超声引导下颈丛神经阻滞在颈动脉内膜斑块切除术中的应用进展

Recent advance in ultrasound-guided cervical plexus block in carotid endarterectomy

颈动脉内膜斑块切除术(CEA)是预防动脉粥样硬化性颈动脉狭窄患者脑卒中的方法之一。颈丛神经阻滞下进行手术可实时对患者意识状态进行评估,确定颈动脉钳夹期是否需要分流。传统的神经阻滞根据解剖标志采用盲穿的方法,而超声引导下神经阻滞可实现穿刺位点的精准定位,改善麻醉效果的同时将穿刺相关并发症的潜在风险降到最低。本文围绕CEA的现状、麻醉方法尤其是超声引导下颈丛神经阻滞在其中的应用进展进行综述,以期为临床工作者提供参考。

Carotid endarterectomy(CEA)is one of the methods to prevent stroke in patients with atherosclerotic carotid stenosis.Under cervical plexus block,the consciousness of patients can be evaluated to determine whether shunt is needed during the clamp period of carotid artery.Traditional nerve block adopts blind technique according to anatomical landmark.UItrasound-guided nerve block can identify accurate location of puncture site,improve anesthesia effect and minimize the potential risk of block-related complications.To provide guidance for clinical application,this article reviews the status quo of carotid endarterectomy,anesthesia methods and ultrasound-guided cervical plexus block.