Bartfield J M, Raccio-Robak N, Salluzzo R F
Department of Emergency Medicine Albany Medical College, NY 12208, USA.
Acad Emerg Med. 1995 Feb;2(2):104-8. doi: 10.1111/j.1553-2712.1995.tb03169.x.
To determine whether topical lidocaine attenuates the pain of buffered lidocaine infiltration.
This was a prospective, randomized, double-blind, placebo-controlled trial conducted at a university-based ED. The subjects were adults who had lacerations being repaired using local anesthesia. Two 0.5-mL injections of buffered lidocaine were given in a standardized manner. The first was given prior to application of topical study solution. The second was given on the opposite side of the laceration after topical application of study solution, which was 5 mL of either 2% lidocaine or saline placebo. The pain of each infiltration was measured using a visual analog pain scale. Pain scores were calculated and compared using a Wilcoxon test with significance defined as p < or = 0.05.
A total of 54 subjects participated; 29 received lidocaine topically and 25 received placebo. The groups were similar with respect to age, gender, wound length, wound location, and initial pain score. Pain scores decreased by 11.6 +/- 18.6 mm for lidocaine and 10.9 +/- 20.9 mm for placebo (p > 0.5). The study had the power to detect a 15-mm pain score difference (alpha = 0.05 and beta = 0.20) on a 100-mm scale.
Topical 2% lidocaine does not attenuate the pain of infiltration of buffered lidocaine more than does topical normal saline. Investigation of other topical anesthetics with and without epinephrine in conjunction with buffered lidocaine is warranted.
确定局部用利多卡因是否能减轻缓冲利多卡因浸润引起的疼痛。
这是一项在大学急诊科进行的前瞻性、随机、双盲、安慰剂对照试验。研究对象为接受局部麻醉修复撕裂伤的成年人。以标准化方式给予两次0.5毫升的缓冲利多卡因注射。第一次在应用局部研究溶液之前注射。第二次在撕裂伤的对侧注射，即在局部应用5毫升2%利多卡因或生理盐水安慰剂的研究溶液之后。每次浸润的疼痛使用视觉模拟疼痛量表进行测量。计算疼痛评分并使用Wilcoxon检验进行比较，显著性定义为p≤0.05。
共有54名受试者参与；29名局部使用利多卡因，25名使用安慰剂。两组在年龄、性别、伤口长度、伤口位置和初始疼痛评分方面相似。利多卡因组疼痛评分下降了11.6±18.6毫米，安慰剂组下降了10.9±20.9毫米（p>0.5）。该研究有能力在100毫米的量表上检测出15毫米的疼痛评分差异（α=0.05，β=0.20）。
局部使用2%利多卡因在减轻缓冲利多卡因浸润疼痛方面并不比局部使用生理盐水更有效。有必要对其他含或不含肾上腺素的局部麻醉剂与缓冲利多卡因联合使用进行研究。
