相关实验视频

Updated: May 30, 2025

Treating Low Back Pain in Failed Back Surgery Patients with Multicolumn-lead Spinal Cord Stimulation

Treating Low Back Pain in Failed Back Surgery Patients with Multicolumn-lead Spinal Cord Stimulation

Published on: June 26, 2018

圆中枢终结:评估在L2-L3间隙中脊柱麻醉的安全性

James E Paul¹, Lisa A Udovic², Kathleen Oman³

¹Department of Anesthesia, McMaster University, Hamilton, Ontario, Canada.

Acta anaesthesiologica Scandinavica

|January 31, 2025

概括

在L2-L3间隙以下的脊髓麻醉在大多数患者中是安全的,神经轴线风险较低. 塔菲尔线可靠地表示L4-L5间隙,支持其作为安全麻醉的解剖学地标.

科学领域:

麻醉学和疼痛医学麻醉学和疼痛医学
放射学和成像学放射学和成像学
脊椎解剖学脊椎解剖学

背景情况:

传统的教学假设脊柱麻醉安全在L2-L3间隙或以下.
精确的髓末端 (CMT) 水平及其与解剖学标志的关系需要进一步调查.

研究的目的:

确定在L1-L2间隙或以下的CMT个体的百分比.
评估塔菲尔线 (TL) 作为脊髓麻醉的解剖学里程碑的可靠性.
检查人口因素和脊柱病理在CMT水平上的影响.

主要方法:

追溯分析了944名成年患者的MRI扫描,以确定CMT水平.
后勤回归用于探索CMT水平与年龄,性别,BMI和脊柱病理之间的关系.
分析了720张腰部X射线,以评估TL对应于L4-L5并与CMT重叠.

主要成果:

18.9%的患者在L1-L2间隙或以下有CMT,这表明在L2-L3.3处麻醉的0.7%的神经轴风险.
先天性脊柱异常是低CMT水平的唯一显著预测因素.
图菲尔线与99.8%的患者的L4-L5间隙相对应,证明非常可靠.

结论:

在L2-L3间隙进行脊髓麻醉,由塔菲尔线指导,在99%以上的患者中是安全的.
虽然通常是安全的,但建议谨慎,因为人口因素是低CMT水平的不良预测因素.
塔菲尔线是安全脊柱麻醉程序的可靠地标.

关键词:

髓末端的终点这就是为什么MRI是MRI.脊髓麻醉脊髓麻醉塔菲尔的线是塔菲尔的线.

更多相关视频

Transtubular Endoscopic Posterolateral Decompression for L5-S1 Lumbar Lateral Disc Herniation

Transtubular Endoscopic Posterolateral Decompression for L5-S1 Lumbar Lateral Disc Herniation

Published on: October 14, 2022

Author Spotlight: Enhancing Success of Ultrasound-Guided Neuraxial Anesthesia in Cases with Difficult Anatomy

Author Spotlight: Enhancing Success of Ultrasound-Guided Neuraxial Anesthesia in Cases with Difficult Anatomy

Published on: January 31, 2025

相关概念视频

Local Anesthetics: Clinical Application as Spinal Anesthesia

Local Anesthetics: Clinical Application as Spinal Anesthesia

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...

Local Anesthetics: Clinical Application as Epidural Anesthesia

Local Anesthetics: Clinical Application as Epidural Anesthesia

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...

Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia

Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia

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...