连续外周阻滞作为7岁儿童疼痛治疗和物理治疗的一例报告

Prilozi Pub Date : 2022-03-01 DOI:10.2478/prilozi-2022-0011
L. Mikjunovikj-Derebanova, L. Donev, L. Todorović, Vesna Cvetanovska-Naunov, V. Demjanski, Natalija Cokleska-Shuntov, V. Ognjanova
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引用次数: 0

摘要

连续周围神经阻滞,也称为“局部麻醉神经周围输注”,是指在周围神经或神经丛附近经皮放置导管,然后通过导管给予局部麻醉剂,以提供麻醉或镇痛数天,在某些情况下甚至一个月。本报告描述了一例7岁男童左肘挛缩,屈伸受限,在儿科外科诊所接受肘关节矫治和物理治疗。超声引导下进行腋窝臂丛阻滞,放置非隧道式神经周围导管。左肘关节复位两次,每次复位前均通过神经周围导管给予局麻药。物理治疗无痛,持续神经周围输注。置管第5天拔除神经周导管,无血肿、感染、导管脱位、局麻药漏出等并发症。我们的目标是尽量减少病人的心理和生理创伤,不管病人有多不成熟。儿童持续区域麻醉是一种安全的术后疼痛管理技术,由于其充分的镇痛和更好的舒适性,有助于早期活动。它可以提供家庭治疗,为患者和家长提供充分的教育,并改善儿童的康复。
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Continuous Peripheral Block as a Pain Treatment for Redressment and Physical Therapy in a 7-Year-Old Child – A Case Report
Abstract Continuous peripheral nerve block, also known as “local anesthetic perineural infusion,” refers to percutaneous placement of a catheter near a peripheral nerve or plexus followed by administration of a local anesthetic through a catheter to provide anesthesia, or analgesia for several days, in some cases even for a month. This report describes the case of a 7 year old boy with left elbow contracture with limited flexion and extension who was admitted to the Clinic of Pediatric Surgery for redressment of the elbow and physical therapy. An ultrasound-guided axillary brachial plexus block was performed, with placement of a non-tunneled perineural catheter. Redressment of the left elbow was performed twice and before each redressment boluses of local anesthetic were applied through the perineural catheter. Physical therapy was performed painlessly with continuous perineural infusion. On the 5th day of catheter placement, the perineural catheter was removed without any prior complications such as hematoma, infection, catheter dislocation or leakage of local anesthetic. Our goal is to minimize the psychological and physical trauma to the patient, no matter how immature the patient is. Continuous regional anesthesia in children is a safe technique in postoperative pain management that facilitates early mobilization due to its sufficient analgesia and better comfort. It can provide in-home treatment, with adequate education for patients and parents, and improve rehabilitation in children.
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