局部麻醉剂系统性毒性:努力识别跨专业的知识差距
Renuka Rudra1, Allan Probert1, Justin Ceasar2
1Department of Physical Medicine & Rehabilitation, Penn State Health, Hershey, Pennsylvania, USA.
PM & R : the journal of injury, function, and rehabilitation
|October 26, 2023
概括
与物理医学和康复医生相比,麻醉学医生表现出对局部麻醉系统毒性 (LAST) 的卓越知识. 这凸显了对PM&R专业人员进行加强LAST教育的需要.
科学领域:
- 医学教育 医学教育
- 麻醉学 麻醉学
- 物理医学和康复 康复
背景情况:
- 物理医学和康复 (PM&R) 医生在手术中使用局部麻醉剂 (LA).
- 局部麻醉的全身毒性 (LAST) 是LA的潜在并发症.
- 关于LAST的培训在麻醉学和PM&R专业之间可能有所不同.
研究的目的:
- 为了确定医生和麻醉学医生之间是否存在关于局部麻醉系统毒性 (LAST) 的知识差距.
- 在两个专业之间比较自我报告的知识和对LAST的客观理解.
主要方法:
- 进行了一项前性,横截面的调查研究.
- 参与者包括在学术医疗中心的麻醉学和PM&R部门的住院医生,研究员和主治医生.
- 测量结果包括自我报告的接触LAST教育,对LAST知识的舒适程度,以及对基于知识的问题的准确性.
主要成果:
- 麻醉学医生 (实习生和护理人员) 报告了比PM&R医生更高的感知知识和更大的接触LAST教育.
- 客观评估显示,在麻醉学和PM&R学员之间,在LAST方面存在统计学上显著的知识差距.
- 在这两个专业的临床医生之间也观察到一个显著的知识差异.
结论:
- 在PM&R和麻醉医生之间对LAST的主观和客观知识存在显著差异.
- 有一个机会来改善 LAST教育的物理治疗师和在训练中的住院医生.
- 对于LAST的教育策略的进一步评估在PM&R中是有必要的.
相关概念视频
Local Anesthetics: Adverse Effects
424
While local anesthetics are generally safe and well-tolerated, they can occasionally cause adverse effects that vary in severity. Local anesthetics can induce toxicity at two distinct levels. They can either produce local effects through direct contact with the neural elements or be absorbed into the bloodstream from the injection site, leading to systemic effects.
Once absorbed into the systemic circulation, local anesthetics can affect the organs that depend on the functioning of sodium...
Once absorbed into the systemic circulation, local anesthetics can affect the organs that depend on the functioning of sodium...
424
Local Anesthetics: Pharmacokinetics
775
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...
775
Local Anesthetics: Clinical Application as Spinal Anesthesia
646
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...
646
Local Anesthetics: Clinical Application as Epidural Anesthesia
439
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...
439
Local Anesthetics: Differential Sensitivity of Nerve Fibers
844
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...
844
Local Anesthetics: Common Agents and Their Applications
460
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...
460


