Cuomo Roberto, D'Aniello Carlo, Grimaldi Luca, Nisi Giuseppe, Botteri Gaia, Zerini Irene, Brandi Cesare
Unit of Plastic and Reconstructive Surgery, Santa Maria Alle Scotte Hospital, University of Siena , Siena, Italy .
Adv Wound Care (New Rochelle). 2015 Jun 1;4(6):358-361. doi: 10.1089/wound.2014.0605.
In this study the author proposes to compare eutectic mixture of local anesthetics (EMLA) and an odontoiatric spray solution of 10% Lidocaine (Ecocain) for surgical debridement in venous leg ulcers. Fifty patients were recruited and randomly assigned into two groups (A, B). All of them have venous leg ulcer in the medial and/or lateral malleolar region. Group A: topical anesthetic EMLA with film occlusion. Group B: topical anesthesia with Ecocain. The author proceeded to surgical debridement after local anesthesia. A questionnaire and a visual analog scale (VAS) were administered to assess the amount of pain felt during the debridement and during the following 6 h. The analysis of the VAS revealed no major significant differences statistically. The analysis of the questionnaires showed patients treated with Ecocain took more analgesic drugs. Analysis of the timing and quality of procedure showed that Ecocain reduced the timing of debridement and dressing change, improving the outpatient management and patient compliance. For rapid debridement, the most appropriate is to use Ecocain. Methods of local anesthesia are multiple and must be identified according to the needs of the patient and the surgeon trying to get the best anesthesia with minimal use of time and resources.
在本研究中，作者提议比较局部麻醉药的 eutectic 混合物（EMLA）和 10%利多卡因的牙科学喷雾溶液（Ecocain）用于下肢静脉溃疡手术清创的效果。招募了 50 名患者并随机分为两组（A 组、B 组）。他们均在内侧和/或外侧踝区患有下肢静脉溃疡。A 组：使用带贴膜封闭的局部麻醉药 EMLA。B 组：使用 Ecocain 进行局部麻醉。作者在局部麻醉后进行手术清创。采用问卷调查和视觉模拟评分法（VAS）评估清创过程中及随后 6 小时内的疼痛程度。VAS 分析显示在统计学上无重大显著差异。问卷调查分析表明，使用 Ecocain 治疗的患者服用了更多的镇痛药。对手术时间和质量的分析表明，Ecocain 缩短了清创和换药时间，改善了门诊管理和患者依从性。对于快速清创，最合适的是使用 Ecocain。局部麻醉方法多种多样，必须根据患者和外科医生的需求来确定，以便在最少的时间和资源使用下获得最佳麻醉效果。
