TECHNICAL PERFECT IN THE MANAGEMENT OF PAIN
The mésoperfusion or slow mesotherapy is a multi-targeted hypodermoclysis mini-dosed. Hypodermoclysis = deep hypodermic infusion = -cutanée under infusion.
Initially used to treat dehydration in pediatrics and geriatrics.
Hypodermoclysis was abandoned in 1950 following complications such as sepsis and cardiovascular collapse, most often linked to improper use of the technique. Resurgent past fifteen years in geriatrics and diabetes. The technique of subcutaneous administration of solutes was validated by the study Lipschitz et al. which shows that the absorption of saline solution and tritium labeled technetium infused subcutaneously is equivalent to that obtained by the intravenous route. It provides a generator tissue impregnation of different stimuli, both in the microcirculation that micro-innervation and local immunity.
Comment of Dr. Michel PISTOR: "To better define this new process, we can say that the slow mesotherapy.Mesotherapy is normal that the infusion is a simple intravenous injection."
WHY MESOPERFUSION SEQUENTIAL ???
- Stimulation Effect of mechanoreceptors at the beginning of each sequence.
- Micro-injection rooms, no brutal tissue lacerations no hematoma that traps some of the mixture and whose absorption is accompanied by destruction of the mixture.
- Dissemination of rapid systemic part of the mixture, and slow for emptying reservoirs created indication, opioids have an onset of action: · 30 minutes po · a minute by intravenous route of · two to three minutes hypodermically
- Concept of "payload"
- Large area of effect: loco-regional dissemination in the target dermatome without first pass hepatic no decrease in circulating levels of AP
RULES OF MESOPERFUSION
Which molecules use?
In practice, the rule is that there is no usable intravenous drug which can be dermally or hypodermically. More generally, all the products for which the Vidal does not mention "deep IM" or "IV strict" may be utilisés.Rappelons that the pharmacokinetics of hypodermically is roughly equivalent to the IV route, it which involves the same caution. Resorption but hypodermically is not still exactly as good as the IV route, and it is not as smooth and linear as depends on many local factors
The absorption rate depends on:
- The lipid solubility,
- Osmolarity (290 to 305 mOsmol / l)
- Vascularization at the injection site,
- The injected volume
- Inequality tanks to 4 outputs
RULES OF MESOPERFUSION
1- Preparation mixtures - Water solubility and / or lipid solubility - isotonic - pH between 3.5 and 7.5 - Use the same amounts of products that meso classic and dilute with +++ serum phy - Merely max 3 products ,
- Respect the rule of pH, critical to the stability of the mixture, which should remain stable 30 minutes - Dilute with phy serum or pidolate Mg - Using a syringe body 3 10ml polypropylene UU
2 - Asepsis
-Lavage Hands according procedure
Alcohol--Gel or gloves
-Disinfection Skin in 2 stages with an approved disinfectant
3 - Installation and implementation
- Sterile Tubing U.U. 4 outputs Luer Lock.
- Purge tubulure- meso needles or 0.35 0,29x12, but still four needles of the same diameter
- Needles should be asked in hypodermic with the technical skinfold
When installing needles: - No blood reflux - Although fastening needles to the skin - Patient supine
3 - Monitoring mésoperfusion
- To detect the earliest possible a possible intolerance or allergy
-There Is an illusion to achieve the same rate at the end of the 4 needles connected to the same flow generator
- Continuous monitoring pdt the video session
Indications for mésoperfusion are the ones traditionnelle.Cependant mesotherapy, it has two focus areas: - acute painful conditions - neuropathic pain.
-WHY MESOPERFUSION IN THE MANAGEMENT OF PAIN?
- Technique bit aggressive for children and adults pusillanimous
- Minimizes the emotional component of pain
- Virtually painless, so very comfortable for the patient
- Rapid therapeutic action because of rapidly elevated serum - reduced number of sessions.
- Stimulation of mechanoreceptors of the hypodermis is exponential during the course of the meeting and "overflows" into the dermis to the JDE stimulating dermal receptors
- Stimulation is metameric.