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双针技术用于胸腰椎骨折手术的脊髓麻醉:病例系列

Spinal Anesthesia Using the Double-Needle Technique for Thoracolumbar Spine Fracture Surgery: A Case Series.

作者信息

Chandra Richa, Pullano Carmine, Khan Imran Ahmed

机构信息

Anesthesiology, Rohilkhand Medical College and Hospital, Bareilly, IND.

Anesthesiology, Casa di Cura Privata Villa Salaria Hospital, Rome, ITA.

出版信息

Cureus. 2025 May 1;17(5):e83288. doi: 10.7759/cureus.83288. eCollection 2025 May.

Abstract

Spinal anesthesia (SA) has emerged as a viable alternative to general anesthesia (GA) for thoracolumbar spine surgeries. The double-needle technique (DNT) aims to enhance the precision and efficacy of SA in these procedures. The DNT (SA at two levels) involves performing two separate spinal punctures at different vertebral interspaces during the same procedure, often used to optimize anesthesia spread. This case series evaluates the feasibility, safety, and clinical outcomes of DNT in patients undergoing thoracolumbar spine fracture fixation. This case series includes five patients diagnosed with thoracolumbar spine fractures who underwent surgical fixation under SA using the DNT. Data on patient demographics, intraoperative hemodynamics, sensory and motor blockade characteristics, anesthesia-related complications, and postoperative recovery were collected and analyzed. All patients achieved adequate surgical anesthesia with the DNT. Hemodynamic stability was maintained in most cases, with minimal vasopressor requirements. None of the patients required conversion to GA. Multimodal analgesia was used to manage postoperative pain. No major anesthesia-related complications were observed. The DNT appears to be a safe and effective approach for SA in thoracolumbar spine surgery. It offers hemodynamic stability, adequate surgical anesthesia, and prolonged postoperative analgesia. Further studies with larger sample sizes are warranted to validate these findings.

摘要

对于胸腰椎手术,脊髓麻醉(SA)已成为全身麻醉(GA)的一种可行替代方案。双针技术(DNT)旨在提高SA在这些手术中的精准度和效果。DNT(在两个节段进行SA)包括在同一手术过程中于不同椎间隙进行两次单独的脊髓穿刺,常用于优化麻醉平面扩散。本病例系列评估了DNT在接受胸腰椎骨折固定手术患者中的可行性、安全性和临床结局。该病例系列包括五例诊断为胸腰椎骨折的患者,他们在SA下采用DNT接受了手术固定。收集并分析了患者人口统计学数据、术中血流动力学、感觉和运动阻滞特征、麻醉相关并发症及术后恢复情况。所有患者通过DNT均获得了足够的手术麻醉。大多数情况下血流动力学保持稳定,血管升压药需求极少。无患者需要转为GA。采用多模式镇痛管理术后疼痛。未观察到重大麻醉相关并发症。DNT似乎是胸腰椎手术中SA的一种安全有效的方法。它提供血流动力学稳定性、足够的手术麻醉和延长的术后镇痛效果。有必要进行更大样本量的进一步研究以验证这些发现。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4929/12126935/ab37b8fb3c9c/cureus-0017-00000083288-i01.jpg

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