利多卡因乳膏或冰敷对A型肉毒毒素治疗双侧腓肠肌肥大镇痛效果分析  

Analgesic effects of lidocaine cream and ice application during botulinum toxin type A injection for bilateral gastrocnemius hypertrophy

作　　者：刘丹丹 徐祥文 罗林 吴梦凡 冯隽 党纤曦 李天石[1] Liu Dandan;Xu Xiangwen;Luo Lin;Wu Mengfan;Feng Jun;Dang Qianxi;Li Tianshi(Department of Plastic and Reconstructive Surgery,Peking University Shenzhen Hospital,Shenzhen 518036,China)

机构地区：[1]北京大学深圳医院整形外科,深圳518036

出　　处：《中华医学美学美容杂志》2024年第6期561-564,共4页Chinese Journal of Medical Aesthetics and Cosmetology

基　　金：国家自然科学基金(82302810);广东省医学科学技术研究基金(A2023237);深圳市医学重点学科(SZXK026);深圳市科技创新委员会自然科学基金(JCYJ20220531094004010);北京大学深圳医院科研项目(LCYJ2020008)。

摘　　要：目的评估利多卡因乳膏或冰敷对A型肉毒毒素治疗双侧腓肠肌肥大的镇痛效果。方法回顾性纳入2020年1月至2022年1月北京大学深圳医院接受A型肉毒毒素治疗双侧腓肠肌肥大的60例瘦腿患者,根据不同的镇痛方式分为2组:利多卡因表面麻醉组(30例)和冰敷镇痛组(30例)。利多卡因表面麻醉组男2例,女28例,年龄(27.0±5.0)岁;冰敷镇痛组女30例,年龄(26.2±4.4)岁。根据患者需求,每只小腿注射A型肉毒毒素剂量为100~200 U。利多卡因表面麻醉组在注射前由护士根据注射区域涂抹利多卡因软膏,并使用薄膜覆盖该区域。冰敷镇痛组由护士通过自制冰袋环绕注射区域进行冰敷10 min。通过疼痛视觉模拟评分(VAS)量表评估注射过程中患者疼痛情况,包括对针刺反应的疼痛评分以及对推注药物反应的疼痛评分。记录患者术后不良反应发生率,评估患者满意率。结果利多卡因表面麻醉组对针刺反应的VAS评分为(2.60±1.25)分,冰敷镇痛组为(2.30±1.12)分,差异无统计学意义(P=0.331)。利多卡因表面麻醉组对推注药物反应的VAS评分为(3.47±1.25)分,高于冰敷镇痛组的(2.77±1.28)分,差异有统计学意义(P=0.036)。利多卡因表面麻醉组总体镇痛的VAS评分为(3.37±1.16)分,高于冰敷镇痛组的(2.60±1.25)分,差异有统计学意义(P=0.017)。利多卡因表面麻醉组出现2例局部红肿,1例术后局部瘙痒伴红疹;冰敷镇痛组未发生相关不良反应。利多卡因表面麻醉组患者满意率为86.7%(26/30),冰敷镇痛组患者满意率为93.3%(28/30)。结论冰敷对A型肉毒毒素治疗双侧腓肠肌肥大的镇痛效果优于利多卡因乳膏表面麻醉。ObjectiveTo evaluate the analgesic effects of lidocaine cream and ice application during botulinum toxin type A treatment on bilateral gastrocnemius hypertrophy.MethodsA retrospective study was conducted,including 60 patients who underwent botulinum toxin type A treatment for bilateral gastrocnemius hypertrophy at Peking University Shenzhen Hospital from January 2020 to January 2022.Patients were divided into two groups based on the analgesic methods:lidocaine surface anesthesia group(lidocaine group,30 cases)and ice application analgesia group(ice group,30 cases).The lidocaine group consisted of 2 males and 28 females,with a mean age of(27.0±5.0)years,while the ice group consisted of 30 females,with a mean age of(26.2±4.4)years.Depending on individual needs,100-200 U of botulinum toxin type A was injected into the calf muscle of each patient.In the lidocaine group,nurses applied lidocaine cream to the injection area and covered it with a film before injection.In the ice group,nurses used custom-made ice packs to surround the injection site for 10 minutes.Pain levels were assessed using the visual analog scale(VAS)during injection,including pain scores for needle puncture and drug injection.The incidence of postoperative adverse reactions and patient satisfaction rates were also recorded.ResultsThe VAS score for needle puncture pain was(2.60±1.25)in the lidocaine group and(2.30±1.12)in the ice group,with no statistically significant difference(P=0.331).However,the VAS score for drug injection pain was significantly higher in the lidocaine group(3.47±1.25)than that in the ice group(2.77±1.28,P=0.036).The overall analgesic VAS score was(3.37±1.16)in the lidocaine group,also significantly higher than that(2.60±1.25)in the ice group(P=0.017).Two patients in the lidocaine group experienced localized swelling,and one reported localized itching with a rash,while no adverse reactions were observed in the ice group.Patient satisfaction rates were 86.7%(26/30)in the lidocaine group and 93.3%(28/30)in the ice group.

关 键 词：利多卡因 冰敷 镇痛 肉毒毒素 

分 类 号：R622[医药卫生—整形外科]