Efeitos da Lidocaína Associada ao Propofol sobre a Dor, a Pressão Arterial e a Freqüência Cardíaca, Durante Injeção Venosa
Effects of Lidocaine-Propofol Association on Pain, Blood Pressure and Heart Rate, During Intravenous Injection
Getúlio Rodrigues de Oliveira Filho, Saul Fernando Linhares, Asmir Luiz Boso, Nicolau Teixeira Filho
Resumo
Justificativa e Objetivos - Dor nas veias da mão durante a injeção do propofol ocorre em 69% dos pacientes. A lidocaína misturada ao propofol atenua a dor, mas existem dúvidas quanto aos efeitos hemodinâmicos desta associação. Este estudo avaliou os efeitos da mistura de lidocaína com propofol sobre a dor durante a injeção e sobre parâmetros hemodinâmicos. Método - Oitenta e duas mulheres foram divididas, prospectivamente, por sorteio, para receber 1 ml de solução fisiológica (grupo S) ou 1 ml de lidocaína a 2% (Grupo L) adicionada a 19 ml de propofol, injetado na veia do dorso da mão (2 mg.kg-1 ). A dor foi graduada como 0 = ausente, 1 = leve, 2 = moderadae3= forte. As pressões arteriais sistólica (PAS) e diastólica (PAD), a freqüência cardíaca (FC) e a SpO2 foram medidas antes (M0) e depois (M1) do propofol. Resultados - As medianas [quartil inferior; superior] dos escores de dor foram 3 [1;3] e 0 [0;1] (p < 0,001) e dor ocorreu em 90,24% e em 34,46% das pacientes dos gruposSeL, respectivamente (p = 0). A PAS diminuiu 0,76 ± 9,85% e 7,14 ± 8,84% (p < 0,001), a PAD variou 1,3 ± 11,72% e -7,02 ± 11,45% (p < 0,001) nos grupos S e L, respectivamente. A FC e a SpO2 não se alteraram. Conclusões - A adição de 1 ml de lidocaína a 2% a 19 ml de propofol diminui a prevalência e a intensidade da dor durante a injeção, com mínimas alterações hemodinâmicas.
Palavras-chave
Abstract
Background and Objectives - Pain on propofol injection into hand veins is present in 69% of cases. Lidocaine mixed to propofol mitigates this symptom but there are concerns about the hemodynamic safety of such association. This study aimed to asses the effects of lidocaine/propofol mixture upon pain prevalence and intensity and on hemodynamic parameters. Methods - Participated in this study 82 female patients who were prospectively and randomly assigned to receive either 1 ml saline (group S), or 1 ml of 2% lidocaine (group L) added to 19 ml propofol injected in one dorsal vein of the hand (2 mg.kg-1). Pain was graded as 0 = none, 1 = mild, 2 = moderate or 3 = severe. Systolic (SBP) and diastolic (DBP) blood pressures, heart rate (HR), and SpO2 were measured before (M0) and after (M1) propofol. Results - Median [lower and upper quartiles] of pain scores were 3 [1; 3] and 0 [0; 1] in groups S and L (p < 0.001). Pain occurred in 90.24% and in 34.46% of patients in groups S and L, respectively (p = 0). SBP decreased 0.76 ± 9.85% and 7.14 ± 8.84% (p < 0.001) in groups S and L. DBP variations were 1.3 11.72% and -7.02 11.45% (p < 0.001) in groups S and L. HR and SpO2 did not change. Conclusions - The addition of 1 ml of 2% lidocaine to 19 ml propofol decreases prevalence and intensity of pain on injection, with minor hemodynamic changes.
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Referencias
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