Smith G A, Strausbaugh S D, Harbeck-Weber C, Cohen D M, Shields B J, Powers J D
Department of Pediatrics, The Ohio State University College of Medicine, Children's Hospital, Columbus, USA.
Pediatr Emerg Care. 1998 Oct;14(5):324-8.
To compare the effectiveness of prilocaine-phenylephrine (Prilophen), a new topical anesthetic that does not contain cocaine, to that of lidocaine infiltration during repair of lacerations on or near mucous membranes in children.
A prospective, randomized, blinded trial.
The emergency department of a large academic children's hospital.
Children one year of age or older with a laceration 5 cm or less in length on or near a mucous membrane.
Forty patients were randomly assigned one of the two local anesthetics, with 20 patients in each treatment group.
Pain felt during suturing was scored by suture technicians, research assistants, a videotape reviewer, parents, and patients five years of age and older using a visual analog scale (VAS).
There was no statistically significant difference in performance between topical Prilophen and lidocaine infiltration when VAS pain scores of research assistants, parents, and patients were compared. However, lidocaine infiltration performed significantly better than topical Prilophen when comparing VAS scores of suture technicians (P = 0.003) and the videotape reviewer (P = 0.02). When power analyses were performed using alpha = 0.05 and beta = 0.20, it was possible to detect a difference of 2 units for VAS scores of suture technicians, 2 VAS units for research assistants, 3 VAS units for the videotape reviewer and parents, and 7 VAS units for patients. There were no wound healing or other complications.
Prilophen is a new topical anesthetic alternative to lidocaine infiltration for closure of lacerations on or near mucous membranes, where use of tetracaine-adrenaline-cocaine is contraindicated. The performance of Prilophen was rated by two of the observer groups as statistically inferior to that of lidocaine infiltration; however, the differences in pain scores were small and may not be clinically significant. Further investigation of this new topical anesthetic is warranted.
比较不含可卡因的新型局部麻醉药丙胺卡因 - 去氧肾上腺素（Prilophen）与利多卡因浸润麻醉在儿童黏膜或黏膜附近裂伤修复术中的效果。
一项前瞻性、随机、双盲试验。
一家大型学术儿童医院的急诊科。
年龄在1岁及以上、黏膜或黏膜附近有长度为5厘米或更短裂伤的儿童。
40名患者被随机分配使用两种局部麻醉药中的一种，每个治疗组20名患者。
缝合时的疼痛由缝合技术人员、研究助理、录像评审员、家长以及5岁及以上患者使用视觉模拟评分法（VAS）进行评分。
比较研究助理、家长和患者的VAS疼痛评分时，局部应用Prilophen与利多卡因浸润麻醉在效果上无统计学显著差异。然而，比较缝合技术人员（P = 0.003）和录像评审员（P = 0.02）的VAS评分时，利多卡因浸润麻醉的效果明显优于局部应用Prilophen。当使用α = 0.05和β = 0.20进行效能分析时，有可能检测到缝合技术人员的VAS评分有2分的差异、研究助理有2分的差异、录像评审员和家长有3分的差异以及患者有7分的差异。未出现伤口愈合问题或其他并发症。
Prilophen是一种新型局部麻醉药，可替代利多卡因浸润麻醉用于禁忌使用丁卡因 - 肾上腺素 - 可卡因的黏膜或黏膜附近裂伤的缝合。有两个观察组认为Prilophen的效果在统计学上低于利多卡因浸润麻醉；然而，疼痛评分差异较小，可能无临床意义。有必要对这种新型局部麻醉药进行进一步研究。
