心胸外科筋膜平面阻滞:综述。

Paolo Capuano, Giuseppe Sepolvere, Antonio Toscano, Paolo Scimia, Simona Silvetti, Mario Tedesco, Luca Gentili, Gennaro Martucci, Gaetano Burgio
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引用次数: 0

摘要

近年来,越来越多的人意识到在包括心胸外科在内的各种外科手术中过度依赖阿片类药物的局限性和相关风险。这种疼痛管理向减少对阿片类药物依赖的转变,以及改善患者预后、减轻痛苦、术后早期活动、缩短住院时间、提高患者满意度和功能恢复的需求,导致了术后恢复强化方案(ERAS)的制定和广泛实施。在此背景下,筋膜平面阻滞正逐渐成为心脏手术多模式镇痛的一部分,并成为胸外科手术传统神经阻滞的替代疗法,越来越多的证据表明,筋膜平面阻滞能有效、安全地缓解这些手术的疼痛。在这篇综述中,我们讨论了心胸外科领域最常用的筋膜平面阻滞技术,全面概述了区域麻醉技术,并介绍了胸壁平面阻滞专门用于这种手术环境的最新证据。
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Fascial plane blocks for cardiothoracic surgery: a narrative review.

In recent years, there has been a growing awareness of the limitations and risks associated with the overreliance on opioids in various surgical procedures, including cardiothoracic surgery.This shift on pain management toward reducing reliance on opioids, together with need to improve patient outcomes, alleviate suffering, gain early mobilization after surgery, reduce hospital stay, and improve patient satisfaction and functional recovery, has led to the development and widespread implementation of enhanced recovery after surgery (ERAS) protocols.In this context, fascial plane blocks are emerging as part of a multimodal analgesic in cardiac surgery and as alternatives to conventional neuraxial blocks for thoracic surgery, and there is a growing body of evidence suggesting their effectiveness and safety in providing pain relief for these procedures. In this review, we discuss the most common fascial plane block techniques used in the field of cardiothoracic surgery, offering a comprehensive overview of regional anesthesia techniques and presenting the latest evidence on the use of chest wall plane blocks specifically in this surgical setting.

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