通过巴克洛芬为外科手术期间的止痛药物输送内吗啡
Austin W Li1, Christina K Hardesty
1From the Case Western Reserve University School of Medicine, Cleveland, OH (Mr. Li and Dr. Hardesty), and the Pediatric Orthopedic Surgery, Rainbow Babies and Children's Hospital, Cleveland, OH (Dr. Hardesty).
概括
通过巴克洛芬输入肠道吗啡可以为接受手术的儿童提供有效的疼痛管理. 这种方法提供安全的外科手术期间止痛,最大限度地减少常见的副作用.
科学领域:
- 儿科麻醉学 儿科麻醉学
- 神经外科 神经外科
- 疼痛管理 疼痛管理
背景情况:
- 患有异常声调的儿童往往需要内巴克洛芬来进行管理.
- 这些患者经常患有神经肌肉脊柱病或其他需要广泛手术和缓解疼痛的疾病.
- 巴克洛芬具有一个导管接入口,用于导管内空间的流体操纵.
研究的目的:
- 描述植入的巴克洛芬用于输入甲状腺吗啡的使用.
- 评估该方法在儿科患者的术后疼痛管理中的有效性和安全性.
- 要突出实施这种技术的基本安全考虑.
主要方法:
- 一系列案例描述了通过现有的巴克洛芬给人注射内吗啡 (Duramorph) 的情况.
- 专注于治疗需要广泛手术的患者的术后疼痛.
- 详细审查安全协议和程序步骤.
主要成果:
- 通过巴克洛芬输送的内吗啡被证明对外科手术期间止痛有效.
- 该技术显示,副作用的风险很小,包括呼吸抑制,和恶心/吐.
- 在描述的情况中,成功实现了疼痛控制.
结论:
- 植入的巴克洛芬可以安全有效地用于静脉注射吗啡.
- 这种方法为选择儿科群体的外科手术期疼痛控制提供了可行的选择.
- 仔细遵守安全指南对于成功实施至关重要.
相关概念视频
Drug Delivery: Parenteral Route
1.4K
The parenteral route is a critical method of drug administration. It delivers compounds directly into the systemic circulation and bypasses the gastrointestinal tract. This approach is particularly advantageous for drugs that exhibit poor absorption or instability when administered orally.
There are three primary parenteral routes: intravenous (IV), intramuscular (IM), and subcutaneous (SC). The IV route introduces the drug directly into the bloodstream, ensuring immediate action. The IM route...
There are three primary parenteral routes: intravenous (IV), intramuscular (IM), and subcutaneous (SC). The IV route introduces the drug directly into the bloodstream, ensuring immediate action. The IM route...
1.4K
Local Anesthetics: Clinical Application as Epidural Anesthesia
669
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...
669
Local Anesthetics: Clinical Application as Spinal Anesthesia
1.3K
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...
1.3K
Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia
1.1K
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...
One of the advantages of...
1.1K
Opioid Analgesics: Synthetic and Semisynthetic Opioids
878
Synthetic and semisynthetic opioids are pivotal in pain management and tackling opioid addiction. Semisynthetic opioids, including morphinans (morphine derivatives), oxycodone, oxymorphone, hydrocodone, and hydromorphone, have improved pharmacokinetic profiles compared to morphine. Additionally, heroin and 6-MAM (6-Monoacetylmorphine) show better CNS penetration than morphine due to heightened lipid solubility. Hydromorphone, a potent opioid, undergoes hepatic metabolism to form the active...
878
Parenteral Anesthetics: Overview
541
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.
541


