Halperin D L, Koren G, Attias D, Pellegrini E, Greenberg M L, Wyss M
Department of Pediatrics, Hospital for Sick Children, Toronto, Canada.
Pediatrics. 1989 Aug;84(2):281-4.
A new topical anesthetic ointment (EMLA, "eutectic mixture of prilocaine and lidocaine was studied in a double-blind, placebo-controlled trial to evaluate its efficiency in alleviating pain associated with venous, subcutaneous drug reservoir and lumbar punctures in children. Pain intensity was scored by the children themselves, using a visual analogue scale in which 0 corresponded to absence of sensation and 10 to the worst imaginable painful sensation. Venipunctures were performed on 18 children (6.1 to 12.2 years of age) equally divided in the study and control groups; EMLA cream was associated with lesser pain scores than those with placebo (means +/- SD: 2.8 +/- 2.4 vs 6.8 +/- 2.1, P less than .01). A crossover trial was used in the studies of subcutaneous drug reservoir and lumbar punctures, eight children (6.1 to 15.1 years of age) were tested for subcutaneous drug reservoir punctures; pain induced by this procedure was rated at 3.9 +/- 2.2 with placebo compared with 1.2 +/- 1.8 with EMLA cream (P less than .04). In lumbar punctures (14 children studied, 5.5 to 15.3 years of age), EMLA cream was again associated with less pain (1.9 +/- 1.9) than was placebo (5.6 +/- 3.0, P less than .01). It was concluded that the use of EMLA cream substantially reduces pain caused by venous, subcutaneous drug reservoir, and lumbar punctures in children and may therefore be offered to young patients, particularly those repeatedly submitted to such procedures.
一种新型局部麻醉药膏（EMLA，“丙胺卡因和利多卡因的共熔混合物”）在一项双盲、安慰剂对照试验中进行了研究，以评估其减轻儿童静脉穿刺、皮下药物储库穿刺和腰椎穿刺相关疼痛的效果。疼痛强度由儿童自己使用视觉模拟量表进行评分，其中0表示无感觉，10表示可想象到的最严重疼痛感觉。对18名儿童（6.1至12.2岁）进行静脉穿刺，研究组和对照组各9名；与安慰剂相比，EMLA乳膏的疼痛评分更低（均值±标准差：2.8±2.4 vs 6.8±2.1，P＜0.01）。在皮下药物储库穿刺和腰椎穿刺研究中采用了交叉试验，8名儿童（6.1至15.1岁）接受皮下药物储库穿刺测试；该操作引起的疼痛，安慰剂组评分为3.9±2.2，而EMLA乳膏组为1.2±1.8（P＜0.04）。在腰椎穿刺研究中（14名儿童，5.5至15.3岁），EMLA乳膏引起的疼痛（1.9±1.9）再次低于安慰剂组（5.6±3.0，P＜0.01）。得出的结论是，使用EMLA乳膏可大幅减轻儿童静脉穿刺、皮下药物储库穿刺和腰椎穿刺引起的疼痛，因此可提供给年轻患者，尤其是那些反复接受此类操作的患者。
