Reiz S
Ann Chir Gynaecol. 1984;73(3):166-70.
The methods of providing postoperative analgesia by regional anaesthetic techniques with local anaesthetics are outlined. For the use of epidural analgesia, the techniques of inserting an epidural catheter at any level of the spine must be familiar. The block should be regional, restricted to the area of pain and effective at all times after its institution with a minimum of side effects. Bupivacaine is at present the best local anaesthetic and can be administered either as intermittent injections with an interval of 1-2 hours or as a continuous infusion. A dose regimen for thoracic, abdominal, perineal and lower extremity pain is presented. Side effects of the epidural technique and ways to treat and avoid them are discussed. The intercostal nerve block for post-thoracotomy and upper abdominal pain is described with special reference to the recent development of the continuous technique with bupivacaine and the cryoanalgesia technique.
概述了使用局部麻醉药通过区域麻醉技术提供术后镇痛的方法。对于硬膜外镇痛的使用，必须熟悉在脊柱任何水平插入硬膜外导管的技术。阻滞应是区域性的，局限于疼痛区域，在建立后应始终有效且副作用最小。布比卡因目前是最好的局部麻醉药，可每隔1 - 2小时进行间歇性注射或持续输注。给出了针对胸部、腹部、会阴和下肢疼痛的给药方案。讨论了硬膜外技术的副作用以及治疗和避免这些副作用的方法。特别参考了布比卡因连续技术和冷冻镇痛技术的最新进展，描述了开胸术后和上腹部疼痛的肋间神经阻滞。
