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当前对用于胸壁镇痛的筋膜平面阻滞的认识:2020 年技术和适应证更新。

Current understanding of the fascial plane blocks for analgesia of the chest wall: techniques and indications update for 2020.

机构信息

Department of Anesthesiology & Perioperative Medicine, Penn State College of Medicine, Hershey, Pennsylvania, USA.

出版信息

Curr Opin Anaesthesiol. 2020 Oct;33(5):692-697. doi: 10.1097/ACO.0000000000000909.

Abstract

PURPOSE OF REVIEW

Thoracic myofascial plane blocks have gained popularity because of their ease of performance and relative safety. This review highlights current research demonstrating the efficacy of these blocks for specific surgical procedures and provides a brief description of how these techniques are performed.

RECENT FINDINGS

Fascial plane blocks of the thorax and chest wall have been shown to be beneficial in providing perioperative analgesia for a variety of surgical procedures. Studies discussed in this review compare thoracic fascial plane blocks to systemic analgesia alone, contrast these novel methods of pain control to more traditional techniques, such as paravertebral nerve blocks and epidural anesthesia, and attempt to determine, which fascial plane blocks provide optimal postsurgical analgesia.

SUMMARY

Thoracic fascial plane blocks provide the anesthesiologist a number of techniques to address postsurgical pain. The relative ease of performance and safety profile of these blocks make them an appealing option for pain control for many patients undergoing thoracic or chest wall surgery. Further research is needed to not only define additional indications for each of these blocks, but also explore optimal dosing including the use of continuous catheter techniques.

摘要

目的综述

胸肌筋膜平面阻滞因其易于操作和相对安全而受到关注。本综述重点介绍了这些阻滞技术在特定手术中的有效性的最新研究,并简要描述了这些技术的操作方法。

最新发现

胸壁和胸廓的筋膜平面阻滞已被证明对多种手术的围手术期镇痛有益。本综述中讨论的研究将胸肌筋膜平面阻滞与单纯全身镇痛进行了比较,将这些新的疼痛控制方法与更传统的技术(如椎旁神经阻滞和硬膜外麻醉)进行了对比,并试图确定哪种筋膜平面阻滞提供最佳术后镇痛。

总结

胸肌筋膜平面阻滞为麻醉医师提供了多种技术来解决术后疼痛问题。这些阻滞的相对易于操作和安全性使它们成为许多接受胸部或胸壁手术的患者的一种有吸引力的疼痛控制选择。需要进一步的研究不仅要确定这些阻滞的每个阻滞的其他适应证,还要探索最佳剂量,包括使用连续导管技术。

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