在患有心血管疾病的患者中比较白内障手术中的周周和局部麻醉
Geeta Behera1, Akhilesh Kothari2, Anandaraja Subramanian3
1Department of Ophthalmology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.
Korean journal of ophthalmology : KJO
|January 15, 2024
概括
局部麻醉是一种安全有效的选择,用于控制心血管疾病的患者的白内障手术,显示出较少的血液动力学变化和较低的疼痛得分,与周周麻醉相比.
科学领域:
- 眼科医生 眼科 眼科
- 麻醉学 麻醉学
- 心脏病学 心脏病学
背景情况:
- 白内障手术是一种常见的手术,但麻醉选择可能会影响患有心血管疾病的患者.
- 血液动力学稳定性和患者舒适性是这一群体中至关重要的考虑因素.
研究的目的:
- 为了比较局部麻醉与白内障手术中的周周麻醉.
- 评估心血管疾病患者的血液动力学变化,并发症率和疼痛评分.
主要方法:
- 一项前性比较研究包括150名患有受控心血管疾病,接受白内障手术的患者.
- 患者接受了局部或周腹膜麻醉.
- 血液动力学参数,并发症和疼痛评分 (视觉模拟尺度) 在多个时间点记录.
主要成果:
- 两种类型的麻醉都是安全的,但围巴麻醉显示脉率和血压在手术内显著上升.
- 在外科手术期间,腹膜周周组的静脉血压显著更高.
- 局部麻醉组报告的疼痛得分略低一些.
结论:
- 局部麻醉是一种可取的,非侵入性的选择,用于白内障手术的患者有足够控制的心血管疾病.
- 它提供了足够的止痛与最小的血液动力学影响.
- 患有心血管疾病且接受无并发性白内障手术的患者可以建议进行局部麻醉.
相关概念视频
Local Anesthetics: Common Agents and Their Applications
448
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...
448
Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia
422
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...
422
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: Clinical Application as Spinal Anesthesia
635
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...
635
Local Anesthetics: Pharmacokinetics
760
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...
760
General Anesthesia: Overview
219
Anesthesia is a medical procedure that uses drugs for CNS suppression to enable painless surgeries and procedures. The selection of anesthetics is influenced by their pharmacokinetic properties, side effects, and patient characteristics. Various types of anesthesia include general, local, regional, spinal, and inhalational.
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
219


