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全膝关节置换术的保留运动功能区域麻醉:一项叙述性和系统性文献综述

Motor-sparing regional anaesthesia for total knee arthroplasty: a narrative and systematic literature review.

作者信息

White Leigh, Kerr Michael, Thang Christopher, Pawa Amit

机构信息

Department of Anaesthesia and Perioperative Medicine, Sunshine Coast University Hospital, Sunshine Coast, QLD, Australia; School of Medicine & Dentistry, Griffith University, Sunshine Coast, QLD, Australia.

Department of Anaesthesia and Acute Pain Management, QEII Jubilee Hospital, Coopers Plains, QLD, Australia; Department of Anaesthesia and Acute Pain Management, Princess Alexandra Hospital, Woolloongabba, QLD, Australia; Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia.

出版信息

Br J Anaesth. 2025 Feb;134(2):510-522. doi: 10.1016/j.bja.2024.10.041. Epub 2025 Jan 2.

Abstract

Total knee arthroplasty is a life-changing surgical procedure that is associated with a high incidence of severe postoperative pain. Key to enhancing recovery after surgery is effective analgesia and early mobilisation. Innovations in motor-sparing regional anaesthesia techniques that have improved recovery include targeted surgical local infiltration analgesia, adductor canal blockade, genicular nerve blocks, and the infiltration between the popliteal artery and posterior capsule of the knee (iPACK) block. This narrative review discusses the current available motor-sparing regional anaesthetic techniques and assesses the evidence supporting each.

摘要

全膝关节置换术是一种改变生活的外科手术,术后严重疼痛的发生率很高。术后有效镇痛和早期活动是促进恢复的关键。运动保留型区域麻醉技术的创新改善了恢复情况,包括靶向手术局部浸润镇痛、内收肌管阻滞、膝神经阻滞以及腘动脉与膝关节后囊之间的浸润(iPACK)阻滞。本叙述性综述讨论了当前可用的运动保留型区域麻醉技术,并评估了支持每种技术的证据。

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