超声引导下对门诊病人的区域麻醉(双语)说课.ppt

Ultrasound-guided for Regional Anesthesia for Ambulatory patient(超声引导下对门诊病人的区域麻醉) 原文：Meg A. Rosenblatt, M.D.??? 翻译：福建医大附属协和医院麻醉科规培住院医师 张海梅 introduction Outpatient surgeries now account for more than two-thirds of all surgeries performed in the United States and after GI endoscopies, ophthalmologic procedures, orthopedic operations are the next most frequently performed. 如今在美国所有手术中在门诊执行的手术占了三分之二以上，随后的是胃肠镜检查、眼科手术、骨科手术。 The advantages that regional anesthesia (RA) confers over general anesthesia (GA), especially in the outpatient setting, are numerous. 区域麻醉的优势(RA)超过了全身麻醉(GA),尤其是在门诊病人。 introduction Specifically, orthopedic patients are the group of ambulatory patients with the highest incidence (16.1%) of pain in the PACU. 具体来说,在PACU中骨科病人是门诊病人中疼痛发生率最高的 Peripheral nerve blocks (PNBs) offer predictable intraoperative anesthesia, as well as provide analgesia into the postoperative period, the opportunity to bypass Phase I recovery, and the avoidance of airway manipulations. 外周神经阻滞(PNBs)提供可预测的术中麻醉,还提供术后镇痛,绕过复苏第一阶段,避免了气道处理。 introduction Ultrasound (US) imaging permits direct visualization of peripheral nerves, needle location and distribution of local anesthetic. 超声成像能直接看到周围神经、针的位置及局麻药的分布。 The use of US-guidance to perform nerve blocks is associated with decreased time to onset and quality of block which is equal to or better than PNBs performed with nerve stimulator (NS) techniques, 使用超声引导进行神经阻滞与减少起效时间相关 ,阻滞的效果等于或优于使用神经刺激器(NS)技术。 introduction and the use of US facilitates the placement of blocks in patients who are obese, may be on anticoagulants and those with challenging external anatomy. 超声的使用方便了肥胖病人、可能使用抗凝剂的病人、有挑战的解剖异常的病人的阻滞。 introduction Performing US-guided nerve blocks requires an entirely new skill set for practitioners. 超声引导下神经阻滞要求医生掌握一项全新技能。 Firstly, one must learn to operate ultrasound equipment and then use this to identify anatomy as it appears on