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用于髋关节镜手术围手术期疼痛管理的关节囊周围神经组阻滞

The Pericapsular Nerve Group Block for Perioperative Pain Management for Hip Arthroscopy.

作者信息

Jacob Tannehill I, Tucker Christopher J, Robert Volk W, Dickens Jonathan F

机构信息

Department of Orthopaedic Surgery Walter Reed National Military Medical Center, Bethesda, Maryland.

Department of Anesthesiology, Kimbrough Ambulatory Care Center, Fort Meade, Maryland, U.S.A.

出版信息

Arthrosc Tech. 2021 Jul 22;10(7):e1799-e1803. doi: 10.1016/j.eats.2021.03.029. eCollection 2021 Jul.

Abstract

Perioperative pain control for hip arthroscopy procedures represents a significant challenge for both surgeons and anesthetists. In light of the opioid crisis, greater emphasis has been placed on multimodal pain control techniques. There is considerable debate regarding regional nerve blockade for hip arthroscopy. Although regional anesthesia has a significant role in perioperative pain management strategies, many of the most common techniques present their own risks and limitations. In particular, the less desirable effects of postoperative weakness in the lower extremity and difficulty with ambulation are commonly produced with standard regional blockades. We present a technique for performing a targeted, sensory nerve block that can be done efficiently and safely in the immediate preoperative period. This block can potentially lower the intraoperative and postoperative opioid requirements without the risks of muscle blockade and falls from other regional anesthesia modalities.

摘要

髋关节镜手术的围手术期疼痛控制对外科医生和麻醉师来说都是一项重大挑战。鉴于阿片类药物危机,人们更加重视多模式疼痛控制技术。关于髋关节镜手术的区域神经阻滞存在相当多的争论。尽管区域麻醉在围手术期疼痛管理策略中发挥着重要作用,但许多最常用的技术都有其自身的风险和局限性。特别是,标准区域阻滞通常会导致下肢术后无力和行走困难等不良后果。我们介绍一种在术前即刻能够高效、安全地进行的靶向感觉神经阻滞技术。这种阻滞有可能降低术中及术后对阿片类药物的需求,且没有肌肉阻滞和其他区域麻醉方式导致跌倒的风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9fb7/8322623/5b1d25ba1431/gr1.jpg

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