用于踝关节手术的“高位踝关节阻滞”
"High ankle block" for surgery at the ankle joint.
作者信息
Hofmann-Kiefer Klaus F, Gaube Federico, Groene Philipp, Böcker Wolfgang, Polzer Hans, Baumbach Sebastian F
机构信息
Clinic of Anesthesiology, Intensive Care and Pain Medicine, University Hospital of Munich, Ludwig Maximilians University of Munich, Germany.
Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), University Hospital, LMU Munich, Germany.
出版信息
Foot Ankle Surg. 2022 Dec;28(8):1254-1258. doi: 10.1016/j.fas.2022.05.006. Epub 2022 May 26.
BACKGROUND
Surgery around the ankle is increasingly embedded in outpatient treatment concepts. Unfortunately, the classic "ankle block" as a concept of regional anesthesia is inappropriate for surgery around the ankle because the injection sites are too distal to block this specific region.
METHODS
The "high ankle block" avoids this disadvantage by dislocating the injection points 15 cm proximal to the malleoli. Three of five peripheral nerves necessary to perform the block can be reached by a circumferential subcutaneous wall. The Posterior Tibial Nerve and the Deep Peroneal Nerve are addressed by an ultrasound guided approach.
RESULTS
The efficacy of the technique is highlighted by a case series (3 cases) in which the new blockade was used as a stand-alone procedure, i.e. without additional general anesthesia.
CONCLUSIONS
The "high ankle block" may serve as an ultrasound guided expansion to the classic techniques, extending the operative spectrum to the ankle region.
背景
踝关节周围手术越来越多地纳入门诊治疗方案。遗憾的是，经典的“踝关节阻滞”作为一种区域麻醉方法并不适用于踝关节周围手术，因为注射部位过于靠下，无法阻滞该特定区域。
方法
“高位踝关节阻滞”通过将注射点置于内、外踝近端15厘米处避免了这一缺点。实施该阻滞所需的五条周围神经中有三条可通过环形皮下路径触及。胫后神经和腓深神经通过超声引导的方法进行阻滞。
结果
一个病例系列（3例）突出了该技术的有效性，其中新的阻滞方法作为独立操作使用，即无需额外的全身麻醉。
结论
“高位踝关节阻滞”可作为经典技术的超声引导扩展，将手术范围扩展至踝关节区域。
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