
Journal of Shanghai Jiao Tong University (Medical Science) ›› 2025, Vol. 45 ›› Issue (9): 1079-1098.doi: 10.3969/j.issn.1674-8115.2025.09.001
• Guidelines and consensus • Next Articles
Writing Group of Chinese Expert Consensus on Ultrasound-Guided Pediatric Nerve Blocks in Children (2025 edition)
Received:2025-05-05
Accepted:2025-08-19
Online:2025-09-28
Published:2025-09-30
Contact:
XU Tao, YU Weifeng
Supported by:CLC Number:
Writing Group of Chinese Expert Consensus on Ultrasound-Guided Pediatric Nerve Blocks in Children (2025 edition). Chinese expert consensus on ultrasound-guided nerve blocks in children (2025 edition)[J]. Journal of Shanghai Jiao Tong University (Medical Science), 2025, 45(9): 1079-1098.
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URL: https://xuebao.shsmu.edu.cn/EN/10.3969/j.issn.1674-8115.2025.09.001
阻滞区域 Block region | 首选方案 Primary plan | 升级方案 Advanced plan |
|---|---|---|
上肢 Upper limb | ||
肩部以下 Below shoulder | 腋路臂丛阻滞 Axillary brachial plexus block | 锁骨上臂丛阻滞、锁骨下臂丛阻滞 Supraclavicular brachial plexus block; infraclavicular brachial plexus block |
肘部以下 Below elbow | 肘平面阻滞 Elbow blocks | |
下肢 Lower limb | ||
髋部 Hip | 股神经阻滞 Femoral nerve block | 髂筋膜阻滞、腰丛阻滞 Fascia iliaca block; lumbar plexus block |
大腿及膝部 Thigh and knee | 收肌管阻滞 Adductor canal block | |
膝下至足踝 Below knee | 腘窝坐骨神经阻滞 Sciatic nerve block of popliteal fossa | 踝部阻滞 Ankle block |
躯干 Trunk | ||
胸壁 Chest wall | 尚无推荐 No recommendations | 竖脊肌阻滞、椎旁阻滞、前锯肌平面阻滞 Erector spinae plane block; paravertebral block; serratus anterior plane block |
腹部、腹股沟区 Abdomen,groin | 腹直肌鞘阻滞、腰方肌外侧平面阻滞、阴茎背神经阻滞 Rectus sheath block; lateral quadratus lumborum block; dorsal penile nerve block | 前路腰方肌阻滞、腹横肌平面阻滞、阴部神经阻滞 Anterior quadratus lumborum block; transversus abdominis plane block; pudendal nerve block |
头颈部 Head and neck | ||
颈前区 Anterior region of neck | 颈浅丛阻滞 Superficial cervical plexus block | 尚无推荐 No recommendations |
耳 Ear | 耳大神经阻滞 Great auricular nerve block |
Tab 1 Grading of recommended protocols for ultrasound-guided pediatric nerve blocks
阻滞区域 Block region | 首选方案 Primary plan | 升级方案 Advanced plan |
|---|---|---|
上肢 Upper limb | ||
肩部以下 Below shoulder | 腋路臂丛阻滞 Axillary brachial plexus block | 锁骨上臂丛阻滞、锁骨下臂丛阻滞 Supraclavicular brachial plexus block; infraclavicular brachial plexus block |
肘部以下 Below elbow | 肘平面阻滞 Elbow blocks | |
下肢 Lower limb | ||
髋部 Hip | 股神经阻滞 Femoral nerve block | 髂筋膜阻滞、腰丛阻滞 Fascia iliaca block; lumbar plexus block |
大腿及膝部 Thigh and knee | 收肌管阻滞 Adductor canal block | |
膝下至足踝 Below knee | 腘窝坐骨神经阻滞 Sciatic nerve block of popliteal fossa | 踝部阻滞 Ankle block |
躯干 Trunk | ||
胸壁 Chest wall | 尚无推荐 No recommendations | 竖脊肌阻滞、椎旁阻滞、前锯肌平面阻滞 Erector spinae plane block; paravertebral block; serratus anterior plane block |
腹部、腹股沟区 Abdomen,groin | 腹直肌鞘阻滞、腰方肌外侧平面阻滞、阴茎背神经阻滞 Rectus sheath block; lateral quadratus lumborum block; dorsal penile nerve block | 前路腰方肌阻滞、腹横肌平面阻滞、阴部神经阻滞 Anterior quadratus lumborum block; transversus abdominis plane block; pudendal nerve block |
头颈部 Head and neck | ||
颈前区 Anterior region of neck | 颈浅丛阻滞 Superficial cervical plexus block | 尚无推荐 No recommendations |
耳 Ear | 耳大神经阻滞 Great auricular nerve block |
局麻药 Local anaesthetics | 最大剂量/(mg·kg-1) Maximum allowable dose/(mg·kg-1) | 外周神经和躯干阻滞单次推注 Bolus for peripheral and truncal block | 连续阻滞持续推注 Infusion for continuous block | ||
|---|---|---|---|---|---|
质量浓度/[g·(100 mL)-1] Mass concentration/ [g·(100 mL)-1] | 容量/(mg·kg-1) Volume/(mg·kg-1) | 质量浓度/[g·(100 mL)-1] Mass concentration/ [g·(100 mL)-1] | 速率/[mg·(kg·h)-1] Rate/[mg·(kg·h)-1] | ||
罗哌卡因 Ropivacaine | 2.5 | 0.2 | 0.5 | 0.2/0.1 | 0.4 |
左旋布比卡因 Levobupivacaine | 2.5 | 0.25 | 0.5 | 0.125 | 0.4 |
Tab 2 Recommended dosages of common local anaesthetics[84]
局麻药 Local anaesthetics | 最大剂量/(mg·kg-1) Maximum allowable dose/(mg·kg-1) | 外周神经和躯干阻滞单次推注 Bolus for peripheral and truncal block | 连续阻滞持续推注 Infusion for continuous block | ||
|---|---|---|---|---|---|
质量浓度/[g·(100 mL)-1] Mass concentration/ [g·(100 mL)-1] | 容量/(mg·kg-1) Volume/(mg·kg-1) | 质量浓度/[g·(100 mL)-1] Mass concentration/ [g·(100 mL)-1] | 速率/[mg·(kg·h)-1] Rate/[mg·(kg·h)-1] | ||
罗哌卡因 Ropivacaine | 2.5 | 0.2 | 0.5 | 0.2/0.1 | 0.4 |
左旋布比卡因 Levobupivacaine | 2.5 | 0.25 | 0.5 | 0.125 | 0.4 |
常用神经阻滞方法 Common nerve block technique | 适应证 Indication | 0.2%罗哌卡因 0.2% Ropivacaine |
|---|---|---|
腋路臂丛阻滞 Axillary brachial plexus block | 肘切开复位内固定、前臂和手外科手术 Elbow open reduction and internal fixation; forearm and hand surgery | 0.2‒0.5 mL·kg-1 (最多15 mL/up to 15 mL) |
股神经阻滞 Femoral nerve block | 股骨骨折、股骨上段骨骺滑脱、股骨截骨术 Femoral fracture; slipped upper femoral epiphysis; femoral osteotomy | 0.2‒0.5 mL·kg-1 (最多15 mL/up to 15 mL) |
腘窝坐骨神经阻滞 Popliteal sciatic nerve block | 肌腱转移/延长、下肢创伤、胫骨截骨术、踝关节成形术、畸形足修复 Tendon transfers/lengthening; lower limb trauma; tibial osteotomy; ankle arthroplasty; club foot repair | 0.2‒0.3 mL·kg-1 (最多15 mL/up to 15 mL) |
腹直肌鞘阻滞 Rectus sheath block | 脐疝修补术、幽门环肌切开术、开放性胃造口术 Umbilical herniotomy; pyloromyotomy; open gastrostomy | 0.1‒0.3 mL·kg-1 (单侧/per side) |
外侧腰方肌入路阻滞 Lateral quadratus lumborum block | 腹股沟疝修补术、开放性阑尾切除术 Inguinalherniotomy; open appendicectomy | 0.5 mL·kg-1 (单侧最多20 mL/up to 20 mL per side) |
阴茎背神经阻滞 Dorsal penile nerve block | 包皮环切术、远端尿道下裂修复术 Circumcision; distal hypospadias repair | 0.1 mL·kg-1 (双侧最多5 mL/up to 5 mL both sides) |
Tab 3 Indications and recommended local anaesthetic doses for common pediatric nerve blocks[41]
常用神经阻滞方法 Common nerve block technique | 适应证 Indication | 0.2%罗哌卡因 0.2% Ropivacaine |
|---|---|---|
腋路臂丛阻滞 Axillary brachial plexus block | 肘切开复位内固定、前臂和手外科手术 Elbow open reduction and internal fixation; forearm and hand surgery | 0.2‒0.5 mL·kg-1 (最多15 mL/up to 15 mL) |
股神经阻滞 Femoral nerve block | 股骨骨折、股骨上段骨骺滑脱、股骨截骨术 Femoral fracture; slipped upper femoral epiphysis; femoral osteotomy | 0.2‒0.5 mL·kg-1 (最多15 mL/up to 15 mL) |
腘窝坐骨神经阻滞 Popliteal sciatic nerve block | 肌腱转移/延长、下肢创伤、胫骨截骨术、踝关节成形术、畸形足修复 Tendon transfers/lengthening; lower limb trauma; tibial osteotomy; ankle arthroplasty; club foot repair | 0.2‒0.3 mL·kg-1 (最多15 mL/up to 15 mL) |
腹直肌鞘阻滞 Rectus sheath block | 脐疝修补术、幽门环肌切开术、开放性胃造口术 Umbilical herniotomy; pyloromyotomy; open gastrostomy | 0.1‒0.3 mL·kg-1 (单侧/per side) |
外侧腰方肌入路阻滞 Lateral quadratus lumborum block | 腹股沟疝修补术、开放性阑尾切除术 Inguinalherniotomy; open appendicectomy | 0.5 mL·kg-1 (单侧最多20 mL/up to 20 mL per side) |
阴茎背神经阻滞 Dorsal penile nerve block | 包皮环切术、远端尿道下裂修复术 Circumcision; distal hypospadias repair | 0.1 mL·kg-1 (双侧最多5 mL/up to 5 mL both sides) |
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