Bauer Maria, George John E, Seif John, Farag Ehab
Department of Outcomes Research, Cleveland Clinic, Cleveland, OH 44195, USA.
Anesthesiol Res Pract. 2012;2012:309219. doi: 10.1155/2012/309219. Epub 2011 Nov 24.
Neuraxial anesthesia is a term that denotes all forms of central blocks, involving the spinal, epidural, and caudal spaces. Epidural anesthesia is a versatile technique widely used in anesthetic practice. Its potential to decrease postoperative morbidity and mortality has been demonstrated by numerous studies. To maximize its perioperative benefits while minimizing potential adverse outcomes, the knowledge of factors affecting successful block placement is essential. This paper will provide an overview of the pertinent anatomical, pharmacological, immunological, and technical aspects of epidural anesthesia in both adult and pediatric populations and will discuss the recent advances, the related rare but potentially devastating complications, and the current recommendations for the use of anticoagulants in the setting of neuraxial block placement.
神经轴索麻醉是一个术语,指所有形式的中枢阻滞,包括脊髓、硬膜外和骶管间隙阻滞。硬膜外麻醉是一种在麻醉实践中广泛应用的多功能技术。众多研究已证实其降低术后发病率和死亡率的潜力。为了在将潜在不良后果降至最低的同时最大化其围手术期益处,了解影响阻滞成功置管的因素至关重要。本文将概述成人和儿童硬膜外麻醉相关的解剖学、药理学、免疫学及技术方面的内容,并将讨论近期进展、相关罕见但可能具有毁灭性的并发症,以及在神经轴索阻滞置管情况下使用抗凝剂的当前建议。