GÂY TÊ VÙNG HIỆN ĐẠI: SỰ THAY ĐỔI TỪ PHƯƠNG PHÁP TIẾP CẬN TRỰC TIẾP ĐẾN GÂY TÊ MẶT PHẲNG CÂN MẠC

Abstract

Background: Regional anesthesia has evolved significantly in recent years, with a notable shift from direct nerve approaches to fascial plane blocks. This transformation reflects improved anatomical understanding, advances in ultrasound guidance, and a growing emphasis on multimodal, opioid-sparing analgesia. Methods: This narrative review presents updated insights into regional anesthesia, focusing on the distinctions between direct nerve and fascial plane blocks. Key elements discussed include anatomical considerations, the role of ultrasound and nerve stimulation, safety aspects, and clinical applications. Results: Direct nerve blocks remain an important component of analgesia, especially when performed with dual guidance using ultrasound and nerve stimulation. Meanwhile, fascial plane blocks are increasingly favored due to their wide spread of local anesthetic, technical simplicity, high safety profile, and good effectiveness in thoracic, abdominal, and orthopedic surgeries. Strategies such as continuous catheter infusion or the use of liposomal local anesthetics can prolong analgesic duration, although their effectiveness may be variable and the risk of systemic local anesthetic toxicity requires careful consideration and individualization for each patient. Conclusions: Regional anesthesia is undergoing a shift in practice: traditional techniques remain valuable, but fascial plane blocks are becoming more prominent. Advances in imaging technology, pharmacology, and artificial intelligence are expected to further enhance precision and personalization in clinical practice.