Department of Anesthesiology, St Luke's-Roosevelt Hospital Center, New York, New York 10025, USA.
Curr Opin Anaesthesiol. 2013 Aug;26(4):467-74. doi: 10.1097/ACO.0b013e328362baa4.
There has been an increasing use of peripheral nerve blocks (PNBs) in ambulatory surgery. Several recent reports have contributed to our understanding of the optimal PNB technique for specific surgical procedures in this setting. In this review, we have summarized the available literature on indications of PNBs for outpatient surgery of the upper extremity.
Although many of the recent studies focus on technical aspects of PNBs, few center on evidence-based indications or their utility in the ambulatory setting. The available literature suggests that although multiple techniques have been reported for outpatient shoulder surgery, interscalene brachial plexus block (ISBPB) is currently the most preferred technique. Supraclavicular, infraclavicular, and axillary brachial plexus blocks, however, are all commonly used and effective PNBs for outpatient surgery and analgesia of the arm, forearm, and hand.
ISBPB is currently the most beneficial PNB for outpatient shoulder surgery. Supraclavicular block functionally can be considered an alternative to the traditional ISBPB; however, additional studies are required before routine use can be recommended. Although the review identified several reports with benefits of one PNB technique over the others, the existing literature suggests that many of these techniques may be interchangeable with regards to procedures of the distal upper extremity. Future studies are indicated to help standardize the techniques, selection, and postoperative management of PNBs for specific surgical indications.
外周神经阻滞（PNB）在日间手术中的应用日益增多。最近的几项研究报告有助于我们了解在这种情况下，特定手术中最佳的 PNB 技术。在这篇综述中，我们总结了关于 PNB 用于上肢门诊手术的适应证的现有文献。
尽管最近的许多研究都集中在 PNB 的技术方面，但很少有研究关注基于证据的适应证或它们在日间环境中的实用性。现有文献表明，虽然有多种技术被报道用于门诊肩部手术，但目前最受欢迎的技术是肌间沟臂丛神经阻滞（ISBPB）。然而，锁骨上、锁骨下和腋路臂丛神经阻滞都是上肢、前臂和手部门诊手术和镇痛的常用且有效的 PNB。
ISBPB 是目前最有益于门诊肩部手术的 PNB。锁骨上阻滞在功能上可以被认为是传统 ISBPB 的替代方法；然而，在常规使用之前，还需要更多的研究。尽管该综述确定了几项报告，指出了一种 PNB 技术优于其他技术，但现有文献表明，对于远端上肢的手术，这些技术中的许多可能是可互换的。未来的研究表明，需要帮助标准化特定手术适应证的 PNB 技术、选择和术后管理。
