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关于肩膀手术中的区域麻醉的最新情况:叙述性回顾
Jonathan D Harley1, Alicia K Harrison1, Allison J Rao1
1Department of Orthopaedic Surgery, University of Minnesota Medical School, Minneapolis, MN, USA.
Annals of joint
|August 12, 2025
概括
区域麻醉是肩膀手术疼痛管理的关键. 优选的是间层臂阻塞 (ISB),而其他阻塞和辅助剂提供了好处,尽管连续导管输注和脂质体布皮瓦卡因需要更多的研究.
科学领域:
- 麻醉学 麻醉学
- 整形外科手术 整形外科手术
- 疼痛管理 疼痛管理
背景情况:
- 有效的术后疼痛管理对于肩膀手术的结果至关重要.
- 区域麻醉是骨科手术后疼痛控制的基石.
- 优化区域麻醉技术仍然是肩部外科医生的重点.
研究的目的:
- 审查肩膀手术中常见的区域麻醉技术.
- 突出肩部手术区域麻醉方面的创新.
- 评估关于肩部手术疼痛管理当前实践和结论的证据.
主要方法:
- 在肩膀手术中的区域麻醉 (过去20年) 的PubMed搜索.
- 优先考虑高质量的研究:系统审查,元分析,RCT.
- 包括从精选文章的文献参考.
主要成果:
- 间层臂阻塞 (ISB) 是完全麻醉的黄金标准.
- 超关节 (SCB) 和超关节神经阻塞 (SSNB) 提供了具有较低并发症风险的替代方案.
- 德克萨米他和德克斯米德托米丁等辅助剂延长神经阻塞;脂质体布皮瓦卡因显示混合的结果.
结论:
- 区域麻醉显著影响肩部手术恢复.
- ISB,SCB和SSNB是有价值的技术,具有不同的优缺点.
- 需要对连续导管输注和脂质体布皮瓦卡因进行进一步的研究,以优化结果.
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