有证据表明,区域麻醉可以预防慢性术后疼痛
Hesham Elsharkawy1,2,3, J David Clark4, Kariem El-Boghdadly5
1Anesthesiology Pain, MetroHealth Medical Center, Cleveland, Ohio, USA h_sharkus@yahoo.com.
Regional anesthesia and pain medicine
|February 5, 2025
概括
区域麻醉可以减少慢性术后疼痛 (CPSP),但证据有限. 需要进一步的研究,以了解其在减轻神经损伤和神经可塑性变化中的作用,这些变化有助于CPSP.
科学领域:
- 麻醉学 麻醉学
- 疼痛管理 疼痛管理
- 外科手术的结果
背景情况:
- 慢性术后疼痛 (CPSP) 是手术后经常出现的并发症.
- 对CPSP的风险因素和缓解策略尚未完全理解.
- 区域麻醉是CPSP的潜在干预方法,但它的有效性仍在争论中.
研究的目的:
- 审查区域麻醉与CPSP相关的机制方面.
- 批判性地评估目前关于区域麻醉用于预防CPSP的文献.
- 了解区域麻醉在缓解CPSP中的作用和有效性.
主要方法:
- 机械学方面和临床研究的文献综述.
- 对各种区域麻醉技术的证据评估.
- 分析导致CPSP的因素,包括神经损伤和神经炎症.
主要成果:
- CPSP与神经损伤,神经可塑性和免疫反应有关.
- 区域麻醉技术 (例如,外周麻醉,伤口透,神经阻塞) 显示出降低CPSP风险的潜力.
- 特殊技术,如胸切除术的外周麻醉和乳房/剖腹产手术的伤口透,显示出有前途.
结论:
- 区域麻醉可能在不同的外科设置中起到降低CPSP的作用.
- 由于CPSP的多因素性质,证据是有限的和受限制的.
- 进一步的研究是必不可少的,以澄清区域麻醉的疗效和最佳应用,以预防CPSP.
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