Brewer Jonathan Henry, Sanders Noah, Ayala Alexander, Nagdev Arun
Vanderbilt University Medical Center, Department of Emergency Medicine, Division of Emergency Ultrasound, Nashville, Tennessee.
Highland Hospital, Department of Emergency Medicine, Oakland, California.
Clin Pract Cases Emerg Med. 2023 May;7(2):60-63. doi: 10.5811/cpcem.1408.
Regional anesthesia has long been used in a perioperative setting for the treatment of both pre- and postoperative pain. Recently, this skill has been brought into the emergency department (ED) as a modality for treating acute pain as the pendulum shifts away from an opioid-based armamentarium and toward a multimodal future. In this case series, we describe a way to use the pectoralis nerve block I and II in the treatment of pain with regard to breast abscesses and/or breast cellulitis managed in the ED.
This paper describes three cases, all of which consist of a painful complaint in the thoracic region. The first was a patient diagnosed with a breast abscess. The second patient was diagnosed with breast cellulitis. Finally, the third patient was diagnosed with a large breast abscess that extended into the axilla. All three sustained immense relief with the pectoralis block.
While further research is needed on a larger scale, preliminary data suggests that the ultrasound-guided pectoralis nerve block is an effective and safe modality of acute pain control in regard to breast and axillary abscesses along with breast cellulitis.
区域麻醉长期以来一直用于围手术期,以治疗术前和术后疼痛。最近,随着治疗手段从以阿片类药物为主转向多模式的未来,这项技术已被引入急诊科(ED)作为治疗急性疼痛的一种方式。在本病例系列中,我们描述了一种在急诊科治疗乳腺脓肿和/或乳腺蜂窝织炎时使用胸肌神经阻滞I和II治疗疼痛的方法。
本文描述了三例病例,所有病例均有胸部疼痛主诉。第一例是一名被诊断为乳腺脓肿的患者。第二例患者被诊断为乳腺蜂窝织炎。最后,第三例患者被诊断为一个延伸至腋窝的大乳腺脓肿。所有三例患者在进行胸肌阻滞治疗后疼痛均得到极大缓解。
虽然需要进行更大规模的进一步研究,但初步数据表明,超声引导下的胸肌神经阻滞对于乳腺和腋窝脓肿以及乳腺蜂窝织炎而言,是一种有效且安全的急性疼痛控制方式。