针药复合麻醉在骨科手术中的临床应用与发展趋势综述

晓婧 尉(承德县中医院，中国)
珊珊 邱(承德县中医院，中国)
佳祺 许(承德县中医院，中国)
晓飞 焉(承德县中医院，中国)
凤姣 刘(承德县中医院，中国)

摘要

随着加速康复外科（ERAS）理念的推进，围术期疼痛管理和功能保护成为骨科手术的重要议题。针药复合麻醉结合了传统针刺技术和现代药物麻醉，为骨科手术提供了新的麻醉管理方案。该技术通过调节神经-内分泌-免疫系统，发挥镇痛、抗炎、免疫调节等多重效应，有效减轻术后应激反应、提高麻醉质量，并促进术后恢复。临床研究表明，针药复合麻醉在减少阿片类药物使用、降低认知功能障碍发生率方面表现突出，尤其在老年患者和下肢骨科手术中具有良好的安全性和有效性。随着更多临床证据的积累，针药复合麻醉逐步向个性化、规范化发展，成为优化骨科围术期管理的重要策略。

关键词

针药复合麻醉；围术期管理；骨科手术；加速康复外科；镇痛

参考

Lim, Tiaw-Kee, et al. ‘Acupuncture and neural mechanism in the management of low back pain—an update.’ Medicines 5.3 (2018): 63.

Chao, Yen-Lin, et al. ‘Using a consensus acupoints regimen to explore the relationship between acupuncture sensation and lumbar spinal postoperative analgesia: A retrospective analysis of prospective clinical cooperation.’ Journal of Integrative Medicine 20.4 (2022): 329-337.

Gharby, C., et al. ‘Acupuncture, nutritional augmentation, and physical rehabilitation: improving recovery following spinal fusion.’ OSP Journal of neurology and neurological disorders 1.1 (2023).

Mao, Yu, and Lifang Yang. ‘Clinical application of electroacupuncture in enhanced recovery after surgery.’ Frontiers in Rehabilitation Sciences 4 (2023): 1135618.

Li, Yajun, et al. ‘Effect of transcutaneous electrical acupoint stimulation on postoperative pain in pediatric orthopedic surgery with the enhanced recovery after surgery protocol: a prospective, randomized controlled trial.’ Anaesthesia Critical Care & Pain Medicine 42.6 (2023): 101273.

Yang, Yuwei, et al. ‘A Randomized, Sham-Controlled Trial on the Efficacy and Safety of Electroacupuncture for Lumbar Disc Herniation with Radiculopathy: Rationale and Study Protocol.’Journal of Pain Research (2025): 2307-2319.

Wang, Shu-Ming. ‘Acupuncture and Related Techniques for Perioperative Care of Surgical Patients.’ Advanced Acupuncture Research: From Bench to Bedside. Cham: Springer International Publishing, 2022. 447-459.

Qingchen, Zhou, et al. ‘Clinical Data Analysis of 10,152 Patients Treated with Acupuncture during Perioperative Period.’Acupuncture & Electro-Therapeutics Research 48.4 (2024): 295-308.

王凌飞,刘兆慧,张艳梅,等.针药平衡麻醉对非插管胸腔镜手术患者术后疼痛影响[J].临床军医杂志,2024,52(01):80-82+85.

孙粼希,魏绪强,王珂,等.针药复合麻醉在肺切除手术中应用的系统评价和Meta分析[J].中国针灸,2024,44(01):109-122.

王文瑾,葛文,王婧,等.针药复合麻醉在胸腔镜肺癌手术中的肺保护作用临床观察[J].上海中医药大学学报,2024,38(01):61-66+74.

马钰婷,郭修田.针药复合麻醉在肛肠手术中的临床研究进展[J].中国医药导报,2024,21(08):48-51.

林艳艳.瑞芬太尼复合丙泊酚在下肢骨科手术麻醉中的应用效果[J].中国乡村医药,2021,28(12):5-6.

张辉,贾淑红.丙泊酚复合瑞芬太尼静脉麻醉对老年骨科手术患者免疫及认知功能的影响[J].贵州医药,2022,46(08):1252-1253.

吴小胜,路建,周红梅.帕瑞昔布钠预给药+SGB复合全身麻醉对老年骨科患者术后早期认知功能及炎症因子水平的影响[J].中国现代医生,2023,61(32):28-31.

于飞洋,范怡明,赵全阳,等.右美托咪定复合丙泊酚全凭静脉麻醉对老年骨科腰椎手术患者麻醉效果及术后恢复的影响[J].中国临床医生杂志,2023,51(06):723-727.

Xiaoyan, Y. U., et al. ‘Application and evaluation of acupuncture anesthesia and analgesia pump in post-operative analgesia of shoulder surgery.’ Science & Technology Review 41.3 (2023): 44-50.

Wang, Xue-Song, et al. ‘Annual review of acupuncture research in 2024.’ (2025).

Fang, Shilei, et al. ‘Effect of buccal acupuncture therapy on the incidence of postoperative delirium in older adults undergoing orthopedic lower limb surgery: A randomized controlled trial.’Journal of Psychosomatic Research 192 (2025): 112129.

Wu, Changle, et al. ‘Electroacupuncture for the prevention of perioperative neurocognitive disorder in elderly patients undergoing general anesthesia: a systematic review and meta-analysis.’ Frontiers in Medicine 13 (2026): 1729153.

DOI: http://dx.doi.org/10.12345/yzlcyxzz.v9i4.38113