Box 2
As bupivacaine should be used in prdetence shon acing drugs like lidocaine Care must be taken to avoid exceeding the recom mended maximum dose bupivacaine 2 mekg). Bupivacaine is racemic mixture containing equal quantities of the d and isomers, Levotupivacaine contains only the Hisomer and, dose for dose, has a higher threshold for central nervous and cardio- vascular toxicity so is probably safer when large quantities of agent are injected. The duration of local anaesthesia can be extended using catheter techniques with either infusion or intermittent administration of local anaesthetic This can be applied to epidu. rah, plexus or nerve blocks and has been described as take home analgesia after a number of surgical procedures using an elasto- meric pump
It is always worth considering whether local anaesthesia can contribute to postoperative analgesia. The choice of technique is dictated by the site of surgery (for example spinal for lower limb surgery) and its relationship to the territory of a nerve or nerve plexus (for example brachial plexus). Some techniques such as wound infiltration and fascia iliaca block are simple and easily learnt. Others, such as thoracic epidurals, require extensive training and/or complex equipment. All techniques require planning to anticipate the duration of effect, the need for moni- toring and the potential complications and side-effects.
Box 2 As bupivacaine should be used in prdetence shon acing drugs like lidocaine Care must be taken to avoid exceeding the recom mended maximum dose bupivacaine 2 mekg). Bupivacaine is racemic mixture containing equal quantities of the d and isomers, Levotupivacaine contains only the Hisomer and, dose for dose, has a higher threshold for central nervous and cardio- vascular toxicity so is probably safer when large quantities of agent are injected. The duration of local anaesthesia can be extended using catheter techniques with either infusion or intermittent administration of local anaesthetic This can be applied to epidu. rah, plexus or nerve blocks and has been described as take home analgesia after a number of surgical procedures using an elasto- meric pump It is always worth considering whether local anaesthesia can contribute to postoperative analgesia. The choice of technique is dictated by the site of surgery (for example spinal for lower limb surgery) and its relationship to the territory of a nerve or nerve plexus (for example brachial plexus). Some techniques such as wound infiltration and fascia iliaca block are simple and easily learnt. Others, such as thoracic epidurals, require extensive training and/or complex equipment. All techniques require planning to anticipate the duration of effect, the need for moni- toring and the potential complications and side-effects.
การแปล กรุณารอสักครู่..
