midat enjeksiyon ağrısının lignokain ve metoklopra- mid ile önlenmesi. Türk Anest ve Rean Cem Mecmu¬ ası 1995; 23: 87-90. 8. Yoshikawa T, Wajima Z, Ogura A, et al. Orally admi¬ nistered clonidine significantly reduces pain during injection of propofol. Br J Anaesth 2001; 86: 874-876.

9. Deegan R. Ondansetron: pharmacology of a spesiflc 5 HT3 receptor antagonist. Am J Med Sci 1992; 304- 373-378. ■- ' ' 10. Ambesh SP, Dubey PK, Sinha PK. Ondansetron pret- reatment to alleviate pain on propo'fol injection: A ran¬ domized, controlled, double-blinded stu_____3$r. Anesth Analg 1999; 89: 197-199. 11. Memiş D, Alpaydm T, Alayurt Ş, ve ark. Propofol en¬ jeksiyon ağrısını önlenmede ondansetron ve lidokain kullanılması. Anestezi Dergisi 2000; 8: 283-285. 12. Ganta R, Fee JPH. Pain on injection of propofol. Com¬ parison of lignocaine with metoclopramide. Br J Ana¬ esth 1992; 69: 316. ' 13. Gajraj NM, Nathanson MH. Preventing pain, during in¬ jection of propofol: the optimal dose of lidocaine. J Clin Anesth 1996; 8: 575-577. 14. Pang WW, Mok MS, Huang S, et al. The analgesic ef¬ fect of fentanyl, morphine, meperidine and lidocaine in the peripheral veins: a comparative study. Anesth Analg 1998; 86: 382-386.