穿越中线:单边勃起器脊柱平面块如何可以提供双边内脏止痛
Richard J Gawel1, Daniel M DePietro2, Nicole A Robinson3
1Department of Emergency Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA, USA.
The American journal of emergency medicine
|July 13, 2025
概括
单边勃起器脊柱平面块 (ESPB) 可能为腹部疼痛提供双边内脏镇痛. 本讨论探讨了支持ESPB的解剖学和机制.
科学领域:
- 麻醉学 麻醉学
- 疼痛管理 疼痛管理
- 人体解剖学 解剖学 解剖学
背景情况:
- 勃起器脊柱平面块 (ESPB) 被广泛用于在手术和紧急情况下缓解疼痛.
- 关于单个单边ESPB提供的止痛程度存在争议,特别是对于内脏疼痛.
- 在急诊室 (ED) 治疗腹部疾病的有效疼痛管理至关重要.
研究的目的:
- 为了探索直立脊柱平面块的解剖基础.
- 讨论单边ESPB可能提供双边内脏镇痛的潜在机制.
- 在ED中为腹部疼痛管理提供ESPB的临床实践信息.
主要方法:
- 胸部区域和带平面的解剖学审查.
- 讨论与内脏感觉相关的神经生理路径.
- 综合现有文献和ESPB关于腹痛的病例报告.
主要成果:
- 胸部区域的形平面允许局部麻醉剂的潜在传播.
- 肋间间和椎间的扩散可能会导致双边的感觉阻塞.
- 塞法拉德和caudad的潜在传播到达多个皮肤瘤和内脏 afferents.
结论:
- 单侧胸部ESPB,特别是大体积的ESPB,可以提供双边内脏镇痛.
- 了解解剖分布是优化ESPB对腹痛的关键.
- 需要进一步的研究来证实ESPB双边内脏镇痛的程度和有效性.
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