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A Randomized Observer-Blinded Controlled Trial to Compare Pre-Emptive with Postoperative Ultrasound-Guided Mandibular Nerve Block for Postoperative Analgesia in Mandibular Fracture Surgeries. 一项随机观察-盲法对照试验,比较先发制人与术后超声引导下下颌神经阻滞在下颌骨折术后镇痛中的作用。
IF 2.9 Q3 ANESTHESIOLOGY Pub Date : 2021-02-10 eCollection Date: 2021-01-01 DOI: 10.2147/LRA.S290462
Rajagopalan Venkatraman, Kandhan Karthik, Cherian Belinda, Ramamurthy Balaji

Background and aims: Ultrasound-guided (UG) mandibular nerve block is effective for providing postoperative analgesia in mandibular fracture surgeries. The pre-emptive nerve blockade prolongs the duration of postoperative analgesia and reduces the consumption of intraoperative opioids. The aim of this prospective, randomized, single-blinded study was to compare the efficacy of pre-emptive and postoperative UG mandibular nerve block for postoperative analgesia in mandibular fracture surgeries.

Methods: Sixty patients scheduled for unilateral mandibular fracture surgeries were randomly divided into two groups by computer-generated random numbers and sealed envelope method: Group A received UG mandibular nerve block before surgical incision and group B received after surgery with ropivacaine 0.5% 10mL. The second anesthesiologist, who was blinded to the group involved, monitored the patient. The patients as well as the statistician were also blinded. The patients were started on patient-controlled analgesia (PCA) morphine with bolus 1mg and a lockout interval of 10min. The morphine consumption for 24h was recorded. The pain was assessed by the VAS score. The additional intraoperative fentanyl consumption and time for a request for rescue analgesic were recorded.

Results: The total morphine consumption was reduced in group A (4.566±0.717mg) than group B (5.93±0.876mg) with a p-value of <0.0001. The time for a request for rescue analgesic was also prolonged in group A (794.08±89.561min) than group B (505.333±3.159min). In group A, only four patients required an additional dose of fentanyl as against 11 patients in group B. The heart rate was also lower in group A 30min after the administration of the block and persisted for two hours intraoperatively.

Conclusion: Pre-emptive ultrasound-guided mandibular nerve block reduces morphine consumption, prolongs the time for a request for rescue analgesic, reduces intraoperative fentanyl consumption, provides better control of intraoperative heart rate, and better pain scores postoperatively when compared to the postoperative mandibular nerve block.

背景与目的:超声引导下颌骨神经阻滞是下颌骨骨折术后镇痛的有效方法。先发制人的神经阻断延长了术后镇痛时间,减少了术中阿片类药物的消耗。这项前瞻性、随机、单盲研究的目的是比较先发制人和术后UG下颌神经阻滞对下颌骨折手术术后镇痛的疗效。方法:60例拟行单侧下颌骨骨折手术的患者,采用计算机生成随机数和密封信封法随机分为两组:A组在手术切口前给予UG下颌神经阻滞,B组在手术后给予罗哌卡因0.5% 10mL。另一名麻醉师对参与的人群不知情,负责监测病人。患者和统计学家也被盲测。患者开始使用患者自控镇痛(PCA)吗啡,每丸1mg,闭锁间隔10min。记录24h吗啡用量。疼痛以VAS评分评定。记录术中芬太尼的额外消耗和请求抢救镇痛药的时间。结果:A组吗啡总用量(4.566±0.717mg)低于B组(5.93±0.876mg), p值为。结论:超声引导下先发制人的下颌神经阻滞可减少吗啡用量,延长请求抢救镇痛时间,减少术中芬太尼用量,术中心率控制更好,术后疼痛评分更好。
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引用次数: 6
Spinal Anesthesia Using Ultra-Low-Dose Isobaric Bupivacaine with Intrathecal Morphine-Fentanyl for Bilateral Low Extremity Procedures in a Geriatric Patient with Recent Myocardial Infarction and Percutaneous Coronary Intervention. 超低剂量等比重布比卡因与鞘内吗啡-芬太尼脊髓麻醉用于近期心肌梗死和经皮冠状动脉介入治疗的老年双侧下肢手术。
IF 2.9 Q3 ANESTHESIOLOGY Pub Date : 2021-01-22 eCollection Date: 2021-01-01 DOI: 10.2147/LRA.S287975
Ambrose Rukewe, Linea Nanyalo-Nashima, Nicola Olivier

A recent inferior ST-elevation myocardial infarction and percutaneous coronary intervention in an elderly female patient scheduled for bilateral lower extremity operations simultaneously represent significant risks for re-infarction and mortality. Our index patient required an above-knee amputation of the left leg to prevent infection/progressing gangrene as well as application of a back-slab for the conservative management of a fractured right femur. We employed spinal injection of ultra-low-dose 0.5% isobaric bupivacaine 4 mg with morphine 75 mcg plus fentanyl 10 mcg which provided adequate anesthesia for radical amputation, effective postoperative analgesia and good hemodynamic stability.

近期,一位老年女性患者同时行双侧下肢手术,并发下段st段抬高型心肌梗死和经皮冠状动脉介入治疗,再次梗死和死亡的风险显著。我们的第一例患者需要左腿膝盖以上截肢,以防止感染/坏疽进展,并应用背板对右股骨骨折进行保守治疗。我们采用超低剂量0.5%等压布比卡因4 mg脊柱注射,吗啡75 mcg加芬太尼10 mcg,为根治性截肢提供了充分的麻醉,术后镇痛有效,血流动力学稳定性好。
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引用次数: 1
Anatomic Landmark Technique Thoracic Paravertebral Nerve Block as a Sole Anesthesia for Modified Radical Mastectomy in a Resource-Poor Setting: A Clinical Case Report. 解剖标志技术胸椎旁神经阻滞作为改良乳房根治术在资源贫乏环境下的单一麻醉:一个临床病例报告。
IF 2.9 Q3 ANESTHESIOLOGY Pub Date : 2021-01-14 eCollection Date: 2021-01-01 DOI: 10.2147/LRA.S291308
Abebayehu Zemedkun, Belete Destaw, Mesay Milkias

Mastectomy is mostly performed as definitive management for resectable breast cancer. Implementing paravertebral nerve block for patients with metastasis features of cancer to lungs and other organs, patients with co-morbidity, geriatrics, and malnourished individuals will eliminate the risks and complications of general anesthesia. Though thoracic paravertebral block is an established technique as postoperative pain management for breast surgery, there is no conclusive evidence on its use as a sole anesthetic for modified radical mastectomy. In this case report, we present a 33-year-old woman who underwent a successful modified radical mastectomy for stage IIIb breast cancer associated with clinical and radiological features of metastasis to the lung under a multiple injection landmark technique paravertebral nerve block. We believe that the anatomic landmark technique paravertebral nerve block can be used as an alternative anesthetic technique for modified radical mastectomy in a resource-limited setting for patients who are expected to have a high risk of perioperative complications under general anesthesia.

乳房切除术主要是作为可切除乳腺癌的最终治疗方法。对具有肿瘤向肺等器官转移特征的患者、合并症患者、老年患者和营养不良患者实施椎旁神经阻滞可消除全身麻醉的风险和并发症。尽管胸椎旁阻滞是一种成熟的乳房手术术后疼痛管理技术,但尚无确凿证据表明其可作为改良乳房根治术的唯一麻醉剂。在这个病例报告中,我们报告了一位33岁的女性,她在多次注射标志技术椎旁神经阻滞下成功接受了IIIb期乳腺癌的改良根治术,并伴有肺转移的临床和放射学特征。我们认为解剖标志技术椎旁神经阻滞可以作为一种替代麻醉技术用于改良乳房根治术,在资源有限的情况下,对于那些在全身麻醉下围手术期并发症风险较高的患者。
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引用次数: 1
The Effect of Different Doses of Intravenous Dexmedetomidine on the Properties of Subarachnoid Blockade: A Systematic Review and Meta-Analysis. 静脉注射不同剂量右美托咪定对蛛网膜下腔阻滞特性的影响:系统综述和荟萃分析。
IF 2.9 Q3 ANESTHESIOLOGY Pub Date : 2020-12-15 eCollection Date: 2020-01-01 DOI: 10.2147/LRA.S288726
Mohammad K Al Nobani, Mohammed A Ayasa, Tarek A Tageldin, Abduljabbar Alhammoud, Marcus Daniel Lance

Background: Dexmedetomidine is a sedative and analgesic medication which has gained an increased usage as an adjuvant to both general and regional anaesthesia in recent years. In this systematic review and meta-analysis, we examined the changes to the characteristics of subarachnoid block when accompanied with intravenous dexmedetomidine. Our aim is to evaluate the effects of different doses of intravenous dexmedetomidine on the sensory and motor blockade duration of a single shot spinal anaesthetic and the incidence of any associated side effects.

Methods: We searched published randomized clinical trials (RCTs) from January 1992 to April 2019 that investigated the use of IV dexmedetomidine with spinal anaesthesia. After considering our inclusion and exclusion criteria, we included 15 RCTs with 985 patients. We analyzed the duration of sensory and motor blockade and the related adverse effects in relation to different doses of IV dexmedetomidine.

Results: Intravenous dexmedetomidine, with loading dose of 1 mcg/kg, prolonged the sensory blockade duration of spinal anaesthesia by a mean difference of 49.6 min, P<0.001, and motor blockade duration by a mean difference of 44.7 min, P<0.001, while a loading dose of 0.5 mcg/kg prolonged the sensory blockade by a mean difference of 43.06 min, P<0.001, and motor blockade duration by a mean difference of 29.09 min, P<0.001. Dexmedetomidine-related side effects were higher in patients receiving larger doses; the incidence of bradycardia was higher (OR=3.53, P<0.001) and incidence of hypotension showed a 1.29 fold increase when compared to the control group (P=0.065).

Conclusion: The administration of intravenous dexmedetomidine in conjunction with spinal anaesthesia can significantly prolong the duration of both sensory and motor blockade. The use of larger loading doses of dexmedetomidine was associated with a larger side-effect profile with minimal beneficial changes when compared to lower loading doses.

背景:右美托咪定是一种镇静镇痛药物,近年来作为全身和局部麻醉的辅助用药越来越多。在这篇系统综述和荟萃分析中,我们研究了伴随静脉注射右美托咪定时蛛网膜下腔阻滞特征的变化。我们的目的是评估不同剂量静脉注射右美托咪定对单次脊髓麻醉的感觉和运动阻滞持续时间的影响以及任何相关副作用的发生率。方法:我们检索了1992年1月至2019年4月期间发表的随机临床试验(RCTs),这些试验调查了静脉注射右美托咪定与脊髓麻醉的使用。在考虑纳入和排除标准后,我们纳入了15项随机对照试验,共985例患者。我们分析了不同剂量静脉注射右美托咪定的感觉和运动阻断持续时间及相关不良反应。结果:右美托咪定负荷剂量为1 mcg/kg时,可延长脊髓麻醉感觉阻滞时间,平均差值为49.6 min。结论:右美托咪定联合脊髓麻醉可显著延长感觉阻滞时间和运动阻滞时间。与低剂量右美托咪定相比,大剂量右美托咪定的副作用更大,而有益变化最小。
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引用次数: 3
Delayed Emergence from Anesthesia: What We Know and How We Act. 麻醉延迟苏醒:我们所知道的和我们如何行动。
IF 2.9 Q3 ANESTHESIOLOGY Pub Date : 2020-11-05 eCollection Date: 2020-01-01 DOI: 10.2147/LRA.S230728
Marco Cascella, Sabrina Bimonte, Raffaela Di Napoli

The emergence from anesthesia is the stage of general anesthesia featuring the patient's progression from the unconsciousness status to wakefulness and restoration of consciousness. This complex process has precise neurobiology which differs from that of induction. Despite the medications commonly used in anesthesia allow recovery in a few minutes, a delay in waking up from anesthesia, called delayed emergence, may occur. This phenomenon is associated with delays in the operating room, and an overall increase in costs. Together with the emergence delirium, the phenomenon represents a manifestation of inadequate emergence. Nevertheless, in delayed emergence, the transition from unconsciousness to complete wakefulness usually occurs along a normal trajectory, although slowed down. On the other hand, this awakening trajectory could proceed abnormally, possibly culminating in the manifestation of emergence delirium. Clinically, delayed emergence often represents a challenge for clinicians who must make an accurate diagnosis of the underlying cause to quickly establish appropriate therapy. This paper aimed at presenting an update on the phenomenon, analyzing its causes. Diagnostic and therapeutic strategies are addressed. Finally, therapeutic perspectives on the "active awakening" are reported.

麻醉苏醒期是全麻过程中患者从昏迷状态到清醒状态并恢复意识的阶段。这个复杂的过程具有与诱导不同的精确的神经生物学。尽管麻醉中常用的药物可以在几分钟内恢复,但可能会出现从麻醉中醒来的延迟,称为延迟苏醒。这种现象与手术室的延误和成本的总体增加有关。与涌现性谵妄一起,这种现象代表了涌现性不足的表现。然而,在延迟出现中,从无意识到完全清醒的过渡通常沿着正常的轨迹发生,尽管速度会减慢。另一方面,这种觉醒轨迹可能不正常地进行,可能以出现谵妄的表现达到高潮。临床上,延迟出现通常对临床医生来说是一个挑战,他们必须准确诊断潜在原因,以便迅速建立适当的治疗方法。本文旨在介绍这一现象的最新情况,并分析其原因。讨论了诊断和治疗策略。最后,对“主动觉醒”的治疗观点进行了报道。
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引用次数: 30
Timing of Transversus Abdominis Plane Block and Postoperative Pain Management. 腹横面阻滞时机与术后疼痛处理。
IF 2.9 Q3 ANESTHESIOLOGY Pub Date : 2020-11-03 eCollection Date: 2020-01-01 DOI: 10.2147/LRA.S278372
Maria Escudero-Fung, Erik B Lehman, Kunal Karamchandani

Background: Transversus abdominis plane (TAP) blocks using liposomal bupivacaine can reduce postoperative pain and opioid consumption after surgery. The impact of timing of administration of such blocks has not been determined.

Materials and methods: A retrospective cohort study of all adult patients that underwent colorectal procedures between January 2013 and October 2015 and received TAP blocks with liposomal bupivacaine at our institution was conducted. The primary outcomes were postoperative pain scores and opioid consumption. Secondary outcomes included postoperative use of non-opioid analgesics as well as total hospital cost of admission and postoperative hospital length of stay.

Results: A total of 287 patients were identified and included in the analysis. A total of 71 patients received blocks prior to induction of general anesthesia (pre-ind), 85 patients received blocks after induction of general anesthesia but prior to surgical incision (post-ind) and 131 patients received blocks after completion of surgery (post-op). No significant differences were observed in the postoperative pain scores (either in the first 4 hours or for the entire duration of hospital stay) or opioid consumption between the pre-ind and the post-ind groups. More ketorolac was used in the post-op group compared to the pre-ind group (or= 3.36, 95% CI (1.08, 10.43); p=0.03).

Conclusion: Our findings suggest that there seems to be no difference if tap blocks with liposomal bupivacaine are performed before or after induction of anesthesia. Patient preference as well as operating room efficiency should be considered when deciding on the timing of these blocks.

背景:使用布比卡因脂质体阻滞经腹平面(TAP)可以减少术后疼痛和阿片类药物的消耗。这类药物服用时间的影响尚未确定。材料与方法:对2013年1月至2015年10月在我院接受布比卡因脂质体TAP阻滞治疗的所有结直肠手术成年患者进行回顾性队列研究。主要结局是术后疼痛评分和阿片类药物消耗。次要结局包括术后非阿片类镇痛药的使用、住院总费用和术后住院时间。结果:共有287例患者被纳入分析。共有71例患者在全麻诱导前(pre-ind)接受阻滞,85例患者在全麻诱导后但在手术切口前(后ind)接受阻滞,131例患者在手术完成后(后op)接受阻滞。在术后疼痛评分(前4小时或整个住院期间)或阿片类药物消耗方面,ind前组和ind后组没有观察到显著差异。与术前相比,术后组使用更多的酮咯酸(or= 3.36, 95% CI (1.08, 10.43);p = 0.03)。结论:我们的研究结果表明,在麻醉诱导之前或之后使用布比卡因脂质体进行tap阻断似乎没有差异。在决定这些阻滞的时机时,应考虑患者的偏好以及手术室的效率。
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引用次数: 7
Burnout in Healthcare Workers: Prevalence, Impact and Preventative Strategies. 医护人员的职业倦怠:医护人员的职业倦怠:发生率、影响和预防策略。
IF 2.9 Q3 ANESTHESIOLOGY Pub Date : 2020-10-28 eCollection Date: 2020-01-01 DOI: 10.2147/LRA.S240564
Stefan De Hert

Approximately, one in three physicians is experiencing burnout at any given time. This may not only interfere with own wellbeing but also with the quality of delivered care. This narrative review discusses several aspects of the burnout syndrome: prevalence, symptoms, etiopathogenesis, diagnosis, impact, and strategies on how to deal with the problem.

大约每三名医生中就有一人在任何时候都会出现职业倦怠。这不仅会影响自身的健康,还会影响医疗服务的质量。这篇叙述性综述讨论了职业倦怠综合征的几个方面:流行率、症状、病因、诊断、影响以及应对策略。
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引用次数: 0
Interfascial Plane Blocks and Laparoscopic Abdominal Surgery: A Narrative Review. 筋膜间平面阻滞与腹腔镜腹部手术:叙述性回顾。
IF 2.9 Q3 ANESTHESIOLOGY Pub Date : 2020-10-23 eCollection Date: 2020-01-01 DOI: 10.2147/LRA.S272694
James Harvey Jones, Robin Aldwinckle

Laparoscopic abdominal surgery has become a mainstay of modern surgical practice. Postoperative analgesia is an integral component of recovery following laparoscopic abdominal surgery and may be improved by regional anesthesia or intravenous lidocaine infusion. There is inconsistent evidence supporting the use of interfascial plane blocks, such as transversus abdominis plane (TAP) blocks, for patients undergoing laparoscopic abdominal surgery as evidenced by variable patterns of local anesthetic spread and conflicting results from studies comparing TAP blocks to local anesthetic infiltration of laparoscopic port sites and multimodal analgesia. Quadratus lumborum (QL) and erector spinae plane (ESP) blocks may provide greater areas of somatic analgesia as well as visceral analgesia, which may translate to more significant clinical benefits. Aside from the locations of the surgical incisions, it is unclear what other factors should be considered when choosing one regional technique over another or deciding to infuse lidocaine intravenously. We reviewed the current literature in attempt to clarify the roles of various regional anesthesia techniques for patients undergoing laparoscopic abdominal surgery and present one possible approach to evaluating postoperative pain.

腹腔镜腹部手术已成为现代外科实践的支柱。术后镇痛是腹腔镜腹部手术后恢复的重要组成部分,可以通过区域麻醉或静脉输注利多卡因来改善。支持对腹腔镜腹部手术患者使用筋膜间面阻滞,如腹横面阻滞(TAP)的证据不一致,这可以从不同的局麻扩散模式和将TAP阻滞与腹腔镜端口部位局麻浸润和多模式镇痛进行比较的研究中得到矛盾的结果。腰方肌(QL)和竖脊肌平面(ESP)阻滞可能提供更大范围的躯体镇痛和内脏镇痛,这可能转化为更显著的临床益处。除了手术切口的位置外,在选择一种局部技术或决定静脉注射利多卡因时,还应考虑哪些其他因素尚不清楚。我们回顾了目前的文献,试图阐明各种区域麻醉技术在腹腔镜腹部手术患者中的作用,并提出了一种评估术后疼痛的可能方法。
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引用次数: 8
Benefits and Barriers to Increasing Regional Anesthesia in Resource-Limited Settings. 在资源有限的环境中增加区域麻醉的益处和障碍。
IF 1.5 Q3 ANESTHESIOLOGY Pub Date : 2020-10-22 eCollection Date: 2020-01-01 DOI: 10.2147/LRA.S236550
Lena Ebba Dohlman, Andrew Kwikiriza, Odinakachukwu Ehie

Safe and accessible surgical and anesthetic care is critically limited for over half of the world's population, particularly in Sub-Saharan African and Southeast Asian countries. Increasing the use of regional anesthesia in these areas has potential benefits regarding access, safety, and cost-effectiveness. Perioperative anesthesia-related mortality is significantly higher in resource-limited countries and every effort should be made to encourage the use of anesthetic techniques in these countries that are safest under the present conditions. Studies from Sub-Saharan Africa, although limited in number, have shown a lower risk of death with regional compared to general anesthesia. Regional anesthesia has the further benefit of decreasing the risk of COVID-19 spread to healthcare providers by avoiding the aerosol-generating procedures that occur during general anesthesia. Neuraxial regional anesthesia is relatively easy to teach and perform and is considered the anesthetic of choice for surgeries below the umbilicus in resource-limited settings due to its safety, efficacy, and low cost. Although regional anesthesia has multiple potential advantages, education and training of anesthetic providers in low-and-middle-income countries (LMIC) are a significant barrier to growth. Anesthesia professionals, especially in Sub-Saharan Africa, are often poorly supported and undervalued, and recruitment and retention of adequate numbers of trained practitioners are a continuing problem. Greater use of regional anesthesia could be one way to safely increase anesthesia access and simultaneously create value and enthusiasm for the field. Deficits in anesthesia infrastructure, equipment, and drugs also limit anesthesia capacity in low-and middle-income countries. Ultrasound-guided regional anesthesia may be helpful in improving access to safe and reliable anesthesia in low-resource countries as it continues to become more user-friendly, durable, and affordable.

对于世界上一半以上的人口,尤其是撒哈拉以南非洲和东南亚国家的人口来说,安全、可及的手术和麻醉护理非常有限。在这些地区增加区域麻醉的使用可能会在可及性、安全性和成本效益方面带来益处。在资源有限的国家,围术期麻醉相关死亡率明显较高,因此应尽一切努力鼓励这些国家使用在现有条件下最安全的麻醉技术。撒哈拉以南非洲地区的研究虽然数量有限,但显示区域麻醉的死亡风险低于全身麻醉。区域麻醉的另一个好处是避免了全身麻醉过程中产生气溶胶的程序,从而降低了医护人员感染 COVID-19 的风险。神经轴区域麻醉相对来说比较容易教授和实施,由于其安全性、有效性和低成本,在资源有限的环境中被认为是脐下手术的首选麻醉方式。尽管区域麻醉具有多种潜在优势,但在中低收入国家(LMIC),麻醉提供者的教育和培训是发展的一大障碍。麻醉专业人员,尤其是撒哈拉以南非洲地区的麻醉专业人员,往往得不到良好的支持,其价值也被低估,招聘和留住足够数量的训练有素的从业人员一直是个问题。更多地使用区域麻醉可能是安全地增加麻醉普及率并同时为该领域创造价值和热情的一种方法。麻醉基础设施、设备和药物的不足也限制了中低收入国家的麻醉能力。随着超声引导区域麻醉越来越方便、耐用和经济,它可能有助于提高低收入国家获得安全可靠麻醉的机会。
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引用次数: 0
Enlarged Brachial Plexus Nerve Found During Ultrasound-Guided Peripheral Nerve Block Diagnosed as Charcot-Marie-Tooth Disease: A Case Report. 超声引导周围神经阻滞时发现臂丛神经肿大诊断为腓骨肌病1例。
IF 2.9 Q3 ANESTHESIOLOGY Pub Date : 2020-10-19 eCollection Date: 2020-01-01 DOI: 10.2147/LRA.S270189
Toshie Shiraishi, Kentaro Masumoto, Mitsuyo Nakamura, Gumi Hidano

Ultrasound-guided peripheral nerve block (PNB) has become a popular anesthetic procedure. We report a case of an enlarged brachial plexus nerve noted on ultrasonographic images, as part of PNB, which was diagnosed postoperatively as Charcot-Marie-Tooth disease (CMTD), an inherited neurological disorder of the peripheral nerves. Although nerve enlargement is characteristic of demyelinating diseases such as CMTD, the use of ultrasonography in the diagnosis of neurological disorders is a developing area for neurologists and anesthesiologists can lack knowledge in this emerging field. Unusual nerve presentation on ultrasonographic images during PNB anesthetic procedures should be recognized as being indicative of underlying neurologic disorders. This case highlights that increased awareness of the diagnosis of underlying neurologic disorders by ultrasonography would assist the general practice of PNB in anesthetic medicine. This is especially important as underlying neurological conditions can have important consequences for patient-appropriate anesthesia and may inform best anesthetic practice. A new category, "neurological disorder on ultrasound image", should be introduced to PNB knowledge in anesthetic field.

超声引导周围神经阻滞(PNB)已成为一种流行的麻醉方法。我们报告一例在超声图像上发现扩张的臂丛神经,作为PNB的一部分,术后诊断为Charcot-Marie-Tooth病(CMTD),一种周围神经的遗传性神经疾病。尽管神经肿大是脱髓鞘疾病(如CMTD)的特征,但超声检查在神经系统疾病诊断中的应用对神经科医生和麻醉科医生来说是一个发展中的领域,在这个新兴领域可能缺乏知识。在PNB麻醉过程中,超声图像上异常的神经表现应被认为是潜在神经系统疾病的指示。本病例强调,提高对超声诊断潜在神经系统疾病的认识将有助于麻醉医学中PNB的一般实践。这一点尤其重要,因为潜在的神经系统疾病可能对适合患者的麻醉产生重要影响,并可能为最佳麻醉实践提供信息。麻醉领域的PNB知识应引入“超声影像神经性障碍”这一新的范畴。
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引用次数: 0
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