Abstract:
Multi-modal analgesic strategies, including regional anesthesia techniques, have been shown to contribute to a reduction in the use of opioids and associated side effects in the perioperative setting. Consequently, those so-called multi-modal approaches are recommended and have become the state of the art in perioperative medicine. In the majority of intensive care units (ICUs), however, mono-modal opioid-based analgesic strategies are still the standard of care. The evidence guiding the application of regional anesthesia in the ICU is scarce because possible complications, especially associated with neuraxial regional anesthesia techniques, are often feared in critically ill patients. However, chest and abdominal wall analgesia in particular is often insufficiently treated by opioid-based analgesic regimes. This review summarizes the available evidence and gives recommendations for peripheral regional analgesia approaches as valuable complements in the repertoire of intensive care physicians\' analgesic portfolios.
摘要:
多模式镇痛策略,包括区域麻醉技术,已被证明有助于减少围手术期阿片类药物的使用和相关的副作用。因此,这些所谓的多模式方法是推荐的,并已成为围手术期医学的最新技术。在大多数重症监护病房(ICU)中,然而,基于阿片类药物的单模式镇痛策略仍然是护理标准。由于可能出现的并发症,指导区域麻醉在ICU中应用的证据很少。特别是与神经区域麻醉技术相关的,在危重病人中经常会感到害怕。然而,尤其是胸壁和腹壁镇痛通常不能通过基于阿片类药物的镇痛方案充分治疗。这篇综述总结了现有的证据,并为外周区域镇痛方法提供了建议,作为重症监护医师镇痛组合的有价值的补充。