Blaivas Michael, Lyon Matthew
Section of Emergency Ultrasound, Department of Emergency Medicine, Medical College of Georgia, Augusta, Georgia, GA 30912-4007, USA.
Am J Emerg Med. 2006 May;24(3):293-6. doi: 10.1016/j.ajem.2005.10.004.
Shoulder dislocations are often associated with significant pain, and many emergency physicians choose conscious sedation to achieve reduction. Concerns about oxygenation, airway protection, and aspiration may make some patients poor candidates for conscious sedation. Ideally, complete pain control and muscle relaxation could be achieved without airway compromise. Interscalene nerve blocks are routinely used for shoulder surgery in the operating suite. The equipment required to locate the nerve plexus blindly is typically not available in the ED setting. Recent work has shown that ultrasound guidance is ideal for the interscalene block and would make it possible in the ED. We present 4 cases of patients receiving ultrasound-guided interscalene blocks for pain control and muscle relaxation during shoulder reduction. Complete pain control, muscle relaxation, and joint reduction were achieved in each case.
肩关节脱位常伴有剧痛，许多急诊医生选择清醒镇静来完成复位。对氧合、气道保护和误吸的担忧可能使一些患者不适合清醒镇静。理想情况下，在不影响气道的前提下可实现完全的疼痛控制和肌肉松弛。肌间沟神经阻滞常用于手术室的肩部手术。急诊环境中通常没有盲目定位神经丛所需的设备。最近的研究表明，超声引导对于肌间沟阻滞是理想的，并且能使其在急诊中得以应用。我们报告4例患者在肩关节复位过程中接受超声引导下肌间沟阻滞以控制疼痛和肌肉松弛。每例均实现了完全的疼痛控制、肌肉松弛和关节复位。
