Adriansson Camilla, Suserud Björn-Ove, Bergbom Ingegerd
Borås University College, School of Health Sciences, Kunskapscentrum PreHospen, Borås 501 90, Sweden.
Accid Emerg Nurs. 2004 Apr;12(2):74-84. doi: 10.1016/j.aaen.2003.12.004.
In a great many situations within health care and treatment, children are subjected to unnecessary pain and suffering. When local anaesthetics is to be administered the child can experience this as incomprehensible especially when the nursing staff assures the child that no pain would be felt, only to discover soon after, that it actually did hurt at the moment of anaesthetic infiltration. The soothing of pain during the suturing of wounds in emergency wards can be reduced, ensuring that unnecessary pain in the cafe-and-treatment process is mot meted out to children. In order to prevent this (subjection to unnecessary pain), and by improving accepted practice, it was interesting to investigate whether children felt pain at the time of infiltration anaesthesia following the initial topical anaesthesia.
The aim of the present study was to investigate the effects of introductory topical anaesthesia using Xylocain solution dropped in the wound prior to a definitive infiltration-anaesthesia. An experimental, prospective design was used where children were included in either an experimental group or a control group. The experimental group (n=10) were given a Xylocain solution while the control group (n=10) received physiological Sodium solution. Data collection for the study was made by making VAS estimates and by interviews.
The study shows that a certain alleviation of pain does occur when using Xylocain but no statistically significant difference exists between the two groups. Irrespective of whether the children received an introductory topical anaesthesia with Xylocain or Sodium solution at the time of infiltration anaesthesia, they expressed pain in connection with infiltration. The study also shows that many children express fear and anxiety.
Current research highlights the difficulties involved in offering children a really satisfactory form of pain relief in connection with infiltration anaesthesia and suturing of wounds. It is urgent to throw more light on children's pain, both from a nursing and from a medical point of view. No statistically significant difference was found in children's reported pain, after treatment with Xylocain but the solution can have a positive effect at the time of the infiltration jab, but a larger study needs to be done in order to establish this firmly.
在医疗保健和治疗的许多情况下，儿童遭受不必要的疼痛和痛苦。当要施用局部麻醉剂时，孩子可能会觉得这难以理解，尤其是当护理人员向孩子保证不会感到疼痛时，结果很快就发现，在麻醉剂浸润时实际上确实很疼。急诊病房伤口缝合过程中的疼痛缓解可以减少，以确保在护理和治疗过程中不会给儿童带来不必要的疼痛。为了防止这种情况（遭受不必要的疼痛），并通过改进公认的做法，研究儿童在初次局部麻醉后进行浸润麻醉时是否感到疼痛很有意思。
本研究的目的是调查在进行最终浸润麻醉之前，在伤口中滴入赛罗卡因溶液进行初始局部麻醉的效果。采用实验性前瞻性设计，将儿童纳入实验组或对照组。实验组（n = 10）给予赛罗卡因溶液，而对照组（n = 10）接受生理氯化钠溶液。通过视觉模拟评分（VAS）估计和访谈进行研究数据收集。
研究表明，使用赛罗卡因时确实会有一定程度的疼痛减轻，但两组之间没有统计学上的显著差异。无论儿童在浸润麻醉时接受的是赛罗卡因还是氯化钠溶液的初始局部麻醉，他们在浸润时都表示疼痛。研究还表明，许多儿童表现出恐惧和焦虑。
当前的研究突出了在浸润麻醉和伤口缝合方面为儿童提供真正令人满意的疼痛缓解形式所涉及的困难。从护理和医学角度来看，迫切需要更多地了解儿童的疼痛。在用赛罗卡因治疗后，儿童报告的疼痛方面未发现统计学上的显著差异，但该溶液在浸润注射时可能有积极作用，但需要进行更大规模的研究才能确定这一点。
