骶管阻滞佐剂围手术期应用的研究进展

Research progress on the perioperative application of adjuvants in caudal block

摘要:

骶管阻滞作为一种经典的神经阻滞技术，在临床麻醉实践中已有百年历史。随着超声引导技术的广泛应用，其临床应用范围不断扩大。传统单用局部麻醉药的骶管阻滞存在作用时间有限（通常为4～8 h）和个体反应差异显著等局限性。为克服上述不足，局部麻醉药联合辅助药物（佐剂）使用日益受到关注，并在延长镇痛时间和改善镇痛效果等方面取得了重要进展。该文系统回顾骶管阻滞中常用局部麻醉药及佐剂的应用现状，重点从作用机制、剂量优化、安全性和有效性等多个维度加以归纳与分析，旨在为佐剂在围手术期的规范化临床应用及相关研究提供理论依据与实践参考。

Abstract:

Caudal block, a classic nerve block technique, has a history of a century in clinical anesthetic practice. With the wide application of ultrasound-guided technology, its clinical application scope has been continuously expanded. Traditional caudal block using local anesthetics alone has limitations such as limited duration of action (usually 4~8 hours) and significant individual response differences. To overcome these shortcomings, the combined use of local anesthetics with auxiliary drugs (adjuvants) has attracted increasing attention, and achieved important progress in prolonging analgesic duration and improving analgesic effect. This article systematically reviews the current application status of common local anesthetics and adjuvants in caudal block, focusing on summarizing and analyzing them from multiple dimensions such as mechanism of action, dosage optimization, safety and effectiveness, aiming to provide theoretical basis and practical reference for the standardized clinical application and related research of adjuvants during the perioperative period.