摘要
区域神经阻滞是多模式镇痛的基础方案。与静脉镇痛比较,区域神经阻滞具有更强的针对性和有效性,神经阻滞麻醉镇痛可有效减少阿片类药物使用带来的不良反应。联合应用超声引导技术,能够提高神经阻滞的安全性和精确性。患儿腹部神经阻滞解剖结构以及局麻药物扩散途径、临床应用以及并发症的报道较少,药物浓度与剂量缺乏统一标准,需要进一步的临床研究。本文分别从患儿腰方肌阻滞(QLB)、腹横肌平面阻滞(TAPB)、腹直肌鞘阻滞(RSB)、竖脊肌平面阻滞(ESPB)和椎旁阻滞(PVB)的局麻药物扩散途径、浓度剂量、临床应用及相关并发症等方面进行综述,以期为患儿术后镇痛提供参考。
Regional nerve block in children is a basic scheme of multimode analgesia.Regional nerve block is more targeted and effective than intravenous analgesia,which effectively reduces adverse effects from opioid use.Complementary ultrasound guidance technology can improve the safety and accuracy of nerve block.Since anatomical structure of pediatric abdominal neuroblock and diffusion of local anesthetic drugs,clinical applications and complications are less reported,we lack of unified standards of drug concentration and dose,and further clinical research is needed.Moreover,abdominal truncal blocks,including quadratus lumborum block(QLB),transversus abdominus plane block(TAPB),rectus sheath block(RSB),erector spinae plane block(ESPB),paravertebral block(PVB),have been used routinely in clinical practice for various surgeries.In this review,we discuss the anatomy,indications,complications,and local anesthetic of abdominal truncal nerve blocks commonly used in clinical practice.
作者
杜生芳
石翊飒
张东
张倩倩
金学磊
曾维
DU Shengfang;SHI Yisa;ZHANG Dong;ZHANG Qianqian;JIN Xuelei;ZENG Wei(Department of Anesthesiology,Lanzhou University Second Hospital,Lanzhou 730030,China)
出处
《临床麻醉学杂志》
CAS
CSCD
北大核心
2021年第10期1098-1101,共4页
Journal of Clinical Anesthesiology
基金
兰州大学第二医院“萃英科技创新”计划项目(CY2018-BJ08)。
关键词
患儿
区域神经阻滞
超声引导
腹部手术
镇痛
Child
Regional nerve block
Ultrasound guidance
Abdominal surgery
Analgesia
