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行儿科区域麻醉时是否必须采用超声引导?

Is ultrasound guidance mandatory when performing paediatric regional anaesthesia?

机构信息

Department of Paediatric Anaesthesia & Intensive Care, ALB/Karolinska University Hospital, Stockholm, Sweden.

出版信息

Curr Opin Anaesthesiol. 2010 Jun;23(3):337-41. doi: 10.1097/ACO.0b013e328339276f.

Abstract

PURPOSE OF REVIEW

Since Kapral in 1994 first described the use of real-time ultrasound-guided regional anaesthesia, this novel technique has gained widespread recognition in adult practice and has been shown to be associated with clinically relevant advantages. The aim of this manuscript is to review the currently published paediatric data associated with the use of ultrasound-guided regional anaesthesia.

RECENT FINDINGS

Compared with alternative techniques ultrasound guidance is associated with an increased success rate, reduced onset time, moderately prolonged duration, reduced need for local anaesthetics and lower costs, and may also be considered to reduce the risk for complications.

SUMMARY

Based on current data the use of ultrasound guidance is strongly recommended when performing peripheral nerve blocks in infants and children. Concerning ultrasound assistance in relation to paediatric neuroaxial blocks there is currently not enough supporting evidence to issue a general recommendation regarding its routine use.

摘要

目的综述

自 1994 年 Kapral 首次描述实时超声引导区域麻醉以来,这项新技术在成人实践中得到了广泛认可,并已被证明具有临床相关优势。本文的目的是回顾与超声引导区域麻醉相关的目前已发表的儿科数据。

最近的发现

与替代技术相比,超声引导与更高的成功率、更短的起效时间、适度延长的持续时间、减少局部麻醉剂的需求和更低的成本相关,并且还可以降低并发症的风险。

总结

基于目前的数据,在对婴儿和儿童进行周围神经阻滞时,强烈推荐使用超声引导。关于儿科神经轴索阻滞的超声辅助,目前没有足够的证据支持常规使用,因此不能对此做出一般性推荐。

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