在儿童进行针针相关手术时进行局部镇痛:临床实践指南
Debbie C Stavleu1, Renée L Mulder1, Demi M Kruimer1
1Princess Maxima Center for Pediatric Oncology, Utrecht, The Netherlands.
Archives of disease in childhood
|February 11, 2025
概括
对于儿童的轻微针手术,建议使用局部镇痛剂 (EMLA) 的优化混合物至少60分钟. 建议在30-60分钟内进行快速手术时使用甲类奶油,以减少与针相关的疼痛.
科学领域:
- 儿科麻醉学 儿科麻醉学
- 疼痛管理 疼痛管理
- 临床实践指南 临床实践指南
背景情况:
- 在医疗机构,儿童在轻微的针手术中经常感到疼痛.
- 局部镇痛可以有效地减少手术过程中的疼痛,但最佳的药物选择仍然不清楚.
- 关于EMLA和含有四甲的奶油之间的最佳局部麻醉选择存在不确定性.
研究的目的:
- 制定基于证据的建议,用于在儿童中进行小针手术时选择局部麻醉剂.
- 为医疗保健专业人员提供指导,以尽量减少儿科患者的针相关疼痛.
- 建立一个临床实践指南来管理儿童的手术疼痛.
主要方法:
- 一个多学科小组根据系统的文献审查制定了一份临床实践指南.
- 分析了10项涉及1808名儿童的随机对照试验.
- 使用推评估,开发和评价 (GRADE) 方法来评估证据质量和制定建议.
主要成果:
- 强烈建议使用EMLA,在儿童的轻微针手术中,应用时间至少为60分钟.
- 一个薄弱的建议建议使用含有四甲的奶油,用于需要快速注射或刺穿 (在30-60分钟内) 的情况.
- 对这两项建议的证据质量被评为非常低.
结论:
- 本临床实践指南提供了关于选择局部麻醉剂以缓解儿科手术中针引起的疼痛的建议.
- 实施这些建议旨在减少手术过程中的疼痛,提高儿童护理的质量.
- 可能需要进一步的研究来加强在儿科手术疼痛管理中选择局部麻醉剂的证据基础.
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