BACKGROUND Anterior cutaneous nerve entrapment syndrome(ACNES)is a condition mani-festing with pain caused by strangulation of the anterior cutaneous branch of the lower intercostal nerves.This case report aims to pro...BACKGROUND Anterior cutaneous nerve entrapment syndrome(ACNES)is a condition mani-festing with pain caused by strangulation of the anterior cutaneous branch of the lower intercostal nerves.This case report aims to provide new insight into the selection of peripheral nerve blocks for the ACNES treatment.CASE SUMMARY A 66-year-old woman manifested ACNES after a robot-assisted distal gastrec-tomy.An ultrasound-guided rectal sheath block was effective for pain triggered by the port scar.However,the sudden severe pain,which radiated laterally from the previous site,remained.A transversus abdominis plane block was performed for the remaining pain and effectively relieved it.CONCLUSION In this case,the trocar port was inserted between the rectus and transverse abdominis muscles.The intercostal nerves might have been entrapped on both sides of the rectus and transversus abdominis muscles.Hence,rectus sheath and transverse abdominis plane blocks were required to achieve complete pain relief.To the best of our knowledge,this is the first report on use of a combination of rectus sheath and transverse abdominis plane blocks for pain relief in ACNES.展开更多
Objective:To explore the suitable dosage of dexmedetomidine preemptive analgesia combined with transverse abdominal muscle block for postoperative analgesia of colon cancer.Methods:From March 2018 to October 2019,120 ...Objective:To explore the suitable dosage of dexmedetomidine preemptive analgesia combined with transverse abdominal muscle block for postoperative analgesia of colon cancer.Methods:From March 2018 to October 2019,120 patients undergoing laparoscopic radical resection of colon cancer in our hospital were randomly divided into control group(group C,without dexmedetomidine),low-dose group(group L,0.5μg/kg),medium-dose group(group M,1μg/kg)and high-dose group(group M,0.5μg/kg)The Mean arterial pressure,MAP),Heart rate,HR)and visual analog scale(vas)pain were compared at 2 h(T0),4 h(T1),8 h(T2),12 h(T3),24 h(T4)and 48 h(T5)after operation The pain sensitive area of mechanical stimulation was measured at T4,T5 and 72 h(T6)after operation.The adverse reactions of patients after operation were compared.Results:Compared with C group,MAP and HR of L,M and H groups decreased in different degrees at each time point.MAP and HR of m and h groups were lower than those of l group at different time points(P<0.05).The VAS score and pain sensitive area of T4-T6 in l,m and h groups were significantly lower than those in c group(P<0.05),but there was no significant difference in Ramsay score among groups(p>0.05).The vas score and pain sensitive area of m and h groups were lower than those of l group(P<0.05).Incidence of postoperative adverse reactions in l,m and h groups was lower than that in c group(P<0.05).Conclusion:Dexmedetomidine at doses of 1μg/kg and 1.5μg/kg has a good analgesic effect without increasing the incidence of adverse reactions.It is recommended that 1μg/kg Dexmedetomidine be used as an auxiliary drug dose of ropivacaine during TAP block.At the same time,it is necessary to strengthen monitoring to avoid adverse reactions such as hypotension and bradycardia.展开更多
Since the original publication on the erector spinae plane (ESP) block in 2016, the technique of the ESP block has evolved significantly in the last few years. This review highlights recent developments in the techniq...Since the original publication on the erector spinae plane (ESP) block in 2016, the technique of the ESP block has evolved significantly in the last few years. This review highlights recent developments in the technique for administering the ESP block and proposes directions for future research. Continuous efforts are being aimed at improving understanding regarding the administration of the ESP block. Current reports suggest that the ESP block provides effective analgesia in thoracic and abdominal sites in patients of all ages. However, no cohort studies or randomized controlled trials were performed in 2016 and 2017. The ESP block is an effective analgesic tool in a wide range of sites. However. We are uncertain how effective the ESP block is compared to other types of regional anesthesia. Therefore, more research on ESP blocks is required.展开更多
目的探讨超声引导下腹横肌平面(Transversus abdominis plane,TAP)阻滞在急性胰腺炎中的应用及对腹痛、胰腺炎相关蛋白(Pancreatitis-associated protein,PAP)水平的影响。方法选取2019年7月-2023年8月我院收治的急性胰腺炎患者95例,按...目的探讨超声引导下腹横肌平面(Transversus abdominis plane,TAP)阻滞在急性胰腺炎中的应用及对腹痛、胰腺炎相关蛋白(Pancreatitis-associated protein,PAP)水平的影响。方法选取2019年7月-2023年8月我院收治的急性胰腺炎患者95例,按照随机数表法分成2组,即对照组47例,试验组48例。对照组给予静脉注入舒芬太尼镇痛,试验组给予超声引导下TAP阻滞镇痛。比较两组镇痛后生命体征、腹痛发生率、PAP阳性率、疼痛、镇静评分、淀粉酶、脂肪酶、尿淀粉酶、系统急性生理学及慢性健康状况评分系统Ⅱ(Acute Physiology and Chronic Health Evaluation,APACHEⅡ)、改良多脏器功能障碍(multiple organ dysfunction score,Marshall)评分变化情况。结果两组镇痛后体温比较差异无统计学意义(P>0.05);试验组心率、呼吸频率低于对照组,氧合指数高于对照组(P<0.05);镇痛后,试验组腹痛发生率及PAP阳性率低于对照组(P<0.05);镇痛后,两组疼痛、镇静评分均降低,且试验组降低更显著(P<0.05);镇痛后,两组淀粉酶、脂肪酶及尿淀粉酶均降低,且试验组降低更显著(P<0.05);镇痛后,两组APACHEⅡ、Marshall评分均降低,且试验组降低更显著(P<0.05)。结论超声引导下TAP阻滞在急性胰腺炎镇痛中有一定的效果,可有效改善患者腹痛、PAP水平。展开更多
文摘BACKGROUND Anterior cutaneous nerve entrapment syndrome(ACNES)is a condition mani-festing with pain caused by strangulation of the anterior cutaneous branch of the lower intercostal nerves.This case report aims to provide new insight into the selection of peripheral nerve blocks for the ACNES treatment.CASE SUMMARY A 66-year-old woman manifested ACNES after a robot-assisted distal gastrec-tomy.An ultrasound-guided rectal sheath block was effective for pain triggered by the port scar.However,the sudden severe pain,which radiated laterally from the previous site,remained.A transversus abdominis plane block was performed for the remaining pain and effectively relieved it.CONCLUSION In this case,the trocar port was inserted between the rectus and transverse abdominis muscles.The intercostal nerves might have been entrapped on both sides of the rectus and transversus abdominis muscles.Hence,rectus sheath and transverse abdominis plane blocks were required to achieve complete pain relief.To the best of our knowledge,this is the first report on use of a combination of rectus sheath and transverse abdominis plane blocks for pain relief in ACNES.
基金National Natural Science Foundation of China(No.81803951)Guangdong Medical Science and Technology Foundation Project(No.B2013409)。
文摘Objective:To explore the suitable dosage of dexmedetomidine preemptive analgesia combined with transverse abdominal muscle block for postoperative analgesia of colon cancer.Methods:From March 2018 to October 2019,120 patients undergoing laparoscopic radical resection of colon cancer in our hospital were randomly divided into control group(group C,without dexmedetomidine),low-dose group(group L,0.5μg/kg),medium-dose group(group M,1μg/kg)and high-dose group(group M,0.5μg/kg)The Mean arterial pressure,MAP),Heart rate,HR)and visual analog scale(vas)pain were compared at 2 h(T0),4 h(T1),8 h(T2),12 h(T3),24 h(T4)and 48 h(T5)after operation The pain sensitive area of mechanical stimulation was measured at T4,T5 and 72 h(T6)after operation.The adverse reactions of patients after operation were compared.Results:Compared with C group,MAP and HR of L,M and H groups decreased in different degrees at each time point.MAP and HR of m and h groups were lower than those of l group at different time points(P<0.05).The VAS score and pain sensitive area of T4-T6 in l,m and h groups were significantly lower than those in c group(P<0.05),but there was no significant difference in Ramsay score among groups(p>0.05).The vas score and pain sensitive area of m and h groups were lower than those of l group(P<0.05).Incidence of postoperative adverse reactions in l,m and h groups was lower than that in c group(P<0.05).Conclusion:Dexmedetomidine at doses of 1μg/kg and 1.5μg/kg has a good analgesic effect without increasing the incidence of adverse reactions.It is recommended that 1μg/kg Dexmedetomidine be used as an auxiliary drug dose of ropivacaine during TAP block.At the same time,it is necessary to strengthen monitoring to avoid adverse reactions such as hypotension and bradycardia.
文摘Since the original publication on the erector spinae plane (ESP) block in 2016, the technique of the ESP block has evolved significantly in the last few years. This review highlights recent developments in the technique for administering the ESP block and proposes directions for future research. Continuous efforts are being aimed at improving understanding regarding the administration of the ESP block. Current reports suggest that the ESP block provides effective analgesia in thoracic and abdominal sites in patients of all ages. However, no cohort studies or randomized controlled trials were performed in 2016 and 2017. The ESP block is an effective analgesic tool in a wide range of sites. However. We are uncertain how effective the ESP block is compared to other types of regional anesthesia. Therefore, more research on ESP blocks is required.
文摘目的探讨超声引导下腹横肌平面(Transversus abdominis plane,TAP)阻滞在急性胰腺炎中的应用及对腹痛、胰腺炎相关蛋白(Pancreatitis-associated protein,PAP)水平的影响。方法选取2019年7月-2023年8月我院收治的急性胰腺炎患者95例,按照随机数表法分成2组,即对照组47例,试验组48例。对照组给予静脉注入舒芬太尼镇痛,试验组给予超声引导下TAP阻滞镇痛。比较两组镇痛后生命体征、腹痛发生率、PAP阳性率、疼痛、镇静评分、淀粉酶、脂肪酶、尿淀粉酶、系统急性生理学及慢性健康状况评分系统Ⅱ(Acute Physiology and Chronic Health Evaluation,APACHEⅡ)、改良多脏器功能障碍(multiple organ dysfunction score,Marshall)评分变化情况。结果两组镇痛后体温比较差异无统计学意义(P>0.05);试验组心率、呼吸频率低于对照组,氧合指数高于对照组(P<0.05);镇痛后,试验组腹痛发生率及PAP阳性率低于对照组(P<0.05);镇痛后,两组疼痛、镇静评分均降低,且试验组降低更显著(P<0.05);镇痛后,两组淀粉酶、脂肪酶及尿淀粉酶均降低,且试验组降低更显著(P<0.05);镇痛后,两组APACHEⅡ、Marshall评分均降低,且试验组降低更显著(P<0.05)。结论超声引导下TAP阻滞在急性胰腺炎镇痛中有一定的效果,可有效改善患者腹痛、PAP水平。
