Patterson P, Hussa A A, Fedele K A, Vegh G L, Hackman C M
121st General Hospital, Yong San, Korea.
AANA J. 2000 Feb;68(1):43-51.
This study compared pain on application, pain on venipuncture, cost, and convenience of 4 analgesic agents used for venipuncture. A convenience sample of 280 preoperative subjects was assigned randomly to 1 of 4 groups. Group 1 received 2.5% lidocaine--2.5% prilocaine cream (LPC) topically, Group 2 received dichlorotetrafluoroethane spray (DCTF), Group 3 received 0.5% lidocaine subcutaneously, and group 4 received normal saline with 0.9% benzyl alcohol (BA) subcutaneously. A 7-point verbal descriptor scale measured pain on application, and a 100-mm visual analogue scale measured pain on venipuncture. Cost was measured and compared on unit-dose basis. Convenience was measured with a questionnaire survey completed by the investigators. There was no significant difference (P < .05) among the groups for age, sex, ASA physical status, or difficulty of venipuncture. There was a significant difference in pain on application for all 4 agents (P < .05). The DCTF had the highest pain on application score (1.7 +/- 0.1), while the LPC had no pain on application (0.0 +/- 0). Lidocaine had a higher pain on application score (1.08 +/- 0.1) than the BA (0.52 +/- 0.1) but a lower score than DCTF. Lidocaine (1.3 +/- 0.3) was significantly less painful (P < .05) on venipuncture than LPC (2.18 +/- 0.3) and DCTF (2.5 +/- 0.3) but was not significantly different than BA (1.92 +/- 0.3). (All scores are given as mean +/- SEM.) There was a significant difference in cost and convenience among the 4 agents, with BA and lidocaine being the least expensive analgesic agents. Lidocaine, DCTF, and BA were equally convenient to use, while LPC was the least convenient, (P < .05). Lidocaine had low pain on venipuncture and low cost and convenience of use, but it was less than ideal in terms of pain on application. The BA had all the qualities of an ideal analgesic agent for venipuncture in this sample and should be considered as an analgesic agent for venipuncture.
本研究比较了用于静脉穿刺的4种镇痛剂在涂抹时的疼痛、静脉穿刺时的疼痛、成本及便利性。选取280名术前受试者作为便利样本，随机分为4组。第1组局部涂抹2.5%利多卡因-2.5%丙胺卡因乳膏（LPC），第2组使用二氯四氟乙烷喷雾剂（DCTF），第3组皮下注射0.5%利多卡因，第4组皮下注射含0.9%苄醇（BA）的生理盐水。采用7分语言描述量表测量涂抹时的疼痛，采用100毫米视觉模拟量表测量静脉穿刺时的疼痛。按单位剂量测量并比较成本。通过研究者完成的问卷调查来衡量便利性。在年龄、性别、美国麻醉医师协会（ASA）身体状况或静脉穿刺难度方面，各组之间无显著差异（P<0.05）。4种药物在涂抹时的疼痛存在显著差异（P<0.05）。DCTF在涂抹时的疼痛评分最高（1.7±0.1），而LPC在涂抹时无疼痛（0.0±0）。利多卡因在涂抹时的疼痛评分（1.08±0.1）高于BA（0.52±0.1），但低于DCTF。利多卡因在静脉穿刺时的疼痛（1.3±0.3）明显低于LPC（2.18±0.3）和DCTF（2.5±0.3）（P<0.05），但与BA（1.92±0.3）无显著差异。（所有评分均以平均值±标准误表示。）4种药物在成本和便利性方面存在显著差异，BA和利多卡因是最便宜的镇痛剂。利多卡因、DCTF和BA使用起来同样方便，而LPC最不方便（P<0.05）。利多卡因在静脉穿刺时疼痛较低，成本及使用便利性也较低，但在涂抹时的疼痛方面不太理想。在本样本中，BA具备作为静脉穿刺理想镇痛剂的所有特质，应被视为静脉穿刺的镇痛剂。
