Engberg G, Danielson K, Henneberg S, Nilsson A
Department of Anaesthesiology and Intensive Care, University Hospital, Uppsala, Sweden.
Acta Anaesthesiol Scand. 1987 Oct;31(7):624-8. doi: 10.1111/j.1399-6576.1987.tb02633.x.
The aim of the study was to measure the plasma levels of lidocaine and prilocaine after dermal application of EMLA in infants and to evaluate whether this procedure increases the levels of methaemoglobin (Met-Hb). Two groups of infants, 3-6 (n = 12) and 6-12 months (n = 10) of age, were studied. In total, 2 ml of EMLA was applied to 4 x 4 cm of skin surface for 4 h and blood samples for detection of Met-Hb and plasma levels of local anaesthetics were taken at 0, 2, 4 and 8 h after the application. After removal of the cream the infants were operated mainly for minor procedures under general anaesthesia. The plasma concentrations of lidocaine and prilocaine were in all cases below toxic levels and there were only minor increases in Met-Hb in a few infants. In conclusion, EMLA can be used safely in infants above 3 months of age provided that the recommendations with regard to dose, application area and time are followed. The use of EMLA in smaller infants and in children taking other Met-Hb-inducing drugs needs further evaluation.
本研究的目的是测量在婴儿皮肤涂抹复方利多卡因乳膏（EMLA）后利多卡因和丙胺卡因的血浆水平，并评估该操作是否会增加高铁血红蛋白（Met-Hb）的水平。研究了两组婴儿，年龄分别为3至6个月（n = 12）和6至12个月（n = 10）。总共将2 ml EMLA涂抹于4×4 cm的皮肤表面4小时，并在涂抹后0、2、4和8小时采集血样用于检测Met-Hb和局部麻醉药的血浆水平。去除乳膏后，婴儿主要在全身麻醉下接受小手术。利多卡因和丙胺卡因的血浆浓度在所有情况下均低于中毒水平，少数婴儿的Met-Hb仅有轻微升高。总之，只要遵循关于剂量、涂抹面积和时间的建议，EMLA可安全用于3个月以上的婴儿。在更小的婴儿以及正在服用其他可诱导Met-Hb生成药物的儿童中使用EMLA需要进一步评估。
