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超声引导下仰卧位外侧坐骨神经阻滞（腘部坐骨神经横向入路）用于高危患者膝下手术：一项回顾性病例系列研究

Ultrasound-guided supine lateral CAPS (crosswise approach to popliteal sciatic) block for below-knee surgeries in high-risk patients: A retrospective case series.

作者信息

Patil Shruti S, Parikh Devangi A, Jain Ruchi A

机构信息

Department of Anaesthesiology, Lokmanya Tilak Municipal Medical College and General Hospital, Mumbai, Maharashtra, India.

出版信息

Indian J Anaesth. 2025 Jul;69(7):729-732. doi: 10.4103/ija.ija_21_25. Epub 2025 Jun 12.

DOI:10.4103/ija.ija_21_25
PMID:40657154
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12244463/
Abstract

Ultrasound (US)-guided popliteal sciatic nerve block (PSNB) with a femoral nerve block (FNB) provides adequate surgical analgesia for below-knee (BK) debridements and amputations. This retrospective review of 16 American Society of Anesthesiologists physical status III and IV patients describes a US-guided distal transverse (crosswise) approach to perform supine lateral PSNB (CAPS) with FNB with the limb in the neutral position. The median visibility score was 4. The median block performance time was 8 min. The median time to achieve sensory and motor block was 20 and 25 min, respectively. CAPS block with FNB is a reliable combination for BK amputation and debridement.

摘要

超声（US）引导下的腘部坐骨神经阻滞（PSNB）联合股神经阻滞（FNB）可为膝下（BK）清创术和截肢术提供充分的手术镇痛。这项对16例美国麻醉医师协会身体状况为III级和IV级患者的回顾性研究描述了一种超声引导下的远端横向（交叉）入路，在肢体处于中立位时，仰卧位行外侧PSNB（CAPS）联合FNB。中位可视化评分为4分。中位阻滞操作时间为8分钟。实现感觉和运动阻滞的中位时间分别为20分钟和25分钟。CAPS阻滞联合FNB是BK截肢术和清创术的可靠组合。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/380b/12244463/1bb52247400d/IJA-69-729-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/380b/12244463/1bb52247400d/IJA-69-729-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/380b/12244463/1bb52247400d/IJA-69-729-g001.jpg

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Ultrasound-guided supine lateral CAPS (crosswise approach to popliteal sciatic) block for below-knee surgeries in high-risk patients: A retrospective case series.超声引导下仰卧位外侧坐骨神经阻滞（腘部坐骨神经横向入路）用于高危患者膝下手术：一项回顾性病例系列研究
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本文引用的文献

1
Evaluation of a New Method of Sciatic Nerve Block: A Prospective Pilot Study.一种坐骨神经阻滞新方法的评估：一项前瞻性初步研究。
J Pain Res. 2023 Jun 16;16:2091-2099. doi: 10.2147/JPR.S404489. eCollection 2023.
2
CAPS (Crosswise Approach to Popliteal Sciatic) block: an alternative ultrasound-guided technique for supine popliteal fossa block.腘窝坐骨神经横向入路（CAPS）阻滞：一种用于仰卧位腘窝阻滞的替代超声引导技术。
Br J Anaesth. 2022 May;128(5):e299-e300. doi: 10.1016/j.bja.2022.01.025. Epub 2022 Feb 24.
3
Ultrasound-Guided CAPS (Crosswise Approach to Popliteal Sciatic) Block: A Novel Technique for Supine Popliteal Fossa Block.
超声引导下腘窝坐骨神经横向入路阻滞：一种用于仰卧位腘窝阻滞的新技术。
Cureus. 2022 Jan 3;14(1):e20894. doi: 10.7759/cureus.20894. eCollection 2022 Jan.
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Supine ultrasound-guided popliteal block: a medial approach.
Br J Anaesth. 2016 Feb;116(2):295-6. doi: 10.1093/bja/aev462.
5
Preoperative Predictors of 30-Day Mortality and Prolonged Length of Stay after Above-Knee Amputation.膝上截肢术后30天死亡率及住院时间延长的术前预测因素
Ann Vasc Surg. 2016 Feb;31:124-33. doi: 10.1016/j.avsg.2015.08.017. Epub 2015 Nov 23.
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The CARE guidelines: consensus-based clinical case reporting guideline development.《CARE指南：基于共识的临床病例报告指南制定》
J Med Case Rep. 2013 Sep 10;7:223. doi: 10.1186/1752-1947-7-223.
7
Ultrasound-guided supine posterior approach for popliteal sciatic nerve block.超声引导下仰卧位后路腘部坐骨神经阻滞
J Clin Anesth. 2012 Dec;24(8):680. doi: 10.1016/j.jclinane.2012.04.017.
8
"Figure of four" position improves the visibility of the sciatic nerve in the popliteal fossa.“4字位”可提高腘窝处坐骨神经的可视性。
Agri. 2009 Oct;21(4):149-54.
9
Ultrasound-guided sciatic nerve block in the popliteal fossa using a lateral approach: onset time comparing separate tibial and common peroneal nerve injections versus injecting proximal to the bifurcation.超声引导下经腘窝外侧入路坐骨神经阻滞：比较单独阻滞胫神经和腓总神经与在分叉处近端注射的起效时间。
Anesth Analg. 2010 Feb 1;110(2):635-7. doi: 10.1213/ANE.0b013e3181c88f27. Epub 2009 Dec 8.
10
"Gapped supine" position for ultrasound guided lateral popliteal fossa block of the sciatic nerve.用于超声引导下坐骨神经腘外侧窝阻滞的“间隙仰卧位”
Anesth Analg. 2007 Nov;105(5):1519. doi: 10.1213/01.ane.0000286134.19410.40.