儿童裂伤修复的疼痛管理。
Pain management for children needing laceration repair.
出版信息
Can Fam Physician. 2018 Dec;64(12):900-902.
An 8-year-old child who lives in a small town has presented to my practice with a 3-inch laceration on the calf that has been assessed and needs repair with sutures. The family lives 4 hours from the nearest emergency department and I was planning to repair the wound in the office. What is the best way to manage pain in young patients needing sutures for laceration repair? Children are particularly susceptible to experiencing high levels of pain and anxiety during routine emergency procedures such as laceration repair. It is important to consider measures to reduce procedural pain. Using needle-free anesthesia, such as the lidocaine-adrenaline-tetracaine combination, might be effective to anesthetize the area. In instances where lidocaine-adrenaline-tetracaine is not sufficient, additional injected lidocaine or bupivacaine can be used. Buffering lidocaine with bicarbonate, warming the lidocaine ampule, and injecting the compound slowly at a perpendicular angle to the skin will reduce pain associated with the injection.
一位 8 岁的孩子在小腿上出现了 3 英寸长的撕裂伤，前来我的诊所就诊。该伤口已得到评估，需要缝合修复。孩子的家距离最近的急诊室有 4 小时的车程，我原本计划在办公室为孩子修复伤口。那么，对于需要缝合修复撕裂伤的年轻患者，哪种方法是缓解疼痛的最佳方法？儿童在接受常规急诊程序（如撕裂伤修复）时，特别容易经历高水平的疼痛和焦虑。因此，考虑采取措施减轻手术疼痛非常重要。使用无针麻醉剂（如利多卡因肾上腺素丁卡因合剂）可能可以有效麻醉该区域。如果利多卡因肾上腺素丁卡因不够有效，可以额外注射利多卡因或布比卡因。用碳酸氢钠缓冲利多卡因，加热利多卡因安瓿，以及以垂直于皮肤的角度缓慢注射该混合物，可以减轻注射引起的疼痛。
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