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急诊科采用桡神经髁上阻滞治疗桡骨远端骨折

Supracondylar radial nerve block for treatment of distal radius fractures in the emergency department.

作者信息

Frenkel Oron, Herring Andrew A, Fischer Jason, Carnell Jennifer, Nagdev Arun

机构信息

Department of Emergency Medicine, Highland General Hospital/Alameda County Medical Center, Oakland, California 94602-1018, USA.

出版信息

J Emerg Med. 2011 Oct;41(4):386-8. doi: 10.1016/j.jemermed.2010.11.043. Epub 2011 Feb 5.

Abstract

BACKGROUND

Patients with acute distal radius fractures are frequently treated in the emergency department (ED) with closed reduction and splinting. Many of the anesthesia methods frequently employed may either lack efficacy or require additional monitoring and resources.

CASE REPORT

An 18-year-old woman presented to the ED with a dorsally angulated distal radius fracture (Colles fracture). As an alternative to procedural sedation, an ultrasound-guided block of the radial nerve proximal to its bifurcation into the deep and superficial branches was performed. The resulting anesthesia was adequate to reduce and splint the fracture with minimal discomfort for the patient.

CONCLUSION

Ultrasound-guided supracondylar block of the radial nerve proximal to the origin of the deep and superficial branches provides safe and efficacious anesthesia for distal radius fracture reduction in the ED.

摘要

背景

急性桡骨远端骨折患者常在急诊科接受闭合复位和夹板固定治疗。许多常用的麻醉方法可能效果不佳,或需要额外的监测及资源。

病例报告

一名18岁女性因桡骨远端背侧成角骨折(科雷氏骨折)就诊于急诊科。作为程序性镇静的替代方法,在桡神经分叉为深浅两支的近端进行了超声引导下阻滞。由此产生的麻醉效果足以进行骨折复位和夹板固定,且患者不适感最小。

结论

在桡神经深浅两支起始近端进行超声引导下的髁上阻滞,可为急诊科桡骨远端骨折复位提供安全有效的麻醉。

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