Aaron Shawn D, Vandemheen Katherine L, Naftel Sheila A, Lewis Mary-Jo, Rodger Marc A
Division of Respiratory Medicine, Department of Medicine, The Ottawa Hospital, The Ottawa Hospital Research Institute, General Campus, Room 1812F, 501 Smyth Road, Ottawa, Ont., Canada K1H 8L6.
Respir Med. 2003 Nov;97(11):1195-9. doi: 10.1016/s0954-6111(03)00226-9.
The objective of this randomized, double-blind, placebo-controlled clinical trial was to determine whether a topical anesthetic agent (tetracaine) provides effective local analgesia prior to radial arterial puncture. Tetracaine or placebo gel was applied 45 min prior to arterial puncture to patients who were referred for elective arterial blood gas. The primary outcome was the patient's perception of pain associated with the procedure as measured by a visual analog scale. Fifty patients were randomized into the study, 24 received tetracaine and 26 placebo. Mean pain score on the visual analog scale was 26.2 +/- 32.6 for the tetracaine-treated patients and 23.8 +/- 27.4 for the placebo-treated patients (P = 0.78). Mean time from the first skin puncture to successful procurement of 1 ml of arterial blood was 70 +/- 103s in the tetracaine group and 49 +/- 48s in the placebo group (P = 0.40). Difficulty of arterial puncture as assessed by the respiratory therapist performing the test was identical for the two groups (P = 0.86). We conclude that tetracaine gel did not decrease patient's perception of pain associated with arterial puncture, nor did its use facilitate the ABG procedure.
这项随机、双盲、安慰剂对照临床试验的目的是确定一种局部麻醉剂（丁卡因）在桡动脉穿刺前是否能提供有效的局部镇痛。在对因择期动脉血气分析而转诊的患者进行动脉穿刺前45分钟，涂抹丁卡因或安慰剂凝胶。主要结局是通过视觉模拟量表测量患者对与该操作相关疼痛的感受。50名患者被随机纳入研究，24名接受丁卡因治疗，26名接受安慰剂治疗。丁卡因治疗组患者视觉模拟量表的平均疼痛评分为26.2±32.6，安慰剂治疗组为23.8±27.4（P = 0.78）。丁卡因组从首次皮肤穿刺到成功采集1 ml动脉血的平均时间为70±103秒，安慰剂组为49±48秒（P = 0.40）。进行测试的呼吸治疗师评估的动脉穿刺难度在两组中相同（P = 0.86）。我们得出结论，丁卡因凝胶并未降低患者对动脉穿刺相关疼痛的感受，其使用也未促进动脉血气分析操作。
