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相关概念视频

Local Anesthetics: Clinical Application as Epidural Anesthesia01:29

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...
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Local Anesthetics: Clinical Application as Spinal Anesthesia01:11

Local Anesthetics: Clinical Application as Spinal Anesthesia

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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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Parenteral Anesthetics: Overview01:24

Parenteral Anesthetics: Overview

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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 Intravenous Regional Anesthesia01:16

Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia

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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.
One of the advantages of...
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Local Anesthetics: Clinical Application as Surface, Infiltration, and Conduction Block Anesthesia01:30

Local Anesthetics: Clinical Application as Surface, Infiltration, and Conduction Block Anesthesia

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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...
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对注射聚烯胺凝进行最佳麻醉:一项随机试验

Neha G Gaddam1, Joanna Marantidis2, Noha T Ahmed1

  • 1Departments ofOB/GYN.

Urogynecology (Philadelphia, Pa.)
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概括

综合麻醉方案,包括尿道周阻塞,在办公室用聚烯胺 (PAHG) 注射治疗压力尿失禁 (SUI) 期间显著减少疼痛. 这种方法还改善了手术后的空白,支持其用于SUI/ISD治疗.

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科学领域:

  • 泌尿器科 泌尿器科 泌尿器科 泌尿器科
  • 麻醉学 麻醉学
  • 妇科 妇科医生 妇科

背景情况:

  • 压力尿失禁 (SUI) 和内在器缺陷 (ISD) 是女性常见的疾病.
  • 用聚烯胺液凝 (PAHG) 进行尿道积聚是一种流行的SUI/ISD办公室治疗方法.
  • 对于PAHG注射的最佳麻醉方案尚未建立.

研究的目的:

  • 在办公室PAHG注射期间,比较联合麻醉方案和局部麻醉方案之间的疼痛评分.
  • 评估二次结果,包括患者报告的失禁和改善得分.
  • 评估PAHG手术中不同麻醉方法的安全性和有效性.

主要方法:

  • 一个单盲随机试验比较了两种麻醉方案:联合 (EMLA奶油,尿道内利多卡因,周尿道阻塞) 与局部 (EMLA奶油,尿道内利多卡因).
  • 主要结局是使用10点视觉模拟尺度 (VAS) 评估疼痛.
  • 其次结果包括ICIQ-UI和PGI-I分数,以及非计划区块要求的安全终点.

主要成果:

  • 由于仅在局部治疗的手臂中满足了安全终点,招募工作被提前停止.
  • 组合麻醉组报告的VAS疼痛平均得分 (4.5) 与局部单一组 (7.4) 相比显著较低 (P<0.01).
  • 接受联合麻醉的受试者不太可能需要术后导管 (0%对33%,P=0.04).

结论:

  • 使用周尿道阻塞与局部麻醉剂一起,可以有效地减少在办公室PAHG注射期间的疼痛.
  • 综合麻醉方案改善了手术后排泄和患者舒适度.
  • 这些发现支持在患有SUI/ISD的妇女中实施PAHG手术的综合麻醉方法.