高浓度局麻药神经阻滞

Nerve block using high-concentration local anesthetics

局麻药神经阻滞治疗疼痛对神经损伤少,但镇痛时间短,而多次阻滞增加患者的痛苦。因而高浓度局麻药神经阻滞的应用逐渐增多,其神经毒性的影响除药物本身外,血管收缩药的添加、局麻药液中的防腐剂均参与作用。虽然诸多作者将各种高浓度局麻药应用于临床并取得疗效,但它对阻滞后所引起的神经组织学改变,应高度重视和观察。动物实验的资料与临床上所发生的现象能否一致,以及适应证和药物配方等均应进一步探讨。

Nerve blocks by local anesthetics for the treatment of pain diseases cause lesser damage to nerves. As a matter of fact, the analgesic effect lasts only a short period of time. While repeating blocks add suffering to patients. Therefore, nerve blocks using high-concentration local anesthetics are applied gradually. During the treatment, the influence on neurotoxicity is made not only by local anesthetic itself, but also by vasoconstrictors and antiseptics added to it Though clinical application of high-concentration local anesthetics have been reported and favorable effects achieved, the neurohistological changes after blocking should be monitored and be taken into serious account. The coherence between the data from animal experiment and clinical phenomena, the indications and the prescription should be further discussed.