Автор: Зубарев А.С.
создано: 25.03.2010 14:43
К сожалению, правда заключается в том, что системная токсичность на локальные анестетики (включая остановку сердца) может случаться и у вполне компетентных специалистов, которые не превышали рекомендованных доз и концентраций анестетика и при отсутствии очевидного внутрисосудистого введения (отрицательных аспирационных пробах и пр.).
http://emedicine.medscape.com/article/819628-overview
***
ASRA recommendations on systemic toxicity of local anesthetics
The American Society of Regional Anesthesia (ASRA) has developed a series of recommendations addressing the systemic toxicity of local anesthetics. The AAOS Council on Research, Quality Assessment and Technology reviewed the recommendations, and the AAOS Board of Directors, at its meeting on June 12, 2008, agreed to publish them in AAOS Now.
Prevention of systemic local anesthetic toxicity
Be vigilant. Monitoring electrocardiogram, blood pressure, and arterial oxygen saturation is recommended.
Communicate frequently with the patient to query for symptoms of toxicity.
Limit local anesthetic (LA) dose based on site of injection, hypercapnia, advanced age, poor cardiac function, ischemic heart disease, cardiac conduction abnormalities (see notes), metabolic (especially mitochondrial) disease, or abnormally low plasma protein concentration.
Aspirate syringe prior to each injection observing for blood or cerebrospinal fluid.
Inject small volumes (5 mL), incrementally (45–60 sec intervals) observing for signs and symptoms of toxicity between each injection.
Use a pharmacologic marker (e.g., epinephrine 5 mcg/mL of LA). Know the expected response, onset, duration, and limitations of “test dose” in identifying intravascular injection.
Monitor the patient after completion of injection as peak blood concentrations may not occur for up to 30 minutes.
|
Re: Реакция на лидокаин 
Re: Реакция на лидокаин 
Re: Реакция на лидокаин