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无针喷射利多卡因用于扳机指注射前麻醉:一项随机对照试验

Needle-Free Jet Lidocaine Administration for Preinjection Anesthesia in Trigger Finger Injection: A Randomized Controlled Trial.

作者信息

Earp Brandon E, Stanbury Spencer J, Mora Ariana N, Blazar Philip E

机构信息

Department of Orthopedic Surgery, Brigham and Women's Hospital, Boston, MA.

Department of Orthopedic Surgery, Brigham and Women's Hospital, Boston, MA.

出版信息

J Hand Surg Am. 2017 Aug;42(8):618-622. doi: 10.1016/j.jhsa.2017.05.001. Epub 2017 May 24.

Abstract

PURPOSE

To evaluate the efficacy of needle-free jet lidocaine (J-tip) administration for pain reduction in trigger finger corticosteroid injection compared with simultaneous lidocaine injection with corticosteroid.

METHODS

A prospective randomized clinical trial was performed in which patients received either 0.25 mL of 2% lidocaine administered by J-tip just prior to 0.5 mL of corticosteroid injection by needle or 0.5 mL of 1% lidocaine and 0.5 mL of corticosteroid administered simultaneously through a needle for the treatment of trigger finger. Both the expected pain preinjection and the actual pain experienced postinjection were measured with a visual analog scale (VAS). Pain catastrophizing scale (PCS) scores were recorded before injection.

RESULTS

The use of the J-tip demonstrated a lower mean actual pain, 3.3 VAS, compared with the control group, 4.6 VAS. Both study groups anticipated more pain than they actually experienced. The PCS did not correlate to pre- or post-injection scores.

CONCLUSIONS

Needle-free jet administration of lidocaine reduces the pain associated with trigger finger injection. Patients anticipate more pain than they experience with trigger finger injection.

TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic I.

摘要

目的

评估与同时注射利多卡因和皮质类固醇相比,无针喷射利多卡因(J型针尖)给药在扳机指皮质类固醇注射时减轻疼痛的效果。

方法

进行一项前瞻性随机临床试验,患者接受以下两种治疗之一:在通过针头注射0.5 mL皮质类固醇之前,先通过J型针尖注射0.25 mL 2%利多卡因;或通过针头同时注射0.5 mL 1%利多卡因和0.5 mL皮质类固醇来治疗扳机指。注射前预期疼痛和注射后实际经历的疼痛均采用视觉模拟量表(VAS)进行测量。在注射前记录疼痛灾难化量表(PCS)评分。

结果

与对照组(VAS评分为4.6)相比,使用J型针尖显示平均实际疼痛较低,为3.3 VAS。两个研究组预期的疼痛均比实际经历的更多。PCS与注射前或注射后评分均无相关性。

结论

无针喷射利多卡因给药可减轻与扳机指注射相关的疼痛。患者预期的扳机指注射疼痛比实际经历的更多。

研究类型/证据水平:治疗性I级。

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