周围神经阻塞后的反弹疼痛:一篇评论
Wenqin Yin1, Dan Luo2,3, Haiqi Mi4,5
1Department of Anesthesiology, the Affiliated Hospital of North Sichuan Medical College, Shunqing District, Nanchong, 637000, Sichuan Province, China. ywqwy2023@163.com.
Drugs
|May 22, 2025
概括
外围神经阻塞 (PNB) 提供有效的疼痛缓解,但在阻塞消失后,反弹疼痛 (RP) 可能会发生. 德克萨米他或导管的使用可能有助于防止PNB后的RP.
科学领域:
- 麻醉学 麻醉学
- 疼痛管理 疼痛管理
- 神经学 神经学
背景情况:
- 外围神经阻塞 (PNB) 越来越多地用于外科手术期间的止痛,通常是通过超声波引导的.
- 结合PNB的多模式止痛策略正在取代传统的基于阿片类药物的疼痛管理.
- 反弹疼痛 (RP) 是一个重大问题,如果不管理,可能会否定PNB的好处.
研究的目的:
- 审查定义,临床症状,危险因素,病理生理学和在外围神经阻塞 (PNB) 后反弹疼痛 (RP) 的预防策略.
- 确定与RP相关的特征和高风险因素.
- 为在临床麻醉中最佳使用PNB提供建议.
主要方法:
- 关于外围神经阻塞和反弹疼痛现有研究的文献综述.
- 对RP的定义,临床表现和病因因素的分析.
- 对RP的各种预防和管理策略的评估.
主要成果:
- 在PNB之后RP的确切机制尚不清楚,尽管建议疼痛传播的共同途径.
- 一个单一的PNB与德克萨米他被确定为可靠的预防方案.
- 对于PNB,使用导管被认为是减少RP发生率的更可靠方法.
结论:
- 在PNB之后的RP是一个关键问题,需要仔细考虑和管理.
- 虽然德克萨松看起来有前途,但导管使用似乎是预防RP的更强有力的策略.
- 本综述为PNBs作为麻醉中的辅助止痛药的适当应用提供了指导.
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