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摘要: 术中麻醉根据麻醉药物分布范围可分为全身麻醉和局部麻醉，其中局部麻醉在整形美容手术中的应用较为广泛。传统剂型经皮递送局麻药作用时间较短，且脂溶性差，限制了其在体表透皮方面的应用。近年来，随着麻醉技术的发展，新型体表镇痛局麻药递送系统可将涂抹于皮肤的药物递送至真皮层以阻滞神经末梢痛觉传入，从而达到镇痛的效果，提高了药物递送效率。此外，透皮给药相较于注射给药可显著增加给药安全性和患者舒适度。本文概述了常用的局麻药透皮吸收促进方法以及目前已上市的透皮局麻药物，并结合研究进展对局部麻醉透皮技术在整形美容手术中的应用和发展作一展望。Abstract: Intraoperative anesthesia can be divided into general anesthesia and local anesthesia according to the distribution of anesthetic drugs, and local anesthesia has broad applications in plastic surgery. The short acting time and poor lipid solubility of local anesthetics on conventional dosage limit their application in transdermal delivery. In recent years, there has been rapid developments in the topical analgesic transdermal delivery system, through which a drug penetrates the cuticle of the skin and enters the dermis to block the introduction of nerve terminal pain, so as to achieve the analgesic effect. In addition, transdermal administration can significantly increase safety and patient comfort compared to injectable administration. In this review, the commonly used methods of promoting transdermal absorption and topical analgesics on the market were overviewed, and the application and future direction of anesthetics in plastic and cosmetic surgery were prospected based on the research progress.作者贡献：李默晗、孙丰润负责查阅文献、文章撰写及修改；王涛、贺渝淼、黄宇光提供文章修改建议；马超负责文章立意、审核及修订。利益冲突：所有作者均声明不存在利益冲突
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表 1 常见的透皮给药局麻药剂型
透皮给药方式 常见剂型 传统经皮吸收途径 乳膏剂、微乳剂、凝胶剂、巴布剂、脂质体、传递体 新型透皮给药系统
(微针贴片)实心微针、涂层微针、聚合物微针、空心微针 物理辅助促渗方法 超声、离子导入、激光辅助导入、电致孔 
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表 2 已上市的利多卡因透皮局麻药剂型与含量
商品名 剂型 药物(含量) Lidoderm 巴布剂 利多卡因(5%) ZTlido 贴膏剂 利多卡因(1.8%) EMLA 乳膏剂 利多卡因(2.5%)+丙胺卡因(2.5%) Synera 贴片 利多卡因(7%)+丁卡因(7%) LenzaGel 凝胶 利多卡因(4%)+薄荷醇(1%)
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