实用医学杂志 ›› 2022, Vol. 38 ›› Issue (4): 421-426.doi: 10.3969/j.issn.1006⁃5725.2022.04.006

• 临床新进展 • 上一篇    下一篇

术后区域镇痛技术的应用进展

莫小倩 苏仙 王东信   

  1. 北京大学第一医院麻醉科(北京 100034)

  • 出版日期:2022-02-25 发布日期:2022-02-25
  • 通讯作者: 王东信 E⁃mail:wangdongxin@hotmail.com
  • 基金资助:
    国家重点研发项目资助(编号:2018YFC2001800)

Progress of regional techniques for postoperative analgesia .

MO Xiaoqian,SU Xian,WANG Dongxin   

  1. Depart⁃ment of Anesthesiology and Critical Care Medicine,Peking University First Hospital,Beijing 100034,China

  • Online:2022-02-25 Published:2022-02-25
  • Contact: WANG Dongxin E⁃mail:wangdongxin@hotmail.com

摘要:

良好的镇痛管理是术后患者快速康复的重要保障。区域镇痛技术在各类手术术后镇痛中发挥重要作用。目前常用的区域镇痛技术有硬膜外镇痛、鞘内吗啡镇痛、外周神经阻滞等。硬膜外镇痛是开放性大手术术后镇痛的金标准,但有一定的失败率和不良事件发生率。鞘内吗啡需要剂量小、镇痛效力高、作用时间长。超声引导下外周神经阻滞操作简单、损伤小、成功率高、阻滞效果好。不同镇痛技术的优势与风险各不相同,临床上需要根据患者情况选择相应镇痛策略,以提高镇痛疗效、减少相关并发症。

关键词:

区域镇痛,  , 鞘内镇痛,  , 硬膜外镇痛,  , 外周神经阻滞

Abstract:

Effective analgesic management is the guarantee of rapid recovery following surgery. Regionalanalgesic techniques,including epidural analgesia,intrathecal morphine and peripheral nerve blocks,play animportant role in postoperative analgesia. Epidural analgesia is considered the gold standard for postoperative painrelief following open surgeries,but has a certain rate of failure and adverse events. The superiorities of intrathecalmorphine analgesia include low dose requirement,high analgesic potency,and long duration of action. Ultrasound⁃guided peripheral nerve block has advantages of easy to conduct,less invasive,high success rate,and guaranteedeffect. Given that the advantages and risks of analgesic techniques may not be identical,appropriate analgesic strategiesare supposed to be selected according to the patient condition for better analgesic efficacy and less complications.

Key words:

regional analgesia, intrathecal morphine, epidural analgesia, peripheral nerve block