摘要
Application of local anesthetic(LA) combined with epinephrine in nerve block has been used as a routine for near 100 years.But the routine has oppugned recently.1.The self-modulation function of spinal cord blood-supply can be influenced by some diseases,such as atherosclerosis,diabetes,imbalance of homeostasia spinal cord trauma or disease.It is difficult to avoid the ischemia injury of spinal cord when application of LA adjunctive epinephrine. 2.Peripheral nerve toxicity reaction of LA appears after intrathecal nerve block anesthesia,and action of application of LA combined with epinephrine on "susceptible injury areas" can not be excluded. 3.Permanence or temporality injury of peripheral nerve not only relates to application of LA combined with epinephrine,but also relates to the injury induced by patient positioning or manipulation during surgery. 4.The time to plasm peak concentration of LA may be postponed by LA adjunctive epinephrine,but the concentration can not be reduced.However,there are no a great amount of information or sample of epidemiology investigation may prove that the incidence of LA induced toxicity is diminished by LA adjunctive epinephrine as yet. 5.It is a century since the anesthesiologists added epinephrine to LA in during nerve block anesthesia.The reports of nerve injury in nerve block anesthesia were published ceaselessly.It is uncertain that the nerve injury is related to LA adjunctive epinephrine.However ,it is difficult to affirm correlation to epinephrine.
Application of local anesthetic（LA） combined with epinephrine in nerve block has been used as a routine for near 100 years. But the routine has oppugned recently.
1. The self-modulation function of spinal cord blood-supply can be influenced by some diseases, such as atherosclerosis, diabetes, imbalance of homeostasia spinal cord trauma or disease. It is difficult to avoid the ischemia injury of spinal cord when application of LA adjunctive epinephrine.
2. Peripheral nerve toxicity reaction of LA appears after intrathecal nerve block anesthesia, and action of application of LA combined with epinephrine on ＂susceptible injury areas＂ can not be excluded.
3. Permanence or temporality injury of peripheral nerve not only relates to application of LA combined with epinephrine, but also relates to the injury induced by patient positioning or manipulation during surgery.
4. The time to plasm peak concentration of LA may be postponed by LA adjunctive epinephrine , but the concentration can not be reduced. However, there are no a great amount of information or sample of epidemiology investigation may prove that the incidence of LA induced toxicity is diminished by LA adjunctive epinephrine as yet.
5. It is a century since the anesthesiologists added epinephrine to LA in during nerve block anesthesia. The reports of nerve injury in nerve block anesthesia were published ceaselessly. It is uncertain that the nerve injury is related to LA adjunctive epinephrine. However ,it is difficult to affirm correlation to epinephrine.
出处
《国际麻醉学与复苏杂志》
CAS
2006年第5期290-292,共3页
International Journal of Anesthesiology and Resuscitation
