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内脏痛的交感神经阻滞。

Sympathetic Blocks for Visceral Pain.

机构信息

Division of Pain Medicine, Duke Anesthesiology, Duke University, 2080 Duke University Road, Durham, NC 27708, USA.

Anesthesiology and Critical Care, Duke University, 2080 Duke University Road, Durham, NC 27708, USA.

出版信息

Phys Med Rehabil Clin N Am. 2022 May;33(2):475-487. doi: 10.1016/j.pmr.2022.01.010.

Abstract

For patients with chronic pain or cancer-related pain, the most common indication for sympathetic block is to control visceral pain arising from malignancies or other alterations of the abdominal and pelvic viscera. When it is recalcitrant to conservative care, or if the patient is intolerant to pharmacotherapy, consideration of sympathetic blocks or neurolytic procedures is considered. Potential advantages of a neurolytic procedure, compared with spinal and epidural anesthetic infusions, include cost savings and avoidance of hardware. Interventional therapies that target afferent visceral innervation via the sympathetic ganglia offer effective and durable analgesia and improve multiple metrics of quality of life.

摘要

对于患有慢性疼痛或癌性疼痛的患者,交感神经阻滞的最常见适应证是控制源自恶性肿瘤或腹部和盆腔内脏器其他改变的内脏疼痛。当保守治疗无效,或者患者对药物治疗不耐受时,可考虑进行交感神经阻滞或神经溶解术。与脊髓和硬膜外麻醉输注相比,神经溶解术的潜在优势包括节省成本和避免使用硬件。通过交感神经节靶向内脏传入神经的介入治疗可提供有效且持久的镇痛,并改善生活质量的多个指标。

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