一本关于全身手术局部麻醉选择的实用指南 (WALANT):基于实验室的实验研究
Ahmad AlShammari1, Julia M Harrison1, Bradley Greene1
1From Division of Plastic Surgery, Department of Surgery, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.
供应链问题限制了广泛清醒的局部麻醉选择,局部麻醉没有带 (WALANT) 手术. 这项研究提供了用二碳酸缓冲局部麻醉剂的指导,以达到舒适注射的最佳pH值.
科学领域:
- 麻醉学 麻醉学
- 手术手术手术手术手术
- 药理学 药理学是指药理学的学科.
背景情况:
- 持续的供应链中断影响了手术局部麻醉剂的可用性.
- 广泛清醒局部麻醉无护 (WALANT) 程序需要特定的局部麻醉制剂,通常涉及上腺素和碳酸.
- 优化局部麻醉剂的pH值对于减少注射疼痛和确保患者在WALANT手术期间舒适至关重要.
研究的目的:
- 为了确定二碳酸盐 (NaHCO3) 对WALANT手术中使用的各种局部麻醉剂的最佳缓冲能力.
- 为外科医生提供关于准备局部麻醉溶液的实用指导,以调整pH值以改善患者体验.
- 为了确定哪些局部麻醉剂可以安全地在没有沉的情况下缓冲.
主要方法:
- 商用局部麻醉剂的pH值测试,包括利多卡因,布皮瓦卡因,梅皮瓦卡因和罗皮瓦卡因.
- 系统地向缓冲样本增加0.1毫升的二碳酸 (NaHCO3),直到达到目标生理pH值或形成沉物.
- 评估了上腺素与不同局部麻醉剂和缓冲剂的兼容性.
主要成果:
- 每10毫升1%的利多卡因与上腺素的1.0毫升8.4%的二碳酸产生了7.3.3的pH.
- 布皮瓦卡因沉含量>0.2毫升NaHCO3每10毫升;罗皮瓦卡因沉含所有测试量的NaHCO3.
- 梅皮瓦卡因可以在没有沉的情况下以0.3毫升NaHCO3每10毫升缓冲,达到生理学pH值.
结论:
- 可以使用特定量的碳酸缓冲利多卡因和梅皮瓦卡因,以达到WALANT程序的最佳pH值.
- 由于降水问题,布皮瓦卡因和罗皮瓦卡因不适合用二碳酸进行缓冲.
- 这项研究为外科医生提供了必要的指导,以便在供应链挑战中准备安全和舒适的局部麻醉解决方案.
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