Fink Gerry E
Frances Mahon Deaconess Hospital, Glasgow, Montana, USA.
AANA J. 2009 Aug;77(4):265-9.
Certified Registered Nurse Anesthetists (CRNAs) perform epidural steroid injections for chronic back and extremity pain. Placing epidural needles using fluoroscopy and confirming the needle placement by epidurogram has been suggested as a means to increase the efficacy of epidural injections while decreasing complications. Because of the risk of radiation injury to patients and staff when using fluoroscopy, the purpose of this article is to review the concepts of fluoroscopy and radiation safety for CRNAs. Following a literature search using keywords such as fluoroscopy, radiation injury, and radiation safety, relevant articles were identified. In addition, the reference lists of these articles were reviewed to identify other pertinent sources regarding this topic. The risks of stochastic and deterministic effects from radiation exposure necessitate the need for practitioners who are knowledgeable in equipment, patient, and procedure related factors that influence radiation exposure. Practitioner conduct, using the as-low-as-reasonably achievable (ALARA) principle, results in choices regarding these factors that minimize the time and intensity of radiation exposure to patients, anesthesia providers, and staff.
注册护士麻醉师(CRNAs)为慢性背痛和肢体疼痛患者进行硬膜外类固醇注射。有人建议使用荧光透视法放置硬膜外针,并通过硬膜外造影确认针的位置,以此提高硬膜外注射的疗效,同时减少并发症。由于使用荧光透视法时患者和工作人员有受到辐射损伤的风险,本文旨在综述注册护士麻醉师荧光透视法及辐射安全的相关概念。通过使用荧光透视法、辐射损伤和辐射安全等关键词进行文献检索,确定了相关文章。此外,还查阅了这些文章的参考文献列表,以确定有关该主题的其他相关资料来源。辐射暴露产生随机效应和确定性效应的风险,使得从业者必须了解影响辐射暴露的设备、患者和程序相关因素。从业者遵循“尽可能合理达到最低水平”(ALARA)原则行事,会对这些因素做出选择,从而将患者、麻醉提供者和工作人员所受辐射暴露的时间和强度降至最低。