Adjuvant agents in regional anaesthesia

IF 0.2 Q4 ANESTHESIOLOGY
Mark Gallagher, Calum RK Grant
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引用次数: 0

Abstract

The addition of adjuvant agents to intrathecal and epidural anaesthetic techniques is well established, in particular opioids and clonidine. These adjuvants are utilized to improve the quality of anaesthesia and analgesia. Several other adjuvants have been studied but ongoing concerns surrounding safety and efficacy may limit their use in clinical practice. Epinephrine has for many years been administered in combination with local anaesthetic although more recently a diverse range of adjuvants have been added to peripheral nerve block solutions, again with the aim of prolonging surgical anaesthesia. The evidence to support or refute the benefit of these agents is increasing, as is our understanding of which agents have demonstrable efficacy and safety at clinically appropriate doses. Clinicians must be aware that many adjuvants are not licensed for central neuraxial or perineural use and should be aware of the risks, in particular of neurotoxicity and unwanted side effects.
区域麻醉的辅助药物
在鞘内和硬膜外麻醉技术中添加辅助药物,特别是阿片类药物和氯硝定,已得到广泛认可。使用这些辅助剂是为了提高麻醉和镇痛的质量。还对其他几种辅助剂进行了研究,但对其安全性和有效性的持续关注可能会限制它们在临床实践中的使用。多年来,肾上腺素一直与局部麻醉剂联合使用,但最近外周神经阻滞溶液中添加了多种辅助剂,目的也是为了延长手术麻醉时间。支持或反驳这些药剂益处的证据越来越多,我们对哪些药剂在临床适当剂量下具有可证实的疗效和安全性的认识也越来越深入。临床医生必须意识到,许多辅助剂并未获得用于中枢神经或神经周围麻醉的许可,因此应了解其风险,尤其是神经毒性和不必要的副作用。
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来源期刊
CiteScore
0.50
自引率
0.00%
发文量
152
期刊介绍: Anaesthesia and Intensive Care Medicine, an invaluable source of up-to-date information, with the curriculum of both the Primary and Final FRCA examinations covered over a three-year cycle. Published monthly this ever-updating text book will be an invaluable source for both trainee and experienced anaesthetists. The enthusiastic editorial board, under the guidance of two eminent and experienced series editors, ensures Anaesthesia and Intensive Care Medicine covers all the key topics in a comprehensive and authoritative manner. Articles now include learning objectives and eash issue features MCQs, facilitating self-directed learning and enabling readers at all levels to test their knowledge. Each issue is divided between basic scientific and clinical sections. The basic science articles include anatomy, physiology, pharmacology, physics and clinical measurement, while the clinical sections cover anaesthetic agents and techniques, assessment and perioperative management. Further sections cover audit, trials, statistics, ethical and legal medicine, and the management of acute and chronic pain.
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