周围神经阻断对早期积极运动的有效性:三例发作性柔性紧突炎的病例
Takahiro Sato1, Tsuyoshi Shirahata1, Koji Nozaka1
1Department of Orthopedic Surgery, Akita University, Akita, Japan.
Case reports in orthopedics
|July 14, 2025
概括
周围神经阻塞 (PNBs) 帮助手术后的早期手动炼,改善 flexion. 然而,有限的关节延伸仍然存在,这表明需要进一步干预以优化手部功能恢复.
科学领域:
- 整形外科 整形外科 整形外科
- 手术手术手术手术手术
- 疼痛管理 疼痛管理
背景情况:
- 尽量减少痕组织和粘接对于手术运动范围至关重要.
- 早期积极的手部炼对于预防术后限制至关重要.
- 外周神经阻塞 (PNBs) 可以减少术后疼痛,促进早期动员.
研究的目的:
- 为了评估PNBs对pyogenic flexor肌炎病例运动范围的影响.
- 评估PNBs在早期积极手部练习方面的有效性.
- 为了识别尽管使用PNB,但运动范围的限制.
主要方法:
- 三例发热性柔肌炎的病例被用术后PNB治疗.
- 手术后监测了运动范围,特别是脉-手掌距离 (PPD).
- 功能性结果使用弗林标准进行评估.
主要成果:
- 在PNB的所有情况下,在一周内实现了1毫米的肉皮-手掌距离 (PPD).
- 所有患者在最后一次观察时都取得了"良好"的功能评估.
- PPD恶化了3周,所有患者都观察到有限的近端间关节延伸.
结论:
- PNBs有效地促进了早期的积极手部炼,并改善了曲运动范围.
- 局限的近端间关节延伸仍然是一个挑战.
- 需要额外的策略来增强手部手术后的延伸恢复.
相关概念视频
Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia
588
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...
588
Local Anesthetics: Differential Sensitivity of Nerve Fibers
940
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...
940
Peripherally and Centrally Acting Muscle Relaxants: A Comparison
3.7K
Skeletal muscle relaxants can target the central nervous system [CNS] to reduce muscle tension or act directly at the neuromuscular junction to induce temporary paralysis. These two classes of muscle relaxants are called centrally acting muscle relaxants and peripherally acting muscle relaxants. They differ in their action, mechanism, administration route, and clinical uses.
Centrally acting muscle relaxants can be further divided into spasmolytic and antispasmodic drugs. Spasmolytic...
Centrally acting muscle relaxants can be further divided into spasmolytic and antispasmodic drugs. Spasmolytic...
3.7K
Classification of Skeletal Muscle Relaxants
2.7K
Skeletal muscle relaxants are a group of drugs that can reduce muscle stiffness and induce temporary paralysis to relieve pain. These agents can act centrally to reduce muscle tone or spasms in painful conditions such as multiple sclerosis (MS), amyotrophic lateral sclerosis (ALS), or spinal injuries; they are called antispasmodics or spasmolytics.
Peripherally acting skeletal muscle relaxants interfere with the neurotransmission at the neuromuscular end plate to induce paralysis during...
Peripherally acting skeletal muscle relaxants interfere with the neurotransmission at the neuromuscular end plate to induce paralysis during...
2.7K
Skeletal Muscle Relaxants: Therapeutic Uses
622
Skeletal muscle relaxants are used to relax muscle tone and alleviate painful muscle contractions. However, the choice of skeletal muscle relaxants depends on the duration of the surgical procedure in order to minimize potential side effects. Skeletal muscle relaxants like neuromuscular blocking agents [NMBAs] are commonly employed as adjuvants alongside general anesthetics in clinical settings. NMBAs are also used to maintain controlled ventilation during surgery of the larynx or pharynx...
622
Directly Acting Muscle Relaxants: Dantrolene and Botulinum Toxin
767
Directly acting muscle relaxants like dantrolene and botulinum toxin (BoNT) have distinct mechanisms and applications. Dantrolene, a hydantoin derivative, acts on the ryanodine receptor (RYR1) in skeletal muscle cells. RYR1 are calcium channels present at the sarcoplasmic reticulum membrane. In response to excitation, they release calcium ions from the sarcoplasmic reticulum to the cytosol. Calcium promotes actin-myosin-mediated contraction of muscles.
The binding of dantrolene to the RYR1...
The binding of dantrolene to the RYR1...
767


