Steedman B, Watson J, Ali S, Shields M L, Patmore R D, Allsup D J
Department of Haematology, Hull and East Yorkshire Hospitals NHS Trust, Hull, UK.
Clin Lab Haematol. 2006 Oct;28(5):321-4. doi: 10.1111/j.1365-2257.2006.00807.x.
Bone marrow aspiration and biopsy is a procedure of central importance in the diagnosis of haematological disease and is one that can be safely performed in the outpatient clinic using only local anaesthesia. We evaluated the role of inhaled nitrous oxide (Entonox) as an adjuvant to local anaesthesia (LA) in patients requiring bone examination. We prospectively studied the role of Entonox in patients attending our outpatient department who required bone marrow examination. All patients received LA with injected 2% lignocaine but patients were then assigned to either LA alone or LA plus inhaled Entonox. Following the procedure patients were given a questionnaire and asked to score the discomfort associated with the procedure. Twenty-eight of 85 patients (33%) who received LA alone scored their pain as 3 (severe) compared with seven of 51 patients (14%) who received LA plus Entonox, P = 0.013. No adverse events were associated with Entonox use. Forty-three of the 51 patients who received Entonox stated that they would prefer to use this method of anaesthesia again. We conclude that inhaled Entonox is a useful adjuvant to local anaesthesia for patients undergoing bone marrow examination.
骨髓穿刺和活检是血液病诊断中至关重要的一项操作，并且仅使用局部麻醉就能在门诊安全地进行。我们评估了吸入一氧化二氮（笑气）作为局部麻醉辅助手段在需要进行骨髓检查的患者中的作用。我们前瞻性地研究了笑气在我院门诊需要进行骨髓检查的患者中的作用。所有患者均接受了注射用2%利多卡因进行局部麻醉，但随后患者被分为仅接受局部麻醉组或局部麻醉加吸入笑气组。操作结束后，给患者发放问卷，让他们对与操作相关的不适程度进行评分。仅接受局部麻醉的85名患者中有28名（33%）将疼痛评为3分（重度），而接受局部麻醉加吸入笑气的51名患者中有7名（14%），P = 0.013。使用笑气未出现不良事件。接受笑气的51名患者中有43名表示他们愿意再次使用这种麻醉方法。我们得出结论，吸入笑气是接受骨髓检查患者局部麻醉的一种有用辅助手段。
