Regional anesthesia for orthopedic procedures:What orthopedic surgeons need to know  

作　　者：Ihab Kamel Muhammad F Ahmed Anish Sethi 

机构地区：[1]Department of Anesthesiology,Lewis Katz School of Medicine at Temple University,Philadelphia,PA 19140,United States

出　　处：《World Journal of Orthopedics》2022年第1期11-35,共25页世界骨科杂志（英文版）

摘　　要：Regional anesthesia is an integral component of successful orthopedic surgery.Neuraxial anesthesia is commonly used for surgical anesthesia while peripheral nerve blocks are often used for postoperative analgesia.Patient evaluation for regional anesthesia should include neurological,pulmonary,cardiovascular,and hematological assessments.Neuraxial blocks include spinal,epidural,and combined spinal epidural.Upper extremity peripheral nerve blocks include interscalene,supraclavicular,infraclavicular,and axillary.Lower extremity peripheral nerve blocks include femoral nerve block,saphenous nerve block,sciatic nerve block,iPACK block,ankle block and lumbar plexus block.The choice of regional anesthesia is a unanimous decision made by the surgeon,the anesthesiologist,and the patient based on a risk-benefit assessment.The choice of the regional block depends on patient cooperation,patient positing,operative structures,operative manipulation,tourniquet use and the impact of postoperative motor blockade on initiation of physical therapy.Regional anesthesia is safe but has an inherent risk of failure and a relatively low incidence of complications such as local anesthetic systemic toxicity(LAST),nerve injury,falls,hematoma,infection and allergic reactions.Ultrasound should be used for regional anesthesia procedures to improve the efficacy and minimize complications.LAST treatment guidelines and rescue medications(intralipid)should be readily available during the regional anesthesia administration.

关 键 词：Orthopedic surgery Regional anesthesia Spinal Epidural Combined spinal epidural Peripheral nerve blocks Neuraxial blocks Upper extremity Lower extremity INTERSCALENE SUPRACLAVICULAR Infraclavicular AXILLARY Femoral Fascia iliaca POPLITEAL SCIATIC Saphenous Adductor canal Lumbar plexus Brachial plexus Ankle iPACK Complication Local anesthetic systemic toxicity Nerve injury Block failure Continuous nerve block catheters 

分 类 号：R614[医药卫生—麻醉学]