PDF(Pubmed)
Abstract：
Robotic thoracic surgery is a prominent minimally invasive approach for the treatment of various thoracic diseases. While this technique offers numerous benefits including reduced blood loss, shorter hospital stays, and less postoperative pain, effective pain management remains crucial to enhance recovery and minimize complications. This review focuses on the application of various loco-regional anesthesia techniques in robotic thoracic surgery, particularly emphasizing their role in pain management. Techniques such as local infiltration anesthesia (LIA), thoracic epidural anesthesia (TEA), paravertebral block (PVB), intercostal nerve block (INB), and erector spinae plane block (ESPB) are explored in detail regarding their methodologies, benefits, and potential limitations. The review also discusses the imperative of integrating these anesthesia methods with robotic surgery to optimize patient outcomes. The findings suggest that while each technique has unique advantages, the choice of anesthesia should be tailored to the patient\'s clinical status, the complexity of the surgery, and the specific requirements of robotic thoracic procedures. The review concludes that a multimodal analgesia strategy, potentially incorporating several of these techniques, may offer the most effective approach for managing perioperative pain in robotic thoracic surgery. Future directions include refining these techniques through technological advancements like ultrasound guidance and exploring the long-term impacts of loco-regional anesthesia on patient recovery and surgical outcomes in the context of robotic thoracic surgery.
摘要：
机器人胸部手术是治疗各种胸部疾病的一种突出的微创方法。虽然这种技术提供了许多好处，包括减少失血，缩短住院时间,减少术后疼痛，有效的疼痛管理对于促进康复和减少并发症仍然至关重要.本文综述了各种局部区域麻醉技术在机器人胸外科手术中的应用。特别强调它们在疼痛管理中的作用。技术如局部浸润麻醉（LIA），胸段硬膜外麻醉（TEA），椎旁阻滞(PVB),肋间神经阻滞(INB),和竖脊肌平面块(ESPB)进行了详细的探索，好处,和潜在的限制。该综述还讨论了将这些麻醉方法与机器人手术相结合以优化患者预后的必要性。研究结果表明，虽然每种技术都有独特的优势，麻醉的选择应根据患者的临床状态，手术的复杂性，以及机器人胸部手术的具体要求。该综述得出结论，多模式镇痛策略，可能结合了这些技术中的几种，可能为机器人胸外科围手术期疼痛的管理提供最有效的方法。未来的方向包括通过超声引导等技术进步来完善这些技术，并在机器人胸外科手术的背景下探索局部区域麻醉对患者恢复和手术结果的长期影响。
