腰交感神经节阻滞治疗围手术期下肢疼痛的疗效及应用前景

Ibrain Pub Date : 2022-10-09 DOI:10.1002/ibra.12069
Jing-Han Zhang, Yan-Ping Deng, Min-Jian Geng
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引用次数: 1

摘要

交感神经系统参与了许多不同类型慢性疼痛的生理发病机制。交感神经阻滞可以通过阻断伴随自主神经的有害传入纤维而中断反射控制系统,导致外周或中枢感觉处理的改变。腰椎交感神经节阻滞(LSGB)作为一种治疗方法,是指在相应的腰交感神经节段注射神经阻滞剂,通常需要影像学辅助(CT、x线、超声)引导。目前,LSGB已广泛应用于临床治疗下肢疼痛,如神经性疼痛、下肢缺血性疼痛等。其作用机制可能是通过抑制交感神经活动,扩张血管,从而减轻疼痛,抑制应激反应。然而,在围手术期,特别是在术后疼痛和胃肠功能方面,LSGB的报道很少。因此,本文通过对腰交感神经相关研究文献的梳理,对腰交感神经的解剖、临床应用及可能的机制进行综述。我们综述了LSGB在下肢疼痛和术后疼痛患者中的镇痛效果以及在胃肠功能恢复中的潜在应用前景,最终为其临床应用提供参考。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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Efficacy of the lumbar sympathetic ganglion block in lower limb pain and its application prospects during the perioperative period

The sympathetic nervous system is involved in the physiological pathogenesis of many different types of chronic pain. Sympathetic blocks can interrupt the reflex control system by intercepting the noxious afferent fibers accompanying autonomic nerves, resulting in changes in peripheral or central sensory processing. A lumbar sympathetic ganglion block (LSGB), as a treatment method, refers to the injection of nerve blockers into the corresponding lumbar sympathetic nerve segments, usually requiring imaging assistance (CT, X-ray, ultrasound) to guide. At present, LSGB has been widely used in the clinical treatment of lower limb pain, such as neuropathic pain, lower limb ischemic pain, and so on. Its mechanism of action may be through inhibiting sympathetic nerve activity and dilating blood vessels, thereby alleviating pain and inhibiting stress response. However, there are few reports of LSGB during the perioperative period, especially in postoperative pain and gastrointestinal function. Therefore, by studying the literature about LSGB-related studies, this article reviews the anatomy of the lumbar sympathetic nerve (LSN), with its clinical application and possible mechanism. We reviewed the analgesic effect of LSGB in patients with lower limb pain and postoperative pain and the potential application prospects in the recovery of gastrointestinal function, finally providing a reference for its clinical application.

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