Gad L N, Olsen K S, Lysgaard A B, Culmsee M
Department of Anaesthesia and Intensive Care, Glostrup University Hospital, Copenhagen, Denmark.
Acta Anaesthesiol Scand. 2004 Apr;48(4):491-7. doi: 10.1111/j.1399-6576.2004.00351.x.
Intravenous cannulation in children aged 6-12 years is less painful after a 90-min application of a Lidocaine/ Prilocaine cream followed by a 30-min interval without cream, than cannulation immediately after a 60-min application.
Sixty-min application of an eutectic mixture of 25 mg g(-1) Lidocaine and 25 mg g(-1) Prilocaine cream is widely used in both adults and children to alleviate pain related to intravenous cannulation. However, studies have shown that this is not the optimal procedure in adults. Inspired by the results from these studies, the aim of the present study was to find an improved application regime for children.
In this prospective, randomized, and single-blind study 60 Caucasian children, aged 6-12 years, presenting for an i.v. cannulation were included. The children were allocated to either a 60-min application of anaesthetic cream followed by i.v. cannulation (Group A) or to a 90-min application followed by an interval of 30 min before cannulation (Group B). No sedatives or analgesics were given. The children scored their pain by a faces scale with four faces.
The i.v. cannulations in Group B were less painful than the cannulations in Group A (Mann-Whitney test, P = 0.01). There was no difference between the two groups as regards problems when performing the cannulations.
i.v. cannulation after application of anaesthetic cream for 90 min followed by a 30-min interval is less painful than the widely used 60-min application directly followed by cannulation.
6至12岁儿童静脉置管时，先涂抹利多卡因/丙胺卡因乳膏90分钟，然后间隔30分钟不涂抹乳膏，再进行置管，比涂抹60分钟后立即置管的疼痛感要轻。
25毫克/克利多卡因与25毫克/克丙胺卡因的共熔混合物乳膏涂抹60分钟，在成人和儿童中广泛用于减轻静脉置管相关的疼痛。然而，研究表明，这在成人中并非最佳方法。受这些研究结果的启发，本研究的目的是为儿童找到一种改进的涂抹方案。
在这项前瞻性、随机、单盲研究中，纳入了60名6至12岁因静脉置管就诊的白种儿童。这些儿童被分配到两组，一组是涂抹麻醉乳膏60分钟后进行静脉置管（A组），另一组是涂抹90分钟后间隔30分钟再进行置管（B组）。未给予镇静剂或镇痛药。儿童通过四张面部表情的面部量表对疼痛进行评分。
B组的静脉置管比A组的置管疼痛感轻（曼-惠特尼检验，P = 0.01）。两组在置管操作时的问题方面没有差异。结论：涂抹麻醉乳膏90分钟后间隔30分钟进行静脉置管，比广泛使用的涂抹60分钟后立即置管的疼痛感要轻。
