Divisions of 1Gynecologic Oncology and 2Clinical Research, Department of Obstetrics and Gynecology, Washington University School of Medicine, Saint Louis, MO.
J Low Genit Tract Dis. 2014 Jan;18(1):8-12. doi: 10.1097/LGT.0b013e31828deffd.
Our study evaluated whether buffering reduces pain from lidocaine injection for loop electrosurgical excisional procedures (LEEPs) of the cervix when compared to unbuffered lidocaine.
Women undergoing outpatient LEEPs were randomized to receive either buffered or unbuffered lidocaine. Participants, caregivers, and statisticians were blinded to treatment allocation. Pain was categorized as injection, procedure, or cramping pain. Severity of pain was reported using a Likert visual analog scale and compared using Mann-Whitney tests.
Twenty-eight subjects received buffered lidocaine and 24 subjects received unbuffered lidocaine. The 2 groups were similar in regard to age, race, previous LEEP, anesthetic volume used, and loop size. Mean scores were similar between the nonbuffered and buffered groups for injection pain (25 vs 19, p = .13), procedure pain (27 vs 19, p = .08), and cramping pain (19 vs 18, p = .86).
Pain scores with subepithelial lidocaine plus epinephrine for LEEP are low and are not significantly reduced by buffering the anesthetic.
本研究旨在评估与未缓冲的利多卡因相比，缓冲利多卡因是否能减轻宫颈环形电切术（LEEP）中利多卡因注射引起的疼痛。
接受门诊 LEEP 的女性患者被随机分配接受缓冲或未缓冲的利多卡因。参与者、护理人员和统计人员对治疗分配均不知情。疼痛分为注射痛、手术痛或痉挛痛。疼痛严重程度采用李克特视觉模拟评分法（Likert visual analog scale）进行评估，并采用曼-惠特尼检验（Mann-Whitney test）进行比较。
28 名患者接受了缓冲利多卡因，24 名患者接受了未缓冲利多卡因。两组在年龄、种族、既往 LEEP、麻醉剂用量和环大小方面相似。未缓冲组和缓冲组的注射痛（25 分比 19 分，p =.13）、手术痛（27 分比 19 分，p =.08）和痉挛痛（19 分比 18 分，p =.86）评分相似。
LEEP 中使用表浅下皮层利多卡因加肾上腺素引起的疼痛评分较低，缓冲麻醉并不能显著减轻疼痛。
