新生儿局部应用丁卡因凝胶：起效多快，持续多久？

Topical amethocaine gel in the newborn infant: how soon does it work and how long does it last?

作者信息

Jain A, Rutter N

机构信息

Department of Neonatal Medicine, Nottingham City Hospital, Hucknall Road, Nottingham NG5 1PB, UK.

出版信息

Arch Dis Child Fetal Neonatal Ed. 2000 Nov;83(3):F211-4. doi: 10.1136/fn.83.3.f211.

DOI:10.1136/fn.83.3.f211

PMID:11040171

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC1721176/

Abstract

AIM

To explore the time of onset and duration of action of topical amethocaine gel in the newborn infant.

DESIGN

A randomised double blind placebo controlled trial.

SUBJECTS

Thirty six infants were studied after 30 minutes application and 36 after 60 minutes application. A total of 56 infants (gestation 27-42 weeks, weight 0. 79-4.1 kg) were studied in the first two weeks after delivery.

METHOD

1.5 g amethocaine or placebo was applied to the dorsum of either foot, occluded, and then left for 30 or 60 minutes. Local anaesthesia was assessed by observing the cutaneous withdrawal response to graded nylon filaments (von Frey hairs). If there was a difference between feet in filament thickness required to elicit a response, the infant was studied in an identical manner at hourly intervals until the difference had disappeared.

RESULTS

Evidence of local anaesthetic action of amethocaine was seen in 23 of 36 (64%) infants after 30 minutes and 26 of 36 (72%) infants after 60 minutes application (no significant difference). Evidence of local anaesthetic action was independent of gestation and order of testing. Amethocaine responders showed a significantly deeper anaesthetic action than placebo responders. The median duration of action was 1.5 hours (range 0.5-3.5) after 30 minutes and three hours (range 1-5) after 60 minutes (p<0.001).

CONCLUSION

Topical amethocaine gel has a local anaesthetic action after 30 minutes application, but application for 60 minutes results in longer duration of action.

摘要

目的

探讨局部应用丁卡因凝胶在新生儿中的起效时间和作用持续时间。

设计

随机双盲安慰剂对照试验。

研究对象

36例婴儿在用药30分钟后接受研究，36例在用药60分钟后接受研究。共有56例婴儿（孕周27 - 42周，体重0.79 - 4.1千克）在出生后的前两周接受研究。

方法

将1.5克丁卡因或安慰剂涂于任意一只脚的足背，封闭处理，然后放置30或60分钟。通过观察对分级尼龙丝（von Frey毛发）的皮肤退缩反应来评估局部麻醉效果。如果引起反应所需的丝的厚度在两只脚之间存在差异，则以相同方式每小时对婴儿进行一次研究，直到差异消失。

结果

用药30分钟后，36例婴儿中有23例（64%）出现丁卡因局部麻醉作用的证据，用药60分钟后，36例婴儿中有26例（72%）出现该证据（无显著差异）。局部麻醉作用证据与孕周和测试顺序无关。丁卡因反应者的麻醉作用明显比安慰剂反应者深。用药30分钟后的中位作用持续时间为1.5小时（范围0.5 - 3.5小时），用药60分钟后的中位作用持续时间为3小时（范围1 - 5小时）（p<0.001）。