Опыт применения адъювантов при выполнении регионарных блокад (обзор литературы)

Регионарная анестезия за последние годы зарекомендовала себя как перспективное направление в анестезиологии, позволяющее значитель- но сократить общее периоперационное потребление опиоидов и, соответственно, число осложнений, ассоциированных с их применением. Основная проблема данного направления – ограниченная длительность блокады. Большое внимание уделяется методам фармакологической пролонгации сенсорной блокады. Этого можно достичь с помощью адъювантов – препаратов, усиливающих действие местных анестетиков. Данное направление чрезвычайно популярно в зарубежных исследованиях. В настоящее время описано пять ключевых групп адъювантов: α-адреномиметики (адреналин), α2-агонисты (дексмедетомидин, клофелин), глюкокортикостероиды (дексаметазон), опиоидные анальгетики (морфин, трамадол, фентанил), а также прочие препараты (кетамин, магния сульфат, нестероидные противовоспалительные средства (НПВС), прегабалин).
Цель обзора – систематизировать данные о роли адъювантов в пролонгировании регионарных блокад в комбинации с местными анестетиками.

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