Pere P, Iizuka T, Rosenberg P H, Lindqvist C
Department of Anaesthesia, Helsinki University Central Hospital, Finland.
Br J Oral Maxillofac Surg. 1992 Jun;30(3):153-6. doi: 10.1016/0266-4356(92)90146-a.
The analgesic effect of topical application of a 5% eutectic mixture of lignocaine and prilocaine (EMLA) was studied in 45 patients undergoing removal of oral arch bars used for the treatment of mandibular fractures. Employing a double-blind technique, either 4 g of the eutectic mixture (EMLA group, n = 15) or 4 g of a similar emulsion containing no local anaesthetic (placebo group, n = 15) was applied to the gingivae using a toothbrush and a standardised technique. In the control group (n = 15), infiltration anaesthesia with lignocaine was used only if requested by the patient during the removal of the arch bars. The patients in the EMLA group had significantly better analgesia (P less than 0.005) of the gingivae just before removal of the arch bars than patients in the placebo group, but by the end of the procedure the difference in analgesia was not significant. The number of patients who found the procedure pain-free was significantly higher in the EMLA group (7/14) than in the placebo group (2/15) (P less than 0.005). The plasma concentrations of both lignocaine and prilocaine were well below the toxic levels. Topical application of EMLA can be recommended for short procedures as an alternative to infiltration.
对45例接受用于治疗下颌骨折的口腔牙弓夹板拆除术的患者，研究了局部应用5%利多卡因和丙胺卡因共熔混合物（EMLA）的镇痛效果。采用双盲技术，用牙刷及标准化技术将4克共熔混合物（EMLA组，n = 15）或4克不含局部麻醉剂的类似乳剂（安慰剂组，n = 15）涂于牙龈。在对照组（n = 15），仅在患者要求时于拆除牙弓夹板期间使用利多卡因浸润麻醉。在拆除牙弓夹板前，EMLA组患者牙龈的镇痛效果明显优于安慰剂组患者（P < 0.005），但在手术结束时，镇痛效果的差异不显著。认为手术无痛的EMLA组患者数量（7/14）明显高于安慰剂组（2/15）（P < 0.005）。利多卡因和丙胺卡因的血浆浓度均远低于中毒水平。对于短时间手术，可推荐局部应用EMLA作为浸润麻醉的替代方法。
