EMLA乳膏局部封包的麻醉效果观察

目的观察EMLA乳膏局部封包麻醉效果的最佳时间。方法对1 829例次激光手术患者的麻醉效果进行观察和回顾性总结,按封包时间分为A组(60 min)、B组(90 min)、C组(120 min)、D 组(150 min)、E组(180 min)。涂药前、后分别用无菌针头轻刺病变部位,根据患者对疼痛强度的主观感受判断麻醉效果,标准分为无效、有效、显效3级。结果A组显效率为0,B组显效率30.45％,C、D、E三组显效率分别为58.15％、62.00％、60.42％,C、D、D三组间比较,差异无显著性(P>0.05)。B组显效率分别与C、D、E组比较,差异均有高度显著性(P<0.01)。结论EMLA乳膏作为表面麻醉剂,用于激光手术效果好、安全、无明显副反应,在一定时间内麻醉效果随封包时间增加,用药时间以120～150min为佳。

低频超声对EMLA局部镇痛起效时间影响的随机对照研究

目的 :探讨低频超声波对EMLA(EutecticMixtureofLocalAnesthetics ,EMLA)局部镇痛起效时间的影响 ,为临床研究低频超声给药和扩大EMLA的临床应用提供依据。方法 :对 2 4例健康青年志愿者的双上臂采用随机数字分为试验组和对照组 ,每个试验者两上臂同时涂抹 1克EMLA ,10min后试验组上臂进行低频超声 (2 0kHz )介导 ,介导时间 10min。每 5min测量两组镇痛起始时间 ,试验结束后观察皮肤组织学变化。结果 :低频超声干预组平均镇痛起始时间为 34.5 8± 3.87min ,对照组为 4 3.75± 4 .72min。低频超声可使角质层间质增宽和疏松。结论 :低频超声可以促进EMLA透过皮肤 ,缩短EMLA局部镇痛起效时间。

EMLA用于牙体病治疗镇痛效果的临床研究

目的 :临床观察恩钠 (EMLA)用于牙体病牙齿制备时的镇痛效果及对牙齿电活力的影响。方法 :5 0例患者采用自身牙齿配对随机对照分组 ,实验牙齿用EMLA涂抹牙齿及牙周粘膜后 5min测量牙齿电活力 ,用VAS法评价磨切牙齿时疼痛情况。与空白治疗牙齿进行对比。结果 :EMLA处理后牙齿电活力从 4 5 .76± 1.5 6上升至 6 4.34± 2 .2 8,VAS值为 2 .5 4± 0 .84 ,对照组VAS值为 7.4 2± 0 .5 1,两组VAS值有显著性差异 ,P <0 .0 1。结论 :EMLA可提高牙齿电活力 ,在牙体病牙齿治疗过程中有镇痛作用。

EMLA膏剂对儿科常见有创操作的镇痛作用研究

目的 :探讨EMLA膏剂对儿科常见有创操作的镇痛作用和可行性。方法 :应用便利抽样的方法 ,抽取 4岁以上的患儿 10 0例 ,采用Wong -Baker和FLACC量表对未涂用EMLA和涂于穿刺部位 1h后进行有创操作的主、客观疼痛评分。结果 :EMLA膏剂明显降低各项有创操作的主观、客观疼痛评分 (P <0 .0 0 1) ,学龄期患儿用EMLA后的主、客观疼痛评分显著低于学龄前期的患儿 (P <0 .0 1)。结论

新型高效局部麻醉药5%恩纳(EMLA)霜

5％恩纳霜(EMLA crcam)是由二种非常有效的局部麻醉药利多卡因(lidocaine,lignocaine,也称赛罗卡因xylocaine)和丙胺卡因(prilocaine,citanest)(图1)在低熔(eutectic)条件下,各以2.5％浓度,即1:1的比例配制成油/乳化胶,,其浓度为5％,它们在油相中,属于酰胶类局部麻醉剂。其配方如下:利多卡因25g,丙胺卡因25g羟基聚亚甲基(乳化剂)

配制局麻药与EMLA在激光术中麻醉疗效比较

应用配制局部麻醉药物(Z—EMLA)进行皮肤表面的麻醉,并与进口EMLA局部麻醉药物进行对照,报告如下。 1 患者资料 所有患者均为我院皮肤激光治疗中心接受脉冲激光(VersaPulse C,美国Coherent公司)

皮肤表面麻醉药EMLA乳膏的药理与临床应用

EMLA乳膏是一种安全有效的新型复方皮肤表面麻醉药,其主要成份是利多卡因和丙胺卡因。临床上可用于静脉穿刺、动脉与静脉置管及其它穿刺操作时止痛,也可用于皮肤手术及其它表面小手术的麻醉,尤其适合于小儿患者。其主要并发症是可以引起局部轻度皮肤反应及高铁血红蛋白轻度升高。

The effects of EMLA cream on pain responses of preschoolers

The aim of present study was to assess the effects of a eutectic mixture of topical anesthetics (EMLA cream) on pain responses of preschoolers during venipuncture. The pain responses were reported by children, nurses, and the children’s mothers. The pre- and post-test-designed study, which included a non-equivalent control group, was carried out in a pediatric unit at E University Hospital in South Korea. Pain responses during venipuncture were measured by the self-reporting of the children using the Face Pain Rating Scale (FPRS), the Procedure Behavior Checklist by nurses (PBCL), the Visual Analog Scale (VAS) by mothers, in addition to measurements of the children’s pulse rate and level of oxygen saturation. EMLA cream was effective in decreasing the pain responses of the children as assessed by FPRS, PBCL, and VAS scores. However, pulse rate and level of oxygen saturation of the children during venipuncture were not significantly different between the two groups. EMLA cream could be a useful option for reducing pain in preschool children during invasive procedures.

Comparing EMLA Cream and Ibuprofen on Pain after Insertion of Copper Intrauterine Device

Background and Objective: IUD is a safe, effective, and reversible method throughout the world, particularly in areas where population growth is too much. One of the main barriers to use IUD is the fear and pain of its insertion. Therefore, it is necessary to take measures to reduce the pain, and this study was conducted to investigate the effect of EMLA cream and ibuprofen on pain during IUD insertion. Materials and Methods: This randomized controlled clinical trial study was conducted on 120 women who admitted to Imam Javad health center in Zahedan in 2015-2016 for insertion of IUD. Women who admitted to this center were randomly assigned into 3 groups of EMLA group (n = 40), ibuprofen (n = 40), and control or placebo (n = 40). These women have no problem to insert IUD. Demographic data and pain level were recorded in a questionnaire based on Johnson’s Visual analog scale of pain at 3 stages of IUD insertion, and all IUDs were inserted by a midwife and then data were analyzed by SPSS software. Findings: The results of this research show that the lowest level of pain severity at three stages of insertion related to the EMLA cream (P Conclusion: The results of the study showed that, compared to ibuprofen and placebo, EMLA cream is a safe method in reducing pain caused by IUD insertion in all stages of IUD insertion.

EMLA和亚麻醉剂量氯胺酮复合丙泊酚用于激光美容手术40例

目的探讨EMLA（5％利多卡因和丙胺卡因合剂软膏）和亚麻醉剂量氯胺酮复合丙泊酚静脉麻醉在激光美容手术中的应用效果。方法选择激光美容手术患者80例，ASAⅠ-Ⅱ级，随机分为2组，每组40例。E组：EMLA软膏，K组：氯胺酮＋异丙酚＋芬太尼。麻醉方法：E组：EMLA软膏均匀涂抹于治疗区域，保鲜膜封包50min；K组：先给予咪唑安定2mg＋芬太尼0．05mg缓慢静脉注射，3～5min后．给予氯胺酮0．5mg／kg．再给予异丙酚0．4-0．6mg／kg缓慢静脉注射。术中患者如有体动，酌情给予异丙酚0．6~0．8mg／kg。结果K组患者均获得满意的无痛手术体验．数字评定量表（NRS）均值为0；E组患者治疗时均仍有明显疼痛，NRS值在5-7分之间。E组手术时间明显大于K组。结论亚麻醉剂量氯胺酮复合丙泊酚是激光美容手术有效的麻醉方法，患者无痛体验良好，手术时间大大缩短。

经口给予蔗糖溶液和局部应用Emla~的镇痛效果及早产儿皮下注射促红细胞生成素(EPO)中联合应用二者时的一项前瞻性研究

目的:对吸吮无营养安慰剂、经口给予30%蔗糖溶液、局部应用Emla(?)和将任何二者联合应用在早产儿EPO皮下注射过程中的镇痛效果进行对比。方法:这是一项随机的、前瞻性的研究,共历时5个月。研究对象为出生时胎龄不足33周,已经生后8 d及需要注射EPO (每周皮下注射3次,连续6周)的新生儿。所有研究对象被随机分为4组:吸吮无营养安慰剂组(T),经口给予0.2-0.5 ml

应用EMLA局部麻醉油对包茎行背侧横断扩张包皮成形术

Background/Purpose: In the United States, the treatment of choice for the correction of phimosis is circumcision, whereas in European countries, the condition is usually treated by preputial plasty using Duhamel’ s method or mod-ified versions. We report our experience in correcting phimosis by preputial plasty using transversal widening on the dorsal side with EMLA local anesthetic cream. Methods: Twenty-six patients with phimosis were operated on by pre-putial plasty, under local anesthesia with EMLA cream. A transversal incision is made on the dorsal side of the ring of prepuce, like 3 contiguous Ts, the middle one inverted with the long arm on the preputial mucosa side. The 2 small mucocutaneous flaps of the prepuce are separated and then sutured with interrupted stitches, thus transforming the incisions from T to V. Results: No postoperative complications were observed. At 1-year follow-up, the cosmetic and functional results were satisfactory. Conclusions: The technique of preputial plasty that the authors present enlarges the stenotic ring of prepuce by a transversal wide-ning on the dorsal side. The ring of prepuce obtained is wide and symmetrical on its dorsal and ventral sides and therefore cosmetically and functionally satisfactory. It is a good alternative to the more radical circumcision technique.

EMLA■ Cream coated on endotracheal tube with or without epidural lidocaine reduces isoflurane requirement during general anesthesia

This study was designed to evaluate the effect of tracheal topical anesthesia using EMLA■Cream(EC)coated on the endotracheal tube(ETT)with or without epidural anesthesia(EA)on isoflurane requirement during general anesthesia(GA)and investigate whether EC coated on the ETT with EA was associated with the additive effect compared with the effect when each anesthetic was administered independently.The prospective randomized,double-blinded,and controlled study included 60 ASA Ⅰ-Ⅱ patients scheduled for upper abdominal surgery requiring GA.Patients were randomly assigned to one of the following groups:group 1 received GA,group 2 received EC+GA,group 3 received GA+EA,and group 4 received EC+GA+EA.Isoflurane was administered at the required concentrations to maintain the mean arterial pressure at a level not exceeding 20% of preoperative values.The percentage mean expired concentration(%MEC)was used in calculating the isoflurane requirement.Emergence agitation,postoperative sore throat,and hoarseness were recorded.Groups 2,3,and 4 exhibited a significant reduction on isoflurane requirement compared with group 1(P<0.05).The isoflurane requirement evaluated by%MEC decreased by 12%,38%,and 50% in groups 2,3,and 4,respectively.The incidence of emergence agitation was significantly lower in groups 2 and 4 than those in groups 1 and 3(P<0.05).Tracheal topical anesthesia using EC coated on ETT with or without EA reduced the isoflurane requirement during GA,indicating that EC combined with EA exhibited an additive effect on the requirement of general anesthetic.

静脉穿刺前为什么使用EMLA

问：我是一个儿科护士，我想问为什么我的同事们在实施静脉穿刺时常不用局部麻醉贴（EMLA）？

“恩纳”用于气管表面麻醉的动物实验研究

目的 :研究“恩纳”用于气管插管表面麻醉的可行性。方法 :2 0只成年白兔随机分为两组 ,经耳缘静脉推注安定 0 5mg/kg,氯胺酮 1mg/kg全身麻醉后 ,用直喉镜暴露声门 ,实验组插入直径 3 5mm ,前端 5cm均匀涂有“恩纳”乳剂的气管导管 ;对照组插入同型导管 ,但不使用“恩纳”。观察气管插管后的耐受情况及麻醉苏醒后的呼吸道反应 ;插管 4小时后 ,取气管导管接触段行光镜检查。结果 :两组白兔经全身麻醉气管插管后 ,生命体征平稳 ,嘴唇红润 ,呼吸通畅 ,没有分泌物增加现象 ;麻醉作用消失后 ,实验组白兔一般能耐受气管导管 ,没有呛咳 ,打喷嚏的现象 (0 /10 )。而对照组白兔一般均有呛咳 ,打喷嚏的现象 (10 /10 ) ;两组白兔气管标本均未见形态学改变 ,双肺观察也无水肿、充血、分泌物增加的现象。结论 :“恩纳”乳剂用于气管插管 ,能减轻导管在麻醉维持期及拔管后的应激反应 ,减少术后喉部并发症。

5%恩纳乳膏用于成人静脉穿刺时皮层局部麻醉的临床研究

目的研究5%恩纳乳膏应用于成人静脉穿刺时皮层局部麻醉的最佳起效时间和局部反应。方法随机选取33例无急、慢性疼痛的择期手术患者,均分为3组,A组不用恩纳乳膏,B组在静脉穿刺前1h手背部涂用5%恩纳乳膏0.6g/4cm2,C组在静脉穿刺前2h手背部作同样准备。静脉穿刺前、后测视觉摸拟评分(VAS0~10cm),观察局部反应。结果3组静脉穿刺后VAS评分均较穿刺前显著增加。A、B两组穿刺后VAS评分的差异无显著性。穿刺后C组VAS评分较A组和B组明显降低。所有患者均未发现明显的局部皮肤苍白、红斑和水肿。结论5%恩纳乳膏用于静脉穿刺时皮层局部麻醉的镇痛效果约以2h为佳,能显著减轻疼痛,但不能完全消除患者的不适或疼痛,局部反应不明显,是一种有效、安全的局部麻醉药物。

恩纳气管表面麻醉预防高血压病人全麻拔管时应激反应的临床观察

目的 评价恩纳乳膏气管表面麻醉用于预防高血压病人全麻拔管时的应激反应。方法 高血压病人择期手术 1 0 0例 ,ASAⅠ～Ⅱ级 ,男 4 2例 ,女 5 8例 ,年龄 4 0～ 70岁 ,随机分为两组。实验组在麻醉诱导插管前将恩纳 2～ 3g涂抹于气管导管前端 ,对照组不用。观察评价两组在术毕吸痰、拔管时、拔管后 3min的血流动力学变化 ,并与麻醉诱导前比较。结果 对照组在不同时期的收缩压、舒张压、心率、心率收缩压乘积值均明显高于实验组 (P <0 .0 1 )。

四种麻醉方法对异氟醚用量的影响

比较了单纯全麻(GA)、恩纳气管表面麻醉联合全麻(GA+EMA)、硬膜外阻滞联合全麻(GA+EA)和恩纳气管表面麻醉联合硬膜外阻滞联合全麻(GA+EMA+EA)对术中异氟醚的使用量的影响。结果表明:GA、GA+EMA、GA+EA、GA+EMA+EA 4组病人异氟醚的平均呼气末维持浓度分别为(1.01±0.11)MAC、(0.89±0.07)MAC、(0.63±0.06)MAC和(0.51±0.08)MAC;液态异氟醚消耗量分别为(12.9±1.8)mL/h、(11.2±1.7)mL/h(、6.7±1.2)mL/h和(5.3±0.9)mL/h。其中恩纳气管表面麻醉联合硬膜外阻滞联合全麻中异氟醚用量最少。

5%恩纳霜在皮肤科临床上的应用

目的 :5 %恩纳霜或贴片是一种外用、表面麻醉剂。方法 :涂在皮肤上并用塑料薄膜 (或用 3M公司Tegaderm)封包维持 6 0～ 12 0min。结果 :它的局部麻醉效果可达到 87% ,止痛效果可维持 2～ 3h。结论 :5 %恩纳霜可以用在许多皮肤损害治疗时止痛 ,它特别适用于儿童 ,并且安全有效。