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首页> 外文期刊>Current opinion in anaesthesiology >Peripheral nerve blocks for anaesthesia and postoperative analgesia
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Peripheral nerve blocks for anaesthesia and postoperative analgesia

机译：周围神经阻滞用于麻醉和术后镇痛

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Perioperative analgesia is a major concern for the patient and for the anesthesiologist, whose task is to avoid pain and all related complications on immediate outcome and healing. Regional anesthesia, alone or combined with general anesthesia, is becoming a preferred technique in a variety of surgical procedures. There is increasing interest in peripheral nerve blocks, single or continuous, mainly for perioperative treatment of unilateral surgery. Specificity of analgesic area combined with decreased complications, including spinal or epidural hematoma, urinary retention, or hemodynamic alterations, are advantages of the peripheral nerve block over more central neural blocks.Insertion of catheters near neural plexuses or in the vicinity of single nerves are being continuously developed and improved. The appearance of new techniques and devices is increasing. Percutaneous electrode guidance, ultrasonographic localization of neural structures, and the use of stimulating catheters represent the newest advances in this area. Use of enantiomeric local anesthetic drugs permits a safer and wider range of postoperative treatment, which includes continuous analgesia administered in the patient's home. Use of patient-controlled analgesia, through electronic or elastomeric pumps, is recommended for postoperative pain control. Peripheral nerve block is the standard for anesthesia or analgesia in ambulatory surgery. Complications of the technique have been examined in large clinical studies which have recently been published. Results of such studies highlight the effectiveness and safety of peripheral blocks. These results have given new strength to arguments for regional anesthesia and analgesia and led to the increase in popularity of regional techniques. The articles considered below have, in summary, the main purpose of enhancing safety, as well as dissemination and education regarding regional anesthetic techniques.Possibilities afforded by the use of peripheral nerve blocks mainly consist of prolonged analgesia, selective area of action, and fewer collateral effects when compared with general anesthesia or more central neural blockade. Introduction of new devices and new techniques are increasing, as evidenced by the large number of studies which have appeared in the literature during the past year.
机译：围手术期镇痛是患者和麻醉医师的主要问题，麻醉医师的任务是避免疼痛以及所有有关即时结果和愈合的并发症。局部麻醉，单独或与全身麻醉相结合，已成为各种外科手术中的首选技术。人们越来越关注单个或连续的周围神经阻滞，主要用于单侧手术的围手术期治疗。与周围的中枢神经阻滞相比，周围神经阻滞的优势在于镇痛区域的特异性以及并发症的减少（包括脊柱或硬膜外血肿，尿retention留或血液动力学改变），是神经丛附近或单神经附近的导管插入的优势。不断发展和完善。新技术和设备的出现正在增加。经皮电极引导，神经结构的超声定位以及刺激性导管的使用代表了该领域的最新进展。对映体局部麻醉药的使用允许更安全和更广泛的术后治疗，包括在患者家中连续镇痛。建议通过电子或弹性泵使用患者控制的镇痛，以控制术后疼痛。周围神经阻滞是非卧床手术中麻醉或镇痛的标准。该技术的复杂性已经在最近发表的大型临床研究中进行了研究。这些研究的结果突出了外围模块的有效性和安全性。这些结果为区域麻醉和镇痛的争论提供了新的力量，并导致了区域技术的普及。综上所述，以下文章的主要目的是提高安全性，以及有关区域麻醉技术的宣传和教育。使用周围神经阻滞提供的可能性主要包括长时间的镇痛，选择性的作用区域和较少的侧支与全身麻醉或更多中枢神经阻滞相比较时的效果。过去一年来，文献中出现了大量研究，这证明了新设备和新技术的引入正在增加。

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