dos Reis Júnior Almiro, Quinto Denise
Serviço Médico de Anestesia (SMA), São Paulo, SP, Brazil; Hospital Alemão Oswaldo Cruz, São Paulo, SP, Brazil; Sociedade de Anestesiologia do Estado de São Paulo (Saesp), São Paulo, SP, Brazil.
Serviço Médico de Anestesia (SMA), São Paulo, SP, Brazil; Hospital Alemão Oswaldo Cruz, São Paulo, SP, Brazil.
Braz J Anesthesiol. 2016 Jan-Feb;66(1):63-71. doi: 10.1016/j.bjane.2013.12.004. Epub 2015 Nov 25.
Review of various techniques for digital blocks with local anesthetic, with or without epinephrine.
Description of various procedures and comparison of results reported in the literature, mainly on latency and quality of anesthesia, details on vasoconstrictor effect of epinephrine, intraoperative bleeding, necessity of tourniquet use, duration of anesthesia and postoperative analgesia, blood flow and digital SpO2 behavior, local and systemic complications, and also approaches and drugs to be used in certain situations of ischemia.
The advantages of adding epinephrine to the anesthetic solution are minor when compared to the risks of the procedure, and it seems dangerous to use a vasoconstrictor in the fingers, unless the safety of the technique and the possibility of discarding the tourniquet are definitely proven.
回顾使用或不使用肾上腺素进行局部麻醉数字阻滞的各种技术。
描述各种操作方法，并比较文献报道的结果，主要涉及麻醉潜伏期和质量、肾上腺素的血管收缩作用细节、术中出血情况、使用止血带的必要性、麻醉持续时间和术后镇痛效果、血流及手指脉搏血氧饱和度变化、局部和全身并发症，以及在某些缺血情况下使用的方法和药物。
与操作风险相比，在麻醉溶液中添加肾上腺素的优势较小，除非技术安全性和不使用止血带的可能性得到明确证实，否则在手指使用血管收缩剂似乎很危险。
