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首页> 美国卫生研究院文献>Case Reports in Anesthesiology >Treatment of Digital Ischemia with Liposomal Bupivacaine
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Treatment of Digital Ischemia with Liposomal Bupivacaine

机译：脂质体布比卡因治疗数字缺血

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Objective. This report describes a case in which the off-label use of liposomal bupivacaine (Exparel) in a peripheral nerve block resulted in marked improvement of a patient's vasoocclusive symptoms. The vasodilating and analgesic properties of liposomal bupivacaine in patients with ischemic symptoms are unknown, but our clinical experience suggests a role in the management of patients suffering from vasoocclusive disease. Case Report. A 45-year-old African American female was admitted to the hospital with severe digital ischemic pain. She was not a candidate for any vascular surgical or procedural interventions. Two continuous supraclavicular nerve blocks were placed with modest clinical improvement. These effects were also short-lived, with the benefits resolving after the discontinuation of the peripheral nerve blocks. She continued to report severe pain and was on multiple anticoagulant medications, so a decision was made to perform an axillary nerve block using liposomal bupivacaine (Exparel) given the compressibility of the site as well as the superficial nature of the target structures. Conclusions. This case report describes the successful off-label usage of liposomal bupivacaine (Exparel) in a patient with digital ischemia. Liposomal bupivacaine (Exparel) is currently FDA approved only for wound infiltration use at this time.
机译：目的。该报告描述了一种情况，其中在外周神经阻滞中非常规使用脂质体布比卡因（Exparel）导致患者的血管闭塞症状明显改善。尚不清楚缺血性症状患者中布比卡因脂质体的血管舒张和镇痛作用，但我们的临床经验表明在治疗血管闭塞性疾病的患者中起一定作用。案例报告。一名45岁的非洲裔美国女性因严重的数字缺血性疼痛入院。她不是任何血管外科手术或程序干预的候选人。放置两个连续的锁骨上神经阻滞并在临床上有所改善。这些作用也是短暂的，其益处在周围神经阻滞中断后消失。她继续报告严重疼痛，并且正在使用多种抗凝药物，因此考虑到该部位的可压缩性以及靶标结构的表面性质，因此决定使用脂质体布比卡因（Exparel）进行腋窝神经阻滞。结论。该病例报告描述了脂质体布比卡因（Exparel）在数字缺血患者中的成功使用。目前，FDA仅批准脂质体布比卡因（Exparel）用于伤口浸润。

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