Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Jacksonville, Florida, United States.
Division of Vascular/Interventional Radiology, Mayo Clinic, Jacksonville, Florida, United States.
Muscle Nerve. 2020 Jul;62(1):70-75. doi: 10.1002/mus.26894. Epub 2020 Apr 28.
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.
We retrospectively reviewed patients with ALS undergoing RIG placement under PVB between 2013 and 2017.
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.
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.
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。
我们回顾性分析了 2013 年至 2017 年间行 PVB 下 RIG 置管的 ALS 患者。
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%。
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。
