醇与利多卡因在产卵神经神经溶解中用于关节疼痛
Chiara Maria Tha Crema1, Luiza Previato Trevisan Magario1, Wilian Carlos Siena1
1Hospital das Clínicas, Faculdade de medicina da USP de Ribeirão Preto, SP, Brazil.
Acta ortopedica brasileira
|September 18, 2023
概括
使用enol或利多卡因的阻塞神经阻塞可以在严重的关节骨关节炎患者中提供可比的疼痛缓解和功能改善. 两种治疗都被发现是安全有效的,提供长达四个月的效益.
科学领域:
- 疼痛管理 疼痛管理
- 整形外科 整形外科 整形外科
- 神经学 神经学
背景情况:
- 严重的关节骨关节炎往往需要进行整体关节置换.
- 对于不适合进行手术的患者,阻塞神经阻塞为疼痛控制和功能增强提供了替代方案.
- 醇和利多卡因是常用的药物,预计醇会提供更持久的效果.
研究的目的:
- 为了比较醇与利多卡因在关神经阻塞中对严重关节骨关节炎患者的关节疼痛和功能的疗效.
- 为了评估疼痛控制和功能性表现后的程序在没有响应保守治疗的患者.
主要方法:
- 44名患有严重关节骨关节炎的患者被随机分配,接受前闭关神经阻塞,使用enol或1%的利多卡因,以电刺激为指导.
- 疼痛和功能被评估使用视觉模拟尺度 (VAS),西安大略省和麦克马斯特大学骨关节炎指数 (WOMAC),以及手术前和手术后1个月和4个月的压力疼痛值.
主要成果:
- 和利多卡因组在一个月后在疼痛控制,压力疼痛值和功能方面表现出显著的改善,效果有所减弱,但在四个月后仍然高于基线.
- 在enol和利多卡因组之间没有观察到统计学上显著的结果差异.
- 在任何治疗组中都没有报告严重的不良反应.
结论:
- 使用利多卡因或的阻塞神经阻塞在治疗严重关节骨关节炎患者的疼痛和改善功能方面同样有效和安全.
- 这些神经阻塞为关节骨关节炎患者提供了可行的治疗选择,这些患者不是全关节置换的候选人.
更多相关视频
相关概念视频
Local Anesthetics: Clinical Application as Spinal Anesthesia
672
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...
672
Local Anesthetics: Clinical Application as Epidural Anesthesia
457
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...
457
Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia
457
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...
457
Local Anesthetics: Chemistry and Structure-Activity Relationship
4.4K
Local anesthetics (LAs) are drugs that induce a temporary loss of sensation in a limited body area, preventing pain. Cocaine was the first local anesthetic discovered in the late 19th century. Cocaine is a benzoic acid ester obtained from the leaves of coca shrubs and was often used for its psychotropic effects. Cocaine was first isolated in 1860 by Albert Niemann. Sigmund Freud studied the physiological actions of cocaine. Carl Koller later introduced it into clinical practice in 1884 as a...
4.4K
Local Anesthetics: Common Agents and Their Applications
479
Local anesthetics (LAs) are commonly used for various applications in medical and dental procedures. Some of the common agents used are cocaine, lidocaine, and bupivacaine.
Cocaine is an ester of benzoic acid and methylecgogine. It is used to anesthetize and vasoconstrict locally. Currently, it is used primarily for topical applications. It is beneficial for surgeries on the upper respiratory tract, providing anesthesia and shrinking the mucosa. Cocaine in the form of cocaine hydrochloride is...
Cocaine is an ester of benzoic acid and methylecgogine. It is used to anesthetize and vasoconstrict locally. Currently, it is used primarily for topical applications. It is beneficial for surgeries on the upper respiratory tract, providing anesthesia and shrinking the mucosa. Cocaine in the form of cocaine hydrochloride is...
479
Local Anesthetics: Differential Sensitivity of Nerve Fibers
864
Local anesthetics (LAs) block the sodium channels of nerve trunks, sensory nerve endings, and neuromuscular junctions. Although LAs can block all kinds of nerves, the sensitivity of nerve fibers differs according to nerve types and structures. LAs are known to block myelinated fibers faster than unmyelinated ones. Also, they block pain or sensory neurons at low concentrations without affecting the motor neurons involved in muscle contractions. This helps relieve labor pain without affecting the...
864


