以儿科患者为重点的髋关节手术后疼痛管理的囊周神经群阻滞与腰硬膜外阻滞:叙述性回顾。

IF 3 Q2 CLINICAL NEUROLOGY
Shahab Ahmadzadeh, Hunter M Schwab, Mary O'Dell Duplechin, Kalob M Broocks, Jon D Hirsch, Joseph Drinkard, Sahar Shekoohi
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引用次数: 0

摘要

小儿髋关节手术与中度至重度疼痛相关,严重时可导致阿片类药物的处方和使用。人们越来越关注减少这些患者的术后疼痛,以减少对阿片类药物的需求,并增加早期康复动员。使用阿片类药物缓解疼痛的传统方法可能会对儿科患者产生不必要的负面影响,如呼吸抑制、恶心、意识不清,以及产生依赖的可能性。同样,传统的麻醉方法,如腰硬膜外阻滞,可能会产生意想不到的全身副作用,如低血压、尿潴留、心律失常和脊柱脓肿。这些并发症可导致更长的住院时间和延迟恢复。这篇综述分析了一种新的区域麻醉技术,即囊包神经阻滞(PENG)与腰硬膜外阻滞的疗效。该技术利用精确麻醉选择性阻断髋关节的关节分支,同时避开股神经和闭孔神经的主干。此外,利用高分辨率超声引导阻滞,提供者可以越来越多地依赖于正确的插入和可预测的麻醉扩散。结果是一种运动保留阻滞,显示了在儿童髋关节手术后允许早期活动和更好的功能恢复时间的希望。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Pericapsular Nerve Group Block Versus Lumbar Epidural Block for Pain Management After Hip Surgeries with a Focus on Pediatric Patients: A Narrative Review.

Pediatric hip surgeries are associated with moderate to high levels of pain, which, in severe cases can lead to opioid prescription and use. There is a growing focus on reducing post-operative pain in these patients to decrease the need for opioids, as well as increase early mobilization for recovery. Conventional methods of pain relief using opioids can have unwanted negative impacts on pediatric patients such as respiratory depression, nausea, confusion, and the concerning possibility for the development of dependence. Likewise, traditional methods of anesthesia, like the lumbar epidural block, can have unwanted systemic side effects, such as hypotension, urinary retention, arrhythmias, and spinal abscesses. These complications can lead to longer hospital stays and delayed recovery. This review analyzes the efficacy of a newer regional anesthesia technique, the pericapsular nerve group (PENG) block, in comparison to the lumbar epidural block. This technique utilizes precision-based anesthesia to selectively block the articular branches to the hip joint while avoiding the main trunks of the femoral and obturator nerves. Additionally, with the utilization of high-resolution ultrasound to guide the blocks, providers can increasingly count on proper insertion and predictable anesthetic spread. The result is a motor-sparing blockade that shows promise in allowing earlier mobilization and better functional recovery times after pediatric hip surgeries.

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来源期刊
Neurology International
Neurology International CLINICAL NEUROLOGY-
CiteScore
3.70
自引率
3.30%
发文量
69
审稿时长
11 weeks
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