布比卡因脂质体在前锯肌平面阻滞中应用的研究进展
Research Progress on the Application of Liposomal Bupivacaine in Serratus Anterior Plane Block
摘要: 胸腔镜手术(VATS)术后中重度疼痛的高发生率及其对康复质量的负面影响，使区域阻滞技术成为多模式镇痛的核心环节。前锯肌平面阻滞(SAPB)因操作便捷、安全性高，在胸外科术后镇痛中应用广泛，但传统局麻药单次注射的有限时效(6~8 h)难以覆盖术后48~72 h的疼痛高峰期。布比卡因脂质体(LB)基于DepoFoamTM多囊泡递送系统，可实现72 h以上的缓释镇痛，理论上为单次SAPB提供长效解决方案。近年来，LB在SAPB中的应用研究逐步深入，涉及药代动力学优化、与传统及连续阻滞技术的疗效比较、联合用药策略以及剂量–反应关系探索等领域。本文系统回顾LB的制剂学特性与药代动力学基础、SAPB的解剖学与操作规范，重点综述LB在SAPB中的临床研究证据、量效关系探索进展及安全性评价，并就当前研究的方法学局限与未来精准镇痛研究方向进行展望，以期为LB在胸外科围术期的规范化应用提供参考。
Abstract: The high incidence of moderate-to-severe postoperative pain following video-assisted thoracoscopic surgery (VATS) and its negative impact on recovery quality have established regional blockade as a core component of multimodal analgesia. The serratus anterior plane block (SAPB), owing to its ease of performance and favorable safety profile, has been widely adopted for postoperative analgesia in thoracic surgery. However, the limited duration of action (6~8 hours) of a single injection of conventional local anesthetics is insufficient to cover the peak pain period of 48~72 hours postoperatively. Liposomal bupivacaine (LB), based on the DepoFoamTM multivesicular drug delivery system, provides sustained-release analgesia lasting beyond 72 hours, theoretically offering a long-acting solution for a single-injection SAPB. In recent years, research on the application of LB in SAPB has progressively advanced, encompassing pharmacokinetic optimization, comparative efficacy studies with traditional and continuous block techniques, combination drug strategies, and dose–response investigations. This article systematically reviews the formulation characteristics and pharmacokinetic basis of LB, as well as the anatomy and procedural standards of SAPB, with a focus on the clinical research evidence, dose-response exploration progress, and safety evaluation of LB in SAPB. Furthermore, methodological limitations of current studies and future directions for precision analgesia are discussed, aiming to provide a reference for the standardized perioperative application of LB in thoracic surgery.
文章引用：潘梓默, 高慧, 芦若英, 郑军. 布比卡因脂质体在前锯肌平面阻滞中应用的研究进展[J]. 临床医学进展, 2026, 16(9): 2338-2348. https://doi.org/10.12677/acm.2026.1693277

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