Safety and pharmacokinetics of EMLA in the treatment of postburn pruritus in pediatric patients: A pilot study
Safety and pharmacokinetics of EMLA in the treatment of postburn pruritus in pediatric patients: A pilot study
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DOI：
10.1097/00004630-200105000-00010
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发表时间：
2001-05-01
期刊：
影响因子：
--
通讯作者：
Koren, G
中科院分区：
文献类型：
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作者：
Kopecky, EA;Jacobson, S;Koren, G
本研究的目的是确定局部麻醉药（EMLA）的低共熔混合物的安全性和药代动力学，用于改善烧伤后瘙痒后，应用到新形成的，完整的皮肤在儿童。将EMLA应用于形成愈合皮肤的瘙痒部位一次。收集系列血液样本以测量利多卡因、丙胺卡因、邻甲苯胺和高铁血红蛋白。计算最大血浆浓度、最小血浆浓度、达到最大血浆浓度的时间、消除半衰期和浓度-时间曲线下面积。测量生命体征、氧饱和度、缺氧临床体征和瘙痒强度。5名儿童的皮肤表面积为93.0 +/- 37.0 cm（2），使用了15.7 +/- 2.54 g（+/- SD）的EMLA。利多卡因和丙胺卡因浓度低于毒性水平;未检测到邻甲苯胺。高铁血红蛋白保持在1%至3%之间;患者未表现出任何缺氧的临床体征。平均血氧饱和度为98.9 ± 0.01%。与研究第3天相比，2个研究前对照日的平均过敏发作次数和抗组胺药突破剂量更高（分别为P = 0.01和P = 0.03）。EMLA应用部位的皮肤保持麻醉12至13小时。在这项小型的初步研究中，EMLA似乎是一种安全的，新颖的治疗烧伤后瘙痒症的烧伤儿童时，适用于新愈合的，完整的皮肤。
The purpose of this study was to determine the safety and pharmacokinetics of a eutectic mixture of local anesthetics (EMLA) used to ameliorate postburn pruritus after application onto newly formed, intact skin in children. EMLA was applied once to an itchy site where healed skin had formed. Serial blood samples were collected to measure lidocaine, prilocaine, o-toluidine, and methemoglobin. Maximal plasma concentration, minimal plasma concentration, time to achieve the maximal plasma concentration, elimination half-life, and area under the concentration-time curve were calculated. Vital signs, oxygen saturation, clinical signs of hypoxia, and itch intensity were measured. Five children had 15.7 +/- 2.54 g (+/- SD) of EMLA applied to a skin surface area of 93.0 +/- 37.0 cm(2). Lidocaine and prilocaine concentrations were below toxic levels; o-toluidine was not detected. Methemoglobin remained between 1 and 3%; patients did not exhibit any clinical signs of hypoxia. Mean oxygen saturation was 98.9 +/- 0.01%. The mean number of pruritic episodes and antihistamine breakthrough doses were greater in the 2 prestudy control days compared with study day 3 (P = 0.01 and P = 0.03, respectively). Skin at the site of EMLA application remained anesthetized for 12 to 13 hours. In this small pilot study, EMLA seems to be a safe, novel treatment for postburn pruritus in burned children when applied to newly healed, intact skin.