周围神经阻滞中的佐剂——现有知识状况。
Adjuvants in peripheral nerve blocks - the current state of knowledge.
机构信息
Department of Anaesthesiology and Intensive Therapy, St. Lukas Specialist Hospital in Końskie, Poland.
出版信息
Anaesthesiol Intensive Ther. 2020;52(4):323-329. doi: 10.5114/ait.2020.98213.
Abstract
Regional anaesthetic techniques are an indispensable element of acute and postoperative pain management. The benefits of regional blocks are particularly noticeable in trauma and orthopaedic, joint reconstruction or thoracic surgical procedures. Depending on the local anaesthetic (LA) used, the duration of analgesia is limited to a maximum of 12-16 hours. There are several methods affecting the prolongation of analgesia, e.g. continuous techniques with catheters, liposomal forms of LAs or adjuvants. Due to numerous limitations and problems associated with the use of continuous techniques, lack of approval or availability of liposomal LAs, the optimal measure to prolong the duration of postoperative analgesia is the use of adjuvants. The present study aims to collect and systematise the current knowledge about the most common adjuvants used for nerve / plexus blockades and intravenous regional anaesthesia.
摘要
区域麻醉技术是急性和术后疼痛管理不可或缺的一部分。在创伤和骨科、关节重建或胸外科手术中，区域阻滞的益处尤为明显。根据所用的局部麻醉剂（LA），镇痛持续时间最长限制在 12-16 小时内。有几种方法可以影响镇痛的延长，例如使用导管的连续技术、LA 的脂质体形式或佐剂。由于连续技术的使用存在许多限制和问题，缺乏对脂质体 LA 的批准或可用性，延长术后镇痛持续时间的最佳措施是使用佐剂。本研究旨在收集和系统地总结目前关于用于神经/丛阻滞和静脉内区域麻醉的最常见佐剂的知识。
相似文献
1
Adjuvants in peripheral nerve blocks - the current state of knowledge.周围神经阻滞中的佐剂——现有知识状况。
Anaesthesiol Intensive Ther. 2020;52(4):323-329. doi: 10.5114/ait.2020.98213.
2
[Background and current use of adjuvants for regional anesthesia : From research to evidence-based patient treatment].[区域麻醉辅助剂的背景与当前应用：从研究到基于证据的患者治疗]
Anaesthesist. 2019 Jan;68(1):3-14. doi: 10.1007/s00101-018-0522-6.
3
Effectiveness of ondansetron as an adjunct to lidocaine intravenous regional anesthesia on tourniquet pain and postoperative pain in patients undergoing elective hand surgery: a systematic review protocol.昂丹司琼作为利多卡因静脉区域麻醉辅助药物对择期手部手术患者止血带疼痛和术后疼痛的有效性：一项系统评价方案
JBI Database System Rev Implement Rep. 2015 Jan;13(1):27-38. doi: 10.11124/jbisrir-2015-1768.
4
Measures to prolong duration of sensory block after regional anaesthesia.延长区域麻醉后感觉阻滞持续时间的措施。
Curr Opin Anaesthesiol. 2023 Feb 1;36(1):103-108. doi: 10.1097/ACO.0000000000001204. Epub 2022 Nov 2.
5
New modalities of pain treatment after outpatient orthopaedic surgery.门诊骨科手术后疼痛治疗的新方法。
Orthop Traumatol Surg Res. 2016 Feb;102(1 Suppl):S121-4. doi: 10.1016/j.otsr.2015.05.011. Epub 2016 Jan 20.
6
[Perioperative analgesia with continuous peripheral nerve blocks in children].[儿童围手术期连续外周神经阻滞镇痛]
Ann Fr Anesth Reanim. 2007 Feb;26(2):136-44. doi: 10.1016/j.annfar.2006.10.016. Epub 2006 Dec 15.
7
Facilitatory effects of perineural dexmedetomidine on neuraxial and peripheral nerve block: a systematic review and meta-analysis.周围神经阻滞中鞘内给予右美托咪定的辅助作用：系统评价和荟萃分析。
Br J Anaesth. 2013 Jun;110(6):915-25. doi: 10.1093/bja/aet066. Epub 2013 Apr 15.
8
Adjuvants in clinical regional anesthesia practice: A comprehensive review.临床区域麻醉实践中的佐剂：全面综述。
Best Pract Res Clin Anaesthesiol. 2019 Dec;33(4):415-423. doi: 10.1016/j.bpa.2019.06.001. Epub 2019 Jul 2.
9
Local anaesthetic adjuvants: neuraxial versus peripheral nerve block.局部麻醉辅助剂：椎管内阻滞与外周神经阻滞。
Curr Opin Anaesthesiol. 2009 Oct;22(5):649-54. doi: 10.1097/ACO.0b013e32832ee847.
10
Postoperative analgesia for elective total knee arthroplasty under subarachnoid anesthesia with opioids: comparison between epidural, femoral block and adductor canal block techniques (with and without perineural adjuvants). A prospective, randomized, clinical trial.蛛网膜下隙麻醉下阿片类药物用于择期全膝关节置换术后镇痛：硬膜外、股神经阻滞和收肌管阻滞技术（有和无神经周围辅助剂）的比较。一项前瞻性、随机、临床试验。
Minerva Anestesiol. 2017 Jan;83(1):50-58. doi: 10.23736/S0375-9393.16.11646-3. Epub 2016 Oct 28.
引用本文的文献
1
Effects of Perineural Dexamethasone and Dexmedetomidine on Neuromonitoring and Analgesia in Pediatric Scoliosis Surgery: A Randomized Controlled Trial.神经周围注射地塞米松和右美托咪定对小儿脊柱侧弯手术中神经监测及镇痛的影响：一项随机对照试验
Spine (Phila Pa 1976). 2025 Sep 15;50(18):1233-1242. doi: 10.1097/BRS.0000000000005399. Epub 2025 May 20.
2
Analgesic effect of ropivacaine combined with methylene blue in fascia Iliaca block for patients undergoing hip arthroplasty.罗哌卡因联合亚甲蓝在髋关节置换术患者髂筋膜阻滞中的镇痛效果
BMC Musculoskelet Disord. 2025 Mar 14;26(1):256. doi: 10.1186/s12891-025-08490-6.
3
Role of Adjuvants in Enhancing the Efficacy and Duration of Anesthesia Blocks: A Comprehensive Review.佐剂在增强麻醉阻滞效果和持续时间中的作用：一项综述
Cureus. 2024 Sep 21;16(9):e69880. doi: 10.7759/cureus.69880. eCollection 2024 Sep.
4
The Density of Different Local Anesthetic Solutions, Opioid Adjuvants and Their Clinically Used Combinations: An Experimental Study.不同局部麻醉溶液、阿片类佐剂及其临床应用组合的密度：一项实验研究。
Pharmaceuticals (Basel). 2021 Aug 16;14(8):801. doi: 10.3390/ph14080801.
5
Perioperative Pain Management and Opioid Stewardship: A Practical Guide.围手术期疼痛管理与阿片类药物管理：实用指南。
Healthcare (Basel). 2021 Mar 16;9(3):333. doi: 10.3390/healthcare9030333.
本文引用的文献
1
Regional anaesthesia induced peripheral nerve injury.区域麻醉引起的周围神经损伤。
Anaesthesiol Intensive Ther. 2018;50(5):367-377. doi: 10.5603/AIT.2018.0049.
2
Dexamethasone Is Superior to Dexmedetomidine as a Perineural Adjunct for Supraclavicular Brachial Plexus Block: Systematic Review and Indirect Meta-analysis.地塞米松作为颈丛神经阻滞的辅助用药优于右美托咪定：系统评价和间接荟萃分析。
Anesth Analg. 2019 Mar;128(3):543-554. doi: 10.1213/ANE.0000000000003860.
3
Postoperative pain management - 2018 consensus statement of the Section of Regional Anaesthesia and Pain Therapy of the Polish Society of Anaesthesiology and Intensive Therapy, the Polish Society of Regional Anaesthesia and Pain Therapy, the Polish Association for the Study of Pain and the National Consultant in Anaesthesiology and Intensive Therapy.术后疼痛管理——波兰麻醉与重症治疗学会区域麻醉与疼痛治疗分会、波兰区域麻醉与疼痛治疗学会、波兰疼痛研究协会以及国家麻醉与重症治疗顾问2018年共识声明
Anaesthesiol Intensive Ther. 2018;50(3):173-199. doi: 10.5603/AIT.2018.0026.
4
Benefit and Harm of Adding Epinephrine to a Local Anesthetic for Neuraxial and Locoregional Anesthesia: A Meta-analysis of Randomized Controlled Trials With Trial Sequential Analyses.椎管内和局部麻醉中添加肾上腺素对局部麻醉的获益与危害：一项随机对照试验的荟萃分析和序贯分析。
Anesth Analg. 2018 Jul;127(1):228-239. doi: 10.1213/ANE.0000000000003417.
5
Effects of Intraneural Injection of Dexmedetomidine in Combination With Ropivacaine in Rat Sciatic Nerve Block.盐酸右美托咪定联合罗哌卡因臂丛神经阻滞的效果：在大鼠坐骨神经中的实验研究。
Reg Anesth Pain Med. 2018 May;43(4):378-384. doi: 10.1097/AAP.0000000000000745.
6
Co-administration of dexamethasone with peripheral nerve block: intravenous vs perineural application: systematic review, meta-analysis, meta-regression and trial-sequential analysis.地塞米松与外周神经阻滞联合应用：静脉内与神经周围应用：系统评价、荟萃分析、荟萃回归和试验序贯分析。
Br J Anaesth. 2018 Feb;120(2):212-227. doi: 10.1016/j.bja.2017.11.062. Epub 2017 Nov 22.
7
Analgesic effects of lidocaine-ketorolac compared to lidocaine alone for intravenous regional anesthesia.与单独使用利多卡因相比，利多卡因-酮咯酸用于静脉区域麻醉的镇痛效果。
Caspian J Intern Med. 2018 Winter;9(1):32-37. doi: 10.22088/cjim.9.1.32.
8
The Third American Society of Regional Anesthesia and Pain Medicine Practice Advisory on Local Anesthetic Systemic Toxicity: Executive Summary 2017.美国区域麻醉与疼痛医学学会第三次局部麻醉全身毒性实践咨询意见：2017 年执行摘要。
Reg Anesth Pain Med. 2018 Feb;43(2):113-123. doi: 10.1097/AAP.0000000000000720.
9
Anesthesia and Analgesia Practice Pathway Options for Total Knee Arthroplasty: An Evidence-Based Review by the American and European Societies of Regional Anesthesia and Pain Medicine.膝关节置换术的麻醉与镇痛实践路径选择：美国和欧洲区域麻醉与疼痛医学学会的循证综述。
Reg Anesth Pain Med. 2017 Nov/Dec;42(6):683-697. doi: 10.1097/AAP.0000000000000673.
10
Optimal Dose of Perineural Dexamethasone to Prolong Analgesia After Brachial Plexus Blockade: A Systematic Review and Meta-analysis.臂丛神经阻滞后延长镇痛效果的神经周围地塞米松最佳剂量：系统评价与荟萃分析
Anesth Analg. 2018 Jan;126(1):270-279. doi: 10.1213/ANE.0000000000002488.
Zotero 插件