Svetlov V A, Kozlov S P
Scientific Center of Surgery, RAMN, Moscow.
Anesteziol Reanimatol. 1996 Jul-Aug(4):53-62.
Despite the constant improvements, local and total anesthesia are often regarded as alternative methods while selecting anesthesia. Modern anesthesiology aiming at the maximal regulation and safety of anesthesiological care, by no means confined to mere analgesia, clearly demonstrated the disagreement between the traditional approach to local anesthesia and the practical requirements. It is obvious that today we can speak about a revision of our attitude to local anesthesia. Use of novel technologies helps solve all problems involved in the attaining and maintaining the regional blocking. A great variety of local anesthetics, appreciably differing from the traditional agents by their physicochemical and clinical characteristics, creates objective prerequisites for solving numerous practical problems requiring stable many-hour analgesia, reliable regional immobilization, or selective effects of sympathetic blocking in individual regions. That is why the traditional limitations connected with the local and total-system toxicity, similarly as the regional and total-system hemodynamic effects, should not be regarded as contraindications, but taken into consideration when choosing not only the method of conduction blocking, but the local anesthetic as well. The authors consider that at present the strategic problem of regional anesthesia-regulation and safety of its pharmacological effects-is solved. Such anesthesia is as readily regulated as different variants of total anesthesia, and it may be even safer. This permitted not only extending the indications to regional anesthesia, but using the selective effects of regional blocking as the main or special component of anesthesiology.
