From the Department of Anesthesia, University of Iowa Hospitals and Clinics, Iowa City, Iowa.
Department of Anesthesia and Pain Medicine, University of Alberta, Edmonton, Alberta, Canada.
A A Pract. 2021 Jun 8;15(6):e01487. doi: 10.1213/XAA.0000000000001487.
Pain following amputation is often poorly controlled despite the use of nerve blocks. We describe a novel pain management approach in a 56-year-old woman with episodes of poorly controlled pain following below-knee amputation despite a multimodal analgesic regimen with continuous sciatic nerve block. Effective analgesia was observed during those episodes when the nerve block catheter was briefly stimulated at low frequency using a nerve stimulator designed for regional anesthesia procedural guidance. This case report explains the utilization and rationale of this hybrid technique of combined peripheral nerve stimulation and locoregional analgesia via perineural nerve block catheters to augment analgesia.
尽管采用了神经阻滞，截肢后的疼痛仍常常难以控制。我们描述了一种新的疼痛管理方法，该方法应用于一位 56 岁女性，其在接受多模式镇痛方案（包括持续坐骨神经阻滞）后仍出现膝关节以下截肢后的疼痛，且控制不佳。当使用专为区域麻醉程序指导设计的神经刺激器以低频刺激神经阻滞导管时，在这些发作期间观察到了有效的镇痛效果。本病例报告解释了这种通过外周神经刺激和局部神经阻滞导管联合应用的混合技术（混合外周神经刺激和局部神经阻滞）的使用和原理，以增强镇痛效果。
