超声引导下连续神经阻滞在下肢骨科手术中的应用进展

The Application Progress of Ultrasound-Guided Continuous Peripheral Nerve Block in Orthopedic Surgery of the Lower Extremities

摘要: 连续神经阻滞是指通过留置导管于目标神经周围，持续或间歇性输注局部麻醉药物，以实现长时间、可调控的区域性镇痛的一种技术。该技术广泛应用于术后急性疼痛管理，尤其是四肢及躯干大型手术后，也适用于部分慢性疼痛病症的干预。近年来，随着超声引导技术的普及与发展，CPNB的精准性和安全性显著提高，使其在下肢骨科手术镇痛中的应用日益广泛。常见的下肢CPNB技术包括连续髂筋膜间隙阻滞、连续髋关节囊周围神经阻滞、连续股神经阻滞、连续隐神经阻滞以及连续腘窝坐骨神经阻滞等。不同阻滞方式因其作用神经通路不同，在临床应用范围和镇痛效果上存在明显差异。本文就各种常见CPNB的阻滞效果及临床应用范围展开综述，探讨其在下肢骨科手术中的进展。

Abstract: Continuous peripheral nerve block (CPNB) refers to a technique in which a catheter is indwelled around the target nerve, and local anesthetic drugs are continuously or intermittently infused to achieve long-term and adjustable regional analgesia. This technique has been extensively applied in the management of postoperative acute pain, particularly after major surgeries of the extremities and trunk. It is also suitable for the intervention of some chronic pain disorders. In recent years, with the popularization and development of ultrasound-guided techniques, the precision and safety of CPNB have been remarkably enhanced, leading to an increasingly extensive application of CPNB in postoperative analgesia for lower limb orthopedic surgeries. Common CPNB techniques for the lower limbs include continuous fascia iliaca compartment block, continuous periacetabular nerve block, continuous femoral nerve block, continuous saphenous nerve block, and continuous popliteal sciatic nerve block. Due to the different neural pathways involved in different block methods, there are obvious differences in their clinical application scopes and analgesic effects. This paper comprehensively reviews the block effects and clinical application scopes of various common CPNB techniques and explores their advancements in lower limb orthopedic surgeries.