New insights into the use of dexamethasone-dexmedetomidine as perineural adjuvants in peripheral nerve and fascial blocks: an up-to-date narrative review.

IF 2.9 3区 医学 Q1 ANESTHESIOLOGY
Francesco Marrone, Pierfrancesco Fusco, Eros Pilia, Laura B Colantonio, Carmine Pullano
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引用次数: 0

Abstract

The discovery of the mechanism of action of local anesthetics, involving the blocking of sodium ion channels is considered a milestone in anesthesia. Potentially lethal toxic effects occur in the case of intravascular injection of local anesthetic (LA) or in case of exceeding dosages, as a result of systemic reabsorption. Attempts to prevent these life-threatening events have been made by developing novel LA and by adding adjuvants. The aim of this up-to-date review was to provide the newest insights on the two adjuvants dexamethasone and dexmedetomidine for regional anesthesia. The addition of perineural dexamethasone-dexmedetomidine combination has shown a faster onset, longer duration of action and increased intensity of neuronal blockade of regional anesthesia compared to perineural single adjunct. This is consistent with clinical studies (trials, observational studies and reports) of a marked prolongation of the local anesthetic effect. Nevertheless, further studies are needed to ascertain the full potential of this technique and all possible associated risks.

地塞米松-右美托咪定作为周围神经辅助剂用于周围神经和筋膜阻滞的新见解:最新的叙述回顾。
局部麻醉剂的作用机制的发现,包括钠离子通道的阻断,被认为是麻醉的一个里程碑。由于全身重吸收,在血管内注射局部麻醉剂(LA)或超过剂量的情况下,可能发生致命的毒性作用。通过开发新的LA和添加佐剂,人们试图预防这些危及生命的事件。这篇最新综述的目的是为区域麻醉的两种佐剂地塞米松和右美托咪定提供最新的见解。与神经周围单佐剂相比,加入神经周围地塞米松-右美托咪定联用对区域麻醉起效更快,作用持续时间更长,神经元阻滞强度增加。这与局部麻醉效果显著延长的临床研究(试验、观察性研究和报告)一致。然而,需要进一步的研究来确定这项技术的全部潜力和所有可能的相关风险。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Minerva anestesiologica
Minerva anestesiologica 医学-麻醉学
CiteScore
4.50
自引率
21.90%
发文量
367
审稿时长
4-8 weeks
期刊介绍: Minerva Anestesiologica is the journal of the Italian National Society of Anaesthesia, Analgesia, Resuscitation, and Intensive Care. Minerva Anestesiologica publishes scientific papers on Anesthesiology, Intensive care, Analgesia, Perioperative Medicine and related fields. Manuscripts are expected to comply with the instructions to authors which conform to the Uniform Requirements for Manuscripts Submitted to Biomedical Editors by the International Committee of Medical Journal Editors.
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