经皮条取样法研究局麻药对人体皮下组织胶体渗透压的影响。
Effect of topical anaesthetics on interstitial colloid osmotic pressure in human subcutaneous tissue sampled by wick technique.
机构信息
Department of Paediatrics, Haukeland University Hospital, Bergen, Norway.
出版信息
PLoS One. 2012;7(2):e31332. doi: 10.1371/journal.pone.0031332. Epub 2012 Feb 14.
OBJECTIVES
To measure colloid osmotic pressure in interstitial fluid (COP(i)) from human subcutaneous tissue with the modified wick technique in order to determine influence of topical application of anaesthetics, dry vs. wet wick and implantation time on COP(i).
MATERIAL AND METHODS
In 50 healthy volunteers interstitial fluid (IF) was collected by subcutaneous implantation of multi-filamentous nylon wicks. Study subjects were allocated to two groups; one for comparing COP(i) obtained from dry and saline soaked wicks, and one for comparing COP(i) from unanaesthetized skin, and skin after application of a eutectic mixture of local anaesthetic (EMLA®, Astra Zeneca) cream. IF was sampled from the skin of the shoulders, and implantation time was 30, 60, 75, 90 and 120 min. Colloid osmotic pressure was measured with a colloid osmometer. Pain assessment during the procedure was compared for EMLA cream and no topical anaesthesia using a visual analogue scale (VAS) in a subgroup of 10 subjects.
RESULTS
There were no significant differences between COP(i) obtained from dry compared to wet wicks, except that the values after 75 and 90 min. were somewhat higher for the dry wicks. Topical anaesthesia with EMLA cream did not affect COP(i) values. COP(i) decreased from 30 to 75 min. of implantation (23.2 ± 4.4 mmHg to 19.6 ± 2.9 mmHg, p = 0.008) and subsequently tended to increase until 120 min. EMLA cream resulted in significant lower VAS score for the procedure.
CONCLUSION
COP(i) from subcutaneous tissue was easily obtained and fluid harvesting was well tolerated when topical anaesthetic was used. The difference in COP(i) assessed by dry and wet wicks between 75 min. and 90 min. of implantation was in accordance with previous reports. The use of topical analgesia did not influence COP(i) and topical analgesia may make the wick technique more acceptable for subjects who dislike technical procedures, including children.
TRIAL REGISTRATION
ClinicalTrials.gov NCT01044979.
目的
使用改良的wick 技术测量人体皮下组织间质液的胶体渗透压（COP(i)），以确定局部麻醉剂的外用、wick 的干/湿和植入时间对 COP(i)的影响。
材料和方法
在 50 名健康志愿者中，通过皮下植入多丝尼龙wick 收集间质液（IF）。研究对象分为两组；一组比较干wick 和盐水浸泡 wick 获得的 COP(i)，另一组比较未麻醉皮肤和局部麻醉剂（EMLA®，AstraZeneca）乳膏应用后的皮肤的 COP(i)。IF 取自肩部皮肤，植入时间为 30、60、75、90 和 120 分钟。使用渗透压计测量胶体渗透压。在 10 名受试者的亚组中，使用视觉模拟量表（VAS）比较 EMLA 乳膏和无局部麻醉时的过程中的疼痛评估。
结果
干wick 与湿wick 获得的 COP(i)之间没有显著差异，除了 75 和 90 分钟时干wick 的值稍高。EMLA 乳膏的局部麻醉不影响 COP(i)值。植入 30 至 75 分钟时，COP(i)下降（23.2 ± 4.4mmHg 至 19.6 ± 2.9mmHg，p = 0.008），随后直至 120 分钟时趋于增加。EMLA 乳膏使该过程的 VAS 评分显著降低。
结论
使用局部麻醉时，很容易从皮下组织获得 COP(i)，并且可以很好地耐受液体采集。与 75 分钟至 90 分钟植入期间干wick 和湿wick 评估的 COP(i)之间的差异与之前的报告一致。局部镇痛的使用并不影响 COP(i)，并且局部镇痛可能使 wick 技术更受不喜欢技术操作的受试者（包括儿童）的欢迎。
试验注册
ClinicalTrials.gov NCT01044979。
Zotero 插件