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新型超声引导下梨状肌下注射（SPI）可能对开放性和关节镜下腘绳肌修复均产生有效的镇痛效果：1例病例报告。

Novel Ultrasound-Guided Sub-Piriformis Injection (SPI) May Produce Effective Analgesia for Both Open and Arthroscopic Hamstring Repair: A Case Report.

作者信息

Kline Jonathan P

机构信息

Education, Twin Oaks Anesthesia Services, Wesley Chapel, USA.

出版信息

Cureus. 2024 Nov 28;16(11):e74665. doi: 10.7759/cureus.74665. eCollection 2024 Nov.

DOI:10.7759/cureus.74665
PMID:39735102
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11681955/
Abstract

Open or arthroscopic repair of hamstring tear requires both hard and soft, posterior and proximal thigh analgesia. Regional injections to completely relieve this unique pain are not available to the best of our knowledge. We present a novel, single injection, performed under ultrasound guidance, that utilizes the deep piriformis space. This space contains multiple nerves involved in the surgery and can be completely anesthetized with only 10 ml of local anesthetic. We further extended the block for a total of 80 hours through the use of liposomal bupivacaine.

摘要

腘绳肌撕裂的开放或关节镜修复需要对大腿后部和近端进行硬组织和软组织的镇痛。据我们所知，目前尚无能够完全缓解这种独特疼痛的区域注射方法。我们介绍一种在超声引导下进行的新型单次注射方法，该方法利用梨状肌深层间隙。这个间隙包含手术中涉及的多条神经，仅用10毫升局部麻醉剂即可将其完全麻醉。我们通过使用脂质体布比卡因进一步延长了阻滞时间，总共达到80小时。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/faae/11681955/55dd617eb638/cureus-0016-00000074665-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/faae/11681955/52c03b6868af/cureus-0016-00000074665-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/faae/11681955/e0765ec85af3/cureus-0016-00000074665-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/faae/11681955/54725a803eb0/cureus-0016-00000074665-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/faae/11681955/55dd617eb638/cureus-0016-00000074665-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/faae/11681955/52c03b6868af/cureus-0016-00000074665-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/faae/11681955/e0765ec85af3/cureus-0016-00000074665-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/faae/11681955/54725a803eb0/cureus-0016-00000074665-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/faae/11681955/55dd617eb638/cureus-0016-00000074665-i04.jpg

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本文引用的文献

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Local Reg Anesth. 2024 Apr 24;17:55-65. doi: 10.2147/LRA.S455702. eCollection 2024.
2
A phase 3 active-controlled trial of liposomal bupivacaine via sciatic nerve block in the popliteal fossa after bunionectomy.一项关于拇外翻切除术后经腘窝坐骨神经阻滞使用脂质体布比卡因的3期活性对照试验。
J Clin Anesth. 2024 Jun;94:111402. doi: 10.1016/j.jclinane.2024.111402. Epub 2024 Feb 9.
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Origin, course, and distribution of the posterior femoral cutaneous nerve and the spatial relationship among its branches.
股后皮神经的起源、走行和分布及其分支间的空间关系。
Anat Sci Int. 2023 Sep;98(4):540-547. doi: 10.1007/s12565-023-00721-x. Epub 2023 Apr 5.
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Sciatic Nerve Variants and the Piriformis Muscle: A Systematic Review and Meta-Analysis.坐骨神经变异与梨状肌：一项系统评价与荟萃分析
Cureus. 2020 Nov 17;12(11):e11531. doi: 10.7759/cureus.11531.
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The mechanism of hamstring injuries - a systematic review.腘绳肌损伤机制——一项系统综述
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INTRAPEC Technique Controls Pectoralis Spasm and Pain for Subpectoral Breast Implantation: A Retrospective Study.胸肌下乳房植入术中INTRAPEC技术控制胸肌痉挛和疼痛：一项回顾性研究
Plast Reconstr Surg Glob Open. 2020 Feb 26;8(2):e2646. doi: 10.1097/GOX.0000000000002646. eCollection 2020 Feb.
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The posterior femoral cutaneous nerve contributes significantly to sensory innervation of the lower leg: an anatomical investigation.股后皮神经对小腿的感觉神经支配有重要贡献：一项解剖学研究。
Br J Anaesth. 2020 Mar;124(3):308-313. doi: 10.1016/j.bja.2019.10.026. Epub 2020 Jan 20.
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