Hadzić A, Vloka J D, Saff G N, Hertz R, Thys D M
Department of Anesthesiology, St. Luke's-Roosevelt Hospital Center, Columbia University College of Physicians and Surgeons, New York, New York 10025, USA.
Reg Anesth. 1997 Nov-Dec;22(6):575-8.
Herpes zoster infection in elderly patients frequently results in disabling pain, carries a high risk of postherpetic neuralgia (PHN), and can pose a significant therapeutic challenge.
We describe a successful use of the perivascular technique of lumbar plexus blockade ("three-in-one block") for treatment of pain during acute herpes zoster infection in an 82-year-old severely ill patient in whom other modalities were contraindicated.
Three-in-one block using 40 mL of 0.25% bupivacaine with 1:300,000 epinephrine resulted in excellent pain relief that lasted for 2 weeks.
The perivascular technique of lumbar plexus blockade may be a useful alternative to epidural and paravertebral techniques of lumbar blockade in the occasional patient for whom these other approaches are contraindicated.
老年患者的带状疱疹感染常导致致残性疼痛，发生带状疱疹后神经痛（PHN）的风险高，并且可能带来重大的治疗挑战。
我们描述了在一名82岁重症患者中成功运用腰丛阻滞的血管周围技术（“三合一阻滞”）治疗急性带状疱疹感染期间的疼痛，该患者因其他方法均为禁忌。
使用40毫升含1:300,000肾上腺素的0.25%布比卡因进行三合一阻滞，疼痛得到了极佳缓解，持续了2周。
对于偶尔出现其他方法禁忌的患者，腰丛阻滞的血管周围技术可能是硬膜外和椎旁腰阻滞技术的有用替代方法。
