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"局部麻醉药" 4 results
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摘要:目的:探讨通过腹腔内注射局部麻醉药在腹腔镜胆囊切除术中的镇痛效果。方法:52例患者随机分为4组,Ⅰ组术前腹腔内喷洒0.75％罗哌卡因20 mL;Ⅱ组术后腹腔内喷洒0.75％罗哌卡因20 mL;Ⅲ组为术后腹腔内喷洒0.5％布比卡因20 mL;Ⅳ组术后腹腔内喷洒生理盐水20 mL。麻醉方法均为全凭静脉麻醉。术后1、2、3、4 h 4个时间点记录患者术后疼痛视觉模拟评分(VAS)。并观察4组术后使用镇痛药物的例数和肩背痛、恶心呕吐发生率。结果:术后1、2、3、4 h VAS评分Ⅱ组lt;Ⅲ组lt;Ⅰ组lt;Ⅳ组(Plt;0.05)。Ⅳ组使用镇痛药物的例数明显高于Ⅰ组、Ⅱ组和Ⅲ组(Plt;0.05)。4组术后肩背痛、恶心呕吐发生率差异无显著性(Pgt;0.05)。结论:经腹腔给局麻药镇痛效果明显,术毕给药镇痛效果优于术前给药,罗哌卡因镇痛效果优于布比卡因。Abstract: Objective: To investigate the effect of intraperitoneal local anesthetic on patients undergone laparoscopiccho1ecystectomy.Methods:Fiftytwo patients were randomly divided into four groups. Group Ⅰ received preoperational anesthetic spary with 20 mL of 0.75％ ropivacaine. Group Ⅱ was given the anesthetic ata same dosage after the operation. Group Ⅲ received preoperational anesthetic spary with 20 mL of 0.5％ bupivacaine. Group Ⅳ received preoperational anesthetic spary with 20 mL saline. The LC was completed under general anesthesia.After the operation,visual analog scale (VAS)was recorded at 1,2,3 and 4 hours to evaluate the degree of postoperative pain.Meanwhile,the number of the patients who received anesthetics after the surgery,as well as the incidence rates shoulder or back pain and nausea or vomiting were recorded. Results: Postoperative VAS of the group Ⅱ was significantly lower than that of the other three groups, while the VAS of group Ⅲ was significantly lower than that in group Ⅰ(both Plt;0.05).Compared to groups Ⅰ, Ⅱ and Ⅲ,more patients in the group Ⅳ needed anesthetics after the operation (Plt;0.05).No significant diference was noticed in the incidence rates of shoulder or back pain and nausea or vomiting among the four groups (Pgt;0.05).Conclusions: Intraperitoneal local anesthetic can significantly reduce postoperative pain after LC. It is more effective to give local anesthetic at the end of the procedure than using it before operation. The effect of ropivacaine is better than bupivacaine.
Release date：2016-09-08 10:12
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早泄是最常见的男性性功能障碍，药物一直是早泄治疗的焦点。选择性5-羟色胺再摄取抑制剂（SSRIs）是目前临床证据最多、应用最广泛的药物，其中达泊西汀是唯一被批准用于治疗早泄的短效SSRI；局部麻醉药物疗效确切，可按需使用，且不良反应少，是治疗早泄的理想药物；α1-肾上腺素能受体阻滞剂、5型磷酸二酯酶抑制剂、曲马多的有效性和安全性尚缺乏大量确切临床证据，今后有望成为治疗早泄的新方法。随着对生理性射精过程和相关神经递质的深入研究，将会为早泄的药物治疗提供新的思路和选择。
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局部麻醉药在临床上被广泛应用，但在实际应用中总会产生各种无法避免的毒副作用。近年来相关研究通过加入各种辅助药物使局部麻醉药的毒副作用减轻且增强其麻醉效果，由于每一种辅助药物与局部麻醉药配伍各有其优缺点，寻找起效时间短、作用时间长、感觉运动分离且不良反应少的配伍药物参与的局部麻醉效果，有待大家进一步的努力。现就该领域的最新研究进展作一阐述。
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自局部麻醉药应用于临床以来，临床上出现了许多局部麻醉药心脏毒性不良反应的案例，但目前对这方面的认识仍然存在争议。该文对局部麻醉药心脏毒性不良反应的构效关系、量效关系、诊断、预防及治疗方面的研究进展进行了综述。
Release date：2017-10-27 11:09
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