竖脊肌平面阻滞在老年手术患者心血管保护作用中的研究进展

Research progress on the cardiovascular protective effects of erector spinae plane block in elderly patients

中文关键词: 脊肌平面阻滞  老年  心血管保护  机制研究

英文关键词: Erector spinae plane block  Aged  Cardiovascular protection  Mechanism research

中文摘要:

      在加速术后康复理念驱动下，竖脊肌平面阻滞（ESPB）凭借其操作简便、安全性高、镇痛效果持久等优势，逐渐成为老年手术患者麻醉管理的研究热点。ESPB能够同时阻滞多条脊神经的背侧支、腹侧支及交感神经链，有效抑制伤害性应激反应与交感神经过度激活，兼具镇痛与心血管保护的双重效益。其机制在于通过多节段神经阻滞，抑制疼痛-交感神经反射，减少心脏氧耗，同时调节自主神经功能，减轻炎症反应。然而，目前仍需要进一步开展大规模研究来验证ESPB对老年患者的长期疗效和安全性，并探索其提供心血管保护的具体机制。本文系统地评估了ESPB在老年手术患者心血管保护作用中的机制，为ESPB在临床实践和研究方向提供参考。

英文摘要:

      Driven by the enhanced recovery after surgery (ERAS) concept, the erector spinae plane block (ESPB) has emerged as a research focus in the anesthetic management of elderly surgical patients due to its simplicity, high safety profile, and long-lasting analgesic effects. ESPB can simultaneously block the dorsal and ventral branches of multiple spinal nerves, as well as the sympathetic chain, effectively suppressing pain stress responses and excessive sympathetic activation. This dual benefit of analgesia and cardiovascular protection is achieved through multi-segmental nerve blockade, which inhibits the pain-sympathetic reflex, reduces myocardial oxygen consumption, and modulates autonomic nervous function to attenuate inflammatory responses. However, further large-scale studies are needed to confirm the long-term efficacy and safety of ESPB in elderly patients and to elucidate the specific mechanisms underlying its cardiovascular protection. This article systematically evaluates the mechanisms of the cardiovascular protective effects of ESPB in elderly surgical patients, providing references for its clinical application and research directions.