复方利多卡因乳膏在小儿无痛局部麻醉下包皮环(套)切术中的应用  

Effects of compound lidocaine cream on children with circumcision under painless local anesthesia

作　　者：胡小华[1] 莫优炼 张平锋[1] 苏嘉鸿 钟陈[1] 冯大军[1] 张家德[1] Hu Xiaohua;Mo Youlian;Zhang Pingfeng;Su Jiahong;Zhong Chen;Feng Dajun;Zhang Jiade(Department of Pediatric Surgery, Zhongshan Boai Hospital Affiliated to Southern Medical University, Zhongshan 528408, Chin)

机构地区：[1]南方医科大学附属中山市博爱医院小儿外科,广东中山528408

出　　处：《临床医学》2018年第4期22-25,共4页Clinical Medicine

基　　金：中山市科技计划项目(2015B1217)~~

摘　　要：目的探讨复方利多卡因乳膏在小儿局部麻醉下包皮环(套)切术中的镇痛效果。方法随机连续选取择期行包皮环(套)切术的包茎或包皮过长患儿1 500例,年龄3~13岁,术前90~120 min在阴茎根部局部麻醉穿刺处皮肤及周围涂布复方利多卡因乳膏,用保鲜膜覆盖。手术局部麻醉时观察患儿皮肤进针时的疼痛反应,记录手术时间及疼痛评分,并与2006年局部浸润麻醉研究(3 000例局部浸润麻醉包皮环/套切术)比较,分析其差异。结果 1 500例患儿均为局部麻醉下完成手术,手术时间为(7.3±1.4)min,术后未见严重并发症,患儿术中感觉无痛或轻微疼痛比例为97.86%;手术时间与2006年局部浸润麻醉研究(3 000例局部浸润麻醉包皮环/套切术)比较,差异未见统计学意义(P>0.05);经Mann-Whitney秩和检验,两研究患者痛感分布比较差异有统计学意义(Z=44.19,P<0.01)。结论复方利多卡因乳膏在小儿局部麻醉手术中可减轻浸润麻醉进针时的疼痛,安全且镇痛效果确切,可消除患儿及家属对手术的负面体验,能缩短手术时间,确保手术顺利完成,是简便、安全、可靠的麻醉辅助手段。Objective To evaluate the analgesic effects of compound lidocaine cream on chil- dren with circumcision under painless local anesthesia. Methods A total of 1 500 children who aged from 3 to 13 years underwent circumcision were randomly selected. Compound lidocaine cream was coa- ted on and around the skin and around the site of the local anaesthesia at the root of the penis at 90 ~ 120 min before operation, and then covered with fresh-keeping film. The pain response of children was ob- served when local infiltration anesthesia were performed, the operative time and pain score were recor- ded, and the differences with the local infiltration anesthesia study in 2006 （3 000 cases of local infiltra- tion anesthesia wrapping ring/sleeve resection） were compared. Results All of the 1 500 patients were operated under local anesthesia, and the operative time was （7.3 ± 1.4 ） min. There were no severe complications after operation, the proportion of painless or slight pain was 97.86% during operation. There was no difference in the time of operation between the study of local infiltration anesthesia in 2006. According to the Mann-Whitney rank sum test, there was significant difference in the distribution of pain between the two groups. （Z = 44. 19,P 〈 0. 01 ）. Conclusions Compound lidocaine cream in children with circumcision under local anesthesia can reduce pain in operation, it＇ s safe and effective, and it can eliminate the negative experience of children and their families. It provides a simple, safe and reliable new auxiliary means for circumcision operation in children with Local infiltration anesthesia.

关 键 词：复方利多卡因乳膏 局部麻醉 包皮环(套)切术 浸润麻醉 

分 类 号：R726.1[医药卫生—儿科]