Department of Anaesthesia, Nottingham University Hospitals NHS Trust, Nottingham, UK.
Anaesthesia and Critical Care, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, UK.
Anaesthesia. 2018 Jan;73 Suppl 1:51-60. doi: 10.1111/anae.14140.
In this article, we will discuss the pathophysiology of peripheral nerve injury in anaesthetic practice, including factors which increase the susceptibility of nerves to damage. We will describe a practical and evidence-based approach to the management of suspected peripheral nerve injury and will go on to discuss major nerve injury patterns relating to intra-operative positioning and to peripheral nerve blockade. We will review the evidence surrounding particular strategies to reduce the incidence of peripheral nerve injury during nerve blockade, including nerve localisation methods, timing of blocks, needle techniques and design, injection pressure-monitoring and local anaesthetic and adjunct choice.
在本文中，我们将讨论麻醉实践中周围神经损伤的病理生理学，包括增加神经易感性的因素。我们将描述一种实用且基于证据的疑似周围神经损伤管理方法，并继续讨论与术中定位和周围神经阻滞相关的主要神经损伤模式。我们将回顾围绕减少神经阻滞期间周围神经损伤发生率的特定策略的证据，包括神经定位方法、阻滞时机、针技术和设计、注射压力监测以及局部麻醉剂和辅助剂的选择。
