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急诊科手术室外的区域麻醉。

Regional anesthesia in the emergency department outside the operating theatre.

机构信息

Department of Anesthesia, Norfolk & Norwich University Hospital, Norwich, UK. ORCID ID: 0001-7344-1307.

Department of Anaesthesia, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.

出版信息

Curr Opin Anaesthesiol. 2023 Aug 1;36(4):447-451. doi: 10.1097/ACO.0000000000001281. Epub 2023 Jun 14.

Abstract

PURPOSE OF REVIEW

Moderate to severe pain is common and remains a significant problem in the emergency department and regional anesthesia provides optimal and safe pain relief. This review aims to discuss the benefits, indications of the most common ultrasound-guided regional anesthesia techniques that can be provided by clinicians in the emergency department as part of multimodal analgesia. We will also comment on the education and training for effective and safe ultrasound-guided regional anesthesia in the emergency department.

RECENT FINDINGS

The emergence of multiple new fascial plane blocks that provide easier to learn alternatives, yet effective analgesia for specific patient groups can now safely be taught and utilized in the emergency department.

SUMMARY

Emergency physicians are perfectly placed to utilize the advantages of ultrasound-guided regional anesthesia. Various techniques can now be employed to cover most of the painful injuries presenting to the emergency department, thus modifying the morbidity and outcomes of emergency patients. Some of the new techniques require minimal training, provide safe and effective pain relief with low risk of complications. Ultrasound-guided regional anesthetic techniques should form an integral part of the curriculum of emergency department physicians.

摘要

目的综述

中重度疼痛较为常见,且一直是急诊科的一个重大问题,区域麻醉可提供最佳和安全的止痛效果。本综述旨在讨论急诊科临床医生作为多模式镇痛的一部分可以提供的最常见的超声引导区域麻醉技术的优点、适应证。我们还将对急诊科有效和安全的超声引导区域麻醉的教育和培训进行评论。

最近的发现

多种新的筋膜平面阻滞技术的出现为特定患者群体提供了更容易学习的替代方案,同时也能提供有效的镇痛,现在可以在急诊科安全地教授和使用。

总结

急诊医生非常适合利用超声引导区域麻醉的优势。现在可以采用各种技术来覆盖大多数疼痛性损伤,从而改变急诊患者的发病率和结局。一些新技术需要最少的培训,提供安全有效的止痛效果,并发症风险低。超声引导区域麻醉技术应成为急诊医师课程的一个组成部分。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/997d/10328532/5168da6b9d03/coana-36-447-g001.jpg

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