Pregledni rad
https://doi.org/10.20471/acc.2022.61.s2.07
Pro and Contra on Adjuvants to Neuroaxial Anesthesia and Peripheral Nerve Blocks – Review Article
Lada Kalagac Fabris
orcid.org/0000-0001-8645-2128
; Departement of Anesthesiology, Intensive Medicine and Pain Therapy General Hospital Pula, Croatia
Sažetak
Modern approach in surgical treatment and in managing acute and chronic pain is
nowadays more and more based on the implementation of all possible techniques of regional anesthesia
(RA). Local anesthetics (LA) are needed to achieve standard regional anesthesia. Local anesthetics
are primarily characterized by time constraints and duration of action, and depending on the amount
applied, adverse effects on the cardiac and central nervous system may occur.
Adjuvants are drugs used together with LA due to their synergistic effect, i.e. they improve start
latency and duration of sensory and motor blockade and enable reduction of cumulative dose of LA
and reduction of adverse effects on cardiac and nervous system. Nowadays, there is a huge variety of
drugs that can be administered in combination with LA, and they, in general, can be divided into
opioid and non-opioid adjuvants. The administration of opioids in RA over an extended time period
was accompanied by some negative characteristics as respiratory depression, nausea, vomiting. So,
their usage is still under a special control. Due to the positive effects shown by drugs from non-opioid
adjuvants group (e.g. adrenaline, alpha adrenergic agonists, steroids, magnesium, midazolam, ketamine
etc.), indications for their administration broadened. However, there are still some restrains in clinical
practice based on the fact that neurotoxicity and demonstration of neurological complications in regional
anesthesia haven’t been properly researched yet.
Ključne riječi
Adjuvants; Local anesthetics; Neuraxial block; Peripheral neural block; Opioids; Non-opioids
Hrčak ID:
284301
URI
Datum izdavanja:
1.9.2022.
Posjeta: 879 *