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首页> 外文期刊>Regional anesthesia and pain medicine >Ultrasound-guided obturator nerve block: a preliminary report of a case series.
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Ultrasound-guided obturator nerve block: a preliminary report of a case series.

机译：超声引导下闭孔神经阻滞:一个案例系列的初步报告。

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BACKGROUND AND OBJECTIVES: Obturator-nerve block improves analgesia for knee surgery. Traditional techniques rely on surface landmarks, which can be variable and result in excessive performance times and multiple needle passes. The objective of this study was to evaluate a novel ultrasound-guided technique for localizing the obturator nerve. METHODS: A total of 22 patients undergoing anterior cruciate ligament repair had ultrasound-guided obturator-nerve blocks. Needles were directed under real-time ultrasound guidance. Endpoint for injection consisted of identifying contact of the tip of an insulated needle to nerve confirmed by adductor muscles' contraction. Local anesthetic was injected, and block was evaluated within 30 minutes. After that, ultrasound-guided sciatic-femoral blocks were placed for surgical purposes. Data collected included: time required for nerve identification, minimum stimulating current, number of attempts for correct identification, preblock and postblock adductor muscles' strength, sensory-nerve block, and quality of surgical anesthesia. RESULTS: In 91% of cases, the obturator nerve was correctly identified on first attempt within 30 +/- 23 seconds, as a hyperechoic flat or lip-shaped structure with internal hypoechoic dots. Minimal intensity of current to nerve stimulation was 0.30 +/- 0.08 mA. All patients exhibited decreases in adductor strength. Sensory territories were variable, with no cutaneous distribution in 32% of the patients. Small-dose opioid supplementation was required in 14% of the patients, but none required general anesthesia to complete surgery. CONCLUSIONS: These preliminary data suggest that ultrasound-guided obturator-nerve identification and block are technically easy and highly successful.
机译：背景和目的:闭孔神经提高了膝盖手术的镇痛。技术依赖于表面地标,变量,导致过度的表现时间和多个针通过。本研究旨在评估一个小说超声引导技术的本地化闭孔神经。进行前交叉韧带修复超声引导下闭孔神经块。导演在实时超声吗指导。确定接触尖端的绝缘针,证实了神经内收肌肌肉的收缩。块是评估在30分钟内。超声引导下sciatic-femoral块被用于外科手术。包括:神经识别所需时间,最小刺激电流、尝试为正确识别、preblock和postblock内收肌的肌肉的力量,感觉神经,以及手术的质量麻醉。闭孔神经被正确识别尝试在30 + / - 23秒,高回声持平或lip-shaped结构内部呈点。当前神经刺激是0.30 + / - 0.08妈的力量。在32%的病人没有皮肤的分布。中小剂量阿片类药物的补充要求14%的病人,但是没有要求完成手术麻醉。这些初步数据表明,超声引导下闭孔神经识别并阻止技术简单和高度成功的。

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