周囊神经群块:一个3DCT扫描成像研究,以确定注射剂的传播
Angela Lucia Balocco1,2, Nicolas Gautier3, Sam Van Boxstael4,5
1Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium luchy88@gmail.com.
Regional anesthesia and pain medicine
|June 26, 2024
概括
周囊神经组 (PENG) 阻塞
科学领域:
- 麻醉学 麻醉学
- 区域麻醉地区麻醉
- 疼痛管理 疼痛管理
背景情况:
- 目前对周囊神经组 (PENG) 阻断机制的理解依赖于尸体研究.
- 需要对患者进行成像研究,以澄清PENG阻断的止痛机制.
- 一项临床试验 (NCT06062134) 研究了部手术患者的PENG阻断.
研究的目的:
- 为了阐明体内注射器的传播和周囊神经组 (PENG) 块的解剖分布.
- 为了将成像发现与部手术中PENG阻断的拟议止痛机制相关联.
主要方法:
- 10名接受关节手术的患者接受了超声波引导的PENG阻断与罗皮瓦卡因和对比剂.
- 注射后进行了高分辨率的CT扫描,以可视化注射剂的分散.
- 用三维重建来分析对比度扩散模式.
主要成果:
- 注射剂主要局限于腹肌和腹肌表皮质,最小的传播到部囊.
- 在所有参与者的腹腔和/或心肌肌肉中都观察到对比度.
- 没有检测到扩散到胸下平面或闭门孔.
结论:
- PENG 阻断的止痛作用可能源于阻断部神经分支在阴肌内.
- 观察到的扩散模式不支持PENG技术显著阻断闭关神经.
- 这项成像研究为PENG块的作用机制提供了体外证据.
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