微针经皮导入复方利多卡因乳膏在皮肤磨削术中的镇痛作用

Analgesic Effect of Microneedle Percutaneous Injection of Compound Lidocaine Cream in Dermabrasion

目的 分析微针经皮导入复方利多卡因乳膏在皮肤磨削术中的镇痛作用。方法 选择2018年3月至2019年3月河北工程大学附属医院整形科收治的92例皮肤磨削术患者为研究对象,根据麻醉方式不同分为对照组和观察组,各46例。对照组行复方利多卡因乳膏局部麻醉,观察组行滚轮微针联合复方利多卡因乳膏局部麻醉。对比两组患者的麻醉效果,麻醉前、术中、术后1h的心率和血氧饱和度变化,疼痛程度[视觉模拟评分(VAS)、Wong-Baker面部表情量评级]、疼痛伴随症状(出汗、喊叫、拒绝手术主述)、皮肤不良反应发生情况(发红、青紫、瘙痒、破损、感染)以及麻醉满意度。结果 观察组总有效率高于对照组[95.7%(44/46)比78.3%(36/46)](P<0.05)。观察组麻醉前、术中、术后1h心率和血氧饱和度无明显变化(P>0.05);对照组麻醉前、术中、术后1h心率和血氧饱和度呈下降趋势(P<0.05),两组各指标组间、组间和时点间交互作用差异有统计学意义(P<0.05),不同时点间差异无统计学意义(P>0.05)。观察组VAS评分低于对照组[(1.5±0.3)分比(4.2±0.7)分],Wong-Baker面部表情量表评级优于对照组(P<0.05)。观察组疼痛伴随症状总发生率低于对照组[2.2%(1/46)比15.2%(7/46)](P<0.05)。观察组麻醉总体满意度高于对照组[95.7%(44/46)比78.3%(36/46)](P<0.05)。结论 微针经皮导入复方利多卡因乳膏在皮肤磨削术麻醉中的效果显著,可显著提升镇痛效果,且对血流动力学影响较小,患者对麻醉效果满意。

Objective To analyze the analgesic effect of percutaneous microneedle injection of compound lidocaine cream in dermabrasion. Methods A total of 92 patients with dermabrasion from the Department of Plastic Surgery,the Affiliated Hospital of Hebei University of Engineering from Mar. 2018 to Mar. 2019 were included in the study. According to different anesthesia methods,they were included in a control group( 46 cases) and an observation group( 46 cases). The control group was given local anesthesia with compound lidocaine cream,and the observation group was given local anesthesia with roller microneedle combined with compound lidocaine cream. The effects of anesthesia,changes of heart rate and oxygen saturation before and during and after anesthesia,degree of pain[visual analogue score( VAS),Wong-Baker facial expression rating],accompanying symptoms of pain( sweating,shouting,refusing surgery complaint),occurrence of skin adverse reactions( red,purple,itchy,damaged,infected) and satisfaction with anesthesia were compared between the two groups.Results The total effective rate in the observation group was higher than that in the control group[95. 7%( 44/46) vs78. 3%( 36/46)]( P < 0. 05). There was no significant change in heart rate and blood oxygen saturation before and after anesthesia( P > 0. 05) in the observation group. Before anesthesia,during operation and 1 hour after operation,the heart rate and oxygen saturation in the control group decreased( P < 0. 05). There were significant differences between groups,and interactions of group and time point( P < 0. 05),but there was no significant difference between different time points( P >0. 05). The VAS score of the observation group was lower than that of the control group[( 1. 5 ± 0. 3) point vs( 4. 2 ± 0. 7)point],and the Wong-Baker facial expression scale was better than that of the control group( P < 0. 05). The overall incidence of pain accompanying symptoms in the observation group was lower than that of the control group[2. 2%( 1/46) vs15. 2%( 7/46)]( P < 0. 05). The overall satisfaction of the observation group was higher than that of the control group[95. 7%( 44/46) vs 78. 3%( 36/46)]( P < 0. 05). Conclusion Microneedle percutaneous injection of compound lidocaine cream in dermabrasion anesthesia has a significant effect,which can significantly improve the analgesic effect,and has less impact on hemodynamics and high patient satisfaction.