Wasiak J, Cleland H
Alfred Hospital, Victorian Adult Burns Service, Commercial Road, Prahran, Melbourne, Victoria, Australia, 3004.
Cochrane Database Syst Rev. 2007 Jul 18(3):CD005622. doi: 10.1002/14651858.CD005622.pub2.
Pain is a major issue for patients suffering from many different types of wounds in particular those with burn injuries. Prompt, aggressive use of opioid analgesics such as morphine has been suggested as critical to avert the cycle of pain and anxiety, but side effects are encountered. It is proposed that newer agents such as lidocaine could be effective in reducing pain and alleviating the escalating opioid dosage requirements in patients with burn injury.
To assess the safety and effectiveness of intravenous lidocaine as a means of pain relief versus no therapy, placebo, other drugs or two or more of the above therapies in combination in patients exposed to burn injury.
We searched the Cochrane Central Register of Controlled Trials (The Cochrane Library, Issue 1, 2007), MEDLINE (1966 to March 2007), EMBASE (1980 to 2007), CINAHL (1982 to March 2007).
Those trials that were considered were: randomised controlled trials (RCTs) and controlled clinical trials (CCTs), both published and unpublished studies, which assessed the efficacy of intravenous lidocaine varying doses as a single-agent therapy with no therapy, placebo, other analgesics such as opioids, lidocaine plus another drug, or two or more of the above therapies as a means of pain relief in patients exposed to burn injury.
The two review authors applied the entry criteria to identified studies.
No clinically relevant RCTs or CCTs were identified through the above searches.
AUTHORS' CONCLUSIONS: No information is available from the published RCTs or CCTs on clinically relevant primary outcome measures which can influence current burns care practice and management. Therefore, since current clinical evidence is subject to the inherent weaknesses of case series or reports, intravenous lidocaine must be considered a pharmacological agent under investigation in burns care whose effectiveness is yet to be determined in well-designed and conducted clinical trials.
疼痛是患有多种不同类型伤口的患者，尤其是烧伤患者的一个主要问题。有人建议迅速、积极地使用阿片类镇痛药（如吗啡）对于避免疼痛和焦虑的循环至关重要，但会出现副作用。有人提出，利多卡因等新型药物可能有效减轻烧伤患者的疼痛并缓解不断增加的阿片类药物剂量需求。
评估静脉注射利多卡因作为一种镇痛方法相对于不治疗、安慰剂、其他药物或上述两种或更多种疗法联合使用在烧伤患者中的安全性和有效性。
我们检索了Cochrane对照试验中央登记册（《Cochrane图书馆》，2007年第1期）、MEDLINE（1966年至2007年3月）、EMBASE（1980年至2007年）、CINAHL（1982年至2007年3月）。
所考虑的试验为：随机对照试验（RCT）和对照临床试验（CCT），包括已发表和未发表的研究，这些研究评估了不同剂量静脉注射利多卡因作为单一药物疗法相对于不治疗、安慰剂、其他镇痛药（如阿片类药物）、利多卡因加另一种药物或上述两种或更多种疗法联合使用在烧伤患者中的镇痛效果。
两位综述作者将纳入标准应用于所识别的研究。
通过上述检索未识别出临床相关的RCT或CCT。
已发表的RCT或CCT中没有关于可影响当前烧伤护理实践和管理的临床相关主要结局指标的信息。因此，由于目前的临床证据存在病例系列或报告的固有弱点，静脉注射利多卡因必须被视为烧伤护理中正在研究的一种药物，其有效性尚待在设计良好且实施得当的临床试验中确定。
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