[院前区域麻醉]。

IF 0.3 4区 医学 Q4 ANESTHESIOLOGY
Christine Gaik, Nicholas Schmitt, Ann-Kristin Schubert, Hinnerk Wulf, Benjamin Vojnar
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引用次数: 0

摘要

疼痛通常是创伤患者的主要症状。虽然外周神经阻滞(PNB)可提供快速、安全和充分的镇痛,但目前在围手术期以外的情况下很少使用。在德国,使用非阿片类镇痛剂(NOPA)和强效阿片类药物进行静脉镇痛是治疗院前疼痛的主要方法。然而,使用强效阿片类药物可能会产生明显的副作用,尤其是对急诊病人而言。因此,许多医院将 PNB 用于治疗围手术期疼痛。与围手术期使用一样,在创伤患者的院前镇痛治疗中,早期 PNB 的优势也是显而易见的,尤其是对于老年患者和多病患者。院前早期 PNB 还能促进脱位骨折或脱位关节的复位以及创伤患者的技术抢救。常见的老年骨折,如股骨近端骨折或肱骨骨折,都可以通过 PNB 得到适当而充分的治疗。我们还提出了一个概念,用于评估院前使用 PNB 是否适用以及在多大程度上适用。这篇文章的目的是让人们注意到 PNB 是创伤患者院前护理概念的可能组成部分,并讨论其院前使用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Regional Anaesthesia in the Prehospital Setting].

Pain is often the main symptom in trauma patients. Although peripheral nerve blocks (PNB) provide fast, safe, and adequate analgesia, they are currently only rarely used outside the perioperative setting. In Germany, intravenous analgesia with non-opioid analgesics (NOPA) and strong opioids is the main treatment concept for prehospital pain. However, the use of highly potent opioids can be associated with significant side effects, especially in emergency patients. Therefore, PNBs are used in many hospitals for the treatment of perioperative pain. As with perioperative use, the advantages of early PNB in the prehospital analgesic treatment of trauma patients are obvious, especially for elderly and multimorbid patients. Early prehospital PNB can also facilitate the reduction of dislocated fractures or dislocated joints as well as the technical rescue of trauma patients. Common geriatric fractures, such as proximal femur or humerus fractures, can be treated appropriately and adequately with PNB.In this article, we show which PNB procedures can be useful in prehospital patient care and which requirements should be met for their safe use. We also present a concept for assessing whether and to what extent the prehospital use of PNB is indicated and appropriate. The aim of this article is to draw attention to PNB as a possible part of prehospital care concepts for trauma patients and to discuss its prehospital use.

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来源期刊
CiteScore
0.80
自引率
25.00%
发文量
115
审稿时长
6-12 weeks
期刊介绍: AINS ist die Fachzeitschrift für Anästhesiologie, Intensivmedizin, Notfallmedizin und Schmerztherapie im Georg Thieme Verlag. Sie vermittelt aktuelles Fachwissen und bietet Fortbildung. AINS hat sich das Ziel gesteckt, den Leserinnen und Lesern – Fachärzten und Weiterbildungsassistenten in der Anästhesiologie – immer praxisbezogenen Nutzwert und größtmögliche Unterstützung zu bieten.
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