通过单点与多点注射技术比较USG引导的关节上臂块:一个前性随机试验
Vandana Mangal1, Chandrashekhar Meena1, Khushboo Meena1
1Anesthesiology, Sawai Man Singh Medical College, Jaipur, IND.
Cureus
|December 19, 2023
概括
与多点注射相比,超声波导向的关节上阻塞显著提高了成功率,而不是单点注射. 然而,多点注射可能会在手术过程中减少神经节约.
科学领域:
- 麻醉学 麻醉学
- 区域麻醉地区麻醉
- 超声指导程序 超声指导程序
背景情况:
- 关节上阻塞是一种常见的区域麻醉技术,用于上肢手术.
- 优化阻塞的成功和最大限度地减少神经损伤是关键的临床目标.
- 超声波指导提高了区域麻醉的精度.
研究的目的:
- 为了比较单点与多点注射技术的成功率,用于超声波导向的关节上阻塞.
- 为了评估神经节约,手术时间,以及两种技术之间的感觉和运动阻塞的开始.
主要方法:
- 在接受上肢手术的204名患者接受了0.5%的罗皮瓦卡因的超声波引导的关节上阻塞.
- 患者被随机分为单点 (A组) 和多点 (B组) 注射组,使用外平面技术.
- 评估了神经功效,手术时间和阻塞开始.
主要成果:
- 在多点组 (98%) 的成功率明显高于单点组 (60.8%).
- 在多点治疗组中,神经节省显著较少,其中最常节省的是肋骨间神经.
- 感觉和运动阻断的开始在各组之间是相似的,尽管在多点组中程序时间更长.
结论:
- 超声波导向关节上阻塞的多点注射技术提供了更高的成功率.
- 单点注射技术似乎提供了更好的神经节约.
- 谨慎的技术和患者选择对于优化关节上阻塞的结果至关重要.
相关概念视频
01:16Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia
430
Intravenous regional anesthesia or the Bier block technique is used to anesthetize a specific limb or extremity. It uses exsanguinated or blood-drained vessels to transport local anesthetics or LAs to the peripheral nerve trunks. Lidocaine without vasoconstrictors like epinephrine is most commonly used for this technique. Other drugs used are prilocaine, ropivacaine, and chloroprocaine. Bupivacaine is not recommended for this technique due to its high cardiac toxicity.
One of the advantages of...
One of the advantages of...
430
01:24Local Anesthetics: Differential Sensitivity of Nerve Fibers
838
Local anesthetics (LAs) block the sodium channels of nerve trunks, sensory nerve endings, and neuromuscular junctions. Although LAs can block all kinds of nerves, the sensitivity of nerve fibers differs according to nerve types and structures. LAs are known to block myelinated fibers faster than unmyelinated ones. Also, they block pain or sensory neurons at low concentrations without affecting the motor neurons involved in muscle contractions. This helps relieve labor pain without affecting the...
838