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[区域麻醉在骨科中的应用]

[The use of regional anesthesia in orthopedics].

作者信息

Zimmermann M, Jansen V, Rittmeister M

机构信息

Klinik für Anästhesiologie, Intensivmedizin und Schmerztherapie der Johann-Wolfgang-Goethe-Universität, Frankfurt am Main.

出版信息

Orthopade. 2004 Jul;33(7):784-95. doi: 10.1007/s00132-004-0673-9.

Abstract

Regional anesthesia has its place in the perioperative pain management of orthopedic patients. A reduction in postoperative mortality and morbidity with regional anesthesia is acknowledged for subsets of patient populations. Single shot and continuous applications are techniques for providing regional analgesia. Continuous infusion of local anesthetics with catheter techniques provides for uninterrupted postoperative analgesia. The combination of regional and general anesthesia reduces the consumption of systemic anesthetics. The side effects of opioid therapy are thereby reduced. The inhibition of intraoperative stress reaction, especially with epidural anesthesia, helps to prevent or lower unwanted metabolic changes. Patient contentment with analgesic quality differs with the technique with which the regional anesthesia is applied (PDA, PCEA, IVRA, peripheral block, i.a. injection), and the medication (LA, opioid) used.

摘要

区域麻醉在骨科患者围手术期疼痛管理中占有一席之地。对于某些患者群体,区域麻醉可降低术后死亡率和发病率。单次注射和持续应用是提供区域镇痛的技术。通过导管技术持续输注局部麻醉药可实现术后不间断镇痛。区域麻醉与全身麻醉联合使用可减少全身麻醉药的用量。从而降低了阿片类药物治疗的副作用。抑制术中应激反应,尤其是硬膜外麻醉,有助于预防或减轻不必要的代谢变化。患者对镇痛质量的满意度因区域麻醉的应用技术(PDA、PCEA、IVRA、外周阻滞、关节内注射等)以及所用药物(局部麻醉药、阿片类药物)而异。

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