皮肤头部和部手术中的局部麻醉:一个随机对照试验
Rory O'Neill1,2, Adrinda Affendi1,2, Nathaniel McHugh1,2
1Department of Otolaryngology, University Hospital Waterford, Waterford, Ireland.
概括
在进行头手术时使用局部麻醉剂时,EMLA奶油和乙化喷雾剂并没有减少疼痛. 患者的体验仍然很好,这表明这些局部药物可能不会对这种手术有效.
科学领域:
- 皮肤病学 皮肤病学
- 手术瘤学手术瘤学
- 麻醉学 麻醉学
背景情况:
- 皮肤头部和部手术依赖局部麻醉 (LA) 为患者的舒适性和程序的成功.
- 在LA施用期间优化疼痛管理对于患者体验至关重要.
- 局部麻醉剂,如EMLA奶油和乙化喷雾,通常被认为可以减轻疼痛.
研究的目的:
- 为了比较EMLA奶油和乙烯化物 (EC) 喷雾在减少LA给药后疼痛的有效性.
- 评估患者在皮肤头部手术期间报告的疼痛和手术经验.
主要方法:
- 一项随机对照试验在一所大学附属的第三级头瘤中心进行.
- 参与者被随机分为四组:EMLA奶油,EMLA安慰剂,EC喷雾和对照组 (没有局部剂).
- 收集了疼痛和手术经验得分,并进行了统计分析 (曼-惠特尼U,克鲁斯卡尔-瓦利斯,奇平方,斯皮尔曼罗).
主要成果:
- 在EMLA (4),EMLA安慰剂 (4.8),EC (5.8) 和对照 (5) 组 (P=0.19) 之间没有发现疼痛评分的显著差异.
- 在所有组中,程序经验得分相似 (P=0.02).
- 诸如手术部位 (头皮),恶性病变和较大的病变表面积等因素与疼痛增加有关.
结论:
- 在皮肤头部手术中,EMLA奶油和乙化喷雾在减轻LA相关的疼痛方面无效.
- 在这种情况下,从业人员应该重新考虑EMLA和EC在疼痛管理中的常规使用.
- 患者的手术经验不论是局部麻醉的应用仍然很高.
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