Berkovitch M, Davis S, Matsui D, Donsky J, Koren G, Olivieri N F
Division of Clinical Pharmacology, Hospital for Sick Children, Toronto, Ontario.
J Clin Pharmacol. 1995 Mar;35(3):295-7. doi: 10.1002/j.1552-4604.1995.tb04062.x.
The efficacy of a eutectic mixture of local anesthetics (EMLA) in alleviating the pain associated with subcutaneous needle insertion for infusion of the iron-chelating agent, deferoxamine, was examined in 12 patients with homozygous beta-thalassemia. As reported by the patient using a 100-mm visual analogue scale, the pain of insertion was rated as significantly less after application of EMLA (mean +/- SD, 1.5 +/- 2.2 mm) than the pain associated with needle insertion without EMLA (34.8 +/- 33.5 mm, P = .005). Subsequently, in a double-blind randomized trial of 10 beta-thalassemia patients, EMLA was significantly better (5.7 +/- 8.2 mm) than placebo (27.0 +/- 22.8 mm, P = .01) in reducing the pain of needle insertion for deferoxamine infusion. No adverse effects were reported with the use of EMLA cream. These results suggest that EMLA may be effective in reducing the pain associated with needle insertion for subcutaneous deferoxamine infusion in beta-thalassemia patients, which may lead to improved compliance with this irritating, prolonged therapy. The safety of EMLA use in these patients, and others receiving regular parenteral therapy, should now be examined.
在12例纯合子β地中海贫血患者中，研究了局部麻醉剂的共晶混合物（EMLA）在减轻与皮下插入针头输注铁螯合剂去铁胺相关的疼痛方面的疗效。根据患者使用100毫米视觉模拟量表的报告，使用EMLA后（平均±标准差，1.5±2.2毫米）插入疼痛的评分明显低于未使用EMLA时与针头插入相关的疼痛（34.8±33.5毫米，P = 0.005）。随后，在一项针对10例β地中海贫血患者的双盲随机试验中，在减轻去铁胺输注的针头插入疼痛方面，EMLA明显优于安慰剂（5.7±8.2毫米对27.0±22.8毫米，P = 0.01）。未报告使用EMLA乳膏有不良反应。这些结果表明，EMLA可能有效地减轻β地中海贫血患者皮下输注去铁胺时与针头插入相关的疼痛，这可能会提高对这种刺激性的长期治疗的依从性。现在应该检查在这些患者以及其他接受常规胃肠外治疗的患者中使用EMLA的安全性。
