Elibol Orhan, Ozkan Berna, Hekimhan Pelin Kaynak, Cağlar Yusuf
Kocaeli University, Faculty of Medicine, Ophthalmology Department, Kocaeli, Turkey.
Ophthalmic Plast Reconstr Surg. 2007 Mar-Apr;23(2):130-3. doi: 10.1097/IOP.0b013e318030459c.
To investigate the efficacy of EMLA cream and local dry cold application for pain relief before periocular botulinum toxin injection, and to compare these two methods.
In this prospective study, 40 patients underwent bilateral periocular botulinum injections for blepharospasm treatment or wrinkle reduction. Patients were divided into three treatment groups. In the first group (n = 12), cold was applied to the periocular area on one side before injection; the other side served as the control. In the second group (n = 12), topical anesthetic cream (EMLA) was applied to one side and the other side served as the control. In the third group (n = 16), cold was applied to one side and EMLA was applied to the other side. A visual analog scale was used for pain intensity, and patients in the third group were asked which treatment they preferred.
In the first group, the average pain score on the side where cold was applied was 3.00 +/- 1.70, whereas it was 5.83 +/- 1.40 on the control side (p < 0.001). In the second group, the average pain score on the side receiving EMLA was 3.25 +/- 1.86, and on the control side was 5.83 +/- 1.89 (p < 0.001). In the third group, the average pain score was 3.18 +/- 1.68 for the EMLA side and 3.12 +/- 1.31 for the cooled side (p > 0.05); nine of the 16 patients (56.2%) preferred EMLA.
Skin cooling and EMLA applications significantly decrease the pain associated with periocular botulinum toxin injections. Clinically or statistically significant difference in pain scores between the two methods was not noted. Patients had a slight preference for EMLA cream over skin cooling.
探讨复方利多卡因乳膏（EMLA 乳膏）和局部干冷应用在眼周肉毒毒素注射前缓解疼痛的效果，并比较这两种方法。
在这项前瞻性研究中，40 例患者接受双侧眼周肉毒毒素注射以治疗眼睑痉挛或减少皱纹。患者被分为三个治疗组。第一组（n = 12），在注射前对一侧眼周区域进行冷敷；另一侧作为对照。第二组（n = 12），在一侧涂抹局部麻醉乳膏（EMLA 乳膏），另一侧作为对照。第三组（n = 16），一侧进行冷敷，另一侧涂抹 EMLA 乳膏。使用视觉模拟量表评估疼痛强度，并询问第三组患者更喜欢哪种治疗方法。
第一组中，冷敷侧的平均疼痛评分为 3.00±1.70，而对照侧为 5.83±1.40（p < 0.001）。第二组中，接受 EMLA 乳膏一侧的平均疼痛评分为 3.25±1.86,对照侧为 5.83±1.89（p < 0.001）。第三组中，EMLA 乳膏侧的平均疼痛评分为 3.18±1.68，冷敷侧为为 3.12±1.31（p > 0.05）；16 例患者中有 9 例（56.2%）更喜欢 EMLA 乳膏。
皮肤冷却和涂抹 EMLA 乳膏可显著减轻眼周肉毒毒素注射相关的疼痛。两种方法在疼痛评分上未发现临床或统计学上的显著差异。与皮肤冷却相比，患者对 EMLA 乳膏略有偏好。
