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机构地区:[1]吉首大学医学院研究生部,湖南 吉首 [2]娄底市中心医院麻醉科,湖南 娄底
出 处:《临床医学进展》2024年第9期40-45,共6页Advances in Clinical Medicine
摘 要:超声引导下的神经阻滞技术在乳腺癌围术期镇痛中承担着重要角色,在众多的阻滞技术中胸椎旁阻滞技术因镇痛效果确切,常作为金标准被各指南推荐。为降低胸椎旁阻滞的风险以及操作难度,竖脊肌平面阻滞、肋横突阻滞、横突–胸膜中点阻滞、椎板阻滞等椎旁平面阻滞技术被陆续开发并应用于临床,文章介绍了上述椎旁平面阻滞技术及其在乳腺手术当中的应用情况,这些阻滞技术操作相对简单,但镇痛效果、药物扩散途径及相关风险目前存在争议,需要进一步研究。Ultrasound-guided nerve block plays an important role in the perioperative analgesia of breast cancer. Among many block techniques, thoracic paravertebral block is often recommended as the gold standard by various guidelines because of its exact analgesic effect. In order to reduce the risk of thoracic paravertebral block and the difficulty of operation, paravertebral block techniques such as erector spinae plane block, costotransverse process block, transverse process-pleural point block, and laminar block have been developed and applied in clinical practice. This article introduces the above paravertebral plane block techniques and their application in breast surgery. But the analgesia effect, way of drug diffusion and related risk is controversial, needs further research.
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