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腕部血肿阻滞治疗桡骨远端移位骨折引发全身神经系统症状：一例报告

A Hematoma Block in the Wrist for a Displaced Distal Radius Fracture Induces Systemic Neurological Symptoms: A Case Report.

作者信息

Burch Christopher S, Stevens Christopher G

机构信息

Orthopaedic Surgery, Tucson Orthopaedic Institute, Tucson, USA.

Hand/Upper Extremity Division, Tucson Orthopaedic Institute, Tucson, USA.

出版信息

Cureus. 2023 Aug 3;15(8):e42921. doi: 10.7759/cureus.42921. eCollection 2023 Aug.

DOI:10.7759/cureus.42921
PMID:37664356
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10474967/
Abstract

Hematoma blocks are considered a relatively simple, safe, and effective technique in the acute setting to provide sufficient anesthesia and allow for closed reduction of displaced distal radius fractures. Complications associated with the utilization of local anesthetics in this setting are rare. We present the case of a patient who had a hematoma block in the wrist and developed short-term systemic neurologic complications likely secondary to systemic absorption of 20 mL of 1% lidocaine without epinephrine via the cancellous bone channels.

摘要

在急性情况下，血肿阻滞被认为是一种相对简单、安全且有效的技术，可提供足够的麻醉并允许对移位的桡骨远端骨折进行闭合复位。在这种情况下使用局部麻醉剂相关的并发症很少见。我们报告了一例患者，该患者在腕部进行了血肿阻滞，并出现了短期全身性神经并发症，可能是由于20毫升不含肾上腺素的1%利多卡因通过松质骨通道发生全身吸收所致。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f0cf/10474967/8c523581945d/cureus-0015-00000042921-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f0cf/10474967/502096e0a8d4/cureus-0015-00000042921-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f0cf/10474967/8c523581945d/cureus-0015-00000042921-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f0cf/10474967/502096e0a8d4/cureus-0015-00000042921-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f0cf/10474967/8c523581945d/cureus-0015-00000042921-i02.jpg

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本文引用的文献

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Epidemiology of distal radius fractures: a detailed survey on a large sample of patients in a suburban area.桡骨远端骨折的流行病学：对郊区大样本患者的详细调查。
J Orthop Traumatol. 2022 Aug 30;23(1):43. doi: 10.1186/s10195-022-00663-6.
2
Perioperative costs of local or regional anesthesia versus general anesthesia in the outpatient setting: a systematic review of recent literature.门诊环境中局部或区域麻醉与全身麻醉的围手术期成本：近期文献的系统评价
Braz J Anesthesiol. 2023 May-Jun;73(3):316-339. doi: 10.1016/j.bjane.2021.09.012. Epub 2021 Oct 7.
3
A review of the mechanism of the central analgesic effect of lidocaine.
利多卡因中枢镇痛作用机制综述。
Medicine (Baltimore). 2020 Apr;99(17):e19898. doi: 10.1097/MD.0000000000019898.
4
Lidocaine turns the surface charge of biological membranes more positive and changes the permeability of blood-brain barrier culture models.利多卡因使生物膜的表面电荷更带正电，并改变血脑屏障培养模型的通透性。
Biochim Biophys Acta Biomembr. 2019 Sep 1;1861(9):1579-1591. doi: 10.1016/j.bbamem.2019.07.008. Epub 2019 Jul 10.
5
Intravenous Lidocaine for Acute Pain: A Systematic Review.静脉注射利多卡因治疗急性疼痛：系统评价。
Pharmacotherapy. 2018 Dec;38(12):1250-1259. doi: 10.1002/phar.2189. Epub 2018 Nov 9.
6
Lipid Emulsion for Treating Local Anesthetic Systemic Toxicity.脂肪乳剂治疗局部麻醉药全身毒性。
Int J Med Sci. 2018 May 14;15(7):713-722. doi: 10.7150/ijms.22643. eCollection 2018.
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Local anesthetic toxicity: acute and chronic management.局部麻醉药毒性：急性和慢性处理
Acute Med Surg. 2017 Mar 6;4(2):152-160. doi: 10.1002/ams2.265. eCollection 2017 Apr.
9
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