老年患者超声引导下腰丛神经阻滞的复杂性：一项回顾性病例系列研究
Intricacies of Ultrasound-guided Lumbar Plexus Block in Octogenarians: A Retrospective Case Series.
作者信息
Diwan Sandeep, Nair Abhijit, Dadke Madhuri, Sancheti Parag
机构信息
Department of Anaesthesiology, Sancheti Hospital, Pune, Maharashtra, India.
Department of Anaesthesiology, Ibra Hospital, Ministry of Health, Ibra, Sultanate of Oman.
出版信息
J Med Ultrasound. 2021 Jul 2;30(1):26-29. doi: 10.4103/JMU.JMU_174_20. eCollection 2022 Jan-Mar.
BACKGROUND
Ultrasound (US)-guided lumbar plexus block (LPB) could be technically challenging in elderly patients. The lumbar paravertebral sonoanatomy is undescribed in the elderly. In an attempt to understand the relevant sonoanatomy, identify the lumbar plexus elements, and understand the difficulties that encountered while performing LPB in elderly patients, we retrospectively analyzed US of 23 elderly patients who were administered US-guided LPBs.
METHODS
After institutional ethics committee approval, we retrospectively reviewed stored US images of lumbar paravertebral sonoanatomy in 23 elderly patients and analyzed psoas major muscle, lumbar vertebral body, lumbar nerve, and lumbar artery.
RESULTS
On US examination, features of psoas major muscle, lumbar vertebral body, lumbar nerve, and lumbar artery were noted and analyzed.
CONCLUSION
US-guided visualization of the components of the lumbar paravertebral area is difficult and inconsistent in the elderly. Therefore, we suggest performing a scout scan, identify the structures, and use neurostimulation all the time for performing LPB in these patients.
背景
超声（US）引导下的腰丛阻滞（LPB）在老年患者中技术上可能具有挑战性。老年患者的腰椎旁超声解剖结构尚未见描述。为了了解相关的超声解剖结构，识别腰丛各组成部分，并了解在老年患者中进行LPB时遇到的困难，我们回顾性分析了23例行超声引导下LPB的老年患者的超声检查情况。
方法
经机构伦理委员会批准后，我们回顾性审查了23例老年患者腰椎旁超声解剖结构的存储超声图像，并分析了腰大肌、腰椎椎体、腰神经和腰动脉。
结果
在超声检查中，记录并分析了腰大肌、腰椎椎体、腰神经和腰动脉的特征。
结论
在老年患者中，超声引导下可视化腰椎旁区域的各组成部分困难且不一致。因此，我们建议在这些患者中进行LPB时始终进行预扫描、识别结构并使用神经刺激。
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