当前位置： SCI文献检索 > Journal of Emergency Nursing期刊下所有文献 > Reducing pain in ED patients during lumbar puncture: the efficacy and feasibility of iontophoresis, collaborative approach.

Reducing pain in ED patients during lumbar puncture: the efficacy and feasibility of iontophoresis, collaborative approach.

Abstract：

INTRODUCTION:This study examined the efficacy and feasibility of a collaborative iontophoresis procedure for dermal anesthesia prior to lumbar puncture (LP) in adult ED patients. METHODS:Patients were randomized to receive lidocaine by iontophoresis or needle infiltration. Emergency nurses and physicians completed a collaborative LP procedure in those randomized to iontophoresis. Usual care was provided for needle infiltration subjects. Pain was assessed at 3 points using an 11-point numeric rating scale to measure pain, and provider satisfaction was recorded. RESULTS:Ninety subjects completed the protocol: infiltration group (n = 48) and iontophoresis group (n = 42). Subjects in the lidocaine infiltration group reported significantly more pain (mean, 4.1A+/-2.6) than subjects in the iontophoresis group (mean, 0.9A+/-1.6) ( t82 = 1.26, P =.000). There was no significant difference between the pain experienced during the lumbar puncture by both groups. Mean pain score during LP was 3.7 (+/-2.7) for iontophoresis compared to 3.4 (+/-2.9) for infiltration. More iontophoresis subjects (18 or 43.9%) required "rescue" lidocaine than infiltration subjects (12 or 24.5%) (chi-square 1 =3.79, P =.0515). Providers reported greater satisfaction with the collaborative procedure compared to physician administered lidocaine infiltration and anecdotally reported that iontophoretic anesthesia administration does not obscure anatomical landmarks, as needle infiltration can. Time for completion of dermal anesthesia using the iontophoretic procedure was longer than time for completion of dermal anesthesia using the lidocaine infiltration procedure (12A+/-12 min vs 2A+/-1.7 min); however, no statistically significant difference in total LP time or ED length of stay was found. NURSING IMPLICATIONS:Dermal anesthesia by lidocaine iontophoresis in patients undergoing an LP with emergency nurses and physicians working in collaboration during the procedure takes longer, but decreases the pain of administering anesthesia, increases provider satisfaction, and fosters collaborative practice in the emergency setting. Iontophoretic administration of anesthesia for LP is now an option for dermal anesthesia in our emergency department.

journal_name

J Emerg Nurs

journal_title

Journal of emergency nursing

authors

Strout TD,Schultz AA,Baumann MR,Jordan PJ,Worthing B,Burton JH

doi

10.1016/j.jen.2004.08.010

keywords:

subject

Has Abstract

pub_date

2004-10-01 00:00:00

pages

423-30

issue

eissn

0099-1767

issn

1527-2966

pii

S0099176704005124

journal_volume

pub_type

临床试验,杂志文章,随机对照试验

在线工具

Reducing pain in ED patients during lumbar puncture: the efficacy and feasibility of iontophoresis, collaborative approach.