硬膜外和周围神经阻滞疗法的用药问题

Drugs used in epidural and peripheral nerve blocking therapy

硬膜外和周围神经阻滞疗法的常用药物主要是局部麻醉药和糖皮质激素类2种。局麻药应采用低浓度,在阻断痛觉的同时尽可能保留其运动功能。糖皮质激素中以长效的得宝松和利美达松为首选,短效的曲安奈德和泼尼松龙也可应用。镇痛合剂中可加入维生素B_(12),但其作用尚待证实。如果硬膜外用药不当或误入蛛网膜下腔会造成截瘫或其他严重并发症。

The local anesthetics and glucocorticoids are the two kinds drugs used commonly in epidural and peripheral nerve blocking therapy. Low concentration of local anesthetics should be used in order to block the conduction of sensory function and keep the motor function simultaneously. Diprospan and limethason among the glucocorticoids of long- term action are recommended firstly. In addition, triamcinolone acetonide and prednisolone of short-term action are also used. Vitamin B12 could be added to the analgesic mixture, but its efficacy should be verified later. The paraplegia and other severe complications will be caused if these drugs are used wrongly in epidural space or injected into the subarachnoid space.