局部麻醉剂的剂量用于带平面块,以避免系统性毒性:一个叙事审查
Jonathan G Bailey1,2, Garrett Barry3,4, Thomas Volk5
1Department of Anesthesia, Pain Management & Perioperative Medicine, Dalhousie University, Halifax, NS, Canada. jon.bailey@dal.ca.
Canadian journal of anaesthesia = Journal canadien d'anesthesie
|September 15, 2025
概括
高容量带状平面块 (FPB) 需要小心剂量,以防止局部麻醉的全身毒性 (LAST). 审查药理动力学数据对于安全的FPB管理和患者监测至关重要.
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:
- 带平面块 (FPB) 越来越多地用于大量局部麻醉剂 (LA).
- 这种做法可以接近或超过最大推的LA剂量.
- 了解LA的药理动力学对于安全至关重要.
研究的目的:
- 对常见的FPB进行药理动力学文献的审查.
- 评估LA的血度和局部麻醉系统毒性 (LAST) 的风险.
主要方法:
- 一个关于FPB研究的叙述性综述.
- 在PubMed,Embase,Cochrane图书馆和谷歌学者中进行了搜索.
- 包括"血度"",药理动力学"",毒性"",LAST"和特定的FPB名称等术语.
主要成果:
- 常见的FPB使用20-40毫升的LA,度如罗皮瓦卡因0.25-0.5%.
- 虽然平均LA血度往往低于毒性值,但有些患者超过了毒性值.
- 超过毒性值的患者有时会出现神经系统症状或发作,但并不总是如此.
结论:
- 谨慎的剂量和监测是必不可少的,以避免在FPBs期间LAST.
- 建议包括基于体重的剂量,吸收,增量注射和超声指导.
- 考虑低剂量的上腺素和降低LA度,随着体积的增加保持在安全范围内.
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