Department of Anesthesiology and Pain Management, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, 75390-9068, Dallas, TX, USA.
Villa Pain Institute, El Paso, TX, USA.
Curr Pain Headache Rep. 2023 Jun;27(6):149-155. doi: 10.1007/s11916-023-01112-7. Epub 2023 Apr 20.
Nerve blocks constitute an integral portion in the management of chronic pain. The widespread use of ultrasound imaging opened the door to a flood of newer blocks especially truncal plane nerve blocks. We reviewed the current medical literature for studies and case reports utilizing the two most common truncal plane nerve blocks, transversus abdominis plane and erector spinae plane blocks, to manage chronic pain.
We found some evidence, mostly in case reports and retrospective observational studies, that supports the use of transversus abdominis plane and erector spinae plane nerve blocks, usually with steroids, as a safe and valuable part of interdisciplinary management of chronic abdominal and chest walls pain. Ultrasound-guided truncal fascial plane nerve blocks are safe, easy to learn, and proven to help with post-operative acute pain management. Although limited, our current review provides evidence from the current medical literature regarding the utility of these blocks to manage some of the challenging chronic and cancer-related pain conditions of the trunk region.
神经阻滞是慢性疼痛管理的一个重要组成部分。超声成像的广泛应用为更多新的阻滞方法,特别是躯干平面神经阻滞的发展开辟了道路。我们回顾了目前利用两种最常见的躯干平面神经阻滞,腹横肌平面和竖脊肌平面阻滞,来治疗慢性疼痛的研究和病例报告的医学文献。
我们发现了一些证据,主要是在病例报告和回顾性观察研究中,支持使用腹横肌平面和竖脊肌平面神经阻滞,通常与类固醇联合使用,作为治疗慢性腹部和胸壁疼痛的多学科管理的安全且有价值的方法。超声引导的躯干筋膜平面神经阻滞安全、易于学习,并已被证明有助于术后急性疼痛管理。虽然有限,但我们目前的综述提供了来自当前医学文献的证据,证明这些阻滞方法可用于治疗躯干区域的一些具有挑战性的慢性和癌症相关疼痛病症。