高效的超声波导向神经块用于紧急部门使用
Joseph Brown1, Michael Prats2, Hilary Stroud2
1University of Colorado, Anschutz Medical Campus, Aurora, Colorado.
The Journal of emergency medicine
|October 23, 2025
概括
超声导向神经阻塞 (UGNBs) 对于急诊室的疼痛管理至关重要,它提供了一种节省阿片类药物的方法. 本次审查涵盖了治疗急性伤害和促进程序的关键UGNB.
科学领域:
- 紧急医疗 紧急医疗
- 麻醉学 麻醉学
- 疼痛管理 疼痛管理
背景情况:
- 超声导向神经阻塞 (UGNB) 越来越多地用于紧急情况下的多模式止痛.
- 在各种疾病和手术镇静中,UGNB提供安全有效的疼痛缓解.
研究的目的:
- 审查紧急医生执行的高效神经阻塞的证据.
- 突出UGNB在紧急部门 (ED) 中不断扩大的作用.
主要方法:
- 审查现有文献,通常在ED中执行的UGNB.
- 专注于在急性伤害和程序背景下证明有用的块.
主要成果:
- 具体检查的阻塞包括表面椎,间层椎,状前平面,直立脊柱平面,周囊神经和跨质坐骨神经阻塞.
- UGNBs对于疼痛管理和作为阿片类药物减少策略的一部分是有效的.
结论:
- UGNB正在成为ED患者护理的关键工具.
- 这些块代表了在急性受伤患者的多式调节止痛的有价值的选择.
相关概念视频
Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia
1.2K
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...
1.2K
Local Anesthetics: Clinical Application as Surface, Infiltration, and Conduction Block Anesthesia
1.8K
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...
1.8K
Local Anesthetics: Clinical Application as Spinal Anesthesia
1.3K
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...
1.3K
Local Anesthetics: Differential Sensitivity of Nerve Fibers
1.4K
Local anesthetics (LAs) block the sodium channels of nerve trunks, sensory nerve endings, and neuromuscular junctions. Although LAs can block all kinds of nerves, the sensitivity of nerve fibers differs according to nerve types and structures. LAs are known to block myelinated fibers faster than unmyelinated ones. Also, they block pain or sensory neurons at low concentrations without affecting the motor neurons involved in muscle contractions. This helps relieve labor pain without affecting the...
1.4K
Depolarizing Blockers: Pharmocokinetics
562
Depolarizing blockers are administered through intravenous injection. Succinylcholine is the most common choice of depolarizing blockers in emergency clinical practices. Although they have a rapid onset, they readily diffuse away from the motor end plate into the extracellular fluid. They are metabolized by enzymes such as liver butyrylcholinesterase and plasma pseudocholinesterases. This produces a short duration of action, typically 5-10 minutes long, unlike nondepolarizing blockers, which...
562
Local Anesthetics: Clinical Application as Epidural Anesthesia
685
Epidural anesthetics are administered in the fat-filled epidural space, the outermost part of the spinal canal. This technique is commonly employed for pain management and anesthesia during lower abdomen and pelvis surgeries or labor and delivery.
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
685


