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【medical-news】Ultrasound aids emergency hand procedure an
11/28/2006
By: Reuters Health
NEW YORK (Reuters Health), Nov 28 - Forearm ultrasound-guided nerve (FUN) blocks are effective for providing anesthesia for hand procedures in the emergency department, and compared to many other techniques, are easy to accomplish, California-based researchers report in the November issue of Annals of Emergency Medicine.
"FUN blocks are performed in the mid forearm, away from structures of the wrist, such as the carpel tunnel where there is risk of damage to the median nerve," lead investigator Dr. Otto Liebmann told Reuters Health.
"With the FUN block, the nerves and arteries can be visualized live-time during the procedure to avoid the risk of puncture," he added.
To evaluate the utility of the block, Dr. Liebmann of Highland Hospital, Oakland, and colleagues prospectively studied 11 patients require hand anesthesia. Blocks were performed using ultrasonography guidance, by attending physicians, ultrasonography fellows or residents who had participated in a one-hour training session.
No additional anesthesia was required in any of the patients and all had significant reduction in visual analogue pain scores. Patients had a median of two blocks and the median completion time for the blocks was nine minutes. There were no complications immediately or at three months' follow-up.
Ten of the 11 patients said that should they have similar injuries in the future, they would want to have such blocks.
Another advantage of the FUN block injections compared to conventional approaches is that "they can be performed further away from the damaged tissue that is being repaired in the hand, thereby reducing further damage and potentially minimizing pain," Dr. Liebmann said.
"This new technique reflects the new prominent role of bedside ultrasound in emergency medicine," he added.
By David Douglas
http://www.auntminnie.com/index.asp?Sec=sup&Sub=ult&Pag=dis&ItemId=73710 Ultrasound aids emergency hand procedure anesthesia
11/28/2006
By: Reuters Health
NEW YORK (Reuters Health), Nov 28 - Forearm ultrasound-guided nerve (FUN) blocks are effective for providing anesthesia for hand procedures in the emergency department, and compared to many other techniques, are easy to accomplish, California-based researchers report in the November issue of Annals of Emergency Medicine.
"FUN blocks are performed in the mid forearm, away from structures of the wrist, such as the carpel tunnel where there is risk of damage to the median nerve," lead investigator Dr. Otto Liebmann told Reuters Health.
纽约（路透社）消息，11月28日——加利福尼亚研究人员在11月份的急诊医学学报著文指出：在超声引导下进行前臂神经阻滞麻醉可以在急诊科为手外科手术提供有效麻醉，与其它技术相比，易于实现。
"With the FUN block, the nerves and arteries can be visualized live-time during the procedure to avoid the risk of puncture," he added.
他说：“在前臂神经麻醉操作中，可以实时观察神经和血管，防止误刺误伤。”。
To evaluate the utility of the block, Dr. Liebmann of Highland Hospital, Oakland, and colleagues prospectively studied 11 patients require hand anesthesia. Blocks were performed using ultrasonography guidance, by attending physicians, ultrasonography fellows or residents who had participated in a one-hour training session.
为了评价这一技术的价值，Highland医院的Liebmann博士小组研究了11例手外科麻醉病例。在超声引导下进行麻醉操作，由住院医师，超声医生，或者接受1个小时培训之后的其它医务人员进行操作。
No additional anesthesia was required in any of the patients and all had significant reduction in visual analogue pain scores 对于本文的观点：这样作可以防止误刺、误伤神经和血管，表示赞同。但是应该主要是防止误伤血管，至于神经，应该是可以看见的，因为这个部位的神经还是比较粗大的，不过不是搞b超的，也不敢说得太绝对。
但是对于与传统方法相比的观点，不能苟同的，因为在我实习的时候，我们采用臂丛麻醉的方法，虽然是优点和本文说的是一样的，不过估计本文的麻醉方法离伤口是远一些，但是尚不到臂丛那么远的位置。
推测：可能如果采用我们的麻醉技术，就得进手术室，属于较大手术了，如果采用本文的技术，可能只要在急诊的换药室就可以完成。如果推测成立，那么意义还是很大的，另外，我们的臂丛麻醉，也是经验，没有b超引导，不除外有损伤血管的可能性。 [标签:content1][标签:content2]
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作者:admin@医学,生命科学 2011-04-16 17:11
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