PDF(Pubmed)
Abstract：
BACKGROUND The efficacy of a eutectic mixture of local anesthetics (EMLA) for pain control in extracorporeal shock wave lithotripsy is unclear. The aim of this study was to assess the effect of EMLA cream on pain control during extracorporeal shock wave lithotripsy. MATERIAL AND METHODS We searched Medline, EMBASE, and the Cochrane Central Register of Controlled Trials to identify relevant randomized controlled trials that compared the pain control efficacies of EMLA vs. placebo. Study eligibility criteria, participants, and interventions: Randomized controlled trials that compared the effect of EMLA with placebo cream for patients underwent extracorporeal shock wave lithotripsy. Study appraisal and synthesis methods: Two review authors extracted data independently using a designed data extraction form and risk of bias by Cochrane Collaboration\'s tool. RESULTS Nine studies, including 10 randomized controlled trials with 1167 patients, were eligible. The EMLA group experienced less pain (mean difference, -0.47; 95% confidence interval, -0.78 to -0.16; p=0.003) and shorter duration of lithotripsy (mean difference, -1.70, 95% confidence interval: -2.31 to -1.10, p<0.0001) than the placebo group. There were no significant differences in the number of patients who needed extra intravenous medication (p=0.610), number of patients with insufficient extracorporeal shock wave lithotripsy pain control (p=0.530), and number of patients with opioid adverse effects (p=0.320). Limitations: Long interval between the studies, different kinds of lithotripters. CONCLUSIONS EMLA can reduce pain during the ESWL procedure.
摘要：
背景技术局部麻醉药的低共熔混合物(EMLA)在体外冲击波碎石术中用于疼痛控制的功效尚不清楚。这项研究的目的是评估EMLA乳膏对体外冲击波碎石术中疼痛控制的影响。材料和方法我们搜索了Medline,EMBASE,和Cochrane中央对照试验注册，以确定相关的随机对照试验，比较EMLA与疼痛控制疗效安慰剂。研究资格标准，参与者,和干预措施：比较EMLA和安慰剂乳膏对体外冲击波碎石患者的效果的随机对照试验。研究评估和综合方法：两位综述作者使用设计的数据提取表和CochraneCollaboration的工具独立提取数据。结果九项研究，包括10个随机对照试验，1167名患者，有资格。EMLA组疼痛较少(平均差异，-0.47；95%置信区间，-0.78至-0.16；p=0.003）和较短的碎石持续时间（平均差异，-1.70，95％置信区间：-2.31至-1.10，p<0.0001）比安慰剂组。需要额外静脉注射药物的患者数量没有显着差异（p=0.610），体外冲击波碎石术疼痛控制不足的患者人数（p=0.530），和阿片类药物不良反应患者人数（p=0.320）。局限性：研究间隔时间长，不同种类的碎石机。结论EMLA可以减轻ESWL手术期间的疼痛。
