利多卡因气雾剂对缓解静脉穿刺痛的时效性观察

目的探讨采用不同间隔时间与剂量进行局部皮肤喷雾麻醉时，利多卡因气雾剂对缓解术前静脉穿刺痛的效果。方法选择180例择期手术的患者采用利多卡因气雾剂在静脉穿刺部位进行表面喷雾麻醉，按喷雾剂量4．5，9．0mg分为A、B两组，分别在用药后3，5，7min进行穿刺，使用数字疼痛分级法（NPIS）、患者满意度调查问卷对两组患者的疼痛和满意度进行评估。结果A、B两组NPIS评分3min分别为（5．3±1．0），（4．9±1．1）分，差异无统计学意义（t=1．17，P〉0．05）；5min分别为（3．9±1．2），（2．9±1．6）分，差异有统计学意义（t=2．33，P〈0．05）；7min分别为（1．9±1．2），（0．9±0．7）分，差异有统计学意义（t=2．94，P〈0．01）。A、B组3，5，7minNPIS评分组内比较，差异有统计学意义（F分别为46．13，56．10；P〈0．01），随时间延长，两组患者的疼痛程度均减轻。A、B两组满意度分别为79％，92％，两组比较差异有统计学意义（x。=6．47，P〈0．05）。结论利多卡因气雾剂对术前缓解静脉穿刺痛效果明显，以注射前7min进行表面麻醉喷雾穿刺部位4．5mg连续2喷，镇痛效果好，通过合理正确掌握用药的方法有利于充分发挥镇痛效果，同时能提高患者对手术室护理工作的满意度。

Observation of the timeliness of lidocaine aerosol to alleviate the pain of intravenous puncture

Objective To explore the effect of lidocaine aerosol on alleviating the pain of intravenous puncture before the operation when the local skin spraying anesthesia was used the different time interval and the dose. Methods One hundred and eighty patients undergoing elective operation received the surface spraying anesthesia through the lidocaine aerosol in intravenous puncture site. The patients were divided into A group （4.5 mg） and B （9 rag） group according to the dose of lidocaine aerosol, and the puncture was carried out 3 min, 5 min, 7 min after the medication （A1, A2, A3, B1, B2, B3）. The pain was evaluated by numeric pain intensity scale （NPIS）, and the satisfaction was evaluated by the questionnaire of patients＇ satisfaction in two groups. Results The scores of NPIS in the A and B group were respectively （5.3 ± 1.0）, （4.9 ±1.1 ） 3 min after the medication, and the difference was not statistically significant （t = 1.17, P 〉0.05） ; the scores were respectively （3.9 ± 1.2）, （2.9± 1.6） after 5 min, and the difference was statistically significant （ t = 2.33, P 〈 0.05） ; the scores were respectively （ 1. 9± 1. 2）, （0.9 ± 0.7） after 7 min, and the difference was statistically significant （t = 2.94, P 〈 0.01 ）. The differences were.found in the scores of the NPIS in the A and B group at the different time including 3,5,7 min （F = 46.13,56.10, respectively; P 〈 0.01 ）, the degree of pain was relieved in all patients with the extension of time. The rates of satisfaction in the A and B group were respectively 79%, 92%, and the difference was statistically significant （X2 = 6. 47, P 〈 0.05 ）. Condusions The effect of lidocaine aerosol on alleviating the pain of intravenous puncture before the operation is obvious. 4.5 mg lidocaine aerosol is sprayed twice in surface anesthesia puncture site seven minutes before the injection, which can cause the good analgesic effect. The method of the medication should be reasonably and correctly mastered, which is beneficial to give full play to the analgesia effect and can increase the patients＇ satisfaction of nursing in the operation room.