Department of Anesthesiology and Reanimation, Sa?l?k Bilimleri University Sultan Abdülhamid Han Research Hospital, Istanbul, Turkey.
Pain Physician. 2021 Jan;24(1):E31-E36.
During spinal anesthesia, patients may experience pain and discomfort associated with dermal puncture. It may also cause involuntary movement, which often disturbs the patient's posture thus affecting the success of spinal anesthesia. Different methods have been studied to cope with needle-related pain. "ShotBlocker" is a flexible, plastic, U-shaped device, which has several blunt points. It is suggested that blunt points provide a nonnoxious physical stimulation and inhibit the transmission of injection pain.
The purpose of this study was to examine the effectiveness of the ShotBlocker for dermal puncture pain during spinal anesthesia.
Prospective randomized trial.
University hospital, operating room.
Ninety-four patients aged 18 to 65 years with physical status American Society of Anesthesiologists (ASA) I or II scheduled for elective surgery under spinal anesthesia were randomly assigned to either a ShotBlocker (n = 47) or control group (n = 47). In the ShotBlocker group, lumbar punctures were performed with the application of ShotBlocker. Needle-associated pain score and patient satisfaction were assessed by the patient, immediately after completion of the spinal anesthesia using a 10-cm Visual Analog Scale (VAS) and a 5-point Likert scale for satisfaction. Patients were also closely observed for symptoms of discomfort such as spontaneous vocalization and involuntary movement.
A total of 88 patients completed the study. There was no significant difference in VAS scores, patient satisfaction, or procedure time between groups (P > 0.05). Spontaneous vocalization did not occur in both groups. However, incidence of unintentional movement during dermal puncture was higher in the control group (6.8% vs. 31.8%; P < 0.05).
Study was conducted in a single-center with a relatively small population of patients. Only the attending anesthetist collecting data was blinded to the procedure. Patients older than age 65 years were also excluded from the study, thus our results cannot be generalized.
ShotBlocker did not show any advantage on VAS scores but decreased the incidence of unintentional movement during dermal puncture.
在脊髓麻醉期间，患者可能会经历与皮肤穿刺相关的疼痛和不适。它还可能引起不自主运动，这通常会扰乱患者的姿势，从而影响脊髓麻醉的成功。已经研究了不同的方法来应对与针相关的疼痛。“ShotBlocker”是一种灵活的塑料 U 形装置，具有几个钝点。据建议，钝点提供无害的物理刺激并抑制注射疼痛的传递。
本研究旨在检查 ShotBlocker 在脊髓麻醉中皮肤穿刺疼痛的有效性。
前瞻性随机试验。
大学医院，手术室。
94 名年龄在 18 至 65 岁之间、身体状况为美国麻醉医师学会（ASA）I 或 II 级的患者，计划在脊髓麻醉下进行择期手术，随机分为 ShotBlocker 组（n = 47）或对照组（n = 47）。在 ShotBlocker 组中，应用 ShotBlocker 进行腰椎穿刺。使用 10cm 视觉模拟量表（VAS）和 5 分满意度量表，在脊髓麻醉完成后立即由患者评估与针相关的疼痛评分和患者满意度。还密切观察患者有无不适症状，如自发发声和不自主运动。
共有 88 名患者完成了研究。两组之间的 VAS 评分、患者满意度或手术时间均无显著差异（P > 0.05）。两组均未发生自发发声。然而，对照组在皮肤穿刺过程中不自主运动的发生率较高（6.8%比 31.8%；P < 0.05）。
该研究在一个单中心进行，患者人数相对较少。只有采集数据的主治麻醉师对程序进行了盲法。也排除了年龄大于 65 岁的患者，因此我们的结果不能推广。
ShotBlocker 在 VAS 评分上没有显示出任何优势，但降低了皮肤穿刺过程中不自主运动的发生率。
