Richtsmeier A J, Hatcher J W
Rush Medical College, Chicago, IL 60612, USA.
J Pain Symptom Manage. 1995 Apr;10(3):198-203. doi: 10.1016/0885-3924(94)00124-4.
This study compared the effects of buffered versus unbuffered lidocaine when used as local anesthetic in preparation for cannulation of the arterial and venous sites of children requiring hemodialysis. The subjects for this study were seven children, ages 6-18 years, observed during 101 dialysis treatments. For each subject undergoing hemodialysis on a given day, one syringe containing 1% lidocaine (L) and one containing buffered lidocaine (BL) were prepared. The BL solution was prepared by adding 2 mL of 8.4% sodium bicarbonate to 20 mL of 1% lidocaine just prior to use. The choice of local anesthetic used for cannulation of the arterial or venous site was randomly assigned to be either L or BL. Nurses, raters, and subjects were blind to contents of the syringe. The procedures for piercing the skin, pausing, and infiltrating were standardized, as was the volume administered. Speed of injection was not controlled. Comparisons of self-reported pain and behavioral observations for L versus BL revealed no significant differences for pain of infiltration or pain of cannulation. Technique variables such as the speed of injection, which tended to be very slow for these children, appear to significantly influence infiltration pain and the relative merits of buffering.
本研究比较了在需要进行血液透析的儿童动脉和静脉部位插管准备过程中，使用缓冲利多卡因与未缓冲利多卡因作为局部麻醉剂的效果。本研究的受试者为7名年龄在6至18岁的儿童，在101次透析治疗过程中进行观察。对于在某一天接受血液透析的每名受试者，准备一支装有1%利多卡因（L）的注射器和一支装有缓冲利多卡因（BL）的注射器。BL溶液是在使用前将2 mL 8.4%碳酸氢钠加入20 mL 1%利多卡因中配制而成。用于动脉或静脉部位插管的局部麻醉剂的选择被随机指定为L或BL。护士、评估者和受试者对注射器内的内容物均不知情。穿刺皮肤、暂停和浸润的操作步骤以及给药体积均标准化。注射速度未控制。对L和BL的自我报告疼痛和行为观察的比较显示，浸润疼痛或插管疼痛方面无显著差异。技术变量如注射速度，这些儿童的注射速度往往非常慢，似乎对浸润疼痛和缓冲的相对优点有显著影响。
