在上臂手术和创伤中,形平面堵塞:叙述性回顾
Francesco Marrone1, Lorenza Sbucafratta1, Pierfrancesco Fusco2
1Unit of Anesthesia and Intensive Care, Santo Spirito Hospital, 00193 Rome, Italy.
Journal of clinical anesthesia
|December 28, 2025
概括
带平面块为上肢手术和创伤提供有希望的缓解疼痛. 需要进一步的高质量研究来确认它们的安全性和有效性,特别是当与其他神经阻塞剂结合时.
科学领域:
- 麻醉学 麻醉学
- 疼痛管理 疼痛管理
- 区域麻醉 区域麻醉
背景情况:
- 带平面块越来越多地被认为是安全有效的疼痛管理.
- 它们在上肢手术和创伤中的应用不如胸部或腹部手术那么成熟.
研究的目的:
- 在过去十年中,审查了关于带平面块的文献,以缓解上肢手术和创伤中的疼痛.
- 评估这些块的有效性,安全性和不断发展的技术.
主要方法:
- 对过去10年发表的随机对照试验,观察性研究和病例报告进行系统审查.
- 专注于特定的技术,包括起器脊柱平面 (ESP) 块,关节骨 (CFP) 平面块,上部后部骨间角平面 (SPSIP) 块和周囊 (PENG) 肩膀块.
主要成果:
- 高胸部ESP阻塞在缓解疼痛方面表现出有效性,通常是通过连续导管输液.
- 观察到一种趋势,即将带平面阻塞结合起来,或将它们与外围神经阻塞一起使用,以提高覆盖率并减少阿片类药物使用.
- 虽然有希望,但由于随机试验的稀缺性,目前的大部分证据质量不佳.
结论:
- 带平面块代表了管理上肢外科手术和创伤相关疼痛的发展区域.
- 建议进一步进行高质量的研究,以确定最佳使用,安全性概况和比较有效性.
- 潜在的并发症,虽然不经常报告,但值得考虑.
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