随着对髋关节解剖结构的深入了解,超声引导下外周神经阻滞在围术期麻醉与镇痛中得到广泛的应用,可为患者提供良好的围术期镇痛效果,有利于患者术后早期功能锻炼,从而降低术后并发症的发生率。本文就不同神经阻滞方式在老年患者髋部骨折围术期中的应用研究进展进行综述,旨在为髋部骨折的围术期镇痛提供新的临床思路和参考。With a profound understanding of the anatomy of the hip joint, the ultrasound-guided nerve block technique has been extensively employed in perioperative anesthesia and analgesia. This method offers patients effective perioperative analgesia, fosters early postoperative functional exercise, and minimizes the occurrence of postoperative complications. This article reviews the advancements in research on various nerve block methods during the perioperative period for hip fractures in elderly patients, with the objective of offering new clinical insights and references for perioperative analgesia.
目前,全球生育率虽在下降,但是各国的剖宫产率持续上升,随之而来的产后痛成为大众关注的焦点,其次产后抑郁也给母婴,社会带来了巨大的负担,所以产后镇痛及抗抑郁对于剖宫产母婴,产科舒适化医疗至关重要。而艾司氯胺酮相比于氯胺酮,不仅抗抑郁作用快速,效果显著,且镇痛效果更好,同时在体内代谢较快,相关不良反应少,对母婴安全,已经被广泛用于剖宫产产妇术后镇痛,但其最适剂量有待商榷。本文通过综述目前已发表的关于不同浓度的艾司氯胺酮联合其他镇痛药用于产妇术后镇痛及抗抑郁的文章,对比不同浓度下的作用效果及不良反应,以期为未来研究剖宫产术后静脉自控镇痛提供新的研究方向,以及为探究艾司氯胺酮用于产妇术后镇痛抗抑郁的最佳用药方案提供参考。Currently, although the global fertility rate is declining, the rate of cesarean delivery continues to rise. Consequently, postpartum pain has become a focal point of public concern. Additionally, postpartum depression poses a significant burden on mothers, infants, and society. Therefore, effective postpartum analgesia and antidepression measures are crucial for the well-being of cesarean mothers and infants, as well as for the advancement of comfortable obstetric care. Esketamine, compared to ketamine, not only offers rapid and significant antidepression effects, but also provides better analgesia. Additionally, it metabolizes more quickly in the body, has fewer associated adverse reactions, and is safe for both mother and infant. It has been widely used for postoperative analgesia in cesarean delivery patients, though the optimal dosage remains to be determined. This article reviews the published studies on the use of esketamine at different concentrations in combination with other analgesics for postoperative analgesia and antidepression effects in parturients. By comparing the effects and adverse reactions at different concentrations, it aims to provide new directions for future research on postoperative patient-controlled analgesia after cesarean delivery and to offer a reference for determining the best dosing regimen for esketamine in postoperative analgesia and antidepression treatment for parturients.
暂无评论