[Local anesthesia in percutaneous nephrostomy and trocar epicystostomy].

Q4 Medicine Khirurgiya Pub Date : 2024-01-01 DOI:10.17116/hirurgia202411165
I V Feofilov
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Abstract

Introduction: In some cases, percutaneous nephrostomy (PNS) and trocar epicystostomy (TCS), which require adequate anesthesia, are used to restore the passage of urine. The choice of method, namely general or local anesthesia, depends on many factors, including the risks and complications of anesthetic care and should be made individually.

Objective: To analyze the efficacy and safety of local anesthesia using articaine in PNS and TCS.

Materials and methods: The study included 85 patients aged 40-60 years who had undergone PNS or TCS. Positive allergic background, significant comorbidity, severe obesity, cicatrical changes in the area of operation were the exclusion criteria. Patients were divided into two groups depending on the type of anesthetic for local anesthesia. Specifically, 2% Articaine-Binergia - 2 ml diluted in 10 ml of 0.9% saline solution was used in the first group of 48 (40 PNS and 8 TCS) humans, and 2% Lidocaine - 2 ml in the same dilution was used in the second group of 37 (30 PNS and 7 TCS) subjects.

Results: The articaine group has been considerably superior to the lidocaine one on all indicators in the clinical evaluation of anesthesia's efficacy in scores. A better safety profile has been noted by symptoms of allergic reaction, tissue neurotoxicity, formation of hematomas and infiltration of the injection site in the analysis of adverse events (complications) in the articaine group.

Conclusions: The conducted study on the use of Articaine-Binergia in urological interventions requiring local anesthesia, in particular such as PNS and TCS, showed that Articaine-Binergia exceeded lidocaine in analgesic effect and safety profile, and, importantly, saving in anesthetic's use due to the lower total volume of administration has been noted.

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[经皮肾造瘘术和套管肾盂造瘘术中的局部麻醉]
导言:在某些情况下,需要进行充分麻醉的经皮肾造瘘术(PNS)和套管肾盂造口术(TCS)可用于恢复尿液通过。选择何种方法,即全身麻醉还是局部麻醉,取决于很多因素,包括麻醉护理的风险和并发症,应根据具体情况而定:分析在 PNS 和 TCS 中使用阿替卡因进行局部麻醉的有效性和安全性:研究纳入了 85 名年龄在 40-60 岁之间、接受过 PNS 或 TCS 的患者。阳性过敏背景、严重合并症、严重肥胖、手术区域有糜烂性病变是排除标准。根据局部麻醉的麻醉剂类型,患者被分为两组。具体来说,第一组 48 人(40 名 PNS 和 8 名 TCS)使用 2% 阿替卡因-宾格亚 - 2 毫升稀释在 10 毫升 0.9% 生理盐水中,第二组 37 人(30 名 PNS 和 7 名 TCS)使用相同稀释度的 2% 利多卡因 - 2 毫升:结果:在麻醉效果的临床评估评分中,阿替卡因组在所有指标上都明显优于利多卡因组。在不良事件(并发症)的分析中,阿替卡因组的过敏反应症状、组织神经毒性、血肿形成和注射部位浸润的安全性更好:关于在需要局部麻醉的泌尿外科手术中使用阿替卡因-宾格亚的研究表明,阿替卡因-宾格亚在镇痛效果和安全性方面均优于利多卡因。
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来源期刊
Khirurgiya
Khirurgiya Medicine-Medicine (all)
CiteScore
0.70
自引率
0.00%
发文量
161
期刊介绍: Хирургия отдельных областей сердце, сосуды легкие пищевод молочная железа желудок и двенадцатиперстная кишка кишечник желчевыводящие пути печень
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