创伤患者外硬膜外导管外位评估

Sergey A. Emelyanov
{"title":"创伤患者外硬膜外导管外位评估","authors":"Sergey A. Emelyanov","doi":"10.20310/2782-5019-2023-5-1-13-18","DOIUrl":null,"url":null,"abstract":"For the purpose of the study, we selected 73 patients who underwent combined two-level spinal-epidural anesthesia with a catheter in the subcutaneous tunnel during operations for lower limbs fractures. All patients underwent postoperative epidural analgesia. We applied a method for assessing the degree of external dislocation of the epidural catheter and an algorithm of actions when a dislocation of the epidural catheter is detected. When changing the fixing aseptic sticker, the degree of epidural catheter dislocation was assessed, and if a pronounced dislocation was detected, additional measures were taken to enhance the fixation of epidural catheter. In 14 cases, we used additional fixation devices “Epi-Fix”, which was associated with the threat of falling out of the epidural catheter with a pronounced degree of dislocation. Additional fixation in this case helped to avoid prolapse and ensure continuation of anesthesia. However, in two cases, the epidural catheter was removed because the dislocation corresponded to the 6th degree of the proposed scale, and its continued use was useless. Thus, the use of the scale we developed enables to monitor and assess the risk of worsening anesthesia and catheter migration or prolapse. Further tactics in relation to prolonged anesthesia depend on an objective assessment of the position of the catheter.","PeriodicalId":199692,"journal":{"name":"Tambov Medical Journal","volume":"32 1","pages":"0"},"PeriodicalIF":0.0000,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"ОЦЕНКА СТЕПЕНИ НАРУЖНОЙ ДИСЛОКАЦИИ ЭПИДУРАЛЬНОГО КАТЕТЕРА В КЛИНИЧЕСКОЙ ПРАКТИКЕ У ТРАВМАТОЛОГИЧЕСКИХ БОЛЬНЫХ\",\"authors\":\"Sergey A. Emelyanov\",\"doi\":\"10.20310/2782-5019-2023-5-1-13-18\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"For the purpose of the study, we selected 73 patients who underwent combined two-level spinal-epidural anesthesia with a catheter in the subcutaneous tunnel during operations for lower limbs fractures. All patients underwent postoperative epidural analgesia. We applied a method for assessing the degree of external dislocation of the epidural catheter and an algorithm of actions when a dislocation of the epidural catheter is detected. When changing the fixing aseptic sticker, the degree of epidural catheter dislocation was assessed, and if a pronounced dislocation was detected, additional measures were taken to enhance the fixation of epidural catheter. In 14 cases, we used additional fixation devices “Epi-Fix”, which was associated with the threat of falling out of the epidural catheter with a pronounced degree of dislocation. Additional fixation in this case helped to avoid prolapse and ensure continuation of anesthesia. However, in two cases, the epidural catheter was removed because the dislocation corresponded to the 6th degree of the proposed scale, and its continued use was useless. Thus, the use of the scale we developed enables to monitor and assess the risk of worsening anesthesia and catheter migration or prolapse. Further tactics in relation to prolonged anesthesia depend on an objective assessment of the position of the catheter.\",\"PeriodicalId\":199692,\"journal\":{\"name\":\"Tambov Medical Journal\",\"volume\":\"32 1\",\"pages\":\"0\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"1900-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Tambov Medical Journal\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.20310/2782-5019-2023-5-1-13-18\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Tambov Medical Journal","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.20310/2782-5019-2023-5-1-13-18","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0

摘要

为了本研究的目的,我们选择了73例下肢骨折手术中采用两段脊髓-硬膜外联合麻醉并在皮下隧道内置入导管的患者。所有患者术后均行硬膜外镇痛。我们应用了一种评估硬膜外导管脱位程度的方法,以及一种检测到硬膜外导管脱位时的动作算法。更换固定无菌贴时,评估硬膜外导管脱位程度,若发现明显脱位,则采取额外措施加强硬膜外导管的固定。在14例病例中,我们使用了额外的固定装置“Epi-Fix”,这与硬膜外导管脱落的威胁以及明显程度的脱位有关。本病例的额外固定有助于避免脱垂并确保麻醉的持续。然而,在两个病例中,由于脱位对应于所建议的尺度的6度,硬膜外导管被移除,其继续使用是无用的。因此,使用我们开发的量表可以监测和评估麻醉恶化和导管移位或脱垂的风险。与延长麻醉有关的进一步策略取决于对导管位置的客观评估。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
ОЦЕНКА СТЕПЕНИ НАРУЖНОЙ ДИСЛОКАЦИИ ЭПИДУРАЛЬНОГО КАТЕТЕРА В КЛИНИЧЕСКОЙ ПРАКТИКЕ У ТРАВМАТОЛОГИЧЕСКИХ БОЛЬНЫХ
For the purpose of the study, we selected 73 patients who underwent combined two-level spinal-epidural anesthesia with a catheter in the subcutaneous tunnel during operations for lower limbs fractures. All patients underwent postoperative epidural analgesia. We applied a method for assessing the degree of external dislocation of the epidural catheter and an algorithm of actions when a dislocation of the epidural catheter is detected. When changing the fixing aseptic sticker, the degree of epidural catheter dislocation was assessed, and if a pronounced dislocation was detected, additional measures were taken to enhance the fixation of epidural catheter. In 14 cases, we used additional fixation devices “Epi-Fix”, which was associated with the threat of falling out of the epidural catheter with a pronounced degree of dislocation. Additional fixation in this case helped to avoid prolapse and ensure continuation of anesthesia. However, in two cases, the epidural catheter was removed because the dislocation corresponded to the 6th degree of the proposed scale, and its continued use was useless. Thus, the use of the scale we developed enables to monitor and assess the risk of worsening anesthesia and catheter migration or prolapse. Further tactics in relation to prolonged anesthesia depend on an objective assessment of the position of the catheter.
求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
自引率
0.00%
发文量
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信