Headquarters Air Armament Center Family Medicine Residency, Eglin Air Force Base, FL, USA.
Am Fam Physician. 2014 Jun 15;89(12):956-62.
When choosing an infiltrative anesthetic agent, the type of procedure, the length of time required for anesthesia, and the pharmacodynamics of each medication are important considerations. Distraction techniques and buffering with sodium bicarbonate can be used to decrease the pain associated with injection. Local cutaneous infiltration is the most commonly used anesthetic technique and involves direct injection into the area requiring anesthesia. Field blocks provide anesthesia by circumferentially blocking innervation to the area. Nerve blocks target the innervation to a specific area and are useful on the face and digits. Using easily identifiable landmarks, blockade of the supraorbital, supratrochlear, infraorbital, and mental nerves can provide site-specific anesthesia. Dorsal and palmar or plantar digital nerve blocks can be performed at a variety of locations on the hands and feet.
在选择浸润性麻醉剂时，需要考虑手术类型、麻醉所需时间以及每种药物的药效动力学。分散注意力技术和碳酸氢钠缓冲液可用于减轻注射相关疼痛。局部皮肤浸润是最常用的麻醉技术，包括直接注射到需要麻醉的区域。区域阻滞通过环绕性阻断该区域的神经支配来提供麻醉。神经阻滞针对特定区域的神经支配，对面部和手指很有用。使用易于识别的解剖标志，可以对眶上神经、滑车上神经、眶下神经和颏神经进行阻滞，以提供特定部位的麻醉。在手和脚的多个部位可以进行背侧和掌侧或跖侧指（趾）神经阻滞。
