Aihara Seishi, Yamada Shunsuke, Shichijo Satoru, Fukumitsu Kento, Kondo Mika, Hirashima Yutaro, Oka Hideaki, Kamimura Taro, Harada Atsumi, Nakano Toshiaki, Tsuruya Kazuhiko, Kitazono Takanari
Kidney Center, Matsuyama Red Cross Hospital, Matsuyama, Japan.
Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Ther Apher Dial. 2020 Feb;24(1):34-41. doi: 10.1111/1744-9987.12813. Epub 2019 Jun 17.
Vascular access intervention therapy (VAIVT) is necessary to maintain vascular access in patients undergoing hemodialysis. VAIVT-associated vasodilatation is painful. However, few reports have focused on effective pain relief at the time of VAIVT. The present study was performed to determine whether lidocaine-propitocain cream, a eutectic mixture of local anesthetics (EMLA), effectively reduces VAIVT-associated pain in patients undergoing hemodialysis. This placebo-controlled, double-blind, crossover study was conducted in a single center. Among 210 patients who underwent a total of 437 VAIVT procedures from August 2017 to June 2018, 30 patients were randomly allocated to either the EMLA-placebo arm or placebo-EMLA arm at the time of VAIVT. EMLA application significantly reduced the visual analog scale score compared with placebo (47.0 ± 21.1 vs. 68.6 ± 20.7 mm, respectively; P < 0.05). EMLA is a safe and effective treatment for relief of VAIVT-associated pain in patients undergoing hemodialysis.
血管通路介入治疗（VAIVT）对于维持接受血液透析患者的血管通路是必要的。VAIVT相关的血管扩张会引起疼痛。然而，很少有报告关注VAIVT时有效的疼痛缓解。本研究旨在确定利多卡因-丙胺卡因乳膏（一种局部麻醉药的共晶混合物，即EMLA）是否能有效减轻接受血液透析患者VAIVT相关的疼痛。这项安慰剂对照、双盲、交叉研究在单一中心进行。在2017年8月至2018年6月期间共接受437次VAIVT手术的210例患者中，30例患者在VAIVT时被随机分配到EMLA-安慰剂组或安慰剂-EMLA组。与安慰剂相比，应用EMLA显著降低了视觉模拟评分（分别为47.0±21.1与68.6±20.7mm；P<0.05）。EMLA是一种安全有效的治疗方法，可缓解接受血液透析患者VAIVT相关的疼痛。
