[Update on the Use of Lower Extremity Peripheral Nerve Blocks and its Future].

Masato Kitayama, Kazuyoshi Hirota, Yutaka Satoh
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Abstract

Regional anesthesia for lower limb surgery not only provides satisfactory analgesia, but also improves the overall postoperative outcome with less postoperative nausea and vomiting by decreasing the opioid con- sumption, encouraging early postoperative mobility. Therefore, high-quality anesthesia and postoperative analgesia accelerate the rehabilitation process and shorten the hospital stay. In the past decade, ultra- sound-guided lower extremity peripheral nerve blocks have become popular in Japanese hospitals. This tech- nique enables the visualization of thee target nerve structures, controlles needle movement and the spread of injected local anesthetic solution in a real real-time manner, and this has been adapted not only for tradi- tional blocks, but also in "new approach" blocks such as adductor canal blocks, depending solely on ultra- sound images. In the decades to come, we hope to obtain more established evidence supporting the utility of ultra- sound-guided techniques for lower extremity nerve blocks based on high-quality clinical studies. These findings may support the development of sustained- release formulation local anesthetics and new devices or techniques in the future.

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[下肢周围神经阻滞的应用进展及其未来]。
下肢手术区域麻醉不仅提供满意的镇痛效果,而且通过减少阿片类药物的消耗,促进术后早期活动能力,改善了术后总体预后,减少了术后恶心和呕吐。因此,高质量的麻醉和术后镇痛加快了康复进程,缩短了住院时间。在过去的十年中,超声引导下的下肢周围神经阻滞在日本的医院中已经很流行。这项技术能够可视化三个目标神经结构,实时控制针头运动和局部麻醉溶液注射的扩散,这不仅适用于传统的阻滞,也适用于“新入路”阻滞,如内收管阻滞,仅依靠超声图像。在未来的几十年里,我们希望在高质量的临床研究的基础上,获得更多可靠的证据来支持超声引导技术在下肢神经阻滞中的应用。这些发现可能支持未来缓释制剂局部麻醉剂和新装置或新技术的发展。
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