Anesthesiology. 2020 Nov 1;133(5):1127-1149. doi: 10.1097/ALN.0000000000003532.
Two regional analgesic modalities currently cleared by the U.S. Food and Drug Administration hold promise to provide postoperative analgesia free of many of the limitations of both opioids and local anesthetic-based techniques. Cryoneurolysis uses exceptionally low temperature to reversibly ablate a peripheral nerve, resulting in temporary analgesia. Where applicable, it offers a unique option given its extended duration of action measured in weeks to months after a single application. Percutaneous peripheral nerve stimulation involves inserting an insulated lead through a needle to lie adjacent to a peripheral nerve. Analgesia is produced by introducing electrical current with an external pulse generator. It is a unique regional analgesic in that it does not induce sensory, motor, or proprioception deficits and is cleared for up to 60 days of use. However, both modalities have limited validation when applied to acute pain, and randomized, controlled trials are required to define both benefits and risks.
两种目前已获得美国食品和药物管理局批准的区域性镇痛方式有望提供术后镇痛,且无阿片类药物和局部麻醉技术的许多局限性。冷冻神经松解术使用极低的温度来可逆性地消融外周神经,从而产生暂时的镇痛效果。在适用的情况下,由于单次应用后可长达数周至数月的作用持续时间,它提供了一个独特的选择。经皮外周神经刺激术涉及通过一根针插入一根绝缘引线,使其毗邻外周神经。通过外部脉冲发生器引入电流来产生镇痛效果。它是一种独特的区域镇痛方法,因为它不会引起感觉、运动或本体感觉缺陷,并且可以使用长达 60 天。然而,这两种方式在急性疼痛中的应用都受到限制,需要进行随机对照试验来确定其益处和风险。
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