微针经皮导入局部麻醉药物在微整形表面麻醉中的镇痛作用

Analgesic Effect of Microneedle Percutaneous Injection of Local Anesthetics in Micro-plastic Topical Anesthesia

目的观察微针经皮导入局部麻醉药物在微整形表面麻醉中的镇痛作用。方法选取2018年3-9月在河北工程大学附属医院整形科就诊的微整形患者60例,所有患者均为初次手术成年患者,按照随机数字法分为试验组和对照组,各30例。两组均使用复方利多卡因乳膏行表面麻醉,治疗前均进行术区皮肤清洁消毒,对照组采用直接涂抹复方利多卡因乳膏行皮肤表面麻醉,试验组患者首先使用500μm滚轮微针在术区皮肤滚动(均滚动两个来回),随后涂抹复方利多卡因乳膏行皮肤表面麻醉。比较两组患者的镇痛效果,Kuttner量表评分、Frankl依从性量表评分、Houpt行为量表评分、视觉模拟评分(VAS)、Wong-Baker面部表情量表评分,以及初次手术成功率和手术满意率以及治疗前后患者皮肤情况和治疗不良反应发生情况。结果试验组镇痛总有效率明显高于对照组[100.0%(30/30)比80.0%(24/30)](P<0.05)。试验组Kuttner量表评分明显低于对照组,Frankl依从性量表和Houpt行为量表评分均高于对照组(P<0.01)。试验组VAS评分显著低于对照组,Wong-Baker面部表情量表评价结果明显优于对照组(P<0.01)。试验组患者初次手术成功率和手术满意率明显高于对照组(P<0.05)。两组均无严重不良反应发生,试验组6例出现皮肤发红症状,均在术后12 h内消失;对照组均未出现皮肤发红,两组患者均无皮肤破损和感染现象。结论微针经皮导入局部麻醉药物在表面麻醉中具有较好的镇痛作用,可明显提高术中患者的舒适度、配合度与耐受度,且患者的初次手术成功率和手术满意率均较高,术后不良反应少。

Objective To observe the analgesic effect of microneedle percutaneous injection of local anesthetics in micro-plastic topical anesthesia.Methods A total of 60 patients who underwent laser surgery in Department of Plastic Surgery,Affiliated Hospital of Hebei University of Engineering from Mar.to Sep.2018 were included(all adult patients undergoing the first-time operation).Before operation,the patients were divided into a test group and a control group by random number method,30 cases each.Both groups used compound lidocaine cream for topical anesthesia,and before treatment,the skin in the operation area was cleaned and disinfected.In the control group,the compound lidocaine cream was directly applied for skin surface anesthesia.In the test group,the patients first used a 500μm roller micro needle to roll on the skin in the operation area(both rolled back and forth two times),and then the compound lidocaine cream was applied for skin surface anesthesia.The analgesic effect,Kuttner scale score,Frank compliance scale score,Houpt behavior scale score,visual analogue scale(VAS),Wong-Baker facial expression scale score,the success rate of the first operation and surgery satisfaction rate,the skin condition and adverse reactions of the two groups before and after treatment were compared.Results The total effective rate of analgesic effect in the test group was significantly higher than that in the control group[100.0%(30/30)vs 80.0%(24/30)](P<0.01);the Kuttner scale score in the test group was significantly lower than that in the control group;the Frankl compliance scale and Houpt behavior scale in the test group were higher than those in the control group(P<0.01);the VAS score in the test group was significantly lower than that in the control group;the Wong-Baker facial expression scale in the test group was significantly better than that in the control group(P<0.01).The success rate of first operation and the surgery satisfaction rate of the test group were significantly higher than those of the control group(P<0.05).There were no serious adverse reactions in both groups.The skin redness symptoms occurred in 6 cases of the test group and disappeared within 12 hours after operation;the skin redness didn’t occurr in the control group.And there was no skin damage and infection in both groups.Conclusion Microneedle percutaneous injection of local anesthetics has a good analgesic effect in surface anesthesia,and can significantly improve the comfort degree,compatibility and tolerance of the patients,which also has a higher success rate of the first operation and surgery satisfaction rate,and less adverse reactions.