Häfner H-M, Thomma S R, Eichner M, Steins A, Jünger M
Department of Dermatology, University of Tübingen, Liebermeisterstr. 25, 72076 Tübingen, Germany.
Clin Hemorheol Microcirc. 2003;28(3):121-8.
Emla cream is frequently used in surgical dermatology and in anesthesiology, for instance, during vascular surgery procedures. Because local anesthetics can have a vasoactive effect in addition to producing analgesia, we decided to document the effect of 5% Emla cream on cutaneous circulation in a prospective, placebo-controlled study. Skin circulation was monitored continuously under standardized conditions using video capillaroscopy, laser Doppler flowmetry and skin temperature. Recordings were made at the nailfold of the fourth finger (DIV) of the left hand of 12 volunteers with healthy veins over an observation period of 60 minutes under either Emla occlusive dressing or an occlusive dressing with placebo. Mean capillary red blood cell velocity changed only minimally under the Emla occlusive dressing, while placebo occlusive dressing led to a reduction of mean capillary red blood cell velocity from 0.21 mm/s to 0.12 mm/s (p<0.01). There was no statistically significant change of arterial capillary diameter under Emla or placebo occlusive dressing. Skin temperature dropped after 60 minutes of Emla cream occlusive dressing from an initial 26.7 to 24.0 degrees C (-10.1%; p<0.02). The same duration of placebo caused skin temperature to drop from 27.6 to 23.0 degrees C (-16.7%; p<0.001). Laser Doppler flux (543 nm) rose 13% with Emla (p=0.9) and dropped 41.9% under placebo occlusive dressing (p<0.03). Emla cream upregulated nutritive perfusion. No clinically relevant vasoconstrictive effects are expected from an application period of 60 minutes.
艾美拉乳膏常用于外科皮肤科和麻醉学领域，例如在血管外科手术过程中。由于局部麻醉剂除了产生镇痛作用外还可能具有血管活性作用，我们决定在一项前瞻性、安慰剂对照研究中记录5%艾美拉乳膏对皮肤循环的影响。在标准化条件下，使用视频毛细血管显微镜、激光多普勒血流仪和皮肤温度连续监测皮肤循环。在12名左手无名指（DIV）甲襞处静脉健康的志愿者中，在60分钟的观察期内，分别使用艾美拉封闭敷料或安慰剂封闭敷料进行记录。在艾美拉封闭敷料下，平均毛细血管红细胞速度变化极小，而安慰剂封闭敷料导致平均毛细血管红细胞速度从0.21毫米/秒降至0.12毫米/秒（p<0.01）。在艾美拉或安慰剂封闭敷料下，动脉毛细血管直径没有统计学上的显著变化。使用艾美拉乳膏封闭敷料60分钟后，皮肤温度从初始的26.7摄氏度降至24.0摄氏度（-10.1%；p<0.02）。相同时间的安慰剂导致皮肤温度从27.6摄氏度降至23.0摄氏度（-16.7%；p<0.001）。使用艾美拉时激光多普勒通量（543纳米）上升了13%（p=0.9），而在安慰剂封闭敷料下下降了41.9%（p<0.03）。艾美拉乳膏上调了营养性灌注。预计60分钟的应用时间不会产生临床相关的血管收缩作用。
