Galinkin Jeffrey L, Rose John B, Harris Kathleen, Watcha Mehernoor F
University of Pennsylvania and Children's Hospital of Philadelphia, 34th Street and Civic Center Blvd., Philadelphia, PA 19104-4399, USA.
Anesth Analg. 2002 Jun;94(6):1484-8, table of contents. doi: 10.1097/00000539-200206000-00020.
Pain during venipuncture is a major source of concern to children and their caretakers. Iontophoresis is a novel technique that uses an electrical current to facilitate movement of solute ions (lidocaine) across the stratum corneum barrier to provide dermal analgesia. In this study, we compared dermal analgesia provided by lidocaine iontophoresis and eutectic mixture of local anesthetics (EMLA). After informed consent, 26 children, aged 7-16 yr, who required venous cannulation on multiple occasions, were enrolled in this prospective, randomized, crossover study to receive EMLA and iontophoresis on separate occasions. During a third session, each subject received his or her preferred treatment. Pain during venipuncture was assessed by the subject, parent, observer, and technician performing the procedure, by use of a 100-mm visual analog scale. The observer also used the Children's Hospital of Eastern Ontario Pain Scale to rate the subject's pain. Ratings of subject satisfaction were also assessed. There were no significant differences between the two groups in the subject-rated visual analog scale or the Children's Hospital of Eastern Ontario Pain Scale scores. Eleven (50%; 95% confidence interval [CI], 31%-69%) of the 22 subjects who completed both sessions preferred iontophoresis. Five subjects (23%; 95% CI, 10%-44%), including two who did not tolerate treatment with iontophoresis, preferred EMLA, and six (27%; 95% CI, 13%-48%) had no preference for the intervention to provide dermal analgesia. We conclude that lidocaine iontophoresis provides similar pain relief for insertion of IV catheters as EMLA and is a useful noninvasive alternative to establish dermal analgesia for venous cannulation.
Iontophoresis is a technique that uses an electrical current to facilitate movement of solute ions (lidocaine) across the stratum corneum barrier to provide dermal analgesia. Lidocaine iontophoresis provides similar pain relief for insertion of IV catheters as eutectic mixture of local anesthetics and is a useful noninvasive alternative to establish dermal analgesia for venous cannulation.
静脉穿刺时的疼痛是儿童及其护理人员主要关注的问题。离子导入法是一种新技术，它利用电流促进溶质离子（利多卡因）穿过角质层屏障，以提供皮肤镇痛。在本研究中，我们比较了利多卡因离子导入法和局部麻醉药的 eutectic 混合物（EMLA）所提供的皮肤镇痛效果。在获得知情同意后，26 名年龄在 7 - 16 岁、需要多次进行静脉置管的儿童被纳入这项前瞻性、随机、交叉研究，在不同时间分别接受 EMLA 和离子导入法治疗。在第三次治疗过程中，每个受试者接受其偏好的治疗。静脉穿刺时的疼痛由受试者、家长、观察者以及执行操作的技术人员使用 100 毫米视觉模拟量表进行评估。观察者还使用安大略东部儿童医院疼痛量表对受试者的疼痛进行评分。同时也评估了受试者的满意度评分。在受试者评定的视觉模拟量表或安大略东部儿童医院疼痛量表得分方面，两组之间没有显著差异。在完成两个疗程的 22 名受试者中，有 11 名（50%；95%置信区间[CI]，31% - 69%）偏好离子导入法。5 名受试者（23%；95%CI，10% - 44%），包括两名不能耐受离子导入法治疗的受试者，偏好 EMLA，6 名（27%；95%CI，13% - 48%）对提供皮肤镇痛的干预措施没有偏好。我们得出结论，利多卡因离子导入法在静脉置管时提供的疼痛缓解效果与 EMLA 相似，是一种用于建立静脉置管皮肤镇痛的有用的非侵入性替代方法。
离子导入法是一种利用电流促进溶质离子（利多卡因）穿过角质层屏障以提供皮肤镇痛的技术。利多卡因离子导入法在静脉置管时提供的疼痛缓解效果与局部麻醉药的 eutectic 混合物相似，是一种用于建立静脉置管皮肤镇痛的有用的非侵入性替代方法。
