经皮胃造瘘术中椎旁阻滞用于肌萎缩侧索硬化症。
Paravertebral block for radiologically inserted gastrostomy tube placement in amyotrophic lateral sclerosis.
机构信息
Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Jacksonville, Florida, United States.
Division of Vascular/Interventional Radiology, Mayo Clinic, Jacksonville, Florida, United States.
出版信息
Muscle Nerve. 2020 Jul;62(1):70-75. doi: 10.1002/mus.26894. Epub 2020 Apr 28.
INTRODUCTION
Radiologically inserted gastrostomy (RIG) placement in patients with amyotrophic lateral sclerosis (ALS) carries risks related to periprocedural sedation and analgesia. To minimize these risks, we used a paravertebral block (PVB) technique for RIG placement.
METHODS
We retrospectively reviewed patients with ALS undergoing RIG placement under PVB between 2013 and 2017.
RESULTS
Ninety-nine patients with ALS underwent RIG placement under PVB. Median (range) age was 66 (28 to 86) years, ALS Functional Rating Scale-Revised score was 27 (6 to 45), and forced vital capacity was 47% (8%-79%) at time of RIG placement. Eighty-five (85.9%) patients underwent RIG placement as outpatients, with a mean postanesthesia care unit stay of 2.3 hours. The readmission rate was 4% at both 1 and 30 days postprocedure.
DISCUSSION
PVB for RIG placement has a low rate of adverse events and provides effective periprocedural analgesia in patients with ALS, the majority of whom can be treated as outpatients.
简介
肌萎缩侧索硬化症（ALS）患者行放射引导下胃造口术（RIG）时，围手术期镇静和镇痛相关风险较大。为了降低这些风险，我们采用了椎旁阻滞（PVB）技术来进行 RIG 置管。
方法
我们回顾性分析了 2013 年至 2017 年间行 PVB 下 RIG 置管的 ALS 患者。
结果
99 例 ALS 患者行 PVB 下 RIG 置管。中位（范围）年龄为 66（28 至 86）岁，改良 ALS 功能评定量表评分为 27（6 至 45），RIG 置管时用力肺活量为 47%（8%至 79%）。85（85.9%）例患者为门诊 RIG 置管，麻醉后恢复室停留时间平均为 2.3 小时。术后 1 天和 30 天的再入院率均为 4%。
讨论
PVB 用于 RIG 置管的不良事件发生率较低，可为 ALS 患者提供有效的围手术期镇痛，其中大多数患者可作为门诊患者进行治疗。
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