From the Department of Orthopaedics, All India Institute of Medical Sciences, New Delhi, India (Garg), the Department of Spine Surgery, Indraprastha Apollo Hospital, New Delhi, India (Ahuja), and WESTMED Spine Center, Yonkers, NY (Sharan).
J Am Acad Orthop Surg. 2022 Sep 1;30(17):809-819. doi: 10.5435/JAAOS-D-22-00101. Epub 2022 May 25.
Current advancements in spine surgery have led to a recent interest in regional anesthesia for spine surgery. Spinal anesthesia, epidural anesthesia, and their combination are commonly used modalities for regional anesthesia in spine surgeries. The successful use of regional anesthesia has led to the emergence of several new concepts such as awake spinal fusion and outpatient spinal surgery. Regarding analgesic techniques, several new modalities have been described recently such as erector spinae and thoracolumbar interfascial plane blocks. These regional analgesic modalities are aimed at decreasing perioperative pain and enhancing early recovery in patients undergoing spine surgery. This narrative review focuses on the techniques, indications and contraindications, benefits, and complications of regional anesthesia in the context of spine surgery.
目前脊柱外科领域的进展促使人们对脊柱手术的区域麻醉产生了新的兴趣。脊柱麻醉、硬膜外麻醉及其联合应用是脊柱手术中常用的区域麻醉方式。区域麻醉的成功应用催生了一些新的概念,如清醒脊柱融合术和日间脊柱手术。在镇痛技术方面,最近也有几种新方法被描述,如竖脊肌和胸腰筋膜平面阻滞。这些区域镇痛方法旨在减少脊柱手术患者的围手术期疼痛,并促进其早期康复。本综述主要聚焦于区域麻醉在脊柱手术中的技术、适应证和禁忌证、优点和并发症。