Garg Bhavuk, Ahuja Kaustubh, Khanna Puneet, Sharan Alok D
Department of Orthopaedics, All India Institute of Medical Sciences, New Delhi.
Department of Orthopaedics, All India Institute of Medical Sciences, Rishikesh, Uttarakhand.
Clin Spine Surg. 2021 Jun 1;34(5):163-170. doi: 10.1097/BSD.0000000000001096. Epub 2020 Oct 9.
Recent advancements in spine surgery anesthesia techniques and pain management has led to a paradigm shift from conventional open spinal procedures to minimally invasive spine surgeries performed on an outpatient basis. Spinal anesthesia and epidural anesthesia alone or in combination with spinal are common regional anesthesia modalities used in spine surgeries. New modalities of regional analgesia have emerged recently including erector spinae and thoracolumbar interfascial plane block, aimed at decreasing perioperative pain and enhancing early recovery in patients undergoing spine surgery. In this narrative review we discuss the characteristics of regional anesthesia including its types, indications, contraindications, benefits, and potential complications along with new modalities of regional analgesia.
脊柱手术麻醉技术和疼痛管理的最新进展已导致一种范式转变,即从传统的开放性脊柱手术转向在门诊进行的微创脊柱手术。单纯的脊髓麻醉和硬膜外麻醉,或与脊髓麻醉联合使用,是脊柱手术中常用的区域麻醉方式。最近出现了新的区域镇痛方式,包括竖脊肌和胸腰筋膜间平面阻滞,旨在减轻脊柱手术患者的围手术期疼痛并促进早期恢复。在这篇叙述性综述中,我们讨论了区域麻醉的特点,包括其类型、适应症、禁忌症、益处和潜在并发症,以及区域镇痛的新方式。