Santacana E, Aliaga L, Bayo M, Villar-Landeira J M
Servicio de Anestesiología, Reanimación y Terapéutica del Dolor, Hospital de la Santa Creu i Sant Pau, Barcelona.
Rev Esp Anestesiol Reanim. 1993 Sep-Oct;40(5):284-91.
The method most widely used at present for cutaneous analgesia is local anesthetic infiltration. Pain occurs when the needle penetrates and when the anesthetic is deposited and diffuses. The procedure is not risk-free. It is therefore not surprising that many attempts have been made to develop an anesthetic formula that is effective when applied topically to intact skin. Early efforts were unsuccessful due to either low analgesic efficacy or side effects. The problem was solved several years ago in the European market by the EMLA (Eutetic Mixture of Local Anesthetics) cream. The EMLA cream has been shown to be useful as a topical anesthetic on either intact or damaged skin. Its clinical profile is safe, with a low incidence of side effects. We feel it is a useful tool for preventing pain in a variety of procedures that call for cutaneous analgesia. It may also be used as premedication for perineural injection of anesthetics, providing greater comfort for the patient. This article describes the main pharmacological principles that make EMLA an effective topical analgesic, as well as indications for its use in the clinical practice of anesthesiology.
目前用于皮肤镇痛最广泛的方法是局部麻醉药浸润。当针刺入以及麻醉药注入和扩散时会产生疼痛。该操作并非没有风险。因此，人们多次尝试开发一种在完整皮肤上局部应用时有效的麻醉配方也就不足为奇了。早期的努力由于镇痛效果低或有副作用而未成功。几年前，欧洲市场上的EMLA（局部麻醉药共熔混合物）乳膏解决了这个问题。EMLA乳膏已被证明可作为完整或受损皮肤上的局部麻醉药。其临床特征是安全的，副作用发生率低。我们认为它是预防各种需要皮肤镇痛的操作中疼痛的有用工具。它也可用作神经周围注射麻醉药的术前用药，为患者提供更大的舒适度。本文描述了使EMLA成为有效的局部镇痛药的主要药理学原理，以及其在麻醉学临床实践中的使用指征。
