超声引导下神经阻滞在胸部手术中的应用现状及研究进展

Current Status and Research Progress of Ultrasound-guided Nerve Block in Thoracic Surgery

超声引导下神经阻滞术可以显示应用部位的神经及伴行血管的图像,将局麻药物注入到神经所在的筋膜层形成水分离平面,进而达到阻滞靶神经的目的,使传统盲探操作造成的神经血管的损伤减少了,操作成功率更高。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,推进快速康复理念。通过综述形式,主要介绍了几种不同的神经阻滞方式在超声引导下所观察到的解剖定位、操作过程、目前应用于临床的情况等。

Ultrasound-guided nerve block can display images of nerves and accompanying vessels at the application site,inject local anesthetic drugs into the fascial layer where the nerve is located to form a water separation plane,and then achieve the pur⁃pose of blocking the target nerve,so that the damage to the nerve vessels caused by the traditional blind exploration operation is re⁃duced and the success rate of the operation is higher.Intraoperative and postoperative multimodal analgesia significantly reduces the amount of opioids,improves patient satisfaction with anesthesia,and advances the concept of rapid recovery.Through a review format,the paper focuses on the anatomical positioning,operative procedures,and current clinical applications of several different nerve block modalities as observed under ultrasound guidance.