Joly L M, Spaulding C, Monchi M, Ali O S, Weber S, Benhamou D
Département d'Anesthésie-Réanimation, Hôpital A. Béclère, Université Paris-Sud, Clamart, France.
Anesth Analg. 1998 Aug;87(2):403-6. doi: 10.1097/00000539-199808000-00032.
In a randomized trial, we compared topical anesthesia by a lidocaine-prilocaine cream (EMLA; Laboratorie ASTRA, Manterre, France) with subcutaneous local lidocaine infiltration for radial artery cannulation. Patients included 538 adults scheduled for coronary angiography using a radial approach. EMLA was applied 2 h before radial cannulation, and lidocaine infiltration was performed 5 min before cannulation. The primary end point was pain as assessed by a verbal numerical scale (0 = no pain, 10 = extreme pain). Pain was less severe in the EMLA group than in the lidocaine infiltration group (Score of 2 vs 7; P = 0.0001). Additional lidocaine infiltration was required significantly less frequently in the EMLA group (relative risk 0.19). The failure rate of cannulation was significantly lower in the EMLA group (relative risk 0.38), and insertion time was shorter (4 versus 6 min). We conclude that EMLA, compared with lidocaine infiltration, reduces pain associated with radial artery cannulation and improves the success rate of the procedure. Routine application of EMLA should be performed in awake patients 2 h before radial artery cannulation.
In a randomized trial, we compared topical anesthesia by a lidocaine-prilocaine cream (EMLA) with subcutaneous local lidocaine infiltration for radial artery cannulation in 538 adults patients. EMLA reduced pain associated with radial artery cannulation and improved the success rate of the procedure.
在一项随机试验中，我们比较了利多卡因-丙胺卡因乳膏（EMLA；法国曼泰尔的阿斯特拉实验室）局部麻醉与皮下注射利多卡因用于桡动脉置管的效果。患者包括538例计划采用桡动脉途径进行冠状动脉造影的成年人。在桡动脉置管前2小时应用EMLA，在置管前5分钟进行利多卡因浸润。主要终点是通过语言数字评分法评估的疼痛程度（0 = 无疼痛，10 = 剧痛）。EMLA组的疼痛程度低于利多卡因浸润组（评分分别为2和7；P = 0.0001）。EMLA组需要额外利多卡因浸润的频率显著更低（相对风险0.19）。EMLA组的置管失败率显著更低（相对风险0.38），且置管时间更短（4分钟对6分钟）。我们得出结论，与利多卡因浸润相比，EMLA可减轻桡动脉置管相关的疼痛并提高操作成功率。对于清醒患者，应在桡动脉置管前2小时常规应用EMLA。
在一项随机试验中，我们比较了利多卡因-丙胺卡因乳膏（EMLA）局部麻醉与皮下注射利多卡因用于538例成年患者桡动脉置管的效果。EMLA减轻了桡动脉置管相关的疼痛并提高了操作成功率。
