鞘内应用辅助药物复合局部麻醉药在蛛网膜下腔阻滞中的研究进展

在蛛网膜下腔阻滞中,影响阻滞平面和效果的最主要因素是药物总剂量。然而,局部麻醉药剂量过大易引起很多不良反应,局麻药剂量过小会导致阻滞平面和效果不足。现有的文献表明,已经有很多减少局部麻醉药剂量同时添加一些鞘内辅助药物如右美托咪定、阿片类药物、氯胺酮等来提高阻滞效果的试验,使用这些辅助用药可以延长阻滞时间,提高腰麻成功率及患者的满意度,与全麻相比,可以减少耗材的使用以及加快患者恢复。现主要对鞘内应用辅助药物复合局部麻醉药在腰麻中的研究进展进行综述。

Research progress of administration of adjuvant drugs added to the intrathecal local anesthetics in subarachnoid block

In subarachnoid block,the most important factor affecting block plane and effect is the total dose of drug.A large dose of local anesthetics is likely to cause many adverse reactions,and a small dose of local anesthetics will lead to insufficient blocking plane and effect.However,the existing literature shows that there have been many trials to reduce the dose of local anesthetics and add some intrathecal auxiliary drugs,such as dexmedetomidine,opioids,ketamine,etc.to improve the blocking effect.Using these auxiliary drugs can prolong the blocking time,improve the power of lumbar anesthesia and improve the satisfaction of patients.Compared with general anesthesia,it can reduce the use of consumables and accelerate the recovery of patients.This article mainly reviews the research progress of intrathecal application of auxiliary drugs combined with local anesthetics in lumbar anesthesia.