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[在疼痛治疗中采用三合一阻滞导管技术连续阻滞腰丛神经]

[Continuous block of the lumbar plexus with the 3-in-1-block catheter technic in pain therapy].

作者信息

Nessler R, Schwippel U

机构信息

Zentrale Anaesthesieabteilung, Städtischen Krankenanstalten Salzgitter.

出版信息

Reg Anaesth. 1988 Apr;11(2):54-7.

PMID:3406468
Abstract

The evaluation of the test protocols on continuous lumbar plexus blockade using the 3-in-1 block with a lumbar plexus catheter showed the following results: The study included 104 patients. In 91.3% of cases, puncture of the fascial sheath of the femoral nerve proved successful. In 95.7% of cases, the plexus catheter could be positioned and left in place (Table 1). Four catheters had to be removed due to intravascular misplacement. Good analgesic results were achieved in 85.7% of patients. In 14.3% of cases, the judgement of pain reduction could not be sufficiently or definitely ascertained (Table 1). From the third day on we started with the injection of 0.25% bupivacaine. The administration of this local anesthetic achieved satisfactory results in terms of facilitating the necessary mobilization procedures. With regard to the individual indication groups, the efficacy differed according to the respective supply area. The most impressive analgestic results (100%) were observed in all the patients who underwent femoral amputation or suffered from pelvic pain. A good outcome could be ascertained after surgical procedures on the knee (87.5%), and satisfactory results were achieved in the femur and hip areas (70.9%). The average indwelling time of the catheter was 6 days, the maximum amounted to 44 days. All catheters could be left in place without complications until the end of therapy. Changing the catheter is possible at any time, as is the replacement of the catheter hub. Such steps were carried out in 5 cases.

摘要

使用腰丛导管进行三合一阻滞对连续腰丛阻滞测试方案的评估结果如下

该研究纳入了104例患者。在91.3%的病例中,股神经筋膜鞘穿刺成功。在95.7%的病例中,腰丛导管能够定位并留置(表1)。4根导管因血管内误置而不得不拔除。85.7%的患者获得了良好的镇痛效果。在14.3%的病例中,疼痛减轻的判断无法充分或明确确定(表1)。从第三天开始,我们开始注射0.25%的布比卡因。这种局部麻醉剂的给药在促进必要的活动程序方面取得了令人满意的效果。关于各个适应证组,疗效根据各自的供应区域而有所不同。在所有接受股截肢或患有盆腔疼痛的患者中观察到了最显著的镇痛效果(100%)。膝关节手术后可确定有良好的结果(87.5%),在股骨和髋部区域取得了满意的效果(70.9%)。导管的平均留置时间为6天,最长为44天。所有导管在治疗结束前均可留置且无并发症。导管可随时更换,导管接头也可更换。5例进行了此类操作。

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