{"title":"Adjuvant agents in regional anaesthesia","authors":"Mark Gallagher, Calum RK Grant","doi":"10.1016/j.mpaic.2024.08.007","DOIUrl":null,"url":null,"abstract":"<div><div>The addition of adjuvant agents to intrathecal and epidural anaesthetic techniques is well established, in particular opioids and clonidine. These adjuvants are utilized to improve the quality of anaesthesia and analgesia. Several other adjuvants have been studied but ongoing concerns surrounding safety and efficacy may limit their use in clinical practice. Epinephrine has for many years been administered in combination with local anaesthetic although more recently a diverse range of adjuvants have been added to peripheral nerve block solutions, again with the aim of prolonging surgical anaesthesia. The evidence to support or refute the benefit of these agents is increasing, as is our understanding of which agents have demonstrable efficacy and safety at clinically appropriate doses. Clinicians must be aware that many adjuvants are not licensed for central neuraxial or perineural use and should be aware of the risks, in particular of neurotoxicity and unwanted side effects.</div></div>","PeriodicalId":45856,"journal":{"name":"Anaesthesia and Intensive Care Medicine","volume":null,"pages":null},"PeriodicalIF":0.2000,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Anaesthesia and Intensive Care Medicine","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1472029924001711","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"ANESTHESIOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
The addition of adjuvant agents to intrathecal and epidural anaesthetic techniques is well established, in particular opioids and clonidine. These adjuvants are utilized to improve the quality of anaesthesia and analgesia. Several other adjuvants have been studied but ongoing concerns surrounding safety and efficacy may limit their use in clinical practice. Epinephrine has for many years been administered in combination with local anaesthetic although more recently a diverse range of adjuvants have been added to peripheral nerve block solutions, again with the aim of prolonging surgical anaesthesia. The evidence to support or refute the benefit of these agents is increasing, as is our understanding of which agents have demonstrable efficacy and safety at clinically appropriate doses. Clinicians must be aware that many adjuvants are not licensed for central neuraxial or perineural use and should be aware of the risks, in particular of neurotoxicity and unwanted side effects.
期刊介绍：
Anaesthesia and Intensive Care Medicine, an invaluable source of up-to-date information, with the curriculum of both the Primary and Final FRCA examinations covered over a three-year cycle. Published monthly this ever-updating text book will be an invaluable source for both trainee and experienced anaesthetists. The enthusiastic editorial board, under the guidance of two eminent and experienced series editors, ensures Anaesthesia and Intensive Care Medicine covers all the key topics in a comprehensive and authoritative manner. Articles now include learning objectives and eash issue features MCQs, facilitating self-directed learning and enabling readers at all levels to test their knowledge. Each issue is divided between basic scientific and clinical sections. The basic science articles include anatomy, physiology, pharmacology, physics and clinical measurement, while the clinical sections cover anaesthetic agents and techniques, assessment and perioperative management. Further sections cover audit, trials, statistics, ethical and legal medicine, and the management of acute and chronic pain.
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