肺移植的区域性镇痛:一个叙事审查
Karam Azem1, Eitan Mangoubi, Benjamin Zribi
1From the Department of Anaesthesia, Rabin Medical Centre, Beilinson Hospital, Petah Tikva (KA, EM. BZ, SF) and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel (KA, EM. BZ, SF).
European journal of anaesthesiology
|May 26, 2023
概括
肺移植 (LTx) 需要有效的疼痛管理. 本次审查强调需要对胸部神经阻塞进行更多研究,作为LTx患者外周止痛治疗的更安全替代方案.
科学领域:
- 胸部外科手术 胸部外科手术
- 麻醉学 麻醉学
- 肺部病理学 肺部病理学
背景情况:
- 肺移植 (LTx) 是对末期肺病的关键治疗方法,全球每年约有4500次手术.
- 有效的麻醉和疼痛管理对LTx至关重要,影响患者的舒适性,早期动员和预防术后并发症.
- 标准化LTx的止痛方案是复杂的,因为不同的病因,外科手术技术,以及潜在的使用体外生命支持 (ECLS).
结论:
- 需要提高人们对胸部神经阻断用于肺移植的有限研究的认识.
- 需要进一步进行高质量的研究,以确定胸部神经阻断在LTx中的有效性.
- 研究更安全,更有效的止痛方法对于改善肺移植的结果至关重要.
相关概念视频
Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia
490
Intravenous regional anesthesia or the Bier block technique is used to anesthetize a specific limb or extremity. It uses exsanguinated or blood-drained vessels to transport local anesthetics or LAs to the peripheral nerve trunks. Lidocaine without vasoconstrictors like epinephrine is most commonly used for this technique. Other drugs used are prilocaine, ropivacaine, and chloroprocaine. Bupivacaine is not recommended for this technique due to its high cardiac toxicity.
One of the advantages of...
One of the advantages of...
490
Local Anesthetics: Clinical Application as Epidural Anesthesia
462
Epidural anesthetics are administered in the fat-filled epidural space, the outermost part of the spinal canal. This technique is commonly employed for pain management and anesthesia during lower abdomen and pelvis surgeries or labor and delivery.
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
462
Local Anesthetics: Clinical Application as Spinal Anesthesia
690
Spinal anesthetics are given during lower abdomen and limb surgeries to block sensory and motor neurons. They are administered in the mid to low lumbar regions, primarily acting on the cauda equina's nerve roots. The blockade level depends on the local anesthetic (LA) concentration. Usually, low LA concentrations are sufficient to block sensory fibers, while only high LA concentrations block motor fibers. Other factors like injection volume and speed, the patient's posture, and the drug...
690
Analgesia and Pain Management
676
Pain is critical to various clinical pathologies, provoking an urgent need for effective management. Pain, whether acute or chronic, is a complex neurochemical process. Its alleviation depends on the type, with nonopioid analgesics effective for mild to moderate pain, such as musculoskeletal or inflammatory pain, while neuropathic pain responds best to anticonvulsants, tricyclic antidepressants, or serotonin/norepinephrine reuptake inhibitors. For severe acute or chronic pain, opioids may be...
676
Local Anesthetics: Clinical Application as Surface, Infiltration, and Conduction Block Anesthesia
1.1K
Depending on the target organ, local anesthetics (LAs) can be administered via various routes. In surface anesthesia, LAs are applied directly to the surface of the skin or mucous membranes. It is widely used for topical skin numbing before venipuncture or minor surgical procedures. Commonly used surface local anesthetics are lidocaine or benzocaine sprays or creams. Surface anesthesia occurs within 5 minutes and lasts for about 60 minutes. One of the main disadvantages of topical anesthesia is...
1.1K


