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化学神经松解术治疗髋部骨折的保守治疗。

Chemical neurolysis for the conservative treatment of hip fractures.

机构信息

Department of Anesthesiology, Unidade Local de Saúde de Santa Maria, Lisboa 1649-028, Portugal.

Department of Orthopedics, Unidade Local de Saúde de Santa Maria, Lisboa 1649-028, Portugal.

出版信息

Pain Manag. 2024 Jun 2;14(5-6):259-264. doi: 10.1080/17581869.2024.2368453. Epub 2024 Jun 28.

Abstract

Hip fracture management is challenging when surgical risks outweigh benefits. Inadequate analgesia from conservative treatments prompted new procedures targeting hip capsule denervation. This study evaluates the efficacy and safety of single injection chemical hip neurolysis in the pericapsular nerve group plane. In eligible patients, an ultrasound-guided diagnostic block was performed using 5 ml of 2% lidocaine in the pericapsular nerve group plane. If positive, 6 ml of 99.9% alcohol was administered. From May 2022 to May 2023, five patients underwent hip neurolysis. None reported pain at day 5 or during follow-up. There were no adverse effects. Chemical neurolysis seems to provide effective and safe conservative treatment for hip fractures, offering reliable analgesia for nonsurgical candidates.

摘要

当手术风险大于收益时,髋部骨折的管理极具挑战性。由于保守治疗的镇痛效果不足,新的手术方法开始针对髋关节囊去神经支配。本研究评估了超声引导下在髋关节囊神经群平面单次注射化学性髋关节神经松解术的疗效和安全性。对于符合条件的患者,在髋关节囊神经群平面进行超声引导下诊断性阻滞,使用 5 毫升 2%利多卡因。如果阻滞阳性,给予 6 毫升 99.9%酒精。2022 年 5 月至 2023 年 5 月,5 例患者接受了髋关节神经松解术。术后 5 天或随访期间均无疼痛报告。无不良反应。化学性神经松解术似乎为髋部骨折提供了一种有效且安全的保守治疗方法,为非手术患者提供了可靠的镇痛效果。

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本文引用的文献

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Neurolysis: A Brief Review for a Fading Art.神经松解术:对一门渐趋式微技艺的简要回顾
Phys Med Rehabil Clin N Am. 2018 Aug;29(3):519-527. doi: 10.1016/j.pmr.2018.03.005. Epub 2018 Jun 4.
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Pericapsular Nerve Group (PENG) Block for Hip Fracture.髋关节骨折的囊周神经群(PENG)阻滞。
Reg Anesth Pain Med. 2018 Nov;43(8):859-863. doi: 10.1097/AAP.0000000000000847.

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