Morris K P, Hughes C, Hardy S P, Matthews J N, Coulthard M G
Department of Paediatric Nephrology, Freeman Hospital, Newcastle upon Tyne, UK.
Nephrol Dial Transplant. 1994;9(9):1299-301.
Recombinant human erythropoietin (rHuEpo) is used to correct anaemia in dialysis patients. Subcutaneous administration of rHuEpo may be associated with pain at the injection site. This study assessed the pain of subcutaneous infiltration of two different preparations of rHuEpo, alpha and beta, and the value of a local anaesthetic (Emla) cream, in reducing the pain of infiltration. Forty-eight haemodialysis patients were enrolled into a double-blind, placebo-controlled, paired-comparison study. Pain was assessed using a visual analogue scale, a verbal descriptive scale and a direct comparison between paired treatments. Subcutaneous injection of rHuEpo alpha was more painful than rHuEpo beta (P < 0.001); using placebo cream 42% of patients described the pain of rHuEpo alpha as severe or very severe, whereas none of the patients found rHuEpo beta so painful. Application of Emla for at least 2 h prior to injection resulted in a significant reduction in the pain of both preparations, but was unable to reduce the pain of rHuEpo alpha to that of rHuEpo beta. Subcutaneous injection of rHuEpo alpha is more painful than rHuEpo beta, even after application of Emla. Although the discomfort of rHuEpo beta is graded as very mild by most adult patients the use of Emla is associated with a significant reduction in discomfort, which may be of benefit to paediatric patients.
重组人促红细胞生成素（rHuEpo）用于纠正透析患者的贫血。皮下注射rHuEpo可能会导致注射部位疼痛。本研究评估了两种不同制剂（α型和β型）的rHuEpo皮下注射时的疼痛情况，以及局部麻醉剂（复方利多卡因）乳膏在减轻注射疼痛方面的作用。48名血液透析患者被纳入一项双盲、安慰剂对照、配对比较研究。使用视觉模拟评分法、语言描述评分法以及配对治疗之间的直接比较来评估疼痛。皮下注射α型rHuEpo比β型rHuEpo更痛（P<0.001）；使用安慰剂乳膏时，42%的患者将α型rHuEpo的疼痛描述为严重或非常严重，而没有患者觉得β型rHuEpo如此疼痛。注射前至少2小时涂抹复方利多卡因可显著减轻两种制剂的疼痛，但无法将α型rHuEpo的疼痛减轻至β型rHuEpo的水平。即使涂抹了复方利多卡因，皮下注射α型rHuEpo也比β型rHuEpo更痛。尽管大多数成年患者将β型rHuEpo的不适程度评为非常轻微，但使用复方利多卡因可显著减轻不适，这可能对儿科患者有益。
