连续外周神经阻滞的研究进展

Advances in Research of Continuous Peripheral Nerve Blocks

连续外周神经阻滞技术已由最初的单纯运动神经阻滞治疗顽固性呃逆,逐渐发展为交感神经阻滞用于增加移植术后上肢血流,直至目前以感觉神经阻滞为目的用于缓解术后急性疼痛。常用的连续外周神经阻滞方法包括非刺激导管技术、刺激导管技术和超声引导下导管技术。输注方法包括固定速率持续输注、持续输注+单次患者自控镇痛剂量和单次患者自控镇痛剂量。该方法用于围术期镇痛,镇痛时间长,不良反应少,术后功能恢复快,患者满意度高。

Perineural catheters for continuous peripheral nerve blocks have developed from simple motor blockade for intractable hiccup to upper limb sympathetic blocks for improving the blood flow after the reimplantation,to sensory blocks for the ambulatory management of acute pains.Three techniques have been proposed for the placement of perineural catheters：the non-stimulating catheter technique,the stimulating catheter technique and the ultrasound-guided catheter placement.There are three basic regimens for continuous peripheral nerve block analgesia：fixed basal rate,fixed basal rate plus patient controlled analgesia（PCA）doses,or PCA doses only.Continuous peripheral nerve blocks offer the potential benefits of the prolonged analgesia with less side effects,the faster functional recovery after surgery and the greater patient satisfaction.