赛肤润缓解浅静脉输注刺激性药液致局部疼痛效果观察

外周浅静脉输注刺激性药液的病人常发生穿刺部位或沿静脉走向的疼痛，临床多采取减慢滴速、持续按摩、局部湿热敷等方法以减轻疼痛，疼痛难忍者则需在另一部位穿刺，增加了病人的痛苦，延长了输液时间，甚至影响药液的输入而延误治疗。为减轻病人痛苦，对2011年8月-2011年12月在本科住院经浅静脉输注刺激性药液出现局部疼痛的110例病人，应用赛肤润外涂于局部，临床效果满意。现报道如下。     

2％利多卡因湿敷对静脉输注氯化钾所致疼痛的影响

[目的]观察2％利多卡因湿敷对静脉输注氯化钾所致疼痛的影响。[方法]采用自身前后对照,选择30例静脉输注舍氯化钾溶液自诉疼痛病人采用2％利多卡因湿敷。比较2％利多卡因湿敷处理前后病人的疼痛程度。[结果]2％利多卡因湿敷处理后病人疼痛程度明显减轻。[结论]2％利多卡因湿敷可缓解静脉输注氯化钾所致疼痛。     

利多卡因缓解静脉输液中疼痛的效果观察

目的：探讨2％盐酸利多卡因注射液在静脉输液穿刺中缓解疼痛的效果，以减轻患者疼痛，提高其舒适度。方法：选择2012年1～6月在本院住院输液的患者60例，随机分为对照组和观察组各30例，观察组按实验设计方法选择好静脉，应用2％盐酸利多卡因注射液4ml浸湿纱布，湿敷拟穿刺输液点3rnin后穿刺静脉输液；对照组采用的生理盐水4ml浸湿纱布湿敷穿刺点3rain行输液作对照，观察两组患者疼痛情况。结果：两组患者疼痛程度比较有统计学意义（P〈0．05）。结论：应用2％盐酸利多卡因注射液湿敷穿刺点3min后，有缓解疼痛的作用。     

氯唑西林钠致静脉血管硬化萎缩1例

1病例报告 男．17岁。于2005—01—20因发热、畏寒、咳嗽、胸痛2d来院就珍，既往健康，无血栓病史及药物过敏史。查体：T38．8℃，P110次／min，R20次／min，BP100／70mmHg。一般情况良好，神志清晰，发热面容．皮肤、巩膜无黄染，咽充血，左肺呼吸音减弱．心脏检查正常。胸片检查显示左下肺中外带点片状模糊影．临床诊断为左下肺炎。门诊给予氯唑西林钠（山东瑞阳制药有限公司生产）2g加入5％葡萄糖注射液250ml中静滴，2次／d，滴速60滴／min．     

2%利多卡因湿敷对静脉输注氯化钾所致疼痛的影响

[目的]观察2%利多卡因湿敷对静脉输注氯化钾所致疼痛的影响。[方法]采用自身前后对照,选择30例静脉输注含氯化钾溶液自诉疼痛病人采用2%利多卡因湿敷。比较2%利多卡因湿敷处理前后病人的疼痛程度。[结果]2%利多卡因湿敷处理后病人疼痛程度明显减轻。[结论]2%利多卡因湿敷可缓解静脉输注氯化钾所致疼痛。     

单次静脉输注氯胺酮缓解严重肢体缺血性疼痛

目的 :静息痛常由于周围动脉疾病的肢体缺血所引起。可通过外科手术、放射介入、药物治疗及改变生活方式等方法治疗。缺血性疼痛引起的临床神经病理性疼痛 ,包括异样疼痛、痛觉过度综合征和痛觉过度等临床表现。基础研究的证据提示周围神经损伤后的异样疼痛、痛觉过度综合征和痛觉过度中的神经病理成份 ,可能与N 甲基 D 天门冬氨酸 (NMDA)受体的介导有关 ,该受体增加了脊索的突触兴奋性。药物治疗的目的在于降低中枢敏感性。氯胺酮为NMDA受体拮抗剂可有效阻滞脊索的NMDA受体 ,较多的研究表明可以减轻多种慢性神经病理性疼痛和缺血性…     

利多卡因局部涂布对静脉穿刺疼痛影响的研究

目的 观察利多卡因静脉穿刺部位涂布对进针疼痛的影响。方法 选取20例进行输液的患者,分别在输液前5min对进针处皮肤用利多卡因涂擦,或无菌蒸馏水涂擦,比较两组进针时的疼痛分值。结果 利多卡因涂布组18例次平均疼痛记分为2.03±1.15,明显低于对照组(3.69±1.99),差异显著(P<0.05);涂布组疼痛分值>3.6占16.0％,少于对照组(53.0％);13例自身对照试验显示,利多卡因涂布的疼痛积分为2.06±1.16,明显低于对照组(3.52±2.00),差异显著;利多卡因涂布与蒸馏水涂布疼痛分值呈中度正相关(r=0.626,P<0.05)。结论 静脉输液患者在进针前使用利多卡因局部涂布,可减轻患者进针时的疼痛。     

静脉输注盐酸利多卡因副反应的临床观察

静脉输注利多卡因发生副反应的１０例患者中，出现耳鸣、肌肉震颤３例，眩晕、思睡６例，意识漠糊、呼吸减慢、血压降低１例，其原因主要为给药速度过快或排出过慢。提出输注速度不超过４ｍｇ／ｍｉｎ，输注总量不超过２００ｍｇ。     

利多卡因静脉输注在老年髋关节手术中应用

股骨粗隆间骨折为老年人常见病,需及时手术治疗。但因患者本身的生理性退行性改变和手术创伤、应激导致过度的炎性反应都给患者的预后带来不良影响既往研究显示麻醉方法为预后影响因素之一,局麻优于     

2%利多卡因对减轻妇科手术患者静脉留置针穿刺疼痛的效果研究

目的:观察2%利多卡因用于减轻妇科手术患者静脉留置针穿刺疼痛的效果。方法:选取需要进行静脉留置针穿刺的妇科手术患者212例,其中122例为观察组,穿刺处皮肤先用2%利多卡因局部喷涂,再涂抹相同范围的75%酒精浸润,2min后,常规消毒行静脉留置针穿刺;90例为对照组,按传统方法行静脉留置针穿刺。穿刺结束后行视觉模拟评分并记录。然后对两组患者及100名护士进行问卷调查,了解其对静脉留置针穿刺镇痛的需求及认识情况。结果:观察组静脉留置针穿刺后视觉模拟评分明显低于对照组,两组比较差异有统计学意义(P<0.05)。调查结果显示,97.17%的患者从未想通过麻醉镇痛药方式来减轻穿刺疼痛,96%的护理人员从未想过要采取任何药物镇痛来减轻患者静脉留置针穿刺的疼痛。结论:2%利多卡因用于减轻妇科手术患者静脉留置针穿刺镇痛效果明显,但患者和护理人员对减轻静脉留置针穿刺镇痛的认识及重视程度较低。     

循证护理在减轻患儿静脉输注时疼痛的应用

外周静脉输注是儿科临床中最常用的护理技术操作,也是患儿最害怕的一种护理操作.害怕原因主要是穿刺时引起的疼痛.而疼痛属于一种不愉快的感觉,是在实际上或潜在造成组织损伤引发的情感经历[1],因此,疼痛包括生理和心理两方面因素.为减轻患儿的疼痛,我科护理人员运用循证理论查证了当前一些先进的、科学的方法和技术,对其进行生理、心理两方面的护理,取得了明显的效果.现报道如下.     

Differential efficacy of intravenous lidocaine in alleviating ipsilateral versus contralateral neuropathic pain in the rat

In the this study we have investigated the threshold plasma concentration of lidocaine for reversal of mechanical ‘allodynia' in a neuropathic pain model in the rat, defined the concentration-dependent limits of that reversal and compared the acute reversal during intravenous drug infusion with the persistent relief of allodynia assayed 48 h later. Actions of i.v. lidocaine on ipsilateral and contralateral legs were also assessed. Forty rats were sorted into five groups (n=7–10) and underwent spinal root (L5–6) ligation to produce allodynia, as quantified by a lower force of von Frey hairs at the plantar hindpaw required to elicit paw withdrawal (PWT, paw withdrawal threshold). During surgery, intravenous catheters were placed for programmed lidocaine infusion and in some animals arterial catheters were also inserted for assaying lidocaine blood levels. PWTs were measured in ipsilateral and contralateral paws before and after ligation and during infusions which, beginning at 5 days after surgery, were conducted every other day to incrementing levels (1.1–9.7 μg/ml plasma). Ligation produced allodynia in ipsilateral paws (PWT=1.22±0.42 g (±SEM)) and in contralateral paws (PWT=4.99±0.61 g), both markedly lower than pre-operative control values for either paw (11.31±0.41 g). The ipsilateral allodynia was partially, but significantly and permanently reversed (to PWT=6–8 g) after a lidocaine infusion to 2.1 mg/ml in two separate groups (n=7, 8). Lower concentrations resulted in elevation of PWT during infusion but no sustained relief. The elevation of PWT during infusion at this threshold level among individual animals was positively correlated with the relief measured 48 h later, but higher lidocaine concentrations infused in subsequent dosings could exact no further sustained relief. The residual PWT level, after reversal by threshold lidocaine and greater, was constant for each individual rat tested over the next 14 days but varied substantially among individuals; some were restored to pre-operative PWTs and some were totally unresponsive to drug. Retrospective analysis revealed a significant and unanticipated correlation between the incidence of low pre-operative PWTs (<10 g) and a lack of sustained reversal of post-operative allodynia by lidocaine. Contralateral allodynia, despite its acute reversal during infusion to 2.1 μg/ml and higher, was not persistently relieved after infusion of lidocaine to any concentration. Repeated infusions to subthreshold levels (<2 μg/ml) did not provide persisting relief of allodynia on either side, and infusions of saline were impotent. These findings show that experimental allodynia results from multiple factors, only some of which are sensitive to lidocaine treatment, and that prolonged reversal of allodynia is limited in extent and likely influenced by pre-existing factors.     

纳布啡在无痛胃肠镜检查中减轻丙泊酚静脉注射痛的效果

目的 评价纳布啡在无痛胃肠镜检查中减轻丙泊酚静脉注射痛的效果。方法 选择于该院住院,择期行无痛胃肠镜检查的患者100例。其中,男54例,女46例,年龄20～65岁,体重指数（BMI）19～26 kg/m²,美国麻醉医师协会（ASA）分级为Ⅰ级或Ⅱ级,采用随机数表法将患者分为纳布啡复合丙泊酚组（N组,n = 50）和对照组（C组,n = 50）。N组静脉注射纳布啡0.15 mg/kg,C组静脉注射等容量生理盐水,3 min后两组均静脉推注丙泊酚1.50～2.00 mg/kg,待患者睫毛反射消失后行胃肠镜检查,根据患者吞咽反射及体动情况,酌情追加丙泊酚0.50～1.00 mg/kg。比较两组患者丙泊酚注射痛发生率、不同部位丙泊酚注射痛发生率、丙泊酚注射痛的严重程度、苏醒时间、检查时间、丙泊酚用量和相关不良反应发生情况。结果 N组丙泊酚注射痛发生率、手背处静脉注射痛发生率和丙泊酚静脉注射后轻、中度疼痛所占比例均明显低于C组（P < 0.05）;N组苏醒时间短于C组,丙泊酚用量少于C组（P < 0.05）。N组出现1例恶心呕吐,C组出现1例心动过缓。两组均未发生反流误吸、低氧血症、低血压及血栓性静脉炎等不良反应。结论 纳布啡0.15 mg/kg预处理,可以减轻丙泊酚静脉注射引起的疼痛,复合丙泊酚用于无痛胃肠镜检查,可缩短苏醒时间,减少丙泊酚用量,安全有效。     

利多卡因低温湿敷对小儿输注果糖时疼痛的影响

目的 观察常温利多卡因、冷湿敷与低温利多卡因湿敷用于缓解小儿输注果糖时引起局部疼痛的效果.方法 将120例住院患儿输注果糖引起局部疼痛者,随机分为冷湿敷组、常温利多卡因组、低温利多卡因冷敷组各40例,观察3组疼痛效果.结果 应用利多卡因低温湿敷组效果明显优于其他2组.结论 小儿输注果糖引起局部疼痛可以选用低温利多卡因湿敷来减轻疼痛,效果肯定.     

针头斜面向下输液减轻阿奇霉素静脉输注时所致疼痛的探讨

目的 探讨针头斜面向下输液减轻阿奇霉素静脉滴注时所致疼痛的效果。 方法 选取静脉滴注阿奇霉素的住院患者136例,采用自身对照的方法,第1天在患者的左手采用常规方法进行静脉输注设为对照组,第2天在患者的右手对称部位采用针头斜面向下进行静脉输注设为实验组。采用主诉疼痛程度分级法评定患者静脉输注阿奇霉素时的疼痛程度。 结果 对照组患者的疼痛发生率为83.09%,实验组患者疼痛发生率为57.35%,两组比较,具有统计学意义(χ²=23.95,P＜0.05)。 结论 针头斜面向下输液可减轻阿奇霉素静脉输注所致的疼痛。     

Response of central pain syndromes to intravenous lidocaine

In this study, 8 patients with central pain syndromes, 6 with hemispheric lesions, and 2 with spinal cord lesions were treated with a 1 mg/kg dose of intravenous lidocaine. Patients first received the same volume of normal saline, in single-blind fashion, to monitor placebo effects. Of the 8 patients, 7 responded to lidocaine, and only 1 responded to normal saline. Responses ranged from partial to complete. All components of central pain, including constant pain, paroxysms ofpain, and evoked pain, responded to lidocaine. In addition, 3 patients had pain relief that lasted for 8-20 wk. These findings, which are in agreement with two previous open-label studies, suggest that a single dose of a local anesthetic, lidocaine, can provide lasting pain relief for patients with central pain syndromes. This analgesic action may be central, and possibly supraspinal, at least in patients with hemispheric lesions.     

Continuous intravenous infusion of ketamine and lidocaine as adjuvant analgesics in a 5-year-old patient with neuropathic cancer pain

For difficult to treat neuropathic pain from cancer, adjuvant analgesics are often used with opioids. We present the case of a 5-year-old girl who was diagnosed with meningitis caused by malignant T-cell lymphoma. She had severe neuropathic pain not relieved by increasing doses of a fentanyl infusion. Intravenous administration of ketamine and lidocaine in combination with fentanyl provided excellent analgesia without significant side effects. Ketamine and lidocaine can be safely infused together with concomitant opioids for the treatment of refractory neuropathic pain caused by cancer.     

林可霉素静滴致过敏反应症状一例

1病例资料患者,男,30岁,某部三级军士长。因间歇发热、咳嗽、咽痛、吞咽困难1d于2010-05-20就诊,不伴有头痛、发热。体检见双侧扁桃体Ⅱ度肿大,有脓点,诊断为急性化脓性