文章摘要

超声下区域麻醉技术用于腰椎术后镇痛的研究进展

作者: 1陈佳馨, 1丁文刚
1 哈尔滨医科大学附属第二医院麻醉科,哈尔滨 150081
通讯: 丁文刚 Email: dingwg999@163.com
DOI: 10.3978/j.issn.2095-6959.2021.06.036

摘要

腰椎手术对骨和肌肉的创伤较大,术后疼痛程度较重,属中等以上的疼痛强度。术后疼痛不仅给患者造成不愉快的体验,而且患者因疼痛不能进行有效功能锻炼,延缓患者的康复。剧烈疼痛还会增加各种术后并发症的发生率,特别是对于老年患者,更加容易诱发心脑血管意外事件。由于担心感染和神经损伤等原因,腰椎手术很少使用椎管内给药作为术后镇痛方案。此类手术的术后镇痛通常是以阿片类为主的全身用药,这增加了术后恶心、呕吐以及呼吸抑制等并发症的发生率。近年来超声引导下区域麻醉技术不断完善和普及,一些区域麻醉方法已经被证实作为腰椎手术后多模式镇痛的重要组成部分,在减轻术后疼痛的同时,还可以提升患者的满意度,加快术后康复速度。
关键词: 超声引导;腰椎手术;区域麻醉;术后镇痛

Research advances in the ultrasound-guided regional anesthesia for analgesia after lumbar spine surgery

Authors: 1CHEN Jiaxin, 1DING Wengang
1 Department of Anesthesiology, Second Affiliated Hospital of Harbin Medical University, Harbin 150081, China

CorrespondingAuthor: DING Wengang Email: dingwg999@163.com

DOI: 10.3978/j.issn.2095-6959.2021.06.036

Abstract

Lumbar spine surgery can cause great trauma to bones and muscles, and high degree of postoperative pain, which belongs to moderate pain intensity. Postoperative pain not only causes unpleasant experience to patients, but also prevents patients from performing effective functional exercise due to pain, thus delaying the recovery of patients. Severe pain also increases the incidence of various postoperative complications. Especially for elderly patients, it is more likely to induce cardiovascular and cerebrovascular accidents. Spinal analgesia is rarely used in lumbar surgery for postoperative analgesia due to concerns about infection and nerve damage. Postoperative analgesia for such an operations is usually systemic, opioid based, which increases postoperative complications such as nausea, vomiting, and respiratory depression. In recent years, ultrasound-guided regional anesthesia has been continuously improved and popularized. Some regional anesthesia methods have been proven to be an important part of multimodal analgesia after the lumbar spine surgery, which can not only reduce postoperative pain, but also improve patient satisfaction and speed up postoperative rehabilitation.
Keywords: ultrasound guided; lumbar spine surgery; regional anesthesia; postoperative analgesia