Nishank P. Nooli, Jordan E. Goldhammer, Regina E. Linganna, Melody Herman, Hari Kalagara
{"title":"筋膜平面阻滞作为心脏手术的局部镇痛技术:技术描述和证据更新","authors":"Nishank P. Nooli, Jordan E. Goldhammer, Regina E. Linganna, Melody Herman, Hari Kalagara","doi":"10.1007/s40140-023-00576-y","DOIUrl":null,"url":null,"abstract":"Abstract Purpose of Review This article aims to review the anatomy and ultrasound techniques of common interfascial plane blocks used for cardiac surgeries along with the current available evidence for regional analgesia. Recent Findings Thoracic erector spinae plane block (ESPB) has a beneficial role in studies when compared with intravenous pain medications or control groups without blocks for cardiac surgeries. Some retrospective studies showed variable analgesic benefits with ESPB, and a recent meta-analysis did not show promising benefits over thoracic epidural analgesia. Serratus anterior plane block (SAPB) is beneficial with minithoractomy incisions for minimally invasive cardiac surgeries, while para sternal blocks (PSB) or parasternal intercostal plane (PIP) blocks are useful for sternotomy incisions. Pectolaris nerve blocks (PECS) have also been used for various cardiac surgeries with a promising role in cardiac pacemaker and ICD surgeries. Summary There is an increasing trend in the usage of fascial plane blocks for cardiac surgeries. Most can be used as components of multimodal analgesia and play a key role in enhanced recovery after cardiac surgery (ERACS) programs. The choice of these fascial plane blocks as opioid-sparing regional analgesia techniques depends on the incision and type of cardiac surgery. A combination of various fascial plane blocks can be used to increase the efficacy of these blocks, but caution should be exercised in limiting the total quantity of the local anesthetic administered.","PeriodicalId":36608,"journal":{"name":"Current Anesthesiology Reports","volume":null,"pages":null},"PeriodicalIF":1.6000,"publicationDate":"2023-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Fascial Plane Blocks as Regional Analgesia Techniques for Cardiac Surgeries: a Technical Description and Evidence Update\",\"authors\":\"Nishank P. Nooli, Jordan E. Goldhammer, Regina E. Linganna, Melody Herman, Hari Kalagara\",\"doi\":\"10.1007/s40140-023-00576-y\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Abstract Purpose of Review This article aims to review the anatomy and ultrasound techniques of common interfascial plane blocks used for cardiac surgeries along with the current available evidence for regional analgesia. Recent Findings Thoracic erector spinae plane block (ESPB) has a beneficial role in studies when compared with intravenous pain medications or control groups without blocks for cardiac surgeries. Some retrospective studies showed variable analgesic benefits with ESPB, and a recent meta-analysis did not show promising benefits over thoracic epidural analgesia. Serratus anterior plane block (SAPB) is beneficial with minithoractomy incisions for minimally invasive cardiac surgeries, while para sternal blocks (PSB) or parasternal intercostal plane (PIP) blocks are useful for sternotomy incisions. Pectolaris nerve blocks (PECS) have also been used for various cardiac surgeries with a promising role in cardiac pacemaker and ICD surgeries. Summary There is an increasing trend in the usage of fascial plane blocks for cardiac surgeries. Most can be used as components of multimodal analgesia and play a key role in enhanced recovery after cardiac surgery (ERACS) programs. The choice of these fascial plane blocks as opioid-sparing regional analgesia techniques depends on the incision and type of cardiac surgery. A combination of various fascial plane blocks can be used to increase the efficacy of these blocks, but caution should be exercised in limiting the total quantity of the local anesthetic administered.\",\"PeriodicalId\":36608,\"journal\":{\"name\":\"Current Anesthesiology Reports\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.6000,\"publicationDate\":\"2023-09-13\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Current Anesthesiology Reports\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1007/s40140-023-00576-y\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"ANESTHESIOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Current Anesthesiology Reports","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1007/s40140-023-00576-y","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ANESTHESIOLOGY","Score":null,"Total":0}
Fascial Plane Blocks as Regional Analgesia Techniques for Cardiac Surgeries: a Technical Description and Evidence Update
Abstract Purpose of Review This article aims to review the anatomy and ultrasound techniques of common interfascial plane blocks used for cardiac surgeries along with the current available evidence for regional analgesia. Recent Findings Thoracic erector spinae plane block (ESPB) has a beneficial role in studies when compared with intravenous pain medications or control groups without blocks for cardiac surgeries. Some retrospective studies showed variable analgesic benefits with ESPB, and a recent meta-analysis did not show promising benefits over thoracic epidural analgesia. Serratus anterior plane block (SAPB) is beneficial with minithoractomy incisions for minimally invasive cardiac surgeries, while para sternal blocks (PSB) or parasternal intercostal plane (PIP) blocks are useful for sternotomy incisions. Pectolaris nerve blocks (PECS) have also been used for various cardiac surgeries with a promising role in cardiac pacemaker and ICD surgeries. Summary There is an increasing trend in the usage of fascial plane blocks for cardiac surgeries. Most can be used as components of multimodal analgesia and play a key role in enhanced recovery after cardiac surgery (ERACS) programs. The choice of these fascial plane blocks as opioid-sparing regional analgesia techniques depends on the incision and type of cardiac surgery. A combination of various fascial plane blocks can be used to increase the efficacy of these blocks, but caution should be exercised in limiting the total quantity of the local anesthetic administered.
期刊介绍:
This journal aims to offer expert review articles on the most significant recent developments in the field of anesthesiology. By providing clear, insightful, balanced contributions, the journal intends to serve those involved in the delivery of anesthesia for surgical and medical procedures, treatment of acute and chronic pain conditions, perioperative management for operative and intensive care unit patients, and associated basic science and clinical research efforts in their areas. We accomplish this aim by appointing international authorities to serve as Section Editors in key subject areas across the field. Section Editors select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. An Editorial Board of more than 20 internationally diverse members reviews the annual table of contents, ensures that topics include emerging research, and suggests topics of special importance to their country/region. Topics covered may include ambulatory anesthesia; anesthesia and inflammation; anesthetic mechanisms; anesthetic pharmacology; cardiovascular anesthesia; critical care anesthesia; local anesthetic pharmacology; monitoring technology; neuroanesthesia; neuromuscular blockade; obstetrical anesthesia; pain mechanisms; pain therapy; patient safety; pediatric anesthesia; quality assessment; regional anesthesia; and transplantation anesthesia.