Release date: 2014-07-09 Guangzhou Daily News (Reporter Wang He correspondent Ning Xiyuan, Wu Jianpeng) 13-year-old Xiao Huang was diagnosed with multiple neurofibromatosis within half a year of birth. Recently, Xiaohuang was swollen in the left lower limb due to swelling and partial ulceration. In order to save his life, the left lower limb with worsening infection must be cut off, but the anesthesia has encountered difficulties. Xiaohuang cannot perform spinal anesthesia because of severe scoliosis. Because of the serious decline in heart and lung and liver and kidney function caused by infection, and the original chest and lung abnormalities, the risk of general anesthesia is also extremely high. After consultation, the anesthesiologist decisively adopted a nerve block anesthesia program, using high-frequency ultrasound instruments to accurately locate the four nerves of the lower limbs of Xiaohuang and block them one by one. Xiaohuang completed the operation in a completely awake state, and escaped the danger. . Dr. Chen Yuming, Department of Anesthesiology, Nanfang Hospital, Southern Medical University, said that in the past, nerve block anesthesia relied mainly on blind or nerve electrical stimulation. With the development of ultrasound visualization technology, the nerve block anesthesia technology guided by ultrasound imaging has great Progress, a "precise blow" that visualizes the peripheral nerves. Multiple factors determine the anesthesia program Chen Yuming said that the choice of anesthesia is mainly determined by three factors, namely, surgical factors, patient factors and anesthesia factors. The anesthesiologist will generally conduct a thorough evaluation of the patient prior to surgery. In addition to general anesthesia and spinal anesthesia, the nerve block anesthesia is also described in the textbook. Traditional nerve block anesthesia has poor accuracy, low success rate and limited locality. With the help of ultrasound navigation technology, peripheral nerve block anesthesia is increasingly showing its potential value. “Older people often give up surgery because of the high risk of anesthesia. It is a misunderstanding.†Chen Yuming said that elderly people with old age generally have contraindications for body organ decline and many traditional anesthesia methods, which are not as strong as young people's ability to withstand surgery. The family members of the patient are concerned about the high risk of surgery. They do not dare to choose to perform surgery on the elderly, so that the elderly can be injured in bed. This is not the right idea. “The surgery itself is risky, but anesthesia often poses a greater risk to older patients. However, with accurate visual nerve block, we can minimize the risk and thus greatly improve the patient’s surgical treatment. The possibility." Chen Yuming said that almost all operations from head to toe can use nerve block. If the patient is only operated on the extremities or the chest and abdomen, the nerve block can be taken alone. If the surgical invasion is more extensive, the combined use of nerve block can greatly reduce the amount of other anesthetics, reduce physiological interference, thereby improving intraoperative stability, increasing safety and improving postoperative comfort. Ultrasound navigation anesthesia is clear Chen Yuming introduced that the positioning technique of nerve block has gone through three stages, blind detection, nerve stimulation and ultrasound localization. Finding the opposite feeling is a method still used by many hospitals in China. It does not require any equipment, but roughly locates the nerve according to the surface anatomical landmarks, and then judges whether the position is appropriate through the patient's complaint. The failure rate and complication rate of this method are high, and patients need to cooperate. Often, the effect is incomplete or failure, and other or change anesthesia methods are needed. The neurostimulator achieves the functional localization of the nerve by giving appropriate muscle stimulation to the corresponding muscle contraction movement. Although the nerve stimulator improves the success rate of the block, it is still a trial-and-error blind puncture and requires electrical stimulation, which is painful. Nowadays, nerve block anesthesia is intuitively visualized with the help of ultrasound. Chen Yuming introduced that ultrasound is what we often say B-ultrasound, but unlike ordinary B-ultrasound, high-frequency B-ultrasound is used in nerve block anesthesia. This type of B-ultrasound can accurately locate the nerve and puncture needle and reduce puncture. The number of times greatly increases the success rate. Ultrasound can not only see the target nerve, but also understand the adjacent relationship between the blood vessels, tendons and fascia around the nerve and the distance from the skin. Under ultrasound, the real-time dynamics of the needle tip or the position of the catheter can be observed. Less medication, effective in reducing complications In addition to the intuitive advantages, ultrasound navigation can help design a more reasonable path for the puncture needle to approach the nerve, and it can be injected in multiple steps, which is beneficial to the local anesthetic evenly distributed around the nerve, so the anesthesia is more effective and the local anesthetic dose is reduced. . Ultrasound images can show nerves, blood vessels, fascia and other tissues, as well as the spread of puncture needles and local anesthetics, thus avoiding the accidental injury to blood vessels, accidental injection of blood vessels, accidental puncture of the pleura or lungs, hemorrhage, local anesthetic poisoning and Serious complications such as pneumothorax. Ultrasound can anatomically locate the nerve. Generally, the patient does not need special coordination. The process is like B-ultrasound examination, no pain and discomfort. It is of great significance for the nerve block of some special populations such as obesity, pediatric, deformed and difficult to cooperate. . Which operations can be anesthetized with nerve block? What are the procedures for nerve block anesthesia? According to Chen Yuming, peripheral nerve block can be used for almost all operations from head to toe. If surgery is only involving the extremities or the chest and abdomen, it is ok to use nerve block alone. For example, hip replacement, knee surgery, and superficial breast surgery avoid general anesthesia. The patient is awake and comfortable during the operation. There is no nausea, vomiting, and hangover after the operation. There is no need to indwell the catheter, and he can quickly eat and defecate. For larger operations such as thoracic and abdominal surgery, nerve block can also greatly reduce the amount of various general anesthetics, intraoperative anesthesia is more stable and satisfactory, postoperative pain is easier to control, hospitalization time is shortened, and medical expenses are also significantly reduced. Source: Guangzhou Daily Fire Alarm Components And Linkage Components Fire Alarm Components And Linkage Components,Fire Smoke Alarm System,Intelligent Smoke Alarm System,Fire Alarm Programmer LIAONING YINGKOU TIANCHENG FIRE PROTECTION EQUIPMENT CO.,LTD , https://www.tcfiretech.com