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Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia01:16

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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.
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肋下TAP阻塞:一次或两次连续注射? 一个尸体研究研究.

Augustin Schaefer1,2, Sébastien Grousson1, Thomas Bessede2,3

  • 1Anesthesia and Intensive Care Medecine, Hôpital Bicêtre, Le Kremlin-Bicetre, France.

Regional anesthesia and pain medicine
|February 23, 2024
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概括

与单次注射 (1scTAPI) 相比,两个连续的下腰部横向腹部平面块 (2scTAPI) 在尸体中实现了显著更大的神经覆盖. 这表明2scTAPI可以提供改善的前腹壁止痛.

关键词:
麻醉,局部麻醉,局部麻醉区域麻醉剂 区域麻醉剂超声波学 超声波学 超声波学止痛药 止痛药 止痛药是一种止痛药.

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科学领域:

  • 麻醉学 麻醉学
  • 区域麻醉地区麻醉
  • 解剖学研究 解剖学研究

背景情况:

  • 肋下横向腹部平面块 (scTAPB) 提供前腹壁止痛,但具有有限和可变的传播.
  • 由于水解难度,scTAPB的连续注入技术具有挑战性.
  • 调查增强scTAPB疗效的替代方法对于临床应用至关重要.

研究的目的:

  • 为了比较两个连续的scTAPB注射 (2scTAPI) 与单次scTAPB注射 (1scTAPI) 的神经覆盖.
  • 用尸体模型评估染料扩散到前腹壁神经的程度.

主要方法:

  • 用了16个尸体受试者,在超声波指导下注射着染料.
  • 一侧接受了一次20mL注射 (1scTAPI) 沿着肋骨边缘.
  • 反侧接受了20mL,分为两次注射 (2scTAPI),中间和侧面的半径线.

主要成果:

  • 2scTAPI达到5个连续神经的中位数 (IQR5-6),明显超过1scTAPI的3个 (IQR3-4).
  • 2scTAPI在85%的受试者中显示了覆盖T8-T12神经的扩散.
  • 1scTAPI主要覆盖神经T9-T11.

结论:

  • 在尸体中,两个连续的scTAPB注射在肋骨边缘提供了更大的扩散.
  • 与1scTAPI相比,2scTAPI表明前腹壁神经的覆盖范围更大.
  • 需要进一步的临床研究来验证这些发现.