Niyonkuru Emery, Iqbal Muhammad Asad, Zeng Rui, Zhang Xu, Ma Peng
Department of Anesthesiology, Affiliated Hospital of Jiangsu University, Zhenjiang City, Jiangsu Province, People's Republic of China.
School of Medicine, Jiangsu University, Zhenjiang City, Jiangsu Province, People's Republic of China.
J Pain Res. 2024 Oct 2;17:3217-3239. doi: 10.2147/JPR.S476563. eCollection 2024.
Opioids remain the mainstay of post-surgical pain management; however, concerns regarding addiction and side effects necessitate the exploration of alternatives. This narrative review highlights the potential of nerve blocks as a safe and effective strategy for post-surgical pain control. This review explores the use of various nerve block techniques tailored to specific surgical procedures. These include nerve blocks for abdominal surgeries; fascial plane blocks for chest surgeries; nerve blocks for arm surgeries; and nerve blocks for lower limb surgery including; femoral, hip, and knee surgeries. By targeting specific nerves, these blocks can provide targeted pain relief without the negative side effects associated with opioids. Emerging evidence suggests that nerve blocks can be as effective as opioids in managing pain, while potentially offering additional benefits such as faster recovery, improved patient satisfaction, and reduced reliance on opioids. However, the effectiveness of nerve blocks varies depending on type of surgery, and in individual patients. Rebound pain, which temporary increase in pain after a block wears off, can occur. In addition, some techniques require specialized guidance for accurate placement. In conclusion, nerve blocks show great promise as effective alternatives for managing post-surgical pain. They can reduce the need for opioids and their side effects, leading to better patient outcomes and satisfaction. Future studies should assess the long-term impacts of specific nerve blocks on mortality rates, cost-effectiveness, and their incorporation into multimodal pain management approaches to further enhance post-surgical care.
阿片类药物仍然是术后疼痛管理的主要手段；然而，对成瘾和副作用的担忧使得有必要探索替代方法。本叙述性综述强调了神经阻滞作为一种安全有效的术后疼痛控制策略的潜力。本综述探讨了针对特定外科手术定制的各种神经阻滞技术的应用。这些技术包括用于腹部手术的神经阻滞；用于胸部手术的筋膜平面阻滞；用于手臂手术的神经阻滞；以及用于下肢手术（包括股骨、髋关节和膝关节手术）的神经阻滞。通过靶向特定神经，这些阻滞可以提供针对性的疼痛缓解，而没有与阿片类药物相关的负面副作用。新出现的证据表明，神经阻滞在疼痛管理方面可以与阿片类药物一样有效，同时可能带来额外的益处，如更快康复、提高患者满意度以及减少对阿片类药物的依赖。然而，神经阻滞的有效性因手术类型和个体患者而异。可能会出现阻滞消退后疼痛暂时增加的反弹痛。此外，一些技术需要专门的引导以准确放置。总之，神经阻滞作为管理术后疼痛的有效替代方法显示出巨大的前景。它们可以减少对阿片类药物及其副作用的需求，从而带来更好的患者预后和满意度。未来的研究应评估特定神经阻滞对死亡率、成本效益的长期影响，以及它们纳入多模式疼痛管理方法以进一步改善术后护理的情况。
