经过双边修改的胸腔腹部神经阻塞后,通过周粒体方法,血levobupivacaine度的时间变化
Katsuhiro Aikawa1, Yuka Uchinami2, Yuji Morimoto2
1Department of Anesthesiology and Critical Care Medicine, Hokkaido University Hospital, Kita-15, Nishi-7, Kita-Ku, Sapporo, 060-8638, Japan. katsuhiro.aikawa@med.hokudai.ac.jp.
Journal of anesthesia
|June 6, 2023
概括
使用50毫升0.25%的levobupivacaine与上腺素的修改型胸腔腹部神经阻塞 (M-TAPA) 会导致血局部麻醉剂 (LA) 水平低于毒性值. 这项研究证实了M-TAPA在LA系统性毒性方面的安全性.
科学领域:
- 麻醉学 麻醉学
- 区域麻醉地区麻醉
- 药理学 药理学是指药理学的学科.
背景情况:
- 局部麻醉 (LA) 系统毒性是干部块的一个重大问题.
- 经过周粒体方法 (M-TAPA) 修改的胸腔腹部神经阻塞正在引起人们的注意,但其血LA水平尚未得到充分记录.
研究的目的:
- 为了评估M-TAPA后的血局部麻醉剂 (LA) 度的峰值.
- 为了确定血LA水平是否仍低于确定的毒性值 (2.6μg/mL).
主要方法:
- 接受腹部手术的10名患者接受了M-TAPA的25毫升0.25%的Levobupivacaine与两侧上腺素.
- 在阻塞后的多个时间点 (10,20,30,45,60,120分钟) 收集了血液样本.
- 血LA度被测量以确定峰值水平.
主要成果:
- 最高个体高峰血LA度为1.03微克/毫升,平均高峰为0.73微克/毫升.
- 所有测量的高峰血LA度都明显低于2.6微克/毫升的毒性水平.
- 在峰值LA水平和患者体重之间观察到负相关性.
结论:
- M-TAPA,使用总共50毫升0.25%的levobupivacaine与上腺素,导致血LA度低于毒性水平.
- 在这个队列中,M-TAPA技术在LA系统毒性方面似乎是安全的.
- 需要使用更大的样本大小进行进一步的研究来证实这些发现.
相关概念视频
Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia
485
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...
485
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
Local Anesthetics: Clinical Application as Epidural Anesthesia
461
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...
461
Depolarizing Blockers: Pharmocokinetics
353
Depolarizing blockers are administered through intravenous injection. Succinylcholine is the most common choice of depolarizing blockers in emergency clinical practices. Although they have a rapid onset, they readily diffuse away from the motor end plate into the extracellular fluid. They are metabolized by enzymes such as liver butyrylcholinesterase and plasma pseudocholinesterases. This produces a short duration of action, typically 5-10 minutes long, unlike nondepolarizing blockers, which...
353
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
Local Anesthetics: Pharmacokinetics
811
The potency and duration of action of local anesthetics (LAs) are determined by their pharmacokinetics. Pharmacokinetics describes how LAs are absorbed, distributed, metabolized, and eliminated from the body. When administered to the vascular tissues, LAs are quickly absorbed and enter the systemic circulation, reducing their localized effects. Adding vasoconstrictors such as epinephrine to LAs reduces their absorption into the systemic circulation, making them clinically effective. The...
811


