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超声引导下的神经轴索麻醉

Ultrasound-Guided Neuraxial Anesthesia.

作者信息

Li Jinlei, Krishna Ramya, Zhang Yang, Lam David, Vadivelu Nalini

机构信息

Department of Anesthesiology, Yale University, New Haven, CT, USA.

Department of Anesthesiology and Perioperative Medicine, University of Rochester, Rochester, NY, USA.

出版信息

Curr Pain Headache Rep. 2020 Aug 18;24(10):59. doi: 10.1007/s11916-020-00895-3.

Abstract

PURPOSE OF REVIEW

There has been a recent surge of interest in clinical applications of ultrasound, which has revolutionized acute pain management. This review is to summarize the current status of ultrasound utilization in neuraxial anesthesia, the most common type of regional anesthesia.

RECENT FINDINGS

Ultrasound-assisted and ultrasound-guided neuraxial anesthesia has improved clinical accuracy and patient safety through landmark identification including proper vertebral level and midline, as well as via measurements on neuraxial space. Direct needle or catheter visualization during the entire procedure has not yet been achieved consistently. The recent introduction of ultrasound into neural anesthesia has clinical performance benefits and patient safety implications, with documented improvement on overall efficacy with higher first attempt success rate as well as less needle pass. More controlled studies are needed for the overall impact of ultrasonography in neuraxial anesthesia in obstetric and non-obstetric patients.

摘要

综述目的

近期,超声在临床应用方面的关注度激增,这给急性疼痛管理带来了变革。本综述旨在总结超声在区域麻醉最常见类型——椎管内麻醉中的应用现状。

最新发现

超声辅助和超声引导下的椎管内麻醉通过识别包括正确椎间隙和中线在内的体表标志以及测量椎管内间隙,提高了临床准确性和患者安全性。在整个操作过程中,尚未始终如一地实现对针或导管的直接可视化。超声最近被引入神经麻醉,具有临床性能优势和患者安全意义,记录显示其整体疗效有所改善,首次尝试成功率更高,进针次数更少。对于超声检查在产科和非产科患者椎管内麻醉中的总体影响,还需要更多对照研究。

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