神经阻滞后反跳痛的研究进展

Research progress of rebound pain after peripheral nerve block

随着超声可视化技术不断地发展,神经阻滞作为一种镇痛技术,广泛地应用于临床麻醉中。传统的以阿片类药物为主的镇痛模式,正在向以外周神经阻滞为主的多模式镇痛转变。全身麻醉复合外周神经阻滞有很多优势,如减少阿片类药物用量,促进病人早期活动,加快术后康复等。但部分病人在神经阻滞作用消退时发生反跳痛,其表现为难以忍受的剧痛,不仅增加术后镇痛药的使用,而且严重影响着术后恢复。本文旨在探讨神经阻滞后反跳痛的定义、临床表现、危险因素、发生机制以及预防和治疗方法的最新进展,为临床麻醉中合理应用神经阻滞作为辅助镇痛提供指导。

With the continual advancement of ultrasound visualization technology,nerve block has become widely utilized in clinical anesthesia as an analgesic technique.The traditional opioid-based analgesic approach is shifting towards multi-modal analgesia based on peripheral blocks.Combining general anesthesia with peripheral nerve blocks offers numerous advantages,including reduced opioid usage,early patient mobilization promotion,and acceleration of postoperative recovery.However,some patients experience rebound pain when the nerve block effect subsides,which manifests as unbearable pain.This not only increases the use of postoperative analgesics,but also seriously affects postoperative recovery.This not only escalates the use of postoperative analgesics,but also significantly impacts the postoperative recovery.This article aims to review the definition,clinical manifestations,risk factors,pathogenesis,prevention,and treatment of rebound pain following nerve blocks,and to offer guidance for the appropriate use of nerve blocks as supplementary analgesia in clinical anesthesia.