兒童在靜脈注射前塗抹止痛藥膏對降低注射部位疼痛之實證運用

Application of Pain Ointment to Intravenous Injection Sites for Pain Relief

兒童住院時常因注射疼痛而害怕恐懼或抗拒治療，因此預防或減緩注射疼痛，不僅可提高治療配合度，更能降低不愉快的住院經驗。本文應用電子資料庫進行檢索查詢，兒童在靜脈注射前塗抹止痛藥膏以降低注射部位疼痛指數之相關文獻。從7個資料庫中，共搜尋到統合分析文獻一篇、系統性回顧文獻二篇、隨機控制試驗文獻二篇，共計五篇，並以Muir Gray提出的證據等級與Jadad score及Critical Appraisal Skills Programme建議之十題項評析研究品質。經統整後，有關靜脈注射前以塗抹局部麻醉藥膏減輕疼痛的方法，在施行時需考量藥物的止痛效果、起始時間、持續時間與局部副作用。故基於不傷害原則、有效暨安全考量下，本案選擇以EMLA藥膏進行臨床實務應用於7~12歲住院兒童共5位，結果發現兒童在靜脈注射前塗抹止痛藥膏能降低注射部位的疼痛指數。

Ill children at the hospital are often afraid of and frightened by needle shots, which causes their refusal of treatment. Prevention or reduction of injection pain may not only increase the ill children's cooperation but also decrease their unpleasant hospital experiences. This article xamines the impact of the application of pain ointments to intravenous injection sites for pain relief, based on relevant literature reviews. Among the five research articles from seven databases, one used the meta-analysis method, two were systematic reviews, and two involved randomized control trials. Muir Gray's level of evidence, Jadad score, and Critical Appraisal Programme (CASP) of the Public Health Resource Unit were used to examine the quality of these research articles. For application of local anesthetic ointments to intravenous injection sites, one must consider the analgesic effect of the ointment, the time of onset, the duration of action, and the side effects. Based on the principle of doing no harm and safe practice, the EMLA ointment was selected for clinical practice. Through clinical practice, it was confirmed that application of pain ointment to intravenous injection sites can lower the pain level at the injection site.