Chin Ki Jinn, Chan Vincent
Department of Anesthesia, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada.
Curr Opin Anaesthesiol. 2008 Oct;21(5):624-31. doi: 10.1097/ACO.0b013e32830815d1.
The use of ultrasound for peripheral nerve blockade is becoming popular. Although the feasibility of ultrasound-guided nerve blockade is now clear, it is uncertain at this time whether it represents the new standard for regional anesthesia in terms of efficacy and safety.
The ability to visualize nerve location, needle advancement, needle-nerve interaction, and local anesthetic spread makes ultrasound-guided nerve block an attractive option. Study results indicate that these advantages can improve the ease of block performance, block success rates, and complications. At the same time there is evidence that ultrasound-guided regional anesthesia is a unique skill in its own right, and that proficiency in it requires training and experience.
Ultrasound is a valuable tool that is now available to the regional anesthesiologist, and it is fast becoming a standard part of practice. It promises to be of especial value to the less experienced practitioner. Ultrasound does not in itself, however, guarantee the efficacy and safety of peripheral nerve blockade. Proper training in its use is required and we can expect to see the development of formal standards and guidelines in this regard.
超声在外周神经阻滞中的应用正日益普及。尽管超声引导神经阻滞的可行性现已明确,但就有效性和安全性而言,目前尚不确定它是否代表区域麻醉的新标准。
超声能够可视化神经位置、进针过程、针与神经的相互作用以及局麻药的扩散,这使得超声引导神经阻滞成为一个有吸引力的选择。研究结果表明,这些优势可提高阻滞操作的简便性、阻滞成功率以及减少并发症。同时,有证据表明超声引导区域麻醉本身是一项独特的技术,熟练掌握需要培训和经验。
超声是区域麻醉医生现有的一项有价值的工具,并且正迅速成为常规操作的标准组成部分。它对经验较少的从业者有望具有特殊价值。然而,超声本身并不能保证外周神经阻滞的有效性和安全性。需要进行关于其使用的适当培训,并且我们可以期待在这方面正式标准和指南的制定。