对一名双侧股骨头血管性坏死的肿瘤患者进行连续 PENG 阻滞。

A. Server, V. Sánchez, E. Schmucker, Á. Mesas, J. Medel
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引用次数: 0

摘要

PENG阻滞(髋关节周围神经群)是最近描述的一种用于治疗髋关节神经支配的技术,髋关节是局部治疗最复杂的解剖区域之一。我们介绍了一例急性淋巴细胞白血病患者的病例,该患者因双侧股骨头无血管性坏死而并发症,既往有严重的慢性疼痛病史,可能对阿片类药物有中枢过敏反应,化疗引起的骨髓毒性导致血小板严重减少。鉴于需要进行骨科手术治疗股骨头坏死,并预计围手术期疼痛治疗将十分复杂,因此计划采用多模式策略,包括双侧超声引导下连续PENG阻滞,以在围手术期实现适当的疼痛控制,促进患者早日康复。手术和初期恢复顺利,患者在 24 小时内出院,并按计划开始早期康复。患者恢复顺利,功能良好。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Continuous PENG block in an oncologic patient with bilateral femoral avascular necrosis

The PENG block (pericapsular nerve group) is a recently described technique to address the innervation of the hip, one of the most complex anatomical regions to treat at the locoregional level.

We present the case of a patient with acute lymphoblastic leukaemia complicated by avascular necrosis of the bilateral femoral head and previous history of severe chronic pain with probable central sensitization to opioids and a severe thrombocytopenia due to myelotoxicity from chemotherapy treatment.

Given the need for orthopaedic surgery to manage femoral necrosis and in anticipation of complex perioperative pain management, a multimodal strategy was planned including bilateral ultrasound-guided continuous PENG blocks to achieve proper pain control in the perioperative period and promote early recovery. The operation and initial recovery were uneventful and the patient was discharged to the ward within 24 h and started early rehabilitation as planned. The patient had a successful recovery with good functionality.

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