上肢不同部位丙泊酚静脉注射疼痛比较性［摘要］目的进行上肢不同部位在丙泊酚静脉注射时疼痛的比较性研究与预防。方法选择ASA分级I~II级447例，在丙泊酚全凭静脉麻醉下实施上消化道内镜诊疗，将患者随机分为肘正中静脉组（EI组）.橈静脉组（RI组）及手背静脉组（HI组），每组149例。EI组在无痛上消化道内窥镜诊疗下于肘正中静脉缓慢匀速注射丙泊酚注射液；采用同样方法对RI组与HI组注射，除常规连续监测收缩压（SBPX舒张压（DBPX心率（HRX血氧饱和度（SpO2）外，采用疼痛视觉模拟评分（VAS）,三组除记录麻醉药物用量和辅助用药情况，均需连续监测患者呼吸、血流动力学变化以及不良反应等内容。结果丙泊酚推注可使局部出现刺激性胀痛与放射性疼痛，HI组与RI组较EI组疼痛明显，三组VAS评分比较差异有高度统计学意义（P<0.01）,EI组局部疼痛减轻，但放射痛仍然存在。实施护理干预、缓慢诱导、匀速注射及复合利多卡因等预防注射痛效果明显。结论上肢不同部位丙泊酚静脉注射痛比较显示，肘正中静脉、扌尧静脉与手背静脉疼痛依次递增，采取复合利多卡因的方法则能有效预防。［关键词］丙泊酚注射液；上消化道内窥镜诊疗；上肢；注射痛；护理干预［中图分类号］R472［文献标识码］C［文章编号］1673-7210(2012)08(b)-0166-03ComparativestudyonPropofolintravenousinjectionpainindifferentpartsofupperlimbsZHANGYanQINYuanlingZHANGYingxian^TheFirstAffiliatedHospitalofHe'nanUniverstyofTCM,He'nanProvince,Zhengzhou450000,China［Abstract］ObjectiveToobservetheupperlimbsindifferentpartsofthepropofolinjectionpainresearchandprevention.Methods447patientsofASAphysicalstatusl-llwereselected,whoweregiventhediagnosisandtreatmentofuppergastrointestinalendoscopyunderPropofoltotalintravenousanesthesia,andrandomlydividedintothemediancubitalveingroup(Elgroup),theradialveingroup(Rlgroup)andthedorsalhandveingroup(HIgroup),eachgrouphad149cases.ElgroupwasgivenPropofolinjectioninmediancubitalveinwiththediagnosisandtreatmentofpainlessdigestivetractendoscopy;thesamewayasRlgroupandHIgroupwereinjected,inadditiontotheconventionalcontinuousmonitoringofSBP,DBP,HR,SpO2,thepainvisualanaloguescale(VAS)wasused,unlesstherecordofthenarcoticdrugdosageandadjuvantneedtoberecord,patientrespiration,hemodynamicchangesandadversereactionscontinuouswerealsomonitored.ResultsPropofolcouldmakeskinappearedlocalirritatingpainandradiatingpain,thepainofHIgroupwasobviouscomparedwiththeRlgroupthantheElgroup,whichVASscorehadsignificantdifference(P<0.01),thelocalpainofElgroupreleased,butradiatingpainstillexisted.Nursingintervention,slowinduction,uniforminjectionandLidocaineforpreventinjectionhadaobviouseffect.ConclusionComparisonofpainoninjectionbyPropofolinthedifferentpartsoftheupperlimbshowsthatthemediancubitalvein,radialveinanddorsalhandveinpaininascendingorder,takingLidocaineiseffectiveinpreventing・[Keywords]PropofolInjection;Uppergastrointestinalendoscopyclinics;Upperlimbs;Painoninjection;Nursingintervention
