Oshima T, Kashiki K, Toyooka H, Masuda A, Amaha K
Department of Anaesthesiology and Critical Care Medicine, School of Medicine, Tokyo Medical and Dental University, Japan.
Can J Anaesth. 1994 Aug;41(8):677-9. doi: 10.1007/BF03015620.
The purpose of this study was to determine whether iontophoretic application of high concentrations of lidocaine, with the same current, would produce cutaneous local anaesthesia rapidly enough for clinical practice. Twenty healthy volunteers, 17 male and three female, were selected for study. After five-minute or ten-minute iontophoresis using lidocaine 4, 10, 20, 30, 50%, we assessed the response to pin prick with a 27-gauge sterile needle inserted to the depth of 2 mm at five random locations in the iontophoretically-stimulated area. Also, plasma lidocaine concentrations were measured in the venous blood samples which had been taken from three male subjects, at 3, 10, and 30 min after iontophoresis with lidocaine 50%. The pain score after five-minute iontophoresis was higher than that after ten-minute iontophoresis, using each concentration of lidocaine (P < 0.001), whereas the pain scores had no correlation with lidocaine concentration within five-minute and ten-minute iontophoresis groups, respectively (P: NS). On the other hand, plasma lidocaine concentration was < 1.0 micrograms.ml-1 in all samples. No side effects other than erythema were observed after iontophoresis using high concentrations of lidocaine up to 50%. These results showed that by increasing the lidocaine concentration of the applied solution up to 50%, the application time of iontophoresis cannot be reduced from ten to five minutes without losing analgesic effect, although iontophoresis itself can be performed with safety.
本研究的目的是确定在相同电流下，离子导入高浓度利多卡因是否能产生足够快的皮肤局部麻醉以应用于临床实践。选取20名健康志愿者，其中17名男性，3名女性进行研究。使用4%、10%、20%、30%、50%的利多卡因进行5分钟或10分钟的离子导入后，我们在离子导入刺激区域的5个随机位置，用一根27号无菌针头插入2毫米深度，评估对针刺的反应。此外，在3名男性受试者经50%利多卡因离子导入后3分钟、10分钟和30分钟采集的静脉血样本中测量血浆利多卡因浓度。使用每种浓度的利多卡因时，5分钟离子导入后的疼痛评分均高于10分钟离子导入后的疼痛评分（P<0.001），而在5分钟和10分钟离子导入组内，疼痛评分分别与利多卡因浓度无相关性（P：无显著性差异）。另一方面，所有样本中的血浆利多卡因浓度均<1.0微克/毫升。使用高达50%的高浓度利多卡因进行离子导入后，除红斑外未观察到其他副作用。这些结果表明，通过将应用溶液中的利多卡因浓度提高到50%，在不丧失镇痛效果的情况下，离子导入的应用时间不能从10分钟缩短至5分钟，尽管离子导入本身可以安全进行。
