Sites B D, Spence B C, Gallagher J, Beach M L, Antonakakis J G, Sites V R, Hartman G S
Department of Anesthesiology, Dartmouth Medical School, Dartmouth-Hitchcock Medical Center, Lebanon, NH 03756, USA.
Acta Anaesthesiol Scand. 2008 Apr;52(4):456-66. doi: 10.1111/j.1399-6576.2008.01604.x.
Despite its well-known benefits, regional anesthesia has not attained the stature, simplicity, and safety of general anesthesia. Many of the challenges and clinical failures of regional anesthetic techniques can be attributed to fact that neurovascular anatomy is highly variable. Furthermore, current nerve localization techniques provide little or no information regarding the anatomical spread local anesthesia. Recently, ultrasound technology has been utilized by anesthesiologists in an attempt to minimize many of the drawbacks of traditional nerve block techniques. This review article will update the reader on the current status of ultrasound-guided regional anesthesia, provide an evidence-based context, and supply key facts regarding ultrasound physics. In the process, we will also highlight several possible limitations of ultrasound techniques including learning curve issues, costs, and artifact generation.
尽管区域麻醉有着众所周知的益处,但它尚未达到全身麻醉那样的地位、简易性和安全性。区域麻醉技术面临的许多挑战和临床失败情况可归因于神经血管解剖结构高度可变这一事实。此外,当前的神经定位技术几乎没有提供关于局部麻醉解剖扩散的信息。最近,麻醉医生开始使用超声技术,试图尽量减少传统神经阻滞技术的诸多弊端。这篇综述文章将向读者介绍超声引导下区域麻醉的当前状况,提供基于证据的背景信息,并提供有关超声物理学的关键事实。在此过程中,我们还将强调超声技术的几个可能局限性,包括学习曲线问题、成本和伪像产生。