Goodell J A, Gilroy G, Huntress J D
Pharmacy Department, Medical Center Hospital of Vermont, Burlington 05401.
Am J Hosp Pharm. 1988 Dec;45(12):2510-3.
A program to reduce the use of cocaine solution in a university teaching hospital by promoting the use of a lidocaine-phenylephrine solution is described. To reduce the use of cocaine solution, pharmacists promoted the use of a mixture of lidocaine 3% and phenylephrine 0.25% in place of cocaine solution for nasotracheal intubation procedures. Because initial clinical use of the lidocaine-phenylephrine solution by the anesthesia service was successful, the pharmacy department began in December 1986 to actively promote use of the solution to the bronchoscopy service, the emergency service, and select inpatient nursing units. Educational measures included an article in the pharmacy and therapeutics newsletter detailing the safety and efficacy of the solution, pharmacist description of the program to physicians and nurses, and designation of the solution as a free floor stock item on nursing units. By 1988, total cocaine solution use had decreased by 66% from the 1984 average of 145.7 doses per month to an average of 50.0 doses per month; overall use of topical anesthetics remained constant. The nursing staff supported the use of the lidocaine-phenylephrine solution because it eliminated the extensive record keeping necessary for the cocaine solution. The program to decrease the amount of cocaine solution used was successful and will be expanded to other areas of the hospital.
本文介绍了一项在大学教学医院减少可卡因溶液使用量的计划，该计划旨在推广使用利多卡因 - 去氧肾上腺素溶液。为减少可卡因溶液的使用，药剂师提倡在鼻气管插管操作中使用3%利多卡因和0.25%去氧肾上腺素的混合溶液替代可卡因溶液。由于麻醉科对利多卡因 - 去氧肾上腺素溶液的初步临床应用取得成功，药剂科于1986年12月开始积极向支气管镜检查科、急诊科以及部分住院护理单元推广该溶液的使用。教育措施包括在药学与治疗学通讯上发表一篇文章，详细介绍该溶液的安全性和有效性；药剂师向医生和护士介绍该计划；以及在护理单元将该溶液指定为免费的科室储备药品。到1988年，可卡因溶液的总使用量从1984年每月平均145.7剂下降了66%，降至每月平均50.0剂；局部麻醉剂的总体使用量保持不变。护理人员支持使用利多卡因 - 去氧肾上腺素溶液，因为它无需像可卡因溶液那样进行大量的记录保存。减少可卡因溶液使用量的计划取得了成功，并将扩大到医院的其他科室。
