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区域神经阻滞治疗周围神经病:罕见临床病例报告。

Regional nerve blocks for peripheral neuropathy: a rare clinical case report.

机构信息

Department of Anesthesiology, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi, China.

出版信息

J Int Med Res. 2024 Oct;52(10):3000605241282248. doi: 10.1177/03000605241282248.

Abstract

Peripheral neuropathy is a common complication in patients with diabetes. However, the appropriateness of administering nerve block anesthesia to these patients remains uncertain. Key concerns include the potential for prolonged block duration, an increased risk of local anesthetic toxicity, and the possibility of further damaging already compromised peripheral nerves. We herein report a case involving a patient with diabetic peripheral neuropathy who underwent finger amputation under ultrasound-guided nerve block anesthesia and subsequently lost pain and temperature sensation in both hands 1 month later. For critically ill patients undergoing surgery, regional anesthesia, such as a nerve block, may be a more suitable option than general anesthesia. When performing nerve block procedures in patients with diabetes, using ultrasound guidance is recommended to ensure precise targeting and reduce the risk of complications. However, it remains unclear whether nerve block anesthesia exacerbates peripheral neuropathy.

摘要

周围神经病变是糖尿病患者常见的并发症。然而,为这些患者施行神经阻滞麻醉的适宜性尚不确定。主要顾虑包括阻滞持续时间延长的可能性、局部麻醉药毒性增加的风险,以及已经受损的外周神经进一步受损的可能性。我们在此报告一例糖尿病周围神经病变患者,在超声引导下神经阻滞麻醉下行手指截肢术,1 个月后双手失去痛温觉。对于接受手术的危重症患者,区域麻醉(如神经阻滞)可能比全身麻醉更合适。在对糖尿病患者施行神经阻滞时,推荐使用超声引导以确保精确定位和降低并发症风险。然而,神经阻滞麻醉是否会加重周围神经病变仍不清楚。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cde2/11483665/f20d1ab23a44/10.1177_03000605241282248-fig1.jpg

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