| 标题： | 超声引导臂丛神经阻滞的临床应用与围手术期管理专家共识 |
| title： | Expert consensus on the clinical application and perioperative management of ultrasound-guided brachial plexus block |
| 版本： | 原创版 |
| version： | Original |
| 分类： | 专家共识 |
| classification： | Experts consensus |
| 领域： | 诊疗 |
| field： | Diagnosis and Treatment |
| 国家和地区： | 中国 |
| Country and region： | China |
| 指南使用者： | 本共识中推荐的临床方案仅适用于麻醉医师，并不能完全替代临床医生的决定。 |
| Guide users： | The clinical protocols recommended in this consensus apply only to Anesthesiologist, and are not a complete substitute for clinician decisions. |
| 证据分级方法： | 1.GRADE 2.OCEBM Levels of Evidence |
| Evidence grading method： | 1.GRADE 2.OCEBM Levels of Evidence |
| 制定单位： | 1. 中山大学附属第三医院 麻醉科；2. 首都医科大学宣武医院 麻醉科；3.福建医科大学附属协和医院 麻醉科 |
| Formulating unit： | 1. Department of Anesthesiology, Third Affiliated Hospital of Sun Yat-sen University; 2.Department of Anesthesiology,Xuanwu Hospital, Capital Medical University; 3. Department of Anesthesiology, Union Hospital affiliated to Fujian Medical University |
| 注册时间： | 2023-11-01 |
| Registration time： | |
| 注册编号： | PREPARE-2023CN842 |
| Registration number： | |
| 指南制订的目的： | 臂丛神经阻滞是上肢创伤、关节、良性或恶性病变等手术麻醉和疼痛管理的常用方法，也是麻醉医师必须掌握的外周神经阻滞技术之一 。相较于全身麻醉，其对呼吸、循环系统干扰小且相对简便，同时是舒适化医疗、加速康复外科管理中的重要组成部分。臂丛神经阻滞经历了近140年的发展，从依靠解剖、神经刺激器定位已转变为超声引导为主；从非选择性神经阻滞发展至可以实施选择性或靶向神经阻滞。超声引导技术不仅使得臂丛神经解剖可视化，而且是精准阻滞、启发新入路和技术的基础。超声扫描和成像、阻滞入路和技术、局麻药物的浓度和容量对臂丛神经阻滞的质量和安全至关重要，也是影响患者围手术期管理和术后康复质量的关键，尤其是对合并慢性疾病、高龄患者。然而，在国内超声引导臂丛神经阻滞的临床应用仍然存在着地区差异且部分技术尚未推广或普及，其围手术期管理水平也有待进一步加强。为了规范和推广应用、帮助临床医师进行准确的评估并制定个体化方案，我们特组织我国麻醉学领域及相关专家组成工作组，在多年临床经验的基础上，以循证医学为证据，通过多次讨论和修订，最终形成了成人的《超声引导臂丛神经阻滞的临床应用与围手术期管理专家共识》，供麻醉学科及相关人员参考。 |
| Purpose of the guideline： | Brachial plexus block is a common anesthesia and pain management method for upper extremity trauma, joint, benign or malignant lesions. Compared with general anesthesia, it has less interference to respiratory and circulatory system and is relatively simple, and is an important part of comfortable medical treatment and accelerated rehabilitation surgery management. Brachial plexus block has experienced nearly 140 years of development, and has changed from relying on anatomy and nerve stimulator localization to ultrasound guidance. Progression from non-selective nerve block to selective or targeted nerve block. Ultrasound guidance technology not only visualizes the brachial plexus anatomy, but also is the basis for accurately blocking and inspiring new approaches and techniques. Ultrasound scanning and imaging, blocking approach and technique, and concentration and volume of local anesthesia drugs are crucial to the quality and safety of brachial plexus block, and are also key to the quality of perioperative management and postoperative rehabilitation of patients, especially for elderly patients with chronic diseases. However, there are still regional differences in the clinical application of ultrasound guided brachial plexus block in China, and some techniques have not been promoted or popularized, and the perioperative management level needs to be further strengthened. In order to standardize and promote the application, help clinicians make accurate evaluation and develop individual programs, we organize a working group of experts in the field of anesthesiology and related fields in China. Based on many years of clinical experience and evidence-based medicine as evidence, through many discussions and revisions, Finally, an expert consensus on the clinical Application and perioperative management of ultrasound-guided brachial plexus Block for adults was formed for reference by anesthesiology department and related personnel. |
