患有既往神经系统疾病患者的区域麻醉。
Regional anesthesia in patients with pre-existing neurologic disease.
作者信息
McSwain Julie R, Doty J Wesley, Wilson Sylvia H
机构信息
Department of Anesthesia and Perioperative Medicine, Medical University of South Carolina, Charleston, South Carolina, USA.
出版信息
Curr Opin Anaesthesiol. 2014 Oct;27(5):538-43. doi: 10.1097/ACO.0000000000000107.
PURPOSE OF REVIEW
Regional anesthesia is controversial in patients with pre-existing neurologic disease. This study reviews the published evidence regarding the utilization and outcomes of regional anesthetics in this population.
RECENT FINDINGS
Although publications are sparse, neuraxial and peripheral regional techniques have been successfully described in patients with spinal cord injury, multiple sclerosis, Guillain-Barre disease, neurofibromatosis, diseases of the neuromuscular junction, and Charcot-Marie Tooth disease without neurologic complications. Ultrasound guidance may aid in reduction in local anesthetic dose, anatomical evaluation and avoidance of needle trauma.
SUMMARY
Regional anesthesia can be safely utilized in patients with pre-existing neurological disease and may have benefits over general anesthesia; however, a conservative approach is warranted. In addition, further publications regarding regional techniques in this population are needed.
综述目的
对于已有神经疾病的患者，区域麻醉存在争议。本研究回顾了已发表的关于该人群使用区域麻醉剂及其结果的证据。
最新发现
尽管相关出版物较少，但在脊髓损伤、多发性硬化症、格林-巴利综合征、神经纤维瘤病、神经肌肉接头疾病和夏科-马里-图斯病患者中，已成功描述了神经轴和外周区域技术，且无神经并发症。超声引导可能有助于减少局部麻醉剂剂量、进行解剖评估以及避免针头创伤。
总结
区域麻醉可安全用于已有神经疾病的患者，可能比全身麻醉更具优势；然而，需要采取保守方法。此外，还需要更多关于该人群区域技术的出版物。
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