超声引导区域阻滞在单侧腹膜外器官手术中的应用研究进展

Research progress of the application of ultrasound⁃guided regional block in unilateral extraperitoneal organ surgery

单侧腹膜外器官主要包括肾、肾上腺及输尿管,手术方式不同,其切口位置及疼痛强度不同,区域阻滞作为直接阻断疼痛应激的方法,具有较好的镇痛效果,有效降低应激反应,加速术后康复,随着超声可视化技术的发展,区域阻滞在单侧腹膜外器官手术中的应用逐渐增多。目前用于单侧腹膜外器官手术的区域阻滞方法主要有椎旁神经阻滞、腰方肌阻滞、竖脊肌平面阻滞、腹横肌平面阻滞和前锯肌平面阻滞,文章对以上区域阻滞方法的解剖、操作方法、阻滞效果、研究现状、应用效果及注意事项等进行综述。

Unilateral extraperitoneal organs mainly include the kidney,adrenal gland and ureter.Surgical methods,incision positions and pain intensity are different.As a direct method to block pain stress,the regional block has a good analgesic effect,effec⁃tively reducing the stress response and accelerating postoperative recovery.With the development of ultrasound visualization technology,regional block is gradually used in unilateral extraperitoneal organ surgery.At present,the regional blocks used for unilateral extraper⁃itoneal surgery mainly include paravertebral nerve block,quadratus lumborum block,erector spinae plane block,transversus abdominis plane block and serratus anterior plane block.This paper reviewed the anatomy,operation method,block effect,research status,appli⁃cation effect and precautions of the above regional block methods,in order to provide references for clinical application.