Sharma Richa, Damiano James, Al-Saidi Ibrahim, Dizdarevic Anis
Department of Anesthesiology, Weill-Cornell Medicine, New York, NY, 10065, USA.
Department of Anesthesiology, Columbia University Medical Center, New York, NY, 10032, USA.
Curr Pain Headache Rep. 2023 Oct;27(10):587-600. doi: 10.1007/s11916-023-01158-7. Epub 2023 Aug 25.
The purpose of this review is to provide an up-to-date description and overview of the rapidly growing literature pertaining to techniques and clinical applications of chest wall and abdominal fascial plane blocks in managing perioperative pain.
Clinical evidence suggests that regional anesthesia blocks, including fascial plane blocks, such as pectoralis, serratus, erector spinae, transversus abdominis, and quadratus lumborum blocks, are effective in providing analgesia for various surgical procedures and have more desirable side effect profile when compared to traditional neuraxial techniques. They offer advantages such as reduced opioid consumption, improved pain control, and decreased opioid-related side effects. Further research is needed to establish optimal techniques and indications for these blocks. Presently, they are a vital instrument in a gamut of multimodal analgesia options, especially when there are contraindications to neuraxial or para-neuraxial procedures. Ultimately, clinical judgment and provider skill set determine which blocks-alone or in combination-should be offered to any patient.
本综述旨在对有关胸壁和腹部筋膜平面阻滞技术及其在围手术期疼痛管理中的临床应用的快速增长的文献进行最新描述和概述。
临床证据表明，区域麻醉阻滞，包括筋膜平面阻滞，如胸大肌、锯肌、竖脊肌、腹横肌和腰方肌阻滞，在为各种外科手术提供镇痛方面是有效的，并且与传统的神经轴技术相比，具有更理想的副作用。它们具有减少阿片类药物消耗、改善疼痛控制和减少阿片类药物相关副作用等优点。需要进一步研究以确定这些阻滞的最佳技术和适应症。目前，它们是多种多模式镇痛选择中的重要手段，尤其是在存在神经轴或神经旁手术禁忌症时。最终，临床判断和医疗人员的技能决定了应向任何患者提供哪种单独或联合的阻滞。
