Sonawane Kartik, Dixit Hrudini, Jayaraj Aparna, Thota Navya, Sekar Chelliah
Anesthesiology, Ganga Medical Centre and Hospitals, Pvt. Ltd., Coimbatore, IND.
Anesthesiology, Sir H. N. Reliance Foundation Hospital and Research Centre, Mumbai, IND.
Cureus. 2023 Jul 12;15(7):e41771. doi: 10.7759/cureus.41771. eCollection 2023 Jul.
Regional anesthesia (RA) is an interplay between the local anesthetic (LA) solution and the neural structures, resulting in nerve conduction blockade. For that, it is necessary to understand which hurdles the LA has to overcome and which components of the nerves are involved. Background knowledge of the neural and non-neural components of the nerve helps locate the safest area for LA deposition. In addition, knowledge of nerve physiology and the conduction process helps to understand the patterns of block onset, involved fibers, and block regression. Neural connective tissue protects the nerve on the one hand and influences the overall effect of the blockade and the occurrence of nerve injuries on the other. The arrangement of the nerve fibers explains the science behind the differential blockage after LA deposition. This article describes the important aspects of nerve anatomy (nerve formation and composition) and nerve physiology (impulse generation and propagation). It also provides insight into the physiological processes involved when a damaged neural structure leads to potential clinical symptoms. It will help readers sharpen their skills and knowledge to execute safe RA without damaging any vital structures in the nerve.
区域麻醉（RA）是局部麻醉（LA）溶液与神经结构之间的相互作用，导致神经传导阻滞。为此，有必要了解局部麻醉药必须克服哪些障碍以及神经的哪些组成部分参与其中。神经和非神经组成部分的背景知识有助于确定局部麻醉药注射的最安全区域。此外，神经生理学和传导过程的知识有助于理解阻滞起效模式、受累纤维和阻滞消退情况。神经结缔组织一方面保护神经，另一方面影响阻滞的总体效果和神经损伤的发生。神经纤维的排列解释了局部麻醉药注射后差异阻滞背后的科学原理。本文描述了神经解剖学（神经形成和组成）和神经生理学（冲动产生和传播）的重要方面。它还深入探讨了受损神经结构导致潜在临床症状时所涉及的生理过程。这将帮助读者提高技能和知识水平，以便在不损伤神经中任何重要结构的情况下实施安全的区域麻醉。
