|
|
外周神经阻滞在髋部骨折术中的应用与进展
|
Abstract:
随着对髋关节解剖结构的深入了解，超声引导下外周神经阻滞在围术期麻醉与镇痛中得到广泛的应用，可为患者提供良好的围术期镇痛效果，有利于患者术后早期功能锻炼，从而降低术后并发症的发生率。本文就不同神经阻滞方式在老年患者髋部骨折围术期中的应用研究进展进行综述，旨在为髋部骨折的围术期镇痛提供新的临床思路和参考。
With a profound understanding of the anatomy of the hip joint, the ultrasound-guided nerve block technique has been extensively employed in perioperative anesthesia and analgesia. This method offers patients effective perioperative analgesia, fosters early postoperative functional exercise, and minimizes the occurrence of postoperative complications. This article reviews the advancements in research on various nerve block methods during the perioperative period for hip fractures in elderly patients, with the objective of offering new clinical insights and references for perioperative analgesia.
| [1] | 丁燮阳. 全身麻醉与外周神经阻滞对老年髋关节骨折患者的影响[J]. 中国现代医生, 2016, 54(29): 124-126, 130. |
| [2] | 阮侠, 徐仲煌, 唐帅, 等. 老年髋关节骨折手术3种不同麻醉方式的预后比较[J]. 基础医学与临床, 2015, 35(5): 695-699. |
| [3] | 李智铭, 陈中洪, 毛国华. 围手术期不同镇痛方式对老年髋部骨折患者髋关节置换术后认知功能的影响[J]. 西部医学, 2019, 31(11): 1744-1748. |
| [4] | 宋景州, 苏帆, 孙莉, 等. 麻醉方式对下肢骨折患者围术期并发症的影响研究进展[J]. 中国中西医结合外科杂志, 2022, 28(2): 276-278. |
| [5] | Laumonerie, P., Dalmas, Y., Tibbo, M.E., Robert, S., Durant, T., Caste, T., et al. (2021) Sensory Innervation of the Hip Joint and Referred Pain: A Systematic Review of the Literature. Pain Medicine, 22, 1149-1157. https://doi.org/10.1093/pm/pnab061 |
| [6] | 周士强. 超声引导下三叶草法定位在老年髋关节骨折手术患者腰丛神经阻滞中的效果[J]. 河南医学研究, 2021, 30(9): 1625-1627. |
| [7] | 孟华, 刘文娜. 超声定位下“三叶草”法腰丛阻滞对全髋关节置换术患者应激反应､炎症状态及疼痛应激因子的影响[J]. 生物医学工程与临床, 2023, 27(5): 638-644. |
| [8] | Diwan, S., Nair, A., Gawai, N., Shah, D. and Sancheti, P. (2023) Circumpsoas Block... An Anterior Myofascial Plane Block for Lumbar Plexus Elements: Case Report. Brazilian Journal of Anesthesiology (English Edition), 73, 689-694. https://doi.org/10.1016/j.bjane.2021.04.015 |
| [9] | Gerhardt, M., Johnson, K., Atkinson, R., Snow, B., Shaw, C., Brown, A., et al. (2012) Characterisation and Classification of the Neural Anatomy in the Human Hip Joint. HIP International, 22, 75-81. https://doi.org/10.5301/hip.2012.9042 |
| [10] | Zhu, K., Zheng, F., Wang, C. and Ding, L. (2022) Effect of Ultrasound-Guided Fascia Iliac Compartment Block on Serum NLRP3 and Inflammatory Factors in Patients with Femoral Intertrochanteric Fracture. Computational and Mathematical Methods in Medicine, 2022, Article ID: 1944659. https://doi.org/10.1155/2022/1944659 |
| [11] | 刘广海. 不同入路髂筋膜阻滞对髋关节骨折手术患者行椎管内麻醉体位摆放的镇痛效应[J]. 吉林医学, 2023, 44(10): 2733-2735. |
| [12] | 宋峰, 钮峥嵘, 杜晓宣. 不同方式超声引导连续髂筋膜阻滞在髋关节置换术后镇痛效果[J]. 骨科, 2018, 9(2): 136-140. |
| [13] | Vermeylen, K., Soetens, F., Leunen, I., Hadzic, A., Van Boxtael, S., Pomés, J., et al. (2018) The Effect of the Volume of Supra-Inguinal Injected Solution on the Spread of the Injectate under the Fascia Iliaca: A Preliminary Study. Journal of Anesthesia, 32, 908-913. https://doi.org/10.1007/s00540-018-2558-9 |
| [14] | 黄超, 黄晔, 濮健峰. 超声引导下髂筋膜间隙阻滞在股骨粗隆间骨折中对血流动力学、血液高凝状态影响分析[J]. 医学理论与实践, 2023, 36(22): 3856-3858. |
| [15] | 杨洁. 腰硬联合麻醉复合高位髂筋膜阻滞麻醉对老年股骨骨折患者认知功能、应激反应及免疫功能的影响[J]. 临床医学研究与实践, 2023, 8(32): 85-88. |
| [16] | 徐嘉灵, 徐东娥, 徐佳圆, 等. 中国老年髋关节置换术后谵妄危险因素的Meta分析[J]. 中国疗养医学, 2024, 33(2): 37-42. |
| [17] | 黄文锋, 栗村瑞. 腰方肌阻滞的解剖基础及其作用机制[J]. 上海医学, 2020, 43(2): 124-128. |
| [18] | Carline, L., McLeod, G.A. and Lamb, C. (2016) A Cadaver Study Comparing Spread of Dye and Nerve Involvement after Three Different Quadratus Lumborum Blocks. British Journal of Anaesthesia, 117, 387-394. https://doi.org/10.1093/bja/aew224 |
| [19] | Han, Y., Chen, X., Mi, P., Ji, Y., Meng, X., Han, P., et al. (2021) Different Concentrations of Ropivacaine under Ultrasound Guidance on Quadratus Lumbar Muscle Nerve Block in Elderly Patients with Hip Replacement. BioMed Research International, 2021, Article ID: 9911352. https://doi.org/10.1155/2021/9911352 |
| [20] | Forero, M., Adhikary, S.D., Lopez, H., Tsui, C. and Chin, K.J. (2016) The Erector Spinae Plane Block: A Novel Analgesic Technique in Thoracic Neuro-Pathic Pain. Regional Anesthesia and Pain Medicine, 41, 621-627. https://doi.org/10.1097/aap.0000000000000451 |
| [21] | Tulgar, S., Selvi, O., Senturk, O., Ermis, M.N., Cubuk, R. and Ozer, Z. (2018) Clinical Experiences of Ultrasound-Guided Lumbar Erector Spinae Plane Block for Hip Joint and Proximal Femur Surgeries. Journal of Clinical Anesthesia, 47, 5-6. https://doi.org/10.1016/j.jclinane.2018.02.014 |
| [22] | 孔宪刚, 宋成军, 王昆, 等. 超声引导腰部竖脊肌平面阻滞在老年患者髋关节置换术中的应用效果[J]. 中国医药科学, 2022, 12(1): 140-143, 148. |
| [23] | 张森兵, 安池冰, 阎文军. 超声引导下髋关节囊周围神经阻滞的研究进展[J]. 临床麻醉学杂志, 2022, 38(8): 869-873. |
| [24] | Morrison, C., Brown, B., Lin, D., Jaarsma, R. and Kroon, H. (2020) Analgesia and Anesthesia Using the Pericapsular Nerve Group Block in Hip Surgery and Hip Fracture: A Scoping Review. Regional Anesthesia & Pain Medicine, 46, 169-175. https://doi.org/10.1136/rapm-2020-101826 |
| [25] | Pascarella, G., Costa, F., Del Buono, R., Pulitanò, R., Strumia, A., Piliego, C., et al. (2021) Impact of the Pericapsular Nerve Group (PENG) Block on Postoperative Analgesia and Functional Recovery Following Total Hip Arthroplasty: A Randomised, Observer‐Masked, Controlled Trial. Anaesthesia, 76, 1492-1498. https://doi.org/10.1111/anae.15536 |
| [26] | 李欣舫, 郭嘉, 王迎斌. 罗哌卡因在老年患者全髋关节置换术中髋关节囊周围神经阻滞的半数有效浓度[J]. 临床麻醉学杂志, 2023, 39(7): 714-718. |
| [27] | 郑龙彬, 秦卫民, 梁文波, 等. 0.375%罗哌卡因用于老年患者股骨颈骨折髋关节囊周围神经阻滞的半数有效容量[J]. 临床麻醉学杂志, 2023, 39(8): 842-845. |
| [28] | Huang, Y., Lu, Y., Wang, J., Lu, Q., Bao, H., Liu, L., et al. (2024) Effect of Pericapsular Nerve Group Block with Different Concentrations and Volumes of Ropivacaine on Functional Recovery in Total Hip Arthroplasty: A Randomized, Observer-Masked, Controlled Trial. Journal of Pain Research, 17, 677-685. https://doi.org/10.2147/jpr.s445000 |
| [29] | 单涛, 韩流, 葛德高, 等. 超声引导下髋关节囊周围神经阻滞联合椎管内麻醉在老年患者全髋关节置换术中的应用[J]. 临床麻醉学杂志, 2021, 37(5): 458-461. |
| [30] | 杨洋, 杨明玉, 马凤丹, 等. 超声引导下髂腰肌平面阻滞用于人工髋关节置换术后镇痛效果及对运动功能的影响[J]. 临床麻醉学杂志, 2023, 39(5): 476-480. |
| [31] | Nielsen, N.D., Madsen, M.N., Østergaard, H.K., Bjørn, S., Pedersen, E.M., Nielsen, T.D., et al. (2019) An Iliopsoas Plane Block Does Not Cause Motor Blockade—A Blinded Randomized Volunteer Trial. Acta Anaesthesiologica Scandinavica, 64, 368-377. https://doi.org/10.1111/aas.13498 |
| [32] | 姜卜维, 马凤丹, 黄瑾, 等. 超声引导下髂腰肌平面阻滞对髋关节置换术患者术后恢复质量的影响[J]. 临床麻醉学杂志, 2024, 40(2): 133-138. |
| [33] | Wang, C., Zhang, Z., Yang, Y., Long, Y., Wang, X. and Ding, Y. (2023) A Randomized Controlled Trial of Iliopsoas Plane Block vs. Femoral Nerve Block for Hip Arthroplasty. BMC Anesthesiology, 23, Article No. 197. https://doi.org/10.1186/s12871-023-02162-5 |
| [34] | 郑煜丽, 高晓曼, 李咸鹏, 等. 超声引导下髂腰肌平面阻滞与髂筋膜间隙阻滞在髋关节置换围术期镇痛效果的比较[J]. 临床麻醉学杂志, 2023, 39(4): 346-350. |
| [35] | 袁亮婧, 伊军, 常颖, 等. 超声引导髂筋膜间隙阻滞在髋关节镜手术中的应用[J]. 中国微创外科杂志, 2017, 17(10): 922-925. |
| [36] | 陈翔, 李洋, 汪燕, 等. 超声引导下连续髂筋膜间隙阻滞与连续腰丛神经阻滞在老年髋部骨折患者术后镇痛中的应用比较[J]. 医学理论与实践, 2024, 37(14): 2405-2407. |
| [37] | ten Hoope, W., Smulders, P.S.H., Baumann, H.M., Hermanides, J., Beenen, L.F.M., Oostra, R., et al. (2023) A Radiological Cadaveric Study of Obturator Nerve Involvement and Cranial Injectate Spread after Different Approaches to the Fascia Iliaca Compartment Block. Scientific Reports, 13, Article No. 12070. https://doi.org/10.1038/s41598-023-39041-5 |
| [38] | 舒坤. 超声引导下腰方肌阻滞与囊周神经阻滞用于全髋关节置换术后镇痛的对比研究[D]: [硕士学位论文]. 大连: 大连医科大学, 2023. |
