神經(jīng)阻滯的臨床問(wèn)題探討(編輯修改稿)
2025-01-31 15:21 本頁(yè)面
【文章內(nèi)容簡(jiǎn)介】 ized,DoubleBlind Clinical Trial Interlaminar Epidural Local Anesthetic with or without Steroid in Chronic Lumbosacral Pain Both were effective,Epidural Local Anesthetic with Steroid is better. 結(jié)論 ：局麻藥 +激素不單用局麻藥都有效，但二者合用效果更好。 Pain Physician 2022。 18:237248 Effectiveness of Parasagittal Interlaminar Epidural Local Anesthetic with or without Steroid in Chronic Lumbosacral Pain: A Randomized, DoubleBlind Clinical Trial 爭(zhēng)議：局麻藥 +激素是否更有效？ 文章 2 ? 275 patients were analysed, including 55 who were diabetic，receiving epidural steroid injection ： 3 ml of lidocaine % and 40 mg of triamcinolone . ? No difference in pain reduction after ESIs between diabetic and nondiabetic patients. ? Pain reduction may generally decrease with increase of the HbA1c level and bees stable and negative for patients with high HbA1c values. J Anaesthesiol Clin Pharmacol. 2022， 32(1):848. doi: difference in pain reduction after epidural steroid injections in diabetic versus nondiabetic patients: Aretrospective cohort study. 結(jié)論 ：局麻藥 +激素不單用局麻藥療效相當(dāng)。 ? 高血壓患者能丌能用激素？ ? 糖尿病患者能丌能用激素？ ? 肺部有少許炎癥、感染者能丌能用激素？ ? 神經(jīng)阻滯治療如何補(bǔ)鈣 ？ 激素的其它問(wèn)題 怎樣評(píng)定神經(jīng)阻滯的效果？ Part 3 ? 即刻評(píng)定 疼痛緩解、感覺(jué)減退、麻木、運(yùn)動(dòng)不肌力？ ? 后續(xù)評(píng)定 疼痛強(qiáng)度、范圍、性質(zhì)、頻率，每次疼痛持續(xù)時(shí)間、靜息 /活動(dòng)時(shí)疼痛？ 麻木不感覺(jué)減退、運(yùn)動(dòng)不肌力？ 例：以前麻木的地方現(xiàn)在疼痛，怎樣解釋?zhuān)? 評(píng)定神經(jīng)阻滯治療效果 神經(jīng)阻滯發(fā)展方向 —可視化、精準(zhǔn)化 …… Part 4 ? X線 ? 彩超 ? CT ? MRI ? 神經(jīng)刺激器 神經(jīng)阻滯發(fā)展方向 —可視化、精準(zhǔn)化 影像提高安全性： 發(fā)現(xiàn)更高穿破硬膜率！ Pain Physician 2022。 18:259266 Do the Gaps in the Ligamentum Flavum in theCervical Spine Translate into Dural Punctures?An Analysis of 4,396 Fluoroscopic InterlaminarEpidural Injec
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