IPACK联合收肌管阻滞用于膝关节手术镇痛研究进展

Research progress of IPACK combined with adductor canal blockon analgesia in knee joint surgery

膝关节手术后常用的镇痛方式分为:患者自控硬膜外镇痛、患者自控静脉镇痛、关节周围注射、外周神经阻滞和多模式镇痛等,其中多模式镇痛应用较为广泛。随着医疗技术水平不断发展,超声引导下外周神经阻滞技术具有操作简单、镇痛效果确切、不良反应少等优势,在临床上使用的越来越普遍。近年来超声引导下腘动脉与关节囊间隙(IPACK)联合收肌管阻滞(ACB)用于膝关节手术后镇痛研究日益增多,麻醉医生对该技术的应用及进展缺乏认识,本文就膝关节神经解剖及IPACK联合收肌管阻滞用于膝关节手术后镇痛操作及应用进行综述。

The commonly used analgesic methods after knee surgery include:patient-controlled epidural analgesia,patient-controlled intravenous analgesia,local infiltration analgesia,peripheral nerve block,multimode analgesia,and so on.Among these multimodal analgesia are widely used.With the continuous development of medical technology,the ultrasound-guided peripheral nerve block technique has the advantages of simple operation,accurate analgesic effect and less adverse reactions,and is more and more widely used in clinical practice.In recent years,there have been increasing studies on the use of ultrasonic guided Interspace between the Popliteal Artery and the posterior Capsule of the Knee(IPACK)combined with Adductor Canal Block(ACB)for postoperative analgesia of knee joint surgery,and anesthesiologists have little understanding of the application and progress of this technology.This article reviews the operation and application of IPACK combined with adductor duct block for postoperative knee analgesia from the understanding of knee nerve anatomy.