Børglum Jens, Gögenür Ismail, Bendtsen Thomas F
aDepartment of Anesthesia and Intensive Care Medicine bDepartment of Surgery, Zealand University Hospital, University of Copenhagen, Copenhagen cDepartment of Anesthesia and Intensive Care Medicine, Aarhus University Hospital, Aarhus, Denmark.
Curr Opin Anaesthesiol. 2016 Oct;29(5):638-43. doi: 10.1097/ACO.0000000000000378.
Abdominal wall blocks in adults have evolved much during the last decade; that is, particularly with the introduction of ultrasound-guided (USG) blocks. This review highlights recent advances of block techniques within this field and proposes directions for future research.
Ultrasound guidance is now considered the golden standard for abdominal wall blocks in adults, even though some landmark-based blocks are still being investigated. The efficiency of USG transversus abdominis plane blocks in relation to many surgical procedures involving the abdominal wall is the most common nerve block effect measurement investigated in goal-directed research. The advent of the various quadratus lumborum block techniques with a long-lasting analgesic effect have opened up a new area of research, and the use of liposomal bupivacaine for transversus abdominis plane blocks have been introduced with success. Future research should also investigate the effect of specific abdominal wall blocks on neuroendocrine and inflammatory stress response after surgery.
USG abdominal wall blocks in adults are commonplace techniques today. Most abdominal wall blocks are assigned evidence grade A or B according to the US Agency for Healthcare Policy and Research guidelines.
在过去十年中，成人腹壁阻滞技术有了很大发展，尤其是随着超声引导（USG）阻滞技术的引入。本综述重点介绍了该领域阻滞技术的最新进展，并提出了未来研究方向。
尽管一些基于体表标志的阻滞方法仍在研究中，但超声引导目前被认为是成人腹壁阻滞的金标准。在目标导向研究中，最常研究的是超声引导下腹横肌平面阻滞对许多涉及腹壁的外科手术的有效性。各种具有长效镇痛作用的腰方肌阻滞技术的出现开辟了一个新的研究领域，脂质体布比卡因用于腹横肌平面阻滞已取得成功。未来的研究还应调查特定腹壁阻滞对术后神经内分泌和炎症应激反应的影响。
如今，成人超声引导下腹壁阻滞是常用技术。根据美国医疗保健政策与研究机构的指南，大多数腹壁阻滞被归类为证据等级A或B。
