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佐剂在增强麻醉阻滞效果和持续时间中的作用:一项综述

Role of Adjuvants in Enhancing the Efficacy and Duration of Anesthesia Blocks: A Comprehensive Review.

作者信息

Singhal Akansha, Taksande Karuna

机构信息

Anesthesiology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND.

出版信息

Cureus. 2024 Sep 21;16(9):e69880. doi: 10.7759/cureus.69880. eCollection 2024 Sep.

Abstract

Anesthesia blocks are integral to modern pain management, offering targeted and effective relief for various surgical and procedural interventions. These techniques, including regional and peripheral nerve blocks (PNBs), involve the administration of local anesthetics to specific body areas, either through epidural, spinal, or direct nerve injections. While effective, incorporating adjuvants, substances added to local anesthetics, can significantly enhance their efficacy and prolong their duration. Adjuvants such as opioids, corticosteroids, alpha-2 agonists, and nonsteroidal anti-inflammatory drugs (NSAIDs) are used to amplify analgesic effects, reduce the need for general anesthesia, and improve postoperative outcomes. This review explores the role of adjuvants in optimizing anesthesia blocks, examining their mechanisms of action, clinical benefits, and safety considerations. Adding adjuvants can lead to enhanced pain control, reduced dosage of local anesthetics, and fewer systemic side effects. By integrating adjuvants into anesthesia practice, clinicians can achieve more precise and sustained pain management, tailoring approaches to individual patient needs and specific procedural demands. This comprehensive review highlights current evidence on using adjuvants, their impact on anesthesia block effectiveness, and future research directions. Understanding the role of adjuvants is crucial for improving patient outcomes and advancing pain management techniques in various surgical settings.

摘要

麻醉阻滞是现代疼痛管理不可或缺的一部分,为各种手术和操作干预提供有针对性的有效缓解。这些技术,包括区域阻滞和周围神经阻滞(PNB),涉及通过硬膜外、脊髓或直接神经注射将局部麻醉剂注射到特定身体部位。虽然有效,但加入佐剂(添加到局部麻醉剂中的物质)可以显著提高其疗效并延长其作用时间。阿片类药物、皮质类固醇、α-2激动剂和非甾体抗炎药(NSAID)等佐剂用于增强镇痛效果、减少全身麻醉的需求并改善术后结果。本综述探讨了佐剂在优化麻醉阻滞中的作用,研究了它们的作用机制、临床益处和安全考虑因素。添加佐剂可导致更好的疼痛控制、减少局部麻醉剂的用量以及减少全身副作用。通过将佐剂纳入麻醉实践,临床医生可以实现更精确和持续的疼痛管理,根据个体患者的需求和特定操作要求调整方法。这篇全面的综述强调了关于使用佐剂的现有证据、它们对麻醉阻滞效果的影响以及未来的研究方向。了解佐剂的作用对于改善患者预后和推进各种手术环境中的疼痛管理技术至关重要。

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