在减肥后手术中使用的神经阻断技术:叙述性回顾
He Xiao1,2, Yudie Du1,2, Guangyi Li1,2
1Department of Gastroenterology, Affiliated Hospital of North Sichuan Medical College, Nanchong, 637000, China.
BMC surgery
|February 20, 2025
概括
神经阻塞在减肥手术 (BS) 后提供有效的疼痛缓解,避免睡眠呼吸暂停患者的阿片类药物风险. 横向腹部平面阻断 (TAPB) 是对体力疼痛最优的,而勃起脊柱平面阻断 (ESPB) 则针对体力和内脏疼痛.
科学领域:
- 麻醉学 麻醉学
- 手术疼痛管理手术疼痛管理
背景情况:
- 腹腔外科 (BS) 患者经常患有阻塞性睡眠呼吸暂停,在术后使用阿片类药物时增加风险.
- 有效的疼痛管理对于减肥手术恢复和患者舒适性至关重要.
研究的目的:
- 为了审查和比较各种神经阻塞用于腹腔外科手术 (BS) 后的疼痛缓解.
- 总结不同神经阻塞用于BS后止痛的优点.
主要方法:
- 对当前神经阻断技术进行全面的审查,以治疗腹痛术后的疼痛.
- 分析横腹部平面块 (TAPB),直立脊柱平面块 (ESPB),四度腰部块 (QLB),外斜肋间块 (EOIB) 和直肠块 (RB).
主要成果:
- 横向腹部平面阻塞 (TAPB) 是针对体质疼痛的优化.
- 勃起器脊柱平面阻塞 (ESPB) 有效地管理体质和内脏疼痛,可以与直肠围阻塞 (RB) 结合使用.
- 前四角腰部块 (QLB) 针对内脏疼痛;外斜肋间块 (EOIB) 适用于肥胖患者.
结论:
- 神经阻塞提供了一个安全有效的替代阿片类药物治疗腹痛术后的疼痛.
- 特定的神经阻塞为不同类型的疼痛 (体质,内脏) 和患者考虑提供量身定制的止痛.
- 需要进一步的研究,以优化神经阻塞策略,用于腹腔外科手术后的疼痛管理.
相关概念视频
Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia
349
Intravenous regional anesthesia or the Bier block technique is used to anesthetize a specific limb or extremity. It uses exsanguinated or blood-drained vessels to transport local anesthetics or LAs to the peripheral nerve trunks. Lidocaine without vasoconstrictors like epinephrine is most commonly used for this technique. Other drugs used are prilocaine, ropivacaine, and chloroprocaine. Bupivacaine is not recommended for this technique due to its high cardiac toxicity.
One of the advantages of...
One of the advantages of...
349
Local Anesthetics: Clinical Application as Spinal Anesthesia
570
Spinal anesthetics are given during lower abdomen and limb surgeries to block sensory and motor neurons. They are administered in the mid to low lumbar regions, primarily acting on the cauda equina's nerve roots. The blockade level depends on the local anesthetic (LA) concentration. Usually, low LA concentrations are sufficient to block sensory fibers, while only high LA concentrations block motor fibers. Other factors like injection volume and speed, the patient's posture, and the drug...
570
Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy
39
Sigmoidoscopy and laparoscopy are distinct medical procedures that enable physicians to internally inspect different parts of the GI tract. Although they serve different purposes, each is essential for diagnosing and, in some cases, treating various medical conditions.
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
39
Skeletal Muscle Relaxants: Therapeutic Uses
460
Skeletal muscle relaxants are used to relax muscle tone and alleviate painful muscle contractions. However, the choice of skeletal muscle relaxants depends on the duration of the surgical procedure in order to minimize potential side effects. Skeletal muscle relaxants like neuromuscular blocking agents [NMBAs] are commonly employed as adjuvants alongside general anesthetics in clinical settings. NMBAs are also used to maintain controlled ventilation during surgery of the larynx or pharynx...
460
General Anesthesia: Overview
187
Anesthesia is a medical procedure that uses drugs for CNS suppression to enable painless surgeries and procedures. The selection of anesthetics is influenced by their pharmacokinetic properties, side effects, and patient characteristics. Various types of anesthesia include general, local, regional, spinal, and inhalational.
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
187
Local Anesthetics: Clinical Application as Surface, Infiltration, and Conduction Block Anesthesia
930
Depending on the target organ, local anesthetics (LAs) can be administered via various routes. In surface anesthesia, LAs are applied directly to the surface of the skin or mucous membranes. It is widely used for topical skin numbing before venipuncture or minor surgical procedures. Commonly used surface local anesthetics are lidocaine or benzocaine sprays or creams. Surface anesthesia occurs within 5 minutes and lasts for about 60 minutes. One of the main disadvantages of topical anesthesia is...
930


