Department of Outcomes Research, Cleveland Clinic, Cleveland, Ohio, USA.
Department of Anesthesiology and Reanimation, Adnan Menderes University, Aydin, Turkey.
Curr Opin Crit Care. 2021 Dec 1;27(6):733-742. doi: 10.1097/MCC.0000000000000873.
To describe current developed regional blocks, their indications and clinical use. Furthermore, describe new local anesthetics recently introduced and the new agents in pipeline.
There are multiple new blocks recently developed with the introduction of ultrasound to regional anesthesia and studies demonstrate effect in different surgical procedures. However, majority of the studies do not compare with gold standard and are relatively small to change clinical practice. Some of these blocks are: erector spinae plane block, infiltration between the popliteal artery and capsule of the posterior knee, pectoral nerve blocks, quadratus lumborum and transversus abdominis plane block. New local anesthetics and adjuvants have been developed in recent years. However, the studies with even with the oldest one introduced Exparel is currently questioned, large future studies are needed to determine efficacy and safety profile and compared with conventional local anesthetics.
New regional block techniques and new local anesthetics have been introduced recently. However, the efficacy/safety and comparison to conventional techniques and local anesthetics are still needed. Future studies must focus on prolonging analgesia with least invasive regional technique and compare new local anesthetics with current ones.
描述当前已开发的区域阻滞技术、其适应证和临床应用。此外，还将描述最近新引入的局部麻醉剂和正在研发的新药物。
随着超声技术在区域麻醉中的应用，出现了多种新的阻滞技术，多项研究证实了其在不同手术中的效果。然而，大多数研究都没有与金标准进行比较，而且样本量相对较小，不足以改变临床实践。其中一些阻滞技术包括：竖脊肌平面阻滞、膝关节后囊和腘窝动脉之间的浸润、胸神经阻滞、腰方肌和腹横肌平面阻滞。近年来，新的局部麻醉剂和佐剂已经被开发出来。然而，即使是最古老的局部麻醉剂 Exparel 也存在争议，需要进行更多的大型未来研究，以确定其疗效和安全性，并与传统局部麻醉剂进行比较。
最近已经引入了新的区域阻滞技术和新的局部麻醉剂。然而，仍需要评估其疗效/安全性，并与传统技术和局部麻醉剂进行比较。未来的研究必须侧重于使用创伤最小的区域技术来延长镇痛时间，并将新的局部麻醉剂与现有的进行比较。
