皆様、こんにちは
最近、さらに暑くなり夏もすぐそこ・・・という感じですね
当クリニックでは、鹿児島にいながら、都内と同じレベルの治療が出来るよう
常日頃、勉強会を開催しています。
先日行われた「美容外科学会」や最近の海外の医学論文データを参考にした
ボトックス治療とヒアルロン酸注入の勉強会がありました。
最近、ボトックス治療やヒアルロン酸・コラーゲン注入においては
大変人気があります。
先日の学会では、鼻根部へのヒアルロン酸注入時の注意点や、顔面の様々な部位へ治療し若返りを得る方法などが報告されていました。
また、注入時の痛みを和らげるための工夫など、それぞれ意見を
皆で出し合いながらの勉強会となりました。
従来の神経ブロック麻酔、貼り麻酔、塗る麻酔に加え、当クリニックの「アクシダーム」による
エレクトロポレーションでの麻酔剤の導入によりより注射針などを使わないで、麻酔効果を高める検討をしました。
これについては、海外の文献でも以前より報告されております。
以下に参考までに英文を載せていますので、ご興味のある方はお読みくださいね。
Reg Anesth Pain Med. 2001 May-Jun; 26(3):229-38.
Topical delivery of lidocaine in healthy volunteers by electroporation, electroincorporation, or iontophoresis: an evaluation of skin anesthesia.
Wallace MS, Ridgeway B, Jun E, Schulteis G, Rabussay D, Zhang L.
Department of Anesthesiology, University of California San Diego, 9500 Gilman Drive #0924, La Jolla, CA 92093, USA.
BACKGROUND AND OBJECTIVES: This study was designed to compare the onset, duration, and depth of local anesthesia after the topical delivery of lidocaine using electroporation (EP), electroincorporation (EI), and iontophoresis (IP) in healthy volunteers. EP and EI were performed with prototype devices and IP with a commercial drug/device product. METHODS: A double-blind, crossover study design was used for 10 randomized volunteers selected for EP treatment with either 4%, 10%, or 20% lidocaine or placebo normal saline. Because it was impossible to blind between IP, EP, and EI, an open label study with randomized volunteers was selected for IP and EP treatments. Onset and duration of anesthesia was determined by measuring warm sensation, cool sensation, and hot pain; depth of anesthesia was determined by measurement of pain sensation to a 27-gauge needle passed through the skin. RESULTS: For EP, all concentrations of lidocaine produced significant changes from baseline on 2 or 3 efficacy measures, however, the 4% concentration appeared to be the most efficacious when delivered by the EP method. The EP and EI methods produced a significant elevation in all 3 thermal thresholds, whereas IP produced significant elevations in cool and warm thresholds only. However, IP resulted in a greater depth of anesthesia. Plasma lidocaine levels were undetectable. CONCLUSIONS: The transdermal delivery of lidocaine by IP, EP, and EI results in similar surface skin anesthesia; however, IP results in a greater depth of anesthesia. Reg Anesth Pain Med 2001;26:229-238.
また、以下は最近のエレクトロポレーションの効果を説明した文献です。
J Control Release. 2006 Feb 21; 110(3):557-65.
Painless electroporation with a new needle-free microelectrode array to enhance transdermal drug delivery.
Wong TW, Chen CH, Huang CC, Lin CD, Hui SW.
Department of Dermatology, Biochemistry and Molecular Biology & Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, 138 Sheng-Li Road, Tainan 704, Taiwan.
A microelectrode array was designed to minimize the pain sensation of electroporation for enhancing transdermal drug delivery. The influence of the size of the electrode-skin contact area and of the distance between electrodes on the pain sensation was tested on human volunteers. The pain level decreased with the dimension of electrode-skin contact area and with inter-electrode distance. When both reached about 0.5 mm, the pain level was not perceptible even at the threshold of transdermal electroporation level of sixty electric pulses at 150 V, 1 ms at 1-10 Hz. An array of 11x11 alternately connected electrodes with 0.6x0.6 mm dimension was fabricated. The electric thresholds for effective drug delivery, using toluidine blue O as a marker on mouse skin, was found to be the same for microelectrode arrays as for larger electrodes and wider inter-electrode distances. In vivo transdermal electroporation using microelectrode array with 180 pulses of 150 V, 0.2 ms at 1 Hz, followed by 30 min methotrexate (MTX) occlusion increased more than 4 fold the systemic MTX level in mice. The results demonstrated the potential of painless delivery of significant amounts of chemotherapeutic agents through skin with the new electrode arrays in a clinical setting.
一般病院の看護師時代には医学論文とは無縁の生活でしたが、最近は英語と格闘中の毎日でもあります。
これからも、皆様が安心して治療を受けられるよう、がんばっていきますね
セイコメディカルビューティクリニック 看護師 外西