Dutta Amitabh, Puri Goverdhan Dutt, Wig Jyotsna
Department of Anaesthesia and Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Can J Anaesth. 2003 Oct;50(8):775-8. doi: 10.1007/BF03019372.
To evaluate and compare the analgesic efficacy and anti-inflammatory effects of topical piroxicam gel vs eutectic mixture of local anesthetic (EMLA) cream applied to the peripheral venous cannulation site in adult volunteers.
Piroxicam gel and EMLA cream were randomly applied on the dorsum of the right and left hand of ten volunteers who acted as their own control. A venous cannula was inserted (no iv infusion) and removed after one hour. Pain scores and signs of inflammation were noted at the cannulation site up to 48 hr.
Pain scores with piroxicam gel were higher on cannulation and on advancement of the cannula (P < 0.05). Thereafter, pain scores were significantly higher with EMLA (P < 0.05). Blanching was present at all the peripheral venous sites treated with EMLA cream. Signs of inflammation (erythema, edema) were not more frequent with EMLA than with piroxicam (P > 0.05). Induration was more frequent with EMLA at six hours.
In volunteers EMLA cream is associated with less pain on cannulation and cannula advancement compared to piroxicam gel. Topical application of piroxicam gel before peripheral venous cannulation alleviates pain and, possibly, inflammation in the period subsequent to cannulation itself.
评估并比较在成年志愿者外周静脉置管部位局部应用吡罗昔康凝胶与局部麻醉剂共熔混合物（EMLA）乳膏的镇痛效果及抗炎作用。
将吡罗昔康凝胶和EMLA乳膏随机涂抹在十名志愿者的右手背和左手背，志愿者自身作为对照。插入静脉套管（不进行静脉输液），1小时后拔除。记录置管部位长达48小时的疼痛评分及炎症体征。
置管时及套管推进时，吡罗昔康凝胶组的疼痛评分更高（P < 0.05）。此后，EMLA组的疼痛评分显著更高（P < 0.05）。用EMLA乳膏治疗的所有外周静脉部位均出现皮肤苍白。EMLA组的炎症体征（红斑、水肿）并不比吡罗昔康组更常见（P > 0.05）。6小时时，EMLA组硬结更常见。
在志愿者中，与吡罗昔康凝胶相比，EMLA乳膏在置管及套管推进时疼痛较轻。外周静脉置管前局部应用吡罗昔康凝胶可减轻置管后一段时间内的疼痛，并可能减轻炎症。
