List F, Kessler P, Volk T
Klinik für Anästhesiologie, Intensivmedizin und Schmerztherapie, Universitätsklinikum des Saarlandes, Gebäude 57, 66421, Homburg, Deutschland.
Anaesthesist. 2013 Mar;62(3):175-82. doi: 10.1007/s00101-012-2097-y.
Regional anesthesia is the most effective procedure for acute pain therapy. Whether neuraxial and peripheral blocks in patients with pre-existing infectious conditions, immune deficits or other risk factors increase the risk of additional infections is unclear. Analyzing the available literature currently seems to indicate that the incidence of severe infectious complications is generally low. Diabetes, steroid therapy or malignant diseases are apparently present in many cases in which infections associated with regional anesthesia and analgesia have been described. A strict contraindication in patients with pre-existing systemic or local infections seems unjustifiable. A clear and documented risk-benefit ratio in these patients is mandatory.
区域麻醉是急性疼痛治疗最有效的方法。对于已有感染性疾病、免疫缺陷或其他风险因素的患者,神经轴阻滞和外周阻滞是否会增加额外感染的风险尚不清楚。分析现有文献目前似乎表明,严重感染并发症的发生率总体较低。在许多描述了与区域麻醉和镇痛相关感染的病例中,明显存在糖尿病、类固醇治疗或恶性疾病。对已有全身或局部感染的患者进行严格禁忌似乎不合理。在这些患者中明确记录风险效益比是必需的。