背景:近年来,筋膜平面阻滞技术有了相当大的发展。与传统的周围神经阻滞方法不同,筋膜平面阻滞的效果可以根据筋膜解剖来预测,并且不需要对目标神经有清晰的视觉。腹膜后筋膜间隙的解剖结构很复杂,因为它包括多个隔间,包括横肌筋膜(TF),腹膜后筋膜(RF),还有腹膜.出于这个原因,一个深入的,准确了解腹膜后筋膜间隙的解剖特征对于感知局部麻醉药(LA)在腹膜后各个隔室外部或内部传播的相关区域阻滞和机制是必要的。
目的:这篇综述旨在总结腹膜后的解剖特征,阐明不同筋膜间隙之间的各种交流及其在局部阻滞中的临床意义。包括但不限于前方肌阻滞(QLB),髂筋膜室阻滞(FICB),横肌筋膜平面阻滞(TFPB),和腹膜前隔室阻滞(PCB)。
方法:这是关于在区域麻醉(RA)中使用腹膜后间隙的相关研究的叙述性综述。
方法:我们在多个数据库中进行了搜索,包括PubMed,MEDLINE,和Embase,使用“腹膜后间隙,“”横肌筋膜,“肾筋膜”,\"\"腰方肌阻滞,\"\"神经阻滞,\"和\"液体扩散\"作为一些关键字。
结果:腹膜后筋膜间隙的解剖结构对许多RA阻断技术中的注射液扩散具有重大影响,特别是QLB,FICB,和TFPB方法。此外,TF与QLB密切相关,TF和髂筋膜之间的延伸为LAs提供了潜在的通路。
结论:我们的研究结果的普遍性受到随机对照试验(RCT)数量不足的限制。
结论:熟悉腹膜后筋膜间隙的解剖结构可以增强我们对周围神经阻滞的认识。通过检查筋膜空间的循环,我们可以更全面地了解RA期间注射物扩散的方向和程度,以及块的平面和范围,可能导致有效的镇痛和更少的有害临床后果。
BACKGROUND: Fascial plane block techniques have evolved considerably in recent years. Unlike the conventional peripheral nerve block methods, the fascial plane block\'s effect can be predicted based on fascial anatomy and does not require a clear vision of the target nerves. The anatomy of the retroperitoneal interfascial space is complex, since it comprises multiple compartments, including the transversalis fascia (TF), the retroperitoneal fasciae (RF), and the peritoneum. For this reason, an in-depth, accurate understanding of the retroperitoneal interfascial space\'s anatomical characteristics is necessary for perceiving the related regional blocks and mechanisms that lie underlie the dissemination of local anesthetics (LAs) outside or within the various retroperitoneal compartments.
OBJECTIVE: This review aims to summarize the retroperitoneum\'s anatomical characteristics and elucidate the various communications among different interfascial spaces as well as their clinical significance in regional blocks, including but not limited to the anterior quadratus lumborum block (QLB), the fascia iliaca compartment block (FICB), the transversalis fascia plane block (TFPB), and the preperitoneal compartment block (PCB).
METHODS: This is a narrative review of pertinent studies on the use of retroperitoneal spaces in regional anesthesia (RA).
METHODS: We conducted searches in multiple databases, including PubMed, MEDLINE, and Embase, using \"retroperitoneal space,\" \"transversalis fascia,\" \"renal fascia,\" \"quadratus lumborum block,\" \"nerve block,\" and \"liquid diffusion\" as some of the keywords.
RESULTS: The anatomy of the retroperitoneal interfascial space has a significant influence on the injectate spread in numerous RA blocking techniques, particularly the QLB, FICB, and TFPB approaches. Furthermore, the TF is closely associated with the QLB, and the extension between the TF and iliac fascia offers a potential pathway for LAs.
CONCLUSIONS: The generalizability of our findings is limited by the insufficient number of randomized controlled trials (RCTs).
CONCLUSIONS: Familiarity with the anatomy of the retroperitoneal fascial space could enhance our understanding of peripheral nerve blocks. By examining the circulation in the fascial space, we may gain a more comprehensive understanding of the direction and degree of injectate diffusion during RA as well as the block\'s plane and scope, possibly resulting in effective analgesia and fewer harmful clinical consequences.