Frowde K, Naeem S, Alzarrad A, Abdel-Aziz D, Schofield O W
Department of Anaesthetics, William Harvey Hospital East Kent University Hospitals Foundation Trust Ashford UK.
Department of Emergency Medicine, William Harvey Hospital East Kent University Hospitals Foundation Trust Ashford UK.
Anaesth Rep. 2024 Aug 31;12(2):e12322. doi: 10.1002/anr3.12322. eCollection 2024 Jul-Dec.
Sternal fractures are associated with significant morbidity and mortality, with some patients requiring admission for pain management, often through systemic analgesia, which may be ineffective. Regional anaesthetic techniques are more challenging for sternal fractures than rib fractures and require experienced clinicians. Local anaesthetic techniques are becoming recognised as a modality to improve pain control and to reduce complications from opioid use, especially in the elderly. We delivered local anaesthetic via a sternal haematoma infusion catheter for an elderly patient with uncontrolled pain despite the provision of intravenous patient-controlled analgesia. This technique enabled an improvement in pain scores, better engagement with physiotherapy and reduced opioid use. Local anaesthesia has been used previously to manage pain after coronary artery bypass graft surgery. Our experience demonstrated the safety, efficacy and tolerability of this approach to analgesia in sternal fractures.
胸骨骨折与显著的发病率和死亡率相关，一些患者需要住院进行疼痛管理，通常采用全身镇痛，但可能无效。区域麻醉技术用于胸骨骨折比用于肋骨骨折更具挑战性，且需要经验丰富的临床医生。局部麻醉技术正逐渐被视为一种改善疼痛控制和减少阿片类药物使用并发症的方法，尤其是在老年人中。尽管为一名老年患者提供了静脉自控镇痛，但该患者疼痛仍无法控制，我们通过胸骨血肿输注导管给予局部麻醉。该技术使疼痛评分得到改善，患者能更好地配合物理治疗，并减少了阿片类药物的使用。局部麻醉此前已用于冠状动脉搭桥手术后的疼痛管理。我们的经验证明了这种镇痛方法在胸骨骨折中的安全性、有效性和耐受性。
