利多卡因可以减少皮质类固醇注射期间的疼痛强度吗? 一个双盲随机控制等效试验
Teun Teunis1, George E Sayegh1, Amir Fatehi1
1Department of Surgery and Perioperative Care Dell Medical School, Austin, TX, USA.
The Journal of hand surgery, European volume
|April 20, 2024
概括
将利多卡因添加到皮质类固醇注射中显著减少了手术期间的直接疼痛. 这一发现支持使用利多卡因在手和手腕治疗中提高患者舒适度.
科学领域:
- 整形外科 整形外科 整形外科
- 疼痛管理 疼痛管理
- 药理学 药理学是指药理学的学科.
背景情况:
- 皮质类固醇注射在手和手腕疾病中很常见.
- 患者在注射期间的不适是令人担忧的.
- 减少注射量和酸度是限制疼痛的潜在策略.
研究的目的:
- 为了评估利多卡因在减少皮质类固醇注射期间疼痛的疗效.
- 为了比较用和没有利多卡因的疼痛强度,在triamcinolone注射期间.
主要方法:
- 采用了贝叶斯的临床试验设计.
- 成年患者接受了带有或没有利多卡因的三氨注射.
- 疼痛强度是用0-10数值评分尺度测量,并进行序列分析,直到达到95%的概率.
主要成果:
- 用利多卡因注射导致疼痛强度平均下降2.4个点.
- 有95%的概率至少减少1点的疼痛与利多卡因.
- 这一发现在90%的重复分析中得到证实.
结论:
- 利多卡因与皮质类固醇注射期间明显降低直接疼痛强度有关.
- 添加利多卡因可以提高患者对手和手腕疾病的舒适度.
- 这些证据支持在皮质类固醇注射中常规使用利多卡因来控制手术疼痛.
相关概念视频
Local Anesthetics: Common Agents and Their Applications
440
Local anesthetics (LAs) are commonly used for various applications in medical and dental procedures. Some of the common agents used are cocaine, lidocaine, and bupivacaine.
Cocaine is an ester of benzoic acid and methylecgogine. It is used to anesthetize and vasoconstrict locally. Currently, it is used primarily for topical applications. It is beneficial for surgeries on the upper respiratory tract, providing anesthesia and shrinking the mucosa. Cocaine in the form of cocaine hydrochloride is...
Cocaine is an ester of benzoic acid and methylecgogine. It is used to anesthetize and vasoconstrict locally. Currently, it is used primarily for topical applications. It is beneficial for surgeries on the upper respiratory tract, providing anesthesia and shrinking the mucosa. Cocaine in the form of cocaine hydrochloride is...
440
Local Anesthetics: Clinical Application as Epidural Anesthesia
430
Epidural anesthetics are administered in the fat-filled epidural space, the outermost part of the spinal canal. This technique is commonly employed for pain management and anesthesia during lower abdomen and pelvis surgeries or labor and delivery.
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
430
Local Anesthetics: Clinical Application as Spinal Anesthesia
623
Spinal anesthetics are given during lower abdomen and limb surgeries to block sensory and motor neurons. They are administered in the mid to low lumbar regions, primarily acting on the cauda equina's nerve roots. The blockade level depends on the local anesthetic (LA) concentration. Usually, low LA concentrations are sufficient to block sensory fibers, while only high LA concentrations block motor fibers. Other factors like injection volume and speed, the patient's posture, and the drug...
623
Local Anesthetics: Chemistry and Structure-Activity Relationship
4.4K
Local anesthetics (LAs) are drugs that induce a temporary loss of sensation in a limited body area, preventing pain. Cocaine was the first local anesthetic discovered in the late 19th century. Cocaine is a benzoic acid ester obtained from the leaves of coca shrubs and was often used for its psychotropic effects. Cocaine was first isolated in 1860 by Albert Niemann. Sigmund Freud studied the physiological actions of cocaine. Carl Koller later introduced it into clinical practice in 1884 as a...
4.4K
Local Anesthetics: Pharmacokinetics
757
The potency and duration of action of local anesthetics (LAs) are determined by their pharmacokinetics. Pharmacokinetics describes how LAs are absorbed, distributed, metabolized, and eliminated from the body. When administered to the vascular tissues, LAs are quickly absorbed and enter the systemic circulation, reducing their localized effects. Adding vasoconstrictors such as epinephrine to LAs reduces their absorption into the systemic circulation, making them clinically effective. The...
757
Local Anesthetics: Clinical Application as Surface, Infiltration, and Conduction Block Anesthesia
1.1K
Depending on the target organ, local anesthetics (LAs) can be administered via various routes. In surface anesthesia, LAs are applied directly to the surface of the skin or mucous membranes. It is widely used for topical skin numbing before venipuncture or minor surgical procedures. Commonly used surface local anesthetics are lidocaine or benzocaine sprays or creams. Surface anesthesia occurs within 5 minutes and lasts for about 60 minutes. One of the main disadvantages of topical anesthesia is...
1.1K


