ПЕРИФЕРИЧЕСКИЕ НЕРВНЫЕ БЛОКАДЫ ПРИ ХИРУРГИИ КОЛЕННОГО СУСТАВА
Ключові слова:
хирургия коленного сустава, периферические невральные блокады, блокада бедренного нерваАнотація
Цель данной работы — анализ современных методов периферических нервных блокад (ПНБ) при хирургических вмешательствах на коленном суставе. В статье показана десятилетняя эволюция от эпидуральной анестезии до блокад, сохраняющих двигательную активность. Хирургические вмешательства на коленном суставе могут быть выполнены под общим наркозом, нейроаксиальной блокадой или их комбинацией. Недостатки эпидуральной анестезии вызвали снижение своего доминирующего положения в региональной анестезии. Различные ПНБ нижней конечности используются для операций на коленном суставе. Также ПНБ является одним из ключевых элементов мультимодальной анальгезии. Блокада бедренного нерва считается «золотым стандартом» послеоперационной анальгезии после тотального эндопротезирования коленного сустава. В последнее время растет интерес к сохранению мышечной силы четырехглавой мышцы после хирургических вмешательств на коленном суставе, что приводит к улучшению качества реабилитации у этой категории больных. Блокада бедренного нерва может быть хорошим вариантом для этих целей. Другие ПНБ, при которых сохраняется моторная функция, будут рассмотрены далее. Вывод. Современная местная анестезия имеет в своем арсенале различные методы, которые могут быть использованы в зависимости от потребностей пациента, хирурга, анестезиолога и медицинского обслуживания.
Посилання
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