MISC

2006年5月

Clonidine-ephedrine combination reduces pain on injection of propofot and blunts hemodynamic stress responses during the induction sequence

JOURNAL OF CLINICAL ANESTHESIA
  • T Ishiyama
  • ,
  • S Kashimoto
  • ,
  • T Oguchi
  • ,
  • A Furuya
  • ,
  • H Fukushima
  • ,
  • T Kumazawa

18
3
開始ページ
211
終了ページ
215
記述言語
英語
掲載種別
DOI
10.1016/j.jclinane.2005.08.005
出版者・発行元
ELSEVIER SCIENCE INC

Study Objectives: To evaluate the effects of clonidine and ephedrine on propofol-induced pain and on hemodynamic changes during the induction sequence.
Design: This was a prospective, randomized, double-blind study.
Setting: The study was conducted at a university hospital.
Patients: 200 ASA physical status I or II adult patients scheduled for elective surgery.
Interventions: Patients were randomly allocated to one of 4 groups (50 patients per group): clonidine-ephedrine (CE), clonidine-saline (CS), diazepam-ephedrine (DE), and diazepam-saline (DS). Thirty seconds after the administration of ephedrine or saline, propofol 2 mg/kg was infused at a rate of 18.3 mL/min.
Measurements: Patients were asked whether they had pain due to propofol injection. A blinded investigator evaluated the pain score: 0 = no pain, 1 = mild pain, 2 = severe pain without behavioral signs such as grimace or arm withdrawal movement, and 3 = severe pain accompanied by behavioral signs. Mean arterial blood pressure (MAP) and heart rate (HR) were measured at 1-minute intervals from just before the administration of ephedrine or saline to 5 minutes after the tracheal intubation.
Main Results: Median pain score in CE was significantly lower than those in the other groups (P < 0.0001). Pain scores in CS and DE were significantly lower than that in DS (P < 0.05). Ephedrine increased HR in CE and DE (P < 0.05), but clonidine did not augment the effect. Mean arterial blood pressure before tracheal intubation decreased to comparable values in all groups. After the intubation, mean arterial blood pressure and FIR in CE and CS were significantly lower than those in DE and DS (P < 0.05).
Conclusions: Combination of clonidine and ephedrine effectively reduced propofol-induced pain, but did not prevent propofol-induced hypotension. Clonidine did not augment low dose of ephedrine-induced increase in HR and produced stable hemodynamic condition during the induction sequence. (C) 2006 Elsevier Inc. All rights reserved.

リンク情報
DOI
https://doi.org/10.1016/j.jclinane.2005.08.005
Web of Science
https://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcAuth=JSTA_CEL&SrcApp=J_Gate_JST&DestLinkType=FullRecord&KeyUT=WOS:000238130400009&DestApp=WOS_CPL
ID情報
  • DOI : 10.1016/j.jclinane.2005.08.005
  • ISSN : 0952-8180
  • Web of Science ID : WOS:000238130400009

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