Richardson J, Sabanathan S
Department of Anaesthetics, Bradford Royal Infirmary, England.
Acta Anaesthesiol Scand. 1995 Nov;39(8):1005-15. doi: 10.1111/j.1399-6576.1995.tb04219.x.
Thoracic paravertebral nerve blockade, although once widely practised, has now only a few centres which contribute to the literature. Data production has, however, continued and this review correlates this new information with existing knowledge. Its history, taxonomy, anatomy, indications, techniques, mechanisms of analgesia, efficacy, contraindications, toxicity, side effects and complications are reviewed. Thoracic paravertebral analgesia is advocated for surgical procedures of the thorax and abdomen, especially wherever the afferent input is predominantly unilateral eg. thoracotomy, cholecystectomy and nephrectomy. It is also of benefit in the prevention and management of chronic pain. It is a simple undertaking with impressive efficacy. Plasma local anaesthetic levels are acceptable and its side effect and complication rates are low. No mortality has been reported. For unilateral surgery of the chest or truck, thoracic paravertebral analgesia should be considered as the afferent block of choice. For bilateral surgery, its efficacy may be limited by the doses of local anaesthetic which could safely be used and further study in this area in particular is required. This form of afferent blockade deserves greater consideration and investigation.
胸段椎旁神经阻滞虽然曾经广泛应用，但目前仅有少数几个中心在撰写相关文献。然而，数据仍在不断积累，本综述将这些新信息与现有知识进行了关联。文中对其历史、分类、解剖、适应证、技术、镇痛机制、疗效、禁忌证、毒性、副作用及并发症进行了综述。胸段椎旁镇痛适用于胸腹部手术，特别是在传入神经主要为单侧输入的情况下，如开胸手术、胆囊切除术和肾切除术。它在慢性疼痛的预防和管理中也有帮助。这是一项操作简单且疗效显著的技术。血浆局部麻醉药水平在可接受范围内，其副作用和并发症发生率较低。尚无死亡病例报告。对于胸部或躯干部的单侧手术，胸段椎旁镇痛应被视为首选的传入神经阻滞方法。对于双侧手术，其疗效可能会受到安全使用的局部麻醉药剂量的限制，尤其需要在该领域进行进一步研究。这种形式的传入神经阻滞值得更多的考虑和研究。
