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优化外周区域麻醉:单次注射和连续阻滞的策略

Optimizing peripheral regional anaesthesia: strategies for single shot and continuous blocks.

作者信息

Johnstone David, Taylor Alasdair, Ferry Jenny

机构信息

Ninewells Hospital and Medical School, Dundee, Scotland.

Aneurin Bevan University Health Board, Newport, Wales, UK.

出版信息

Curr Opin Anaesthesiol. 2024 Oct 1;37(5):541-546. doi: 10.1097/ACO.0000000000001407. Epub 2024 Jun 24.

Abstract

PURPOSE OF REVIEW

Regional anaesthesia is increasingly prominent within anaesthesia, offering alternative analgesic options amidst concerns over opioid-based analgesia. Since Halsted's initial description, the field has burgeoned, with ultrasound visualization revolutionizing local anaesthetic spread assessment, leading to the development of numerous novel techniques. The benefits of regional anaesthesia have gained increasing evidence to support their application, leading to changes within training curricula. Consequently, regional anaesthesia is at a defining moment, embracing the development of core skills for the general anaesthesiologist, whilst also continuing the advancement of the specialty.

RECENT FINDINGS

Recent priority setting projects have focussed attention on key aspects of regional anaesthesia delivery, including pain management, conduct and efficacy, education, and technological innovation. Developments in our current understanding of anatomy and pharmacology, combined with strategies for optimizing the conduct and maximizing efficacy of techniques, minimizing complications, and enhancing outcomes are explored. In addition, advancements in education and training methodologies and the integration of progress in novel technologies will be reviewed.

SUMMARY

This review highlights recent scientific advances in optimizing both single-shot and continuous peripheral regional anaesthesia techniques. By synthesizing these developments, this review offers valuable insights into the evolving landscape of regional anaesthesia, aiming to improve clinical practice and patient care.

摘要

综述目的

区域麻醉在麻醉领域日益突出,在对基于阿片类药物镇痛存在担忧的情况下提供了替代镇痛选择。自霍尔斯特德最初描述以来,该领域蓬勃发展,超声可视化彻底改变了局部麻醉药扩散评估,导致众多新技术的发展。区域麻醉的益处已获得越来越多的证据支持其应用,从而导致培训课程发生变化。因此,区域麻醉正处于一个决定性时刻,既接纳了普通麻醉医生核心技能的发展,同时也在继续推动该专业的进步。

最新发现

近期的优先事项设定项目将注意力集中在区域麻醉实施的关键方面,包括疼痛管理、操作与疗效、教育以及技术创新。探讨了我们目前对解剖学和药理学理解的进展,以及优化操作和最大化技术疗效、最小化并发症和改善结果的策略。此外,还将回顾教育和培训方法的进步以及新技术进展的整合情况。

总结

本综述强调了在优化单次和连续外周区域麻醉技术方面的近期科学进展。通过综合这些进展,本综述为区域麻醉不断演变的格局提供了有价值的见解,旨在改善临床实践和患者护理。

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