Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University, Baltimore, MD 21287, USA.
J Clin Anesth. 2013 Mar;25(2):150-9. doi: 10.1016/j.jclinane.2012.06.024. Epub 2013 Jan 23.
Neural blockade of the scalp may be used as an adjunct to general anesthesia or serve as the principal anesthetic for both intracranial and extracranial procedures. Effective scalp blockade typically requires anesthetizing multiple peripheral nerves; blockade of one or more of these is often used to diagnose and treat conditions such as chronic headache. Improved anatomic knowledge has refined the use of scalp blockade so that directed neural blockade is achieved. The vascularity of the scalp, proximity of arteries supplying the cerebral circulation, use of large volumes of local anesthetic, and presence of intracranial devices or bony defects require attention. The impact of perioperative scalp blockade on acute and chronic pain may offer insight into the benefits of perioperative neural blockade generally.
头皮神经阻滞可作为全身麻醉的辅助手段，也可作为颅内和颅外手术的主要麻醉方法。有效的头皮阻滞通常需要麻醉多个周围神经；这些神经的阻断之一或多个常被用于诊断和治疗慢性头痛等疾病。解剖学知识的提高完善了头皮阻滞的应用，从而实现了定向神经阻滞。头皮的血管分布、为大脑循环供血的动脉的位置、大剂量局部麻醉药的使用以及颅内器械或骨缺损的存在都需要引起注意。围手术期头皮阻滞对急性和慢性疼痛的影响可能有助于了解围手术期神经阻滞的一般益处。
