Characteristics of Local Anesthetics for Epidural Anesthesia

多くの局所麻酔薬のなかから硬膜外麻酔の用途に応じて薬剤を選択することは理想である. しかし, 心毒性, 神経毒性などが明らかとなり, 危険性の少ない薬剤が登場した今, 安全性は第一に考慮される選択基準である. さらに局所麻酔薬の効果の増強目的でさまざまな薬剤の添加が報告されているが, 効果と副作用のバランスを考慮した場合, その選択はごく限られる. また, 医療経済および事故防止の面から多種の同効薬剤を使用することは問題となりうる. その意味ではテスト注入に短時間作用性の薬剤を使用し, そのほかには安全性の高い局所麻酔薬を選択し, 用途に応じた濃度を使用すべきと思われる.

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