Taddio Anna, Gurguis Mona G Y, Koren Gideon
Department of Pharmacy, The Hospital for Sick Children, Toronto, Ontario, Canada.
Ann Pharmacother. 2002 Apr;36(4):687-92. doi: 10.1345/aph.1A138.
To determine the relative efficacy of lidocaine-prilocaine and tetracaine for procedural pain in children.
Systematic review was performed (MEDLINE1990-June 2001) of all studies comparing the efficacy of these 2 modalities of pain relief in children undergoing painful cutaneous procedures. Search terms included lidocaine, prilocaine, tetracaine, and anesthesia.
Eight studies compared lidocaine-prilocaine with tetracaine in children for 4 different procedures: intravenous cannulation, venipuncture, Port-a-Cath puncture, and laser therapy. When used as labeled (60 min for lidocaine-prilocaine, 30 min for tetracaine), the 2 modalities provided similar analgesic efficacy. When both anesthetics were applied for a similar duration of time (40 min, 60 min, 2 h), tetracaine provided superior anesthesia. Tetracaine was commonly associated with erythema, and lidocaine-prilocaine was associated with blanching of the skin.
Lidocaine-prilocaine and tetracaine appear to be comparable for procedural pain relief when used as recommended. Tetracaine is more efficacious than lidocaine-prilocaine when both anesthetics are applied for the same amount of time.
确定利多卡因-丙胺卡因与丁卡因用于儿童操作疼痛时的相对疗效。
对1990年至2001年6月期间MEDLINE收录的所有比较这两种疼痛缓解方式在接受疼痛性皮肤操作的儿童中疗效的研究进行系统评价。检索词包括利多卡因、丙胺卡因、丁卡因和麻醉。
八项研究在儿童中对利多卡因-丙胺卡因与丁卡因进行了4种不同操作的比较：静脉置管、静脉穿刺、输液港穿刺和激光治疗。按说明书使用时（利多卡因-丙胺卡因60分钟，丁卡因30分钟），这两种方式的镇痛效果相似。当两种麻醉剂应用时间相似（40分钟、60分钟、2小时）时，丁卡因的麻醉效果更佳。丁卡因常伴有红斑，利多卡因-丙胺卡因则伴有皮肤变白。
按推荐使用时，利多卡因-丙胺卡因和丁卡因在缓解操作疼痛方面似乎相当。当两种麻醉剂应用时间相同时，丁卡因比利多卡因-丙胺卡因更有效。
