NEURALTHERAPY - THERAPEUTIC USE OF LOCAL ANESTHETICS

Öz

Neural therapy, or therapeutic local anesthesia (TLA), is the diagnostic and therapeutic use of local anesthetics. This review summarizes the scientific and clinical evidence, indications, methods of application, and possible future research. In the literature, there is a gap between the multitude of data supporting a number of different molecular effects and the few clinical trials that are available. The available clinical studies and case reports, however, show effectiveness in acute and chronic pain, functional disorders, vegetative diseases such as the complex regional pain syndrome (CRPS), and chronic inflammation. Five administration methods are described: local, segmental, regional, and systemic application, as well as injections into the so called “stoerfeld” (disturbance field, interference field). Local anesthetics have been used for therapy for over 120 years, which suggests that this therapy may be an important, effective, and efficient therapy that has few side-effects. Possible clinical studies to reveal the potential effectiveness and benefit-risk ratio of this holistic approach are described

Anahtar Kelimeler

• Nervblock, Pharmacology, Pain/drug effects, Effectivness, Chronic Inflammation, Cost effectiveness, Regional Anesthesia, Autonomous nervous system, Procaine, Lidocaine, Lignocaine, Neuralgia including cavitational osteonecrosis.

NÖRALTERAPİ-LOKAL ANESTEZİKLERİN TERAPÖTİK KULLANIMI

Öz

Nöralterapi, ya da terapötik lokal anestezi (TLA), local anesteziklerin diagnostik ya da terapötik kullanımına verilen isimdir. Bu reviewda bilimsel ve klinik kanıtlar, endikasyonlar,uygulama metodları ve konuya ilişkin olası ileri araştırmalar özetlenmiştir. Literatürde, çeşitli moleküler etkileri destekleyen çok sayıda veri olmasına rağmen pek az sayıda klinik çalışma mevcuttur. Öte yandan varolan klinik çalışmalar ve vaka sunumları, akut ve kronik ağrıda, fonksiyonel rahatsızlıklarda, kompleks bölgesel ağrı sendromu (KBAS) gibi vejetatif hastalıklarda nöralterapinin etkinliğine işaret etmektedir. 5 farklı uygulama metodu tanımlanmıştır: lokal, segmental, rejyonal, ve sistemic uygulama ve de stoerfeld alanı içine enjeksiyonlar. (olumsuz uyarılmış alan, girişim alanı). Lokal anestezikler 120 yılı aşkın süredir kullanılmaktadır ki bu da bu tedavinin yan etkileri az, önemli, etkin ve verimli bir tedavi olduğuna işaret etmektedir. Bu bütünsel yaklaşıma dair etkinlik potansiyeli ve fayda-risk oranlarını analiz eden olası klinik çalışmaların tanımlanması da ayrıca hedefler arasındadır

Anahtar Kelimeler

• Nöralterapi Lokal Anestezik, Sinir Blokajı, Farmakoloji, Ağrı, İlaç Etkileri, Etkinlik, Kronik İnflamasyon, Kostefektivite, Rejyonel Anestezi, Otonom Sinir Sistemi, Prokain, Lidokain, Lignokain, Nöralji.

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