WONCA研究论文摘要汇编——应用组织粘合剂修复儿童撕裂伤时,采用利多卡因-肾上腺素-丁卡因进行局部麻醉的止痛效果:一项

发布时间：2018-04-04 10:48

本文选题：组织粘合剂　切入点：肾上腺素　出处：《中国全科医学》2014年03期

【摘要】：背景有些儿童在用组织粘合剂修复伤口时感觉疼痛。此研究对组织粘合剂修复伤口时,局部用利多卡因-肾上腺素-丁卡因止痛溶剂,缓解疼痛的效果做出了评价。方法此研究为随机、安慰剂-对照、参加者不知情的试验,研究对象为221名年龄在3个月~17岁的儿童。将2011年3月—2012年1月在三级医疗机构儿科急诊因撕裂伤需要用组织粘合剂的患儿纳入研究。处理患儿伤口前,分别应用利多卡因-肾上腺素-丁卡因或安慰剂。使用彩色视觉疼痛模拟量表和面部表情疼痛量表-修订版,得出使用粘合剂时疼痛评分。同时请医生对伤口粘合和伤口止血的难度进行评分。结果视觉疼痛模拟量表(P=0.01)和面部表情疼痛量表-修订版评定结果表明〔止痛剂中位数0.00,四分位数间距(IQR)(0.00,2.00),与安慰剂中位数2.00,IQR(0.00,4.00),P0.01〕,与使用安慰剂〔中位数1.00,IQR(0.38,2.50)〕相比,那些在伤口修复时用了止痛剂的患儿疼痛程度要轻〔中位数0.50,IQR(0.25,1.50)〕。用了止痛剂的患儿更倾向于报告自己接受了一次无痛修复过程〔疼痛相对危险度(RR)=0.54,95%CI(0.37,0.80)〕。与安慰剂组相比,使用利多卡因-肾上腺素-丁卡因的患儿,伤口得到完全止血的比例要多(78.2%与59.3%,P=0.008)。解释对于年龄在3个月~17岁的儿童轻度撕裂伤,在使用组织粘合剂修复伤口前用利多卡因-肾上腺素-丁卡因止痛,减少了疼痛评分,提升了无痛修复的比例。此低风险措施将使采用组织粘合剂而不是缝合治疗撕裂伤的儿童受益。
[Abstract]:Some children feel pain in the background with tissue adhesive to repair the wound. The study of tissue adhesive wound repair, topical lidocaine epinephrine tetracaine - analgesic solvent, pain relieving effects were evaluated. Methods this study is a randomized, placebo-controlled trial, participants were not informed, as the research object at the age of 221 3 months ~17 years old children. In March 2011 to January 2012 in three pediatric medical institutions for emergency laceration should be included in the study using tissue adhesive in children. Children with treatment before wound, respectively - Lidocaine epinephrine tetracaine - or placebo. The use of color visual analogue scale and facial pain scale revised that version, pain score. At the same time using adhesive bonding and doctor on wound hemostasis difficulty score. The visual analogue scale (P=0.01) and Facial pain scale revised evaluation results showed that the analgesic was 0, the four percentile interval (IQR) (0.00,2.00), and placebo was 2, IQR (0.00,4.00), P0.01, and placebo, median 1, IQR (0.38,2.50) was compared to that in wound repair with analgesics children with pain to a lesser extent, the median was 0.50, IQR (0.25,1.50). The analgesic were more inclined to report himself received a painless repair process of pain relative risk (RR) =0.54,95%CI (0.37,0.80). Compared with the placebo group, using lidocaine epinephrine tetracaine - with the wound get more complete hemostasis (78.2% vs. 59.3%, P=0.008). At the age of 3 months ~17 years old children with mild laceration, in the use of tissue adhesive to repair the wound before using lidocaine epinephrine tetracaine - pain, reduce the pain Pain scores increase the proportion of painless repair. This low risk measure will benefit children who use tissue adhesives rather than suture for tearing.

【作者单位】：中国石油天然气集团公司中心医院;
【分类号】：R726.5

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