竖脊肌平面阻滞技术的临床应用分析---以其在全髋关节置换术术后镇痛中的临床应用为例
Journal: Basic Medical Theory Research DOI: 10.12238/bmtr.v6i4.8501
Abstract
竖脊肌平面阻滞是一种新型的区域阻滞技术,在临床术后镇痛中应用广泛,可有效缓解术后疼痛,提高患者早期活动能力,降低并发症风险。与腰丛神经阻滞、腰方肌神经阻滞、髂筋膜平面阻滞等相比,ESPB具有操作简便、并发症风险低等优势。多项随机对照试验表明,ESPB能显著降低VAS评分,减少术后阿片类药物的需求。尽管ESPB在术后疼痛管理中取得了积极成果,但目前对其确切的镇痛机制认识尚不完全,且存在一定的技术差异性和个体差异性。未来研究将进一步评估和优化ESPB在髋关节置换术中的应用,提高镇痛质量,降低麻醉师的操作难度,并可能为患者提供更个性化的疼痛管理方案。
Keywords
竖脊肌平面阻滞；髋关节置换手术；术后疼痛管理；作用机制
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[3] Pascarella G, Costa F, Strumia A, et al. The multiple pathways of local anaesthetic during lumbar erector spinae plane block: an ultrasound finding[J].Anaesthesia,2021,76(1):142-143.
[4] 王春霞,刘英,邓媛.布比卡因与罗哌卡因在剖宫产术腰–硬联合麻醉中的麻醉效果比较 [J].深圳中西医结合杂志,2023,33(20):75-78.
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[6] Springer D B ,Mason B J ,Odum M S .Systemic Safety of Liposomal Bupivacaine in Simultaneous Bilateral Total Knee Arthroplasty[J].The Journal of Arthroplasty,2018,33(1):97-101.
[7] H T N,Cesar I,Rohit V.Efficacy of Liposomal Bupivacaine in Spine Surgery: A Systematic Review.[J].The spine journal :official journal of the North American Spine Society,2021,21 (9):1450-1459.
[8] Jing Y,Min Z,XiaoRui Z,etal.Ropivacaine with Dexmedet omidine or Dexamethasone in a Thoracic Paravertebral Nerve Block Combined with an Erector Spinae Plane Block for Thoracoscopic Lobectomy Analgesia: A Randomized Controlled Trial.[J].Drug design,development and therapy,2022,161561- 1571.
[9] Keerati C ,Suphawat T ,Pakpoom R , et al.Efficacy of epinephrine in local infiltration analgesia on pain relief and opioid consumption following total knee arthroplasty: a randomized controlled trial.[J].Acta orthopaedica,2023,94197-101.
[10] 彭婷,邹锋,岳小芳,等.超声引导腰丛神经阻滞技术的研究进展[J].国际麻醉学与复苏杂志,2020,41(9):893-898.
[11] Amy C ,Kerstin K ,Alison S , et al.Continuous Lumbar Plexus Block vs Continuous Lumbar Erector Spinae Plane Block for Postoperative Pain Control After Revision Total Hip Arthroplasty[J].Arthroplasty Today,2021,929-34.
[12] L C ,A G M ,C L .A cadaver study comparing spread of dye and nerve involvement after three different quadratus lumborum blocks.[J].British journal of anaesthesia,2016,117(3):387-94.
[13] Tanggaard K ,Nielsen V M ,Holm U H U, et al.No quadriceps muscle weakness following anterior quadratus lumborum block compared with placebo: a randomized, noninferiority, blinded, volunteer trial.[J].Regional anesthesia and pain medicine,2024,
[14] Ömer K .Unexpected motor block after ultrasoundguided lumbar erector Spinae plane block.[J].Agri:Agri (Algolo ji) Dernegi'nin Yayin organidir = The journal of the Turkish Society of Algology,2023,35(2):112-114.
[15] Qiuru W ,Jian H ,Wanli Z , et al.Comparison between ultrasound-guided suprainguinal fascia iliaca block and ante rior quadratus lumborum block for total hip arthroplasty: a prospective,double-blind,randomized controlled trial.[J].The Journal of arthroplasty,2022,37(4):763-769.
[16] Ahmet K ,Mursel E ,Mustafa D , et al.Lumbar Erector Spinae Plane Block vs. Infrainguinal Fascia Iliaca Compartment Block for Pain Management Following Total Hip Arthroplasty: A Randomized Clinical Trial.[J].Pain medicine (Malden, Mass.), 2023.
[17] Craig M ,Brigid B ,Yin D L,etal.Analgesia and anest hesia using the pericapsular nerve group block in hip surgery and hip fracture: a scoping review[J].Regional Anesthesia PainMedicine,2020,46(2):169-175.
[18] Marrone F ,Fusco P ,Tulgar S , et al.Combination of Pericapsular Nerve Group (PENG) and Sacral Erector Spinae Plane (S-ESP) Blocks for Hip Fracture Pain and Surgery: A Case Series.[J].Cureus,2024,16(2):e53815-e53815.
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[20] Jian H ,Qiuru W ,Jie H , et al.Analgesic efficacy of anterior iliopsoas muscle space block combined with local infiltration analgesia after total hip arthroplasty: a prospe ctive, double-blind, placebo-controlled study.[J].Anaesthes ia,critical care pain medicine,2023,42(6):101282-101282.
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