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患者安全实情调查员:预防潜在的与手术相关的并发症:血管迷走神经反应和脊髓刺激器导线移位。

FactFinders for patient safety: Preventing potential procedure-related complications: Vasovagal reactions and spinal cord stimulator lead migration.

作者信息

Babaria Vivek, Patel Jaymin, Schneider Byron J, Mattie Ryan, McCormick Zachary L

机构信息

Orange County Spine and Sports Physicians, Newport Beach, CA, USA.

Emory University, Department of Orthopaedics, Atlanta, GA, USA.

出版信息

Interv Pain Med. 2023 Jul 22;2(3):100268. doi: 10.1016/j.inpm.2023.100268. eCollection 2023 Sep.

Abstract

This series of FactFinders presents a brief summary of the evidence and outlines recommendations to improve our understanding and management of several potential procedure-related complications. Evidence in support of the following facts is presented. (1)  -- The overall incidence of vasovagal reactions (VVR) ranges from 1 to 8% during interventional pain procedures, though certain patient populations may be at greater risk. Younger age, male sex, and a history of a VVR are associated with an increased likelihood of VVR. In select patients, moderate sedation may be considered for prevention of a repeat vasovagal reaction. (2)  Suturing percutaneous SCS leads does not mitigate the risk of migration compared to taping alone during a trial. Most lead migration does not pose a safety concern during the trial period.

摘要

本系列《事实发现者》简要总结了证据,并概述了一些建议,以增进我们对几种潜在的与手术相关并发症的理解和管理。以下是支持以下事实的证据。(1)——在介入性疼痛手术期间,血管迷走神经反应(VVR)的总体发生率为1%至8%,尽管某些患者群体的风险可能更高。年龄较小、男性以及有VVR病史与VVR发生的可能性增加有关。对于特定患者,可考虑使用中度镇静来预防血管迷走神经反应复发。(2)在试验期间,与单独使用胶带固定相比,缝合经皮脊髓刺激(SCS)导线并不能降低导线移位的风险。在试验期间,大多数导线移位不会引起安全问题。

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本文引用的文献

1
Spinal cord stimulation failure: evaluation of factors underlying hardware explantation.脊髓刺激失败:硬件取出相关因素的评估
J Neurosurg Spine. 2019 Oct 4;32(1):133-138. doi: 10.3171/2019.6.SPINE181099. Print 2020 Jan 1.
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Evaluating and managing postural tachycardia syndrome.评估和管理体位性心动过速综合征。
Cleve Clin J Med. 2019 May;86(5):333-344. doi: 10.3949/ccjm.86a.18002.
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Reflex syncope: Diagnosis and treatment.反射性晕厥:诊断与治疗
J Arrhythm. 2017 Dec;33(6):545-552. doi: 10.1016/j.joa.2017.03.007. Epub 2017 May 17.
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Blood injury and injection phobia: the neglected one.血液损伤和注射恐惧症:被忽视的一个。
Behav Neurol. 2014;2014:471340. doi: 10.1155/2014/471340. Epub 2014 Jun 24.
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Prevention of percutaneous spinal cord stimulation electrode migration: a 15-year experience.经皮脊髓刺激电极迁移的预防:15年经验
Neuromodulation. 2014 Oct;17(7):670-6; discussion 676-7. doi: 10.1111/ner.12151. Epub 2014 Feb 11.

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