Paut O, Calméjane C, Delorme J, Lacroix F, Camboulives J
Department of Pediatric Anesthesia and Intensive Care, La Timone University Hospital, Marseilles, France.
Anesth Analg. 2001 Sep;93(3):590-3. doi: 10.1097/00000539-200109000-00012.
We compared EMLA cream with nitrous oxide (N(2)O) for providing pain relief during venous cannulation in children. In a prospective, double-blinded, randomized study, 40 children, 6-11 yr, ASA status I or II, undergoing scheduled surgery received either EMLA cream and inhaled air and oxygen (Group EMLA) or a placebo cream and inhaled 70% N(2)O in oxygen (Group N(2)O) before venous cannulation. Pain was evaluated with a visual analog scale and the Objective Pain Scale. The ease of venous cannulation and the observer's assessment of its efficacy for preventing pain were assessed. Heart rate, blood pressure, respiratory rate, and oxygen saturation were compared before and after venous cannulation. Visual analog scale scores (4.4 +/- 7.5 vs 3.9 +/- 9.3 mm, P = 0.85), Objective Pain Scale scores (median 0 [0-6] vs 0 [0-1], P = 0.61), efficacy (median 0 [0-1] vs 0 [0-1], P = 0.59), and ease of venous cannulation (0 [0-2] vs 0 [0-1], P = 0.84) were not different between EMLA and N(2)O groups, respectively. There was no statistical difference between the groups for the physiologic variables. Minor side effects were significantly more common in the N(2)O group (11 of 20) than in the EMLA group (7 of 20) (P = 0.0248). We conclude that both techniques provided adequate pain relief during venous cannulation, as demonstrated by the low pain scores.
我们比较了复方利多卡因乳膏与一氧化二氮（N₂O）在儿童静脉穿刺置管时提供疼痛缓解的效果。在一项前瞻性、双盲、随机研究中，40名年龄6 - 11岁、ASA分级为I或II级、接受择期手术的儿童，在静脉穿刺置管前，一组涂抹复方利多卡因乳膏并吸入空气和氧气（复方利多卡因乳膏组），另一组涂抹安慰剂乳膏并吸入70%的N₂O和氧气（N₂O组）。采用视觉模拟评分法和客观疼痛评分法评估疼痛程度。评估静脉穿刺置管的难易程度以及观察者对其预防疼痛效果的评价。比较静脉穿刺置管前后的心率、血压、呼吸频率和血氧饱和度。复方利多卡因乳膏组和N₂O组的视觉模拟评分（4.4±7.5 vs 3.9±9.3 mm，P = 0.85）、客观疼痛评分（中位数0 [0 - 6] vs 0 [0 - 1]，P = 0.61）、效果（中位数0 [0 - 1] vs 0 [0 - 1]，P = 0.59）以及静脉穿刺置管的难易程度（0 [0 - 2] vs 0 [0 - 1]，P = 0.84）均无差异。两组的生理变量无统计学差异。N₂O组（20例中有11例）的轻微副作用明显多于复方利多卡因乳膏组（20例中有7例）（P = 0.0248）。我们得出结论：两种技术在静脉穿刺置管时均能提供充分的疼痛缓解，低疼痛评分证明了这一点。
