【作者】 张国良；

【导师】 史宗道；

【作者基本信息】 四川大学 ， 口腔外科学， 2002， 硕士

【摘要】 目的：刷低频超声波介导下透皮局部麻麻醉药EMLA（含利多卡因和丙胺卡因）临床镇痛效果和安全性，为临床研究低频超声波透皮给药和扩大EMLA的临床应用提供依据。 材料和摊：24名健康青年志愿者的双上臂随机分为试验组和对照组，每个试验者两上臂前臂内侧同时涂抹1克EMLA乳膏，面积约2cm2，厚度约3mm。施于皮肤后10min即开始给予超声干预，低频超声波频率为20kHz，输出功率为0．5W/cm2，超声波传导头直径为１cm2。低频超声持续干预10min。对照组也施于同等面积和温度的金属头，但无超声波。停止干预后，尼龙棒机械压力法坝定痛阈及镇痛作用强度（Transcucer Indicationhodel 1601C），每5min用尼龙棒机械压力测痛仪测量两组镇痛起始时间和镇痛强度，试验结束后用解剖显微镜观察活体皮肤组织学变化。 结果：低频超声试验组平均镇痛起始时间为34．58±3．87min，对照组为43．75±4.72min，低频超声组第70min镇痛强度为33.６6± 1．16g，对照组为29．71±3．73 g。两组在镇痛起始时间 34和镇痛强度上有统计学意义P＜0．０1，解剖显微镜观察显示低频超声可使角质层间质增宽和疏松。 结论：低频超声可以促进EMLA透过皮肤，缩短局部麻醉的起效时间，提高局部的镇痛强度。借助低频超声波技术可以扩大EMLA在临床的推广应用。更多还原

【Abstract】 Objective: To detennine efficacy and safety of low frequencyultrasound with eutectic ndxttire of local anesthetics rsMLA) on skinin reducing time of onset of anaesthesia and decreasing the painintensity.Methods: Concurrent randondzed controlled with self two arinsmatched trial was designed. In each subject EMLA andEMLA+Ultrasound procedure were randorIily aPplied to either one ofthe tWo arms. tow frequency ultrasound was conducted for l0ndnutes with frequency of 20 kHz and outPut of 0.5 Wlcm2. Oncontrol ann, placebo with same instrUment was put on the EMLA.Before and after 30 ndnutes, the thresho1d of pain on the sldn andpain intensity were measured, the later measurement was conducted36in a time interval of 5 minute and lasted for 1.5 hours. Time of onset of anaesthesia and pain intensity of skin were compared between two groups using paired t test, immediately after the experiments, the involved skin was examined microscopically to observe if therewere some pathological changes.Results: 24 volunter in our university participated in the study. The average time of onset of the local anaesthesia in experimental group is 34.58 + 3.87 min, the control group 43.75+4.72 min. The onset time difference of the two groups is statistically significant with P<0.01. The pain intensity in ultrasound group is 33.66?.16g, which is significantly longer than the figure of 29.71?.73g in control group with P<0.01. The microscopical observation showed no pathological changes in the experimental area of the skin. Conclusion: The low frequency ultrasound can promote the EMLA permeation across the human being’ s skin, and reaching more depth in the skin. So that time onset of anaesthesia was shortened and intensity of anaesthesia was increased更多还原