超声引导下神经阻滞在腹部手术中的研究进展

Research progress of ultrasound-guided nerve block in abdominal surgery

腹部手术的神经阻滞即将局麻药物注入到神经所在的筋膜层形成水分离平面从而达到阻滞目的神经的作用,因其操作简单、损伤小、阻滞效果好等优点被普遍接受,尤其是其在超声引导下的神经阻滞操作,增加了阻滞的成功率,术中术后的多模式镇痛,明显减少了阿片类药物的用量,提高患者麻醉满意度,缩短住院天数,推进ERAS理念。本文通过综述形式,主要介绍超声引导下不同神经阻滞的解剖和阻滞方式,包括腹横肌平面阻滞(TAPB)、腰方肌阻滞(QLB)、腹直肌后鞘阻滞(RSB)、竖脊肌阻滞(ESPB)。

Nerve block in abdominal surgery involves injecting local anesthetics into the fascial layer where the nerve is located to form a horizontal separation plane to achieve the purpose of blocking the nerve.It is generally accepted because of its simple operability,small damage,and good blocking effect.Specifically,the nerve block under the guidance of ultrasound increases the success rate of the block.The multi-modal analgesia during and after the operation significantly reduces the dosage of opioids,improves patient satisfaction with anesthesia,shortens the length of hospital stay,and advances ERAS concept.This review mainly introduces the anatomy and block methods of different ultrasound-guided nerve blocks,including transversus abdominis plane block(TAPB),quadratus lumbar muscle block(QLB),rectus sheath block(RSB),and erector spinae block(ESPB).