Walker J D, Summers A, Williams D J
Betsi Cadwaladr University Health Board, Ysbyty Gwynedd, Bangor, Wales, UK.
Abertawe Bro Morgannwg University NHS Trust, Morriston Hospital, Swansea, Wales, UK.
Br Dent J. 2015 Apr 24;218(8):469-71. doi: 10.1038/sj.bdj.2015.297.
While local anaesthetic agents are usually safe and are used ubiquitously, inadvertent overdoses may have potentially fatal consequences. Errors in the dosing of local anaesthetics frequently occur due to inherent difficulties in remembering the toxic dosage limits, difficulties in performing the appropriate calculations correctly, and errors in estimating patient weight. We have developed a simple graphical calculation aid (nomogram) to overcome these problems and facilitate rapid cross-checking of the maximum safe dose for a variety of local anaesthetic agents in common use. Standard mathematical techniques were used to draft the nomogram. A randomised blinded study using simulated patient data and Bland-Altman analysis was used to assess the accuracy and precision of the nomogram. The nomogram was found to have a bias of 0.0 ml, with limits of agreement -0.05-0.04 ml. It was found to be easy to use and suitably accurate for clinical use.
虽然局部麻醉剂通常是安全的且被广泛使用，但意外用药过量可能会产生潜在的致命后果。由于在记忆毒性剂量限值方面存在固有困难、正确进行适当计算存在困难以及估计患者体重存在误差，局部麻醉剂给药错误经常发生。我们开发了一种简单的图形计算辅助工具（列线图）来克服这些问题，并便于快速交叉核对常用的各种局部麻醉剂的最大安全剂量。使用标准数学技术绘制列线图。采用模拟患者数据的随机双盲研究和布兰德-奥特曼分析来评估列线图的准确性和精确性。发现该列线图的偏差为0.0毫升，一致性界限为-0.05至0.04毫升。发现其易于使用且在临床使用中具有足够的准确性。
