混合麻醉有没有有益的影响*?
1Department of Anesthesiology, Hirosaki University Graduate School of Medicine, Hirosaki, 036-8562, Japan. hirotak@hirosaki-u.ac.jp.
Journal of anesthesia
|March 29, 2024
概括
混合麻醉,将低剂量普罗波与吸入剂结合起来,为普罗波的短缺提供了解决方案,并减少了浪费. 这种方法可以减轻全静脉麻醉和挥发性麻醉的缺点.
科学领域:
- 麻醉学 麻醉学
- 药理学 药理学是指药理学的学科.
背景情况:
- 随着COVID-19大流行,ICU中增加了propofol的使用,导致供应短缺和浪费.
- 医院只为诱导而使用普罗波,因注射器中的残留量而增加了废物.
研究的目的:
- 提出混合麻醉,低剂量普罗波福和吸入麻醉剂的组合,作为替代麻醉技术.
- 为了解决普罗波福尔供应问题并减少麻醉剂相关的浪费.
主要方法:
- 文学评论比较了全静脉麻醉 (TIVA) 和挥发性麻醉.
- 混合麻醉的概念建议,结合TIVA和挥发性剂.
主要成果:
- 挥发性麻醉有缺点,包括促进癌症,出现激动,减少运动唤起潜力 (MEP),喉发作和术后恶心和吐 (PONV).
- 在癌症手术中,TIVA提供了诸如改善癌症手术生存率,减少出现动荡,喉发作,PONV和更好的MEP痕迹等好处,但具有更高的手术内意识风险.
结论:
- 混合麻醉可以通过利用各自的优势来抵消TIVA和挥发性麻醉的缺点.
- 这种综合方法提供了一个潜在的可行和有利的麻醉选择.
相关概念视频
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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.
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Various sedation levels offer significant advantages in facilitating procedural interventions for patients undergoing medical or invasive surgical procedures. These levels span from anxiolysis to general anesthesia, providing a spectrum of sedative effects to cater to specific patient needs. Anxiolysis reduces anxiety and is achieved through minimal sedation, enabling patients to remain awake and responsive while feeling more at ease during the procedure. This level can benefit minor...
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Intravenous anesthetics are drugs administered parenterally to induce anesthesia or sedation. Propofol is a widely used agent formulated as a 1% emulsion in soybean oil, glycerol, and egg phosphatide. It induces rapid anesthesia primarily due to its rapid distribution from the bloodstream to target tissues and is metabolized in the liver. However, it can cause significant pain on injection and hypertriglyceridemia. Fospropofol, a water-based prodrug of propofol, lacks these adverse effects.
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Local Anesthetics: Clinical Application as Epidural Anesthesia
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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...
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Inhalational Anesthetics: Overview
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Inhalation anesthetics are drugs that induce general anesthesia upon inhalation. They work by increasing the sensitivity of GABAA receptors or inhibiting NMDA receptors, leading to a decrease in central nervous system activity. The depth of anesthesia can be rapidly adjusted by changing the concentration of the inhaled gas. Some common examples of inhalational anesthetics include volatile liquids like isoflurane, desflurane, sevoflurane and gases like xenon and nitrous oxide. Isoflurane, a...
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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...
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