Smith G A, Strausbaugh S D, Harbeck-Weber C, Cohen D M, Shields B J, Powers J D, Barrett T
Department of Pediatrics, The Ohio State University College of Medicine, Columbus, USA.
Am J Emerg Med. 1998 Mar;16(2):121-4. doi: 10.1016/s0735-6757(98)90026-2.
The effectiveness of two new topical anesthetics that do not contain cocaine (prilocaine-phenylephrine and bupivacaine-phenylephrine) was compared with that of tetracaine-adrenaline-cocaine (TAC) during laceration repair in children. This study was a prospective, randomized, double-blind trial conducted in the emergency department of a large children's hospital. Participants were 180 children 1 year of age or older with a laceration 5 cm or less in length that required suturing. Pain felt during suturing was scored by suture technicians, research assistants, parents, and patients 5 years of age and older using a visual analogue scale (VAS). There was no statistical difference demonstrated between the effectiveness of prilocaine-phenylephrine and that of TAC for any of the observer groups. A statistically significant difference was seen among anesthetics when comparing VAS scores of research assistants (P = .002), suture technicians (P = .006), and parents (P = .03), but not when comparing VAS ratings of patients (P = .07). Based on Tukey's post hoc test, these statistically significant differences were between TAC and bupivacaine-phenylephrine. When power analyses were performed using alpha = 0.05 and beta = 0.20, it was possible to detect a difference of 1.3 VAS units for each rater group. In conclusion, this study demonstrated the effectiveness and safety of prilocaine-phenylephrine and bupivacaine-phenylephrine. Prilocaine-phenylephrine statistically outperformed bupivacaine-phenylephrine and offers an effective alternative to TAC during laceration repair in children.
在儿童伤口缝合修复过程中，将两种不含可卡因的新型局部麻醉剂（丙胺卡因 - 去氧肾上腺素和布比卡因 - 去氧肾上腺素）的有效性与丁卡因 - 肾上腺素 - 可卡因（TAC）进行了比较。本研究是在一家大型儿童医院急诊科进行的一项前瞻性、随机、双盲试验。研究对象为180名1岁及以上、伤口长度为5厘米或更短且需要缝合的儿童。缝合过程中的疼痛由缝合技术人员、研究助理、家长以及5岁及以上的患者使用视觉模拟量表（VAS）进行评分。对于任何观察组而言，丙胺卡因 - 去氧肾上腺素和TAC的有效性之间均未显示出统计学差异。在比较研究助理（P = 0.002）、缝合技术人员（P = 0.006）和家长（P = 0.03）的VAS评分时，不同麻醉剂之间存在统计学显著差异，但在比较患者的VAS评分时（P = 0.07）则没有。基于Tukey事后检验，这些统计学显著差异存在于TAC和布比卡因 - 去氧肾上腺素之间。当使用α = 0.05和β = 0.20进行功效分析时，每个评分组能够检测到1.3个VAS单位的差异。总之，本研究证明了丙胺卡因 - 去氧肾上腺素和布比卡因 - 去氧肾上腺素的有效性和安全性。丙胺卡因 - 去氧肾上腺素在统计学上优于布比卡因 - 去氧肾上腺素，并且在儿童伤口缝合修复过程中是TAC的有效替代药物。
