{"title":"在急诊科使用超声引导下的大枕神经水切割术治疗外伤后枕神经痛","authors":"Gabriel Rose","doi":"10.1016/j.jemrpt.2024.100078","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>Nerve hydrodissection (HD) has previously been described as a treatment for carpal tunnel syndrome and other musculoskeletal disorders; however, its use in the treatment of occipital neuralgia (ON) has rarely been reported. This is the first report of HD used to treat ON in the emergency department (ED).</p></div><div><h3>Case report</h3><p>A 34-year-old male presented to the ED with a 3-month history of posterior neck and scalp pain consistent with ON. He failed multiple outpatient therapies including oral medication and trigger point injections. An ultrasound (US)-guided HD of the greater occipital nerve (GON) was performed successfully. A 25 g needle was inserted in-plane and a solution of 9 mL normal saline and 1 mL 1 % lidocaine was injected within the fascial plane containing the GON until muscle layer separation was achieved.</p><p>Why should an emergency physician be aware of this? A case of refractory ON failing conventional therapy was successfully treated in the ED using US-guided nerve HD.</p></div>","PeriodicalId":73546,"journal":{"name":"JEM reports","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2024-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2773232024000087/pdfft?md5=dd5c501f8b7db494b6aafeb5f5977bef&pid=1-s2.0-S2773232024000087-main.pdf","citationCount":"0","resultStr":"{\"title\":\"Treatment of post-traumatic occipital neuralgia with ultrasound-guided greater occipital nerve hydrodissection in the emergency department\",\"authors\":\"Gabriel Rose\",\"doi\":\"10.1016/j.jemrpt.2024.100078\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><p>Nerve hydrodissection (HD) has previously been described as a treatment for carpal tunnel syndrome and other musculoskeletal disorders; however, its use in the treatment of occipital neuralgia (ON) has rarely been reported. This is the first report of HD used to treat ON in the emergency department (ED).</p></div><div><h3>Case report</h3><p>A 34-year-old male presented to the ED with a 3-month history of posterior neck and scalp pain consistent with ON. He failed multiple outpatient therapies including oral medication and trigger point injections. An ultrasound (US)-guided HD of the greater occipital nerve (GON) was performed successfully. A 25 g needle was inserted in-plane and a solution of 9 mL normal saline and 1 mL 1 % lidocaine was injected within the fascial plane containing the GON until muscle layer separation was achieved.</p><p>Why should an emergency physician be aware of this? A case of refractory ON failing conventional therapy was successfully treated in the ED using US-guided nerve HD.</p></div>\",\"PeriodicalId\":73546,\"journal\":{\"name\":\"JEM reports\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-02-06\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.sciencedirect.com/science/article/pii/S2773232024000087/pdfft?md5=dd5c501f8b7db494b6aafeb5f5977bef&pid=1-s2.0-S2773232024000087-main.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"JEM reports\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2773232024000087\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"JEM reports","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2773232024000087","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
背景神经水切割术（HD）以前曾被描述为治疗腕管综合征和其他肌肉骨骼疾病的方法，但用于治疗枕神经痛（ON）的报道却很少。这是首例在急诊科（ED）使用 HD 治疗枕骨神经痛的报告。病例报告一名 34 岁的男性因颈部后部和头皮疼痛 3 个月来到急诊科就诊，症状与枕骨神经痛一致。他接受了包括口服药物和扳机点注射在内的多种门诊治疗，但均告失败。在超声（US）引导下，成功实施了大枕神经（GON）HD。在平面内插入一根 25 g 的针头，然后在包含 GON 的筋膜平面内注射 9 mL 生理盐水和 1 mL 1 % 利多卡因溶液，直至实现肌层分离。在急诊室使用 US 引导神经 HD 成功治疗了一例常规治疗无效的难治性 ON。
Treatment of post-traumatic occipital neuralgia with ultrasound-guided greater occipital nerve hydrodissection in the emergency department
Background
Nerve hydrodissection (HD) has previously been described as a treatment for carpal tunnel syndrome and other musculoskeletal disorders; however, its use in the treatment of occipital neuralgia (ON) has rarely been reported. This is the first report of HD used to treat ON in the emergency department (ED).
Case report
A 34-year-old male presented to the ED with a 3-month history of posterior neck and scalp pain consistent with ON. He failed multiple outpatient therapies including oral medication and trigger point injections. An ultrasound (US)-guided HD of the greater occipital nerve (GON) was performed successfully. A 25 g needle was inserted in-plane and a solution of 9 mL normal saline and 1 mL 1 % lidocaine was injected within the fascial plane containing the GON until muscle layer separation was achieved.
Why should an emergency physician be aware of this? A case of refractory ON failing conventional therapy was successfully treated in the ED using US-guided nerve HD.
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