Röhm K D, Schöllhorn T A H, Gwosdek M J, Piper S N, Maleck W H, Boldt J
Klinikum Ludwigshafen, Department of Anaesthesiology, Ludwigshafen, Germany.
Eur J Anaesthesiol. 2004 Mar;21(3):214-6. doi: 10.1017/s0265021504003096.
This randomized, prospective study was performed to evaluate the efficacy of a subcutaneous local anaesthetic infiltration prior to venepuncture using different cannula sizes.
Three-hundred-and-one patients were included in the study, 150 received mepivacaine 1% (0.25 mL) subcutaneously, 151 were cannulated without local analgesia. Patients were further allocated to one of five cannula size groups (standard wire gauge (G)): 20-, 18-, 17-, 16- and 14-G. They were asked to quantify the pain experienced using a four-point rating scale.
In the group without local anaesthetics, 28.8% complained about pain compared to 12% receiving local analgesia. The incidence of pain for 14-G (10%) and 16-G (12.9%) cannulae was significantly reduced in the local analgesia group (P < 0.01) compared to no local analgesia (77.4% and 45.1%). Other cannula sizes showed no difference in pain whether using local analgesia or not.
Patients profit from a subcutaneous infiltration with mepivacaine 1% prior to intravenous cathetherization only when cannulae of size > or = 16-G are inserted.
本随机前瞻性研究旨在评估使用不同型号套管针进行静脉穿刺前皮下局部麻醉浸润的效果。
301例患者纳入研究，150例皮下注射1%甲哌卡因（0.25 mL），151例未进行局部镇痛直接进行套管针穿刺。患者进一步被分配到五个套管针型号组之一（标准线规（G））：20G、18G、17G、16G和14G。要求他们使用四点量表对所经历的疼痛进行量化。
未使用局部麻醉剂的组中，28.8%的患者抱怨疼痛，而接受局部镇痛的患者为12%。与未进行局部镇痛（77.4%和45.1%）相比，局部镇痛组中14G（10%）和16G（12.9%）套管针的疼痛发生率显著降低（P < 0.01）。无论是否使用局部镇痛，其他套管针型号在疼痛方面均无差异。
仅当插入≥16G型号的套管针时，患者在静脉置管前皮下注射1%甲哌卡因浸润才会受益。
