对于外周血管再血管化的替代术后止痛技术:一个案例报告
Paulo T Almeida1, Ana R Arantes1, Erica G Carvalho1
1Anesthesiology, Hospital de Braga, Entidade Pública Empresarial (EPE), Braga, PRT.
Cureus
|August 7, 2023
概括
这份病例报告表明,手术内外围神经导管放置可以有效地管理外围动脉疾病 (PAD) 患者进行血管手术后的术后疼痛. 这种技术支持持续的抗凝血和多模式止痛策略.
科学领域:
- 麻醉学 麻醉学
- 血管外科 血管外科
- 疼痛管理 疼痛管理
背景情况:
- 周围动脉疾病 (PAD) 需要外科外围血管再血管化 (PVR).
- 在接受PVR的PAD患者中,术后疼痛管理面临重大挑战.
- 由于抗凝要求,神经轴麻醉和某些止痛技术可能是禁忌的.
研究的目的:
- 描述一项非传统的术后止痛技术,用于PAD患者进行大腿骨位旁路和大腿骨内关节切除.
- 评估手术内外围神经导管安置在这种特定患者群体的疼痛管理中的有效性.
- 探索这种技术在不中断抗凝剂的情况下在多模式止痛策略中的可行性.
主要方法:
- 一个43岁的女性患有PAD的病例报告.
- 这项手术涉及紧急的股骨位旁路,用反向的侧大沙静脉,在全身麻醉下进行左股骨内关节切除.
- 在外科关闭之前,在直接可视化下,在股骨神经附近放置周围神经导管.
主要成果:
- 通过围神经导管,成功地实现了术后止痛.
- 该技术允许有效控制疼痛,而不需要神经轴麻醉.
- 在不间断的情况下维持了外科手术期间的抗凝剂.
结论:
- 术内围神经导管安置是接受PVR的PAD患者术后疼痛控制的可行选择.
- 这种技术,集成到多式联络方法,并由麻醉师监督,可以是有效的.
- 建议在类似的手术中进一步开发包含这种止痛药的正式方案.
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