From the Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine; Stanford, California.
A A Pract. 2022 Aug 12;16(8):e01614. doi: 10.1213/XAA.0000000000001614. eCollection 2022 Aug 1.
Rib fractures carry high morbidity and mortality due to pain-related complications, such as hypoventilation, atelectasis, and pneumonia. Ultrasound-guided regional anesthesia is a common treatment for pain associated with rib fractures. But, due to a variety of reasons, ultrasound images can be ambiguous or unhelpful. In these instances, it is advantageous to have a tactile or landmark-based approach to treating rib fracture pain. We present a case of a continuous retrolaminar nerve block catheter placed without ultrasound guidance in a 67-year-old man with oxygen-dependent chronic obstructive pulmonary disease and a prior intrathecal pump, who presents with multiple unilateral rib fractures.
肋骨骨折可引起疼痛相关并发症，如低通气、肺不张和肺炎，导致发病率和死亡率较高。超声引导下区域麻醉是治疗肋骨骨折相关疼痛的常用方法。但是，由于各种原因，超声图像可能会不清晰或无帮助。在这些情况下，采用触诊或基于体表标志的方法治疗肋骨骨折疼痛具有优势。我们报告了一例氧依赖慢性阻塞性肺疾病且有鞘内泵植入史的 67 岁男性患者，他因多发性单侧肋骨骨折，在无超声引导下成功置入连续椎旁神经阻滞导管。
