实时超声提高小儿骶管阻滞的准确性。
Real-Time Ultrasound Improves Accuracy of Caudal Block in Children.
机构信息
From the Department of Anesthesiology, Perioperative and Pain Medicine, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas.
Dan L. Duncan Institute for Clinical and Translation Research, Baylor College of Medicine, Houston, Texas.
出版信息
Anesth Analg. 2020 Apr;130(4):1002-1007. doi: 10.1213/ANE.0000000000004067.
BACKGROUND
Caudal block, the most common regional anesthetic in children, is predominantly performed using palpation to determine placement. The efficacy of the palpation technique is unknown with respect to block success. While ultrasound has been suggested for use during caudal block, its use is infrequent.
METHODS
A single-blinded prospective observational trial was performed evaluating provider success rate of caudal blocks placed by palpation alone. After needle insertion and partial local anesthetic injection, an ultrasound was performed to confirm correct location.
RESULTS
A total of 109 caudal blocks were performed during the prospective observational study. Success rate for caudal blocks done by palpation alone was 78.9% as confirmed by ultrasound. In 21.1% of caudal blocks, the provider incorrectly judged the needle to be in the caudal space as confirmed with ultrasound.
CONCLUSIONS
Real-time ultrasound visualization of local anesthetic injection provides reliable and immediate confirmation during caudal block in children.
背景
骶管阻滞是儿童最常用的区域麻醉方法，主要通过触诊来确定阻滞位置。但触诊技术在阻滞成功方面的效果尚不清楚。虽然超声已被建议用于骶管阻滞，但实际应用并不常见。
方法
进行了一项单盲前瞻性观察性试验，评估了仅通过触诊进行骶管阻滞的提供者成功率。在针插入和局部麻醉剂的部分注射后，进行超声检查以确认正确的位置。
结果
在前瞻性观察研究中，共进行了 109 例骶管阻滞。超声确认，触诊单独进行的骶管阻滞成功率为 78.9%。在 21.1%的骶管阻滞中，提供者错误地判断针头在骶管空间，而超声检查证实了这一点。
结论
实时超声可视化局部麻醉剂注射为儿童骶管阻滞提供了可靠和即时的确认。
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