Zelickson Blake R, Goldberg Leonard H, Rubenzik Marc K, Wu Wesley J
*All authors are affiliated with DermSurgery Associates, Houston, Texas; Houston Methodist Hospital, Houston, Texas.
Dermatol Surg. 2018 Feb;44(2):204-208. doi: 10.1097/DSS.0000000000001279.
The injection of local anesthetic into the skin is often the only memorable event described by the patient after dermatologic procedures.
The authors compared the pain felt during injection of local anesthetic using a minimal needle insertion technique with a 30- or 33-gauge needle.
Three hundred eighteen patients with tumors on the head and neck were injected with lidocaine using a previously described technique with either a 30- or 33-gauge needle. After injection, patients were surveyed using the visual assessment scale for pain.
Seventy-seven percent of patients felt no pain with injection on the face using a 33-gauge needle compared with 64% with a 30 gauge, whereas 94% of patients felt no pain on the scalp with a 33-gauge needle compared with 54% with a 30 gauge. Visual analog scale scores were also significantly decreased on the face and scalp using the smaller needle. There was no difference in pain between the 2 needles with injection on the neck.
This study further validates the use of this technique for the injection of lidocaine and the preference of a 33 gauge over a 30-gauge needle for the initial injection on the face and scalp.
在皮肤科手术中,向皮肤注射局部麻醉剂往往是患者描述的唯一令人印象深刻的事件。
作者比较了使用最小进针技术,分别用30号或33号针头注射局部麻醉剂时的疼痛程度。
318例头颈部有肿瘤的患者,采用先前描述的技术,分别用30号或33号针头注射利多卡因。注射后,使用视觉疼痛评估量表对患者进行调查。
使用33号针头在面部注射时,77%的患者没有疼痛感,而使用30号针头时这一比例为64%;使用33号针头在头皮注射时,94%的患者没有疼痛感,而使用30号针头时这一比例为54%。使用较细针头时,面部和头皮的视觉模拟评分也显著降低。在颈部注射时,两种针头引起的疼痛没有差异。
本研究进一步验证了该技术在注射利多卡因中的应用,以及在面部和头皮初次注射时,33号针头优于30号针头。