Long-term placement of continuous popliteal nerve block catheter for management of a wounded patient in a combat field environment: a case report.

IF 1.5 Q3 ANESTHESIOLOGY Local and Regional Anesthesia Pub Date : 2019-08-29 eCollection Date: 2019-01-01 DOI:10.2147/LRA.S210462
Costantino Fontana, Monica Rocco, Luigi Vetrugno, Elena Bignami
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Abstract

Continuous peripheral nerve block is a relevant part of multimodal treatment of postoperative pain. In this context the continuous popliteal nerve block is described as an option for postoperative pain management for surgical procedures on the leg, and particularly on the ankle and foot. We applied continuous popliteal nerve block for different types of anesthesia and postoperative pain management via the same catheter. No clear evidence of this specific use has been described in the literature. A 38 year-old patient wounded in combat with a displaced fracture of left tibia and extensive loss of substance needed orthopedic surgeries as well as several reconstructive procedures. A continuous popliteal nerve block was applied via ultrasound-guided catheter for anesthesia at different times, and postoperative pain control for all surgical procedures. The continuous popliteal nerve block and its long-term positioning, of non-common evidence in literature, was utilized to treat a poly-traumatized patient, thereby avoiding repeated general anesthesia and opioid use and their adverse effects. This technique, within a complicated combat field environment, was demonstrated to be clinically effective with high patient satisfaction.

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长期放置连续腘神经阻滞导管治疗战场环境中受伤患者一例报告。
持续周围神经阻滞是术后疼痛多模式治疗的重要组成部分。在这种情况下,连续腘神经阻滞被描述为腿部外科手术后疼痛管理的一种选择,特别是在脚踝和足部。我们通过同一导管应用连续腘神经阻滞用于不同类型的麻醉和术后疼痛管理。文献中没有明确的证据说明这种特殊用途。一名38岁的患者在战斗中受伤,左胫骨移位性骨折并大面积丢失,需要进行骨科手术和几次重建手术。超声引导导管连续阻滞腘窝神经,在不同时间麻醉,并对所有手术过程进行术后疼痛控制。利用文献中不常见的腘神经连续阻滞及其长期定位治疗多处创伤患者,避免了反复全身麻醉和阿片类药物的使用及其不良反应。在复杂的战场环境中,该技术被证明是临床有效的,患者满意度高。
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来源期刊
CiteScore
6.30
自引率
0.00%
发文量
12
审稿时长
16 weeks
期刊最新文献
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