Department of Anaesthesia, Alexandra Hospital (Worcestershire Acute Hospitals NHS Trust), Redditch, Worcestershire, England.
Reg Anesth Pain Med. 2010 Nov-Dec;35(6):545-8. doi: 10.1097/AAP.0b013e3181fa6b90.
For more than 25 years, regional anesthesia has challenged anesthesiologists to determine whether it offers real benefits in terms of patient outcome from major surgery, compared with general anesthesia. Although there is good evidence that regional analgesia offers superior pain relief to systemic opioid analgesia, evidence to support improved outcome from surgery remains elusive. Although many publications appear to support the hypothesis, others show no benefit, and the lack of properly conducted, large studies makes it difficult to draw any evidence-based conclusions in favor of regional anesthesia. Given that all major regional techniques have the potential to cause significant risks to patient outcome, it is incumbent on all anesthesiologists to balance the intended benefits against the significant adverse events associated with regional techniques. We are beginning to develop an evidence base for both the benefits and risks of regional anesthesia, when used for specific patient groups and for specific surgical procedures. This presentation looks at some of the evidence and examines how it can be used to develop guidelines for best practice.
25 多年来，区域麻醉一直让麻醉师感到困扰，他们需要确定与全身麻醉相比，区域麻醉是否在重大手术的患者预后方面具有真正的优势。尽管有充分的证据表明区域镇痛可提供优于全身阿片类药物镇痛的疼痛缓解，但支持手术结果改善的证据仍难以捉摸。尽管许多出版物似乎支持这一假设，但其他出版物则没有显示出任何益处，而且缺乏精心设计的大型研究使得很难得出支持区域麻醉的循证结论。鉴于所有主要的区域技术都有可能对患者的预后造成重大风险，所有麻醉师都有责任权衡区域技术的预期益处与相关的重大不良事件。我们开始为特定患者群体和特定手术程序的区域麻醉的益处和风险建立证据基础。本演讲探讨了一些证据，并研究了如何将其用于制定最佳实践指南。
