Regional anaesthesia for ambulatory surgery

IF 4.7 3区医学 Q1 ANESTHESIOLOGY

Best Practice & Research-Clinical Anaesthesiology Pub Date : 2023-09-01 DOI:10.1016/j.bpa.2022.12.001

Kristof Nijs MD , Joke Ruette MD , Marc Van de Velde MD, PhD, EDRA, FESAIC (Professor) , Björn Stessel MD, PhD (Professor)

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Abstract

Regional anaesthesia (RA) has an important and ever-expanding role in ambulatory surgery. Specific practices vary depending on the preferences and resources of the anaesthesia team and hospital setting. It is used for various purposes, including as primary anaesthetic technique for surgery but also as postoperative analgesic modality. The limited duration of action of currently available local anaesthetics limits their application in postoperative pain control and enhanced recovery. The search for the holy grail of regional anaesthetics continues. Current evidence suggests that a peripheral nerve block performed with long-acting local anaesthetics in combination with intravenous or perineural dexamethasone gives the longest and most optimal sensory block.

In this review, we outline some possible blocks for ambulatory surgery and additives to perform RA. Moreover, we give an update on local anaesthesia drugs and adjuvants, paediatric RA in ambulatory care and discuss the impact of RA by COVID-19.

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门诊手术的区域麻醉

区域麻醉（RA）在门诊手术中具有重要且不断扩大的作用。具体做法因麻醉团队和医院环境的偏好和资源而异。它被用于各种目的，包括作为手术的初级麻醉技术，也作为术后镇痛方式。目前可用的局部麻醉剂的作用时间有限，限制了它们在术后疼痛控制和增强恢复方面的应用。对区域麻醉学圣杯的探索仍在继续。目前的证据表明，用长效局部麻醉剂与静脉或神经周围地塞米松联合进行的外周神经阻滞可以提供最长、最理想的感觉阻滞。在这篇综述中，我们概述了一些可能的阻碍门诊手术和添加剂执行RA。此外，我们还介绍了局部麻醉药物和佐剂的最新情况，以及门诊护理中的儿科RA，并讨论了新冠肺炎对RA的影响。

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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Best Practice & Research-Clinical Anaesthesiology ANESTHESIOLOGY-

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审稿时长

36 days