Huff Lori, Hamlin Annette, Wolski Diane, McClure Tracy, Eliades Aris Beoglos, Weaver Laurie, Shelestak Deb
Akron Children’s Hospital, One Perkins Sq., Akron, OH 44308, USA.
Issues Compr Pediatr Nurs. 2009;32(2):65-76. doi: 10.1080/01460860902737418.
The purpose of this study was to investigate whether the application of heat placed to a child's potential intravenous (IV) site after the application of EMLA Cream™ decreases vasoconstriction, therefore promoting atraumatic care in the hospitalized pediatric patient. Venipuncture in children is a painful and frequently performed procedure. While use of EMLA Cream™ to reduce pain on insertion is a common practice with pediatric patients, no studies had measured venous size in relation to EMLA Cream™ and heat application. A descriptive quantitative design was used to examine the use of EMLA Cream™ and application of heat to facilitate venipuncture for peripheral venous cannulation. A convenience sample of 30 hospitalized Caucasian children, eight to twelve years old, participated. Vascular ultrasound directly measured the vein prior to and 1 hour after EMLA Cream™ application, as well as 2 minutes after heat application. Mean vein measurements were 0.243 cm prior to EMLA Cream™, 0.205 cm after EMLA Cream™ applied for 1 hour, and 0.253 cm after two minutes of heat. There was a significant increase in vein visualization from pre-application of heat to post application of heat with a success rate of 80% with the first time attempt of IV insertion. Therefore, application of heat counteracts the adverse effect of vasoconstriction that occurs with EMLA Cream™ application, potentially increasing peripheral venous cannulation success rates.
本研究的目的是调查在涂抹EMLA乳膏™后对儿童潜在的静脉注射（IV）部位进行热敷是否会减少血管收缩，从而促进对住院儿科患者的无创伤护理。儿童静脉穿刺是一项痛苦且经常进行的操作。虽然使用EMLA乳膏™来减轻穿刺时的疼痛是儿科患者的常见做法，但尚无研究测量与涂抹EMLA乳膏™和热敷相关的静脉大小。采用描述性定量设计来研究使用EMLA乳膏™和热敷以促进外周静脉置管的静脉穿刺情况。选取了30名8至12岁住院的白人儿童作为便利样本参与研究。在涂抹EMLA乳膏™之前、涂抹1小时后以及热敷2分钟后，使用血管超声直接测量静脉。涂抹EMLA乳膏™之前的平均静脉测量值为0.243厘米，涂抹1小时后的测量值为0.205厘米，热敷两分钟后的测量值为0.253厘米。从热敷前到热敷后，静脉可视化有显著增加，首次静脉穿刺插入的成功率为80%。因此，热敷可抵消涂抹EMLA乳膏™时出现的血管收缩的不良影响，有可能提高外周静脉置管的成功率。
