Department of Anesthesiology, LSU Health Sciences Center, Room 653, 1542 Tulane Ave., New Orleans, LA, 70112, USA.
Department of Anesthesiology, LSU Health Sciences Center, Room 656, 1542 Tulane Ave., New Orleans, LA, 70112, USA.
Best Pract Res Clin Anaesthesiol. 2018 Jun;32(2):83-99. doi: 10.1016/j.bpa.2018.06.011. Epub 2018 Jul 3.
Regional and neuraxial anesthesia can provide a safer perioperative experience, greater satisfaction, reduced opioid consumption, and reduction of pain, while minimizing side effects. Ultrasound technology has aided clinicians in depositing local anesthetic medication in precise proximity to targeted peripheral nerves. There are a plethora of adjuvants that have been utilized to prolong local anesthetic actions and enhance effects in peripheral nerve blocks. This manuscript describes the current state of the use of adjuncts, e.g., dexmedetomidine, dexamethasone, clonidine, epinephrine, etc., in regional anesthesia. Additionally, evidence behind dosing and block prolongation is summarized along with patient outcomes, adverse effects, and future directions.
区域阻滞和神经阻滞可提供更安全的围手术期体验、更高的满意度、减少阿片类药物的使用和减轻疼痛,同时将副作用降至最低。超声技术帮助临床医生将局部麻醉药物精确地沉积在靶向周围神经附近。有大量的佐剂已被用于延长局部麻醉作用并增强周围神经阻滞的效果。本文描述了辅助药物(如右美托咪定、地塞米松、可乐定、肾上腺素等)在区域麻醉中的使用现状。此外,还总结了剂量和阻滞延长的证据,以及患者结局、不良反应和未来方向。