区域麻醉在心脏手术快速康复中的应用进展

Progress of regional anesthesia in enhanced postoperative recovery after cardiac surgery

正中劈开胸骨的心脏手术创伤大,术后加速康复一直是手术和麻醉的重点和难点。目前,由于区域麻醉可以阻断疼痛的传导通路,减少手术应激,有益于术后镇痛,因此已广泛应用于普通外科手术的辅助麻醉。由于心脏手术中心肺转流需要全身肝素化,区域麻醉的应用一直存在争议。本文对几种常见的应用于正中劈开胸骨的心脏手术的区域麻醉方式及其并发症等研究状况进行综述,为开胸心脏手术麻醉管理提供参考。

Conventional open-heart surgery through a media sternum approach can result in severe trauma.How to enhance recovery after cardiac surgery(ERCAS)is a focus and a difficulty of surgery and anesthesia.At present,regional anesthesia inhibits nociception signal transmission through afferent pathways,reduces surgical stress,and helps to perform postoperative analgesia,it is widely used as auxiliary anesthesia in general surgical anesthesia.However,regional anesthesia used in cardiac surgery remains debatable due to systemic administration of heparin for cardiopulmonary bypass surgery.In this review,it have summarized various regional anesthesia techniques that are utilized in open-heart surgery and their associated complications,and it will provide valuable reference for anesthesia managements in open-heart surgery.