区域神经阻滞技术用于口腔癌缺损皮瓣修复手术的研究进展. (Chinese)

Research progress on the application of regional nerve block technique in oral cancer defects repaired with free flaps reconstruction. (English)

Due to large trauma after oral cancer resection repaired with free flaps reconstruction, patients often experience severe pain after surgery. Opioids are the most powerful analgesics used for postoperative pain alleviation, but they also have adverse effects such as respiratory depression, postoperative nausea and vomiting. In addition, factors including the relatively extensive surgical resection, expected postoperative edema, and accumulation of secretions may contribute to increased airway complications in these patients. On the other hand, vomiting can lead to postoperative bleeding and wound infection. Thus, there is a necessity to find an analgesic strategy with high safety, good analgesic effect and few side effects. To address this dilemma, ultrasound-guided regional nerve block technology, as a part of multimodal analgesia, has been developed in recent years, which can significantly reduce opioids requirement and their side effects. This paper described the anatomy of commonly used free flaps, the researches and operational procedures of ultrasound-guided nerve block, in order to provide reference for the application of this technology in oral cancer resection with free flaps reconstruction. [ABSTRACT FROM AUTHOR]

口腔癌缺损皮瓣修复手术由于创伤大,患者术后常伴有剧烈疼痛. 术后镇痛往往使用最强效的镇痛药——阿片 类药物,但这类药物有呼吸抑制、恶心、呕吐等副作用. 此外,口腔组织扩大切除、术后水肿、分泌物聚集等危险因素, 使这类手术患者术后呼吸系统并发症风险增高. 另一方面,恶心、呕吐可能造成患者术后口内切口出血、感染等. 因 此,急需寻找一种安全性高,镇痛效果好、副作用少的镇痛方案. 近年来,超声引导下的区域神经阻滞技术得到较多 的临床应用,其作为多模式镇痛的一部分,可以明显减少阿片类药物的需求量及副作用. 本文对常见皮瓣制作的解 剖学基础、超声引导神经阻滞的操作方法及临床研究等做一综述. [ABSTRACT FROM AUTHOR]

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