在跨外内镜腰椎间盘切除术中获得疼痛,以治疗前或外椎间盘
Yong Ahn1, Ji-Eun Choi2, Sol Lee3
1Department of Neurosurgery, Kyung Hee University Hospital at Gangdong, Kyung Hee University College of Medicine, Seoul 05278, Republic of Korea.
Diagnostics (Basel, Switzerland)
|October 25, 2024
概括
椎间盘的跨外内镜腰椎间盘切除术 (TELD) 可能会导致入口疼痛,特别是在外外的病例中. 管理这种疼痛是成功手术和更短的住院时间的关键.
科学领域:
- 神经外科 神经外科
- 脊柱外科手术 脊柱外科手术
- 最少侵入性手术的方法
背景情况:
- 跨膜内镜腰椎间隔切除术 (TELD) 是腰椎间盘 (LDH) 的最小侵入性选择.
- 在TELD期间预测和管理接入疼痛,特别是对于前性或外性LDH,仍然不太了解.
- 在TELD中,对于前性/外性LDH,没有确定的进入疼痛的预测规则.
研究的目的:
- 为了确定预测TELD期间对前性或外性LDH的接入疼痛的因素.
- 评估接入疼痛对临床结果的影响.
- 在内镜脊柱手术中为疼痛预防和管理提供信息的策略.
主要方法:
- 一项对73名连续接受TELD治疗的患者进行的观察性研究,该研究涉及前性或外性LDH.
- 评估与显著的入口疼痛相关的术前临床和放射性因素.
- 评估接触疼痛与临床结果,手术时间和住院时间之间的关系.
主要成果:
- 在13.70%的患者中出现了显著的接入疼痛.
- 额外的LDH与相对的LDH (p <0.05) 相比,额外的LDH与更严重的接入疼痛有关.
- 增加的接入疼痛与更长的手术时间和住院时间相关 (p < 0.05),但不是总体临床结果.
结论:
- 在局部麻醉下,TELD对前性和外性LDH有效.
- 额外的LDH可能会增加由于工作区域狭窄而导致接入疼痛的风险.
- 管理显著的入口疼痛至关重要,可能需要专门的技术来优化手术持续时间和住院.
相关概念视频
Local Anesthetics: Clinical Application as Spinal Anesthesia
585
Spinal anesthetics are given during lower abdomen and limb surgeries to block sensory and motor neurons. They are administered in the mid to low lumbar regions, primarily acting on the cauda equina's nerve roots. The blockade level depends on the local anesthetic (LA) concentration. Usually, low LA concentrations are sufficient to block sensory fibers, while only high LA concentrations block motor fibers. Other factors like injection volume and speed, the patient's posture, and the drug...
585
Local Anesthetics: Clinical Application as Epidural Anesthesia
414
Epidural anesthetics are administered in the fat-filled epidural space, the outermost part of the spinal canal. This technique is commonly employed for pain management and anesthesia during lower abdomen and pelvis surgeries or labor and delivery.
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
414


