Rapid local anesthesia in humans using minimally invasive microneedles.
Rapid local anesthesia in humans using minimally invasive microneedles.
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DOI：
10.1097/ajp.0b013e318225dbe9
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发表时间：
2012-02
期刊：
影响因子：
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通讯作者：
Prausnitz MR
中科院分区：
文献类型：
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作者：
Gupta J;Denson DD;Felner EI;Prausnitz MR
本研究检验了以下假设：微创微针在利多卡因注射过程中引起的疼痛较小，但在人体受试者中诱导局部麻醉，起效速度和有效性与使用皮下注射针进行皮内利多卡因注射相同。本研究为随机、单盲、受试者内对照设计。使用空心500 μ m长的微针向15名人类受试者的前臂注射利多卡因。使用视觉模拟疼痛量表（VAS）记录相关疼痛。在注射后0、7.5和15 min测定麻木的面积和深度。利多卡因也被注射到手背附近的静脉，然后放置静脉导管和测量相关的疼痛。26号皮内斜面皮下注射针同样在对侧前臂/手上给予利多卡因，作为阳性对照。VAS疼痛评分显示，对于前臂和手背注射，使用微针注射的疼痛明显低于皮下注射针。然而，在任何时间点（0、7.5和15 min），两种治疗方法之间产生的麻木的面积或深度均无显著差异，表明微针立即起效，并且在诱导皮肤麻醉方面与皮下注射针一样有效。此外，在手背上注射利多卡因后立即插入IV导管导致显微针和皮下注射针治疗部位的疼痛评分相当，进一步证实了显微针诱导快速局部麻醉的疗效。最后，77%的受试者更喜欢微针，80%的受试者表示他们不认为微针会带来疼痛。本研究首次证明，基于微针的利多卡因注射在诱导局部麻醉方面与皮下注射一样快速和有效，同时在注射期间显著减少疼痛。
This study tested the hypothesis that minimally invasive microneedles cause less pain during injection of lidocaine but induce local anesthesia in human subjects with the same rapid onset and efficacy as intradermal lidocaine injection using hypodermic needles. This study was a randomized, single-blinded, within subjects, controlled design. Hollow 500 μm-long microneedles were used to inject lidocaine to the forearm of 15 human subjects. The associated pain was recorded using a visual analog pain scale (VAS). The area and depth of numbness were determined at 0, 7.5, and 15 min after injection. Lidocaine was also injected to the dorsum of the hand near a vein, followed by placement of an intravenous catheter and measurement of associated pain. A 26-gauge intradermal bevel hypodermic needle similarly administered lidocaine on the opposite forearm/hand to serve as the positive control. VAS pain scores revealed that injection using microneedles was significantly less painful than hypodermic needles for both the forearm and dorsum of the hand injections. However, there was no significant difference in the area or depth of the resulting numbness between the two treatment methods at any time-point (0, 7.5, and 15 min) indicating that microneedles had immediate onset and were as effective as hypodermic needles in inducing dermal anesthesia. Moreover, insertion of an IV catheter immediately after lidocaine injection on the dorsum of the hand led to comparable pain scores for the microneedle and hypodermic needle treated sites, further confirming efficacy of microneedles in inducing rapid local anesthesia. Lastly, 77% of the subjects preferred microneedles and 80% indicated that they did not consider microneedles to be painful. This study demonstrates for the first time that microneedle-based lidocaine injection is as rapid and as effective as hypodermic injection in inducing local anesthesia while resulting in significantly less pain during injection.