关于患者安全的事实:尽量减少宫外周注射的风险
Eric K Holder1, Haewon Lee2, Aditya Raghunandan3
1Yale University School of Medicine, Department of Orthopedics and Rehabilitation, New Haven, CT, USA.
Interventional pain medicine
|November 6, 2024
概括
降低宫外围注射类固醇注射的风险包括精确的针位置,特别是在间层手术期间避免带隙. 仔细考虑镇静和抗凝治疗对于患者的安全至关重要.
科学领域:
- 疼痛管理 疼痛管理
- 神经外科 神经外科
- 放射学 放射学是一门学科.
背景情况:
- 宫外围注射类固醇注射 (CESI) 携带风险,包括持续穿刺,脊髓损伤和血管事件.
- 特定的技术和患者因素影响了宫内膜外皮类固醇注射 (CILESIs) 和宫外皮类固醇注射 (CTFESIs) 的安全性.
研究的目的:
- 总结证据并提供建议,以尽量减少与CILESI相关的风险.
- 为了强调术前成像对CTFESI安全的重要性.
- 讨论多级或双边CTFESI的安全考虑.
主要方法:
- 对支持CILESI的具体程序建议的证据的审查.
- 强调解剖学标志和成像技术,以确保安全放置针头.
- 在CESI的背景下讨论镇静和抗凝管理.
主要成果:
- 最佳的CILESI接入是C7-T1,以避免长度穿孔和脊髓损伤.
- 建议在中间层间放置针头,以避免带膜间的空隙.
- 术前成像有助于CTFESI计划预防血管并发症.
- 建议在多级/双边CTFESI时谨慎使用,因为动脉注射可能会导致对比度变暗.
结论:
- 坚持推的技术和程序前规划可以显著降低宫外周类固醇注射的风险.
- 谨慎的患者选择,镇静管理和考虑抗凝剂对于安全的CESI程序至关重要.
- 可能需要进一步的研究,以充分阐明与多级/双边CTFESI相关的风险.
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