Hasoon Jamal, Nguyen Anvinh
Department of Anesthesiology, Critical Care, and Pain Medicine The University of Texas Health Science Center at Houston.
Department of Anesthesiology Baylor College of Medicine.
Orthop Rev (Pavia). 2025 Mar 31;17:133570. doi: 10.52965/001c.133570. eCollection 2025.
Regional anesthesia has become a cornerstone in orthopedic surgeries due to its ability to provide precise, localized pain relief while minimizing the systemic risks associated with general anesthesia and opioid use. This review aims to provide a compact guide for anesthesia trainees and practicing anesthesiologists on the use of regional anesthesia techniques for upper and lower extremity procedures.
This guide outlines the main regional block options for orthopedic surgeries, detailing the targeted anatomy, common surgical indications, important adjacent structures, and potential complications for each technique. Key blocks for upper extremity surgeries include interscalene, supraclavicular, infraclavicular, axillary, and intercostobrachial blocks, while lower extremity techniques encompass femoral, adductor canal, sciatic, popliteal, and lumbar plexus blocks. Advances in ultrasound guidance have enhanced the safety and efficacy of these techniques, making them indispensable for modern anesthesiology practice. By mastering these approaches, providers can optimize patient outcomes, expand their skillset, and contribute to enhanced perioperative care in orthopedic surgery.
区域麻醉已成为骨科手术的基石，因为它能够提供精确的局部疼痛缓解，同时将与全身麻醉和使用阿片类药物相关的全身风险降至最低。本综述旨在为麻醉住院医师和执业麻醉医师提供一份关于在上下肢手术中使用区域麻醉技术的简明指南。
本指南概述了骨科手术的主要区域阻滞选择，详细介绍了每种技术的目标解剖结构、常见手术适应症、重要相邻结构和潜在并发症。上肢手术的关键阻滞包括肌间沟阻滞、锁骨上阻滞、锁骨下阻滞、腋路阻滞和肋间臂神经阻滞，而下肢技术包括股神经阻滞、收肌管阻滞、坐骨神经阻滞、腘窝阻滞和腰丛阻滞。超声引导技术的进步提高了这些技术的安全性和有效性，使其成为现代麻醉实践中不可或缺的一部分。通过掌握这些方法，医疗人员可以优化患者预后，扩展他们的技能，并为骨科手术中加强围手术期护理做出贡献。
