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利多卡因/丁卡因药物贴剂或剥离剂在皮肤科手术中的疗效和安全性：一项荟萃分析。

Efficacy and safety of a lidocaine/tetracaine medicated patch or peel for dermatologic procedures: a meta-analysis.

机构信息

Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Korea.

出版信息

Korean J Anesthesiol. 2012 May;62(5):435-40. doi: 10.4097/kjae.2012.62.5.435. Epub 2012 May 24.

DOI:10.4097/kjae.2012.62.5.435
PMID:22679540
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3366310/
Abstract

BACKGROUND

To justify the use of the lidocaine/tetracaine medicated patch or peel as a preventive treatment for reducing pain and discomfort in adults and children. We reviewed randomized controlled trials (RCTs) to evaluate the efficacy and safety of the lidocaine/tetracaine medicated patch or peel compared with placebo.

METHODS

Ten RCTs (574 patients) were included in this systemic review. Relevant studies were identified through searches of MEDLINE, SCOPUS and the Cochrane database library. The outcome was the adequacy of cutaneous anesthesia reflected in the patient's assessment of pain intensity during minor dermatologic procedures and adverse effects after application of the lidocaine/tetracaine medicated patch or peel versus placebo.

RESULTS

The efficacy of the lidocaine/tetracaine patch or peel was consistently very significantly beneficial 30 or 60 minutes after the application compared to placebo (Relative risk, RR: 2.5; Number needed to treat, NNT: 2.2). We did not identify any difference in the effectiveness of adequate analgesia between the lidocaine/tetracaine patch and peel (the number needed to treat or to harm, NNT 2.4 vs. 2.0). No serious side effects or adverse events were observed with the lidocaine/tetracaine medicated patch or peel and placebo. Minor skin reactions were transient and resolved without treatment (Odd ratio, OR: 1.4 and 95% confidence interval, CI: 0.9-2.1; NNT: 14.9).

CONCLUSIONS

The lidocaine/tetracaine medicated patch or peel is a well accepted, effective and safe method for minor dermatologic procedures based on pooled data of trials in terms of adequacy of cutaneous anesthesia and adverse effects.

摘要

背景

为了证明利多卡因/ 四卡因贴剂或剥离剂作为预防成人和儿童疼痛和不适的治疗方法是合理的。我们综述了随机对照试验（RCT），以评估利多卡因/ 四卡因贴剂或剥离剂与安慰剂相比的疗效和安全性。

方法

本系统综述纳入了 10 项 RCT（574 例患者）。通过检索 MEDLINE、SCOPUS 和 Cochrane 数据库，确定了相关研究。主要结局为患者在接受小面积皮肤操作时对疼痛强度的评估，以及使用利多卡因/ 四卡因贴剂或剥离剂与安慰剂后不良反应的发生率。

结果

与安慰剂相比，利多卡因/ 四卡因贴剂或剥离剂在使用后 30 或 60 分钟时的皮肤麻醉效果始终非常显著（相对风险 RR：2.5；需要治疗的人数 NNT：2.2）。我们未发现利多卡因/ 四卡因贴剂和剥离剂在充分镇痛效果方面存在差异（需要治疗或需要伤害的人数 NNT：2.4 比 2.0）。利多卡因/ 四卡因贴剂或剥离剂和安慰剂均未观察到严重的副作用或不良事件。轻微的皮肤反应是短暂的，无需治疗即可缓解（比值比 OR：1.4，95%置信区间 CI：0.9-2.1；需要治疗的人数 NNT：14.9）。

结论

基于试验的汇总数据，利多卡因/ 四卡因贴剂或剥离剂在充分的皮肤麻醉和不良反应方面是一种可接受、有效且安全的小面积皮肤操作方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5353/3366310/8406fff54f72/kjae-62-435-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5353/3366310/b1c755435b7c/kjae-62-435-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5353/3366310/8406fff54f72/kjae-62-435-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5353/3366310/b1c755435b7c/kjae-62-435-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5353/3366310/8406fff54f72/kjae-62-435-g002.jpg

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本文引用的文献

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Contribution of a heating element to topical anesthesia patch efficacy prior to vascular access: results from two randomized, double-blind studies.加热元件对血管通路前局部麻醉贴剂疗效的贡献：两项随机、双盲研究的结果。
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Topical local anesthesia: focus on lidocaine-tetracaine combination.局部麻醉：聚焦于利多卡因-丁卡因合剂
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