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1.
Background
Local anesthesia used for incision and drainage of abscesses is known to be painful.Study Objective
We studied the analgesia provided by a lidocaine/tetracaine patch compared to injectable lidocaine during incision and drainage (I&D) of skin abscesses.Methods
This was a prospective, double-blind, randomized, controlled trial carried out in the Emergency Department (ED) of an adult tertiary referral center. Adult patients with a skin abscess in need of I&D were randomized to one of two groups. One group received a lidocaine/tetracaine patch and injectable normal saline for anesthesia. The second group received a placebo patch and injectable 1% lidocaine. A visual analog pain scale was used to record the patient's pain level prior to treatment, during the procedure, and after I&D.Results
There were 20 patients enrolled in the study, including 12 randomized to the lidocaine/tetracaine patch and 8 to the injectable lidocaine. Pain scores preprocedure were similar in the two groups. Pain scores during I&D and postprocedure were compared between groups using a paired t-test. Patients receiving injectable lidocaine experienced pain that was similar (50.1 ± 5.9 mm; 95% confidence interval [CI] 45.2–55.1) to those receiving the transdermal lidocaine/tetracaine patch (60.1 mm ± 11.0; 95% CI = 55.2–68.1), p = 0.04, with a power of 80% to detect a difference of 20 mm at p ≤ 0.05; although this was statistically significant, it was not clinically significant. There was also no statistical difference between the two groups in the postprocedure pain scores (p = 0.65).Conclusion
Local injection of lidocaine provided clinically similar analgesia compared to the lidocaine/tetracaine patch during I&D of skin abscesses in the ED. Pain at presentation and after the procedure was similar in both groups. Emergency physicians should continue to use a local injected anesthetic for I&D of skin abscesses until a less painful alternative is identified. 相似文献2.
Molly B. Hasty MD Ann Klasner MD MPH Sean Kness MD T. Kent Denmark MD Don Ellis MD Martin I. Herman MD Lance Brown MD MPH 《Academic emergency medicine》2007,14(1):35-40
Objectives
To describe the culture results of cutaneous infections affecting otherwise healthy children presenting to two pediatric emergency departments (EDs) in the southeastern United States and southern California.
Methods
Medical records of 920 children who presented to the pediatric EDs with skin infections and abscesses (International Classification of Diseases, Ninth Revision codes 680.0–686.9) during 2003 were reviewed. Chronically ill children with previously described risk factors for community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) were excluded. Data abstracted included the type of infection; the site of infection; and, if a culture was obtained, the organism grown, along with their corresponding sensitivities.
Results
Of the 270 children who had bacterial cultures obtained, 60 (22%) were CA-MRSA–positive cultures, most cultured from abscesses (80%). Of all abscesses cultured, CA-MRSA grew in more than half (53%). All CA-MRSA isolates tested were sensitive to vancomycin, trimethoprim-sulfamethoxazole, rifampin, and gentamicin. One isolate at each center was resistant to clindamycin. The sensitivities at both institutions were similar.
Conclusions
The authors conclude that CA-MRSA is responsible for most abscesses and that the pattern of CA-MRSA infections in these geographically distant pediatric EDs is similar. These data suggest that optimal diagnostic and management strategies for CA-MRSA will likely be widely applicable if results from a larger, more collaborative study yield similar findings. 相似文献
To describe the culture results of cutaneous infections affecting otherwise healthy children presenting to two pediatric emergency departments (EDs) in the southeastern United States and southern California.
Methods
Medical records of 920 children who presented to the pediatric EDs with skin infections and abscesses (International Classification of Diseases, Ninth Revision codes 680.0–686.9) during 2003 were reviewed. Chronically ill children with previously described risk factors for community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) were excluded. Data abstracted included the type of infection; the site of infection; and, if a culture was obtained, the organism grown, along with their corresponding sensitivities.
Results
Of the 270 children who had bacterial cultures obtained, 60 (22%) were CA-MRSA–positive cultures, most cultured from abscesses (80%). Of all abscesses cultured, CA-MRSA grew in more than half (53%). All CA-MRSA isolates tested were sensitive to vancomycin, trimethoprim-sulfamethoxazole, rifampin, and gentamicin. One isolate at each center was resistant to clindamycin. The sensitivities at both institutions were similar.
Conclusions
The authors conclude that CA-MRSA is responsible for most abscesses and that the pattern of CA-MRSA infections in these geographically distant pediatric EDs is similar. These data suggest that optimal diagnostic and management strategies for CA-MRSA will likely be widely applicable if results from a larger, more collaborative study yield similar findings. 相似文献
3.
Luisa Galli Elisabetta Venturini Andrea Bassi Guido Castelli Gattinara Elena Chiappini Claudio Defilippi Andrea Diociaiuti Susanna Esposito Silvia Garazzino Antonietta Giannattasio Andrzej Krzysztofiak Stefano Latorre Andrea Lo Vecchio Paola Marchisio Carlotta Montagnani Giangiacomo Nicolini Andrea Novelli Gian Maria Rossolini Iria Neri 《Clinical therapeutics》2019,41(3):532-551.e17