利多卡因表面麻醉减轻切开排脓伤口机械清创疼痛的效果

目的探讨利多卡因表面麻醉减轻伤口清创疼痛的效果,为减轻伤口清创疼痛提供一种方便可行的方法。方法将2011年1-8月南京市某三级甲等综合性医院伤口治疗中心的64例切开排脓患者随机分为A组和B组各32例,研究过程中脱落5例,最终A组30例、B组29例。采用两阶段交叉设计:第1次换药时,A组清创前给予2%利多卡因喷雾麻醉3min,B组给予生理盐水喷雾3min;第2次换药时,A组清创前给予生理盐水喷雾3min,B组给予2%利多卡因喷雾3min。观察清创前、清创中及清创结束后5min各组疼痛数字等级评分及心率变化情况。结果生理盐水和利多卡因在减轻伤口机械清创时疼痛、影响患者心率等方面差异有统计学意义(P<0.05),两次换药阶段对测定结果无影响。结论利多卡因表面麻醉可减轻伤口清创的疼痛,促进换药后心率的恢复。

Effects of Superficial Anesthesia with Lidocaine in Reducing Pains of Incision and Drainage on Patients Undergoing Machine Debridement

Objective To explore the effect of superficial anesthesia with lidocaine in reducing the pain of incision and drainage on patients who experienced machine debridement,and to find a convenient and workable way to reduce the pain induced by debridement.Methods From January to August 2011,64 patients from a grade-Ⅲ level-A hospital in Nanjing undergoing incision and drainage were enrolled.They were randomized into two groups,with 32 cases in each group.Except 5 dropped cases during the research,30 cases in group A and 29 in group B completed the research.Two-stage crossover design was adopted during the research:before the first time of changing dressings,the patients in group A were given topic anesthesia with 2% Lidocaine for 3 minutes,and the patients in group B were given topic anesthesia with 0.9% Nacl for 3 minutes.During the second time of changing dressings,the patients in group A were given topic anesthesia with 0.9% Nacl for 3 minutes,and the patients in group B were given topic anesthesia with 2% Lidocaine for 3 minutes.Nurses measured their pain with NRS and Heart Rate before the debridement,during the debridement and after the debridement for 5 minutes.Results There were significant differences between 0.2% lidocaine and 0.9%Nacl in reducing the pain caused by debridement and patients’ heart rate(P<0.05),but there were no differences on the pain and patients’ heart between the first time and the second time of changing dressings.Conclusion Superficial anesthesia with Lidocaine can reduce the pain during or after the debridement and promote the recovery of patients’ heart rate after changing dressings.