Sib sib zog nqus daim ntawv thov ntawm Echogenic koob nyob rau hauv qis Extremity Deep Nerve Block Anesthesia 1. Clinical Pain Points

https://www.nature.com/articles/s41598-024-72620-8

Kev phais orthopedic qis qis xws li pob txha pob txha, lub hauv caug arthroscopy thiab calf reconstruction xav tau cov hlab ntsha sib sib zog nqus nrog rau cov hlab ntsha sciatic thiab femoral hlab ntsha block, uas yog ib qho teeb meem tseem ceeb hauv kev tshuaj loog hauv cheeb tsam. Qhov chaw kho mob tseem ceeb nyob rau hauv cov hlab ntsha sib sib zog nqus qhov chaw thiab cov ntaub so ntswg nyuaj: lub hom phiaj cov hlab ntsha yog them los ntawm cov roj subcutaneous tuab thiab ntau- txheej cov leeg nqaij, ua rau muaj teeb meem loj heev ntawm ultrasonic attenuation. Cov koob txhaj tshuaj zoo ib yam muaj qhov tsis muaj zog nthwv dej hauv cov ntaub so ntswg sib sib zog nqus, qhov muag qhov muag qhov muag tsis pom kev thiab tsis paub txog kev sib tsoo, ua rau qhov tseeb - lub sijhawm tsis tuaj yeem. Kev coj noj coj ua ultrasound nkaus xwb tuaj yeem tso siab rau kev ua haujlwm empirical, uas yooj yim ua rau qhov tob tob tob ua rau cov hlab ntsha sib sib zog nqus thiab pleura, lossis qhov tob tsis txaus ua rau ua tsis tiav. Rau cov neeg mob rog rog nrog cov rog tuab, cov duab nyuaj ntxiv yog nce ntxiv, nrog rau qhov tshwm sim siab ntawm intraoperative analgesia insufficiency, postoperative mob rebound thiab hematoma teeb meem, cuam tshuam loj rau kev phais kev nyab xeeb thiab cov neeg mob prognosis.

2. Cov khoom siv tseem ceeb ua haujlwm

Echogenic koob rau Nerve Blocklov los ntawm cov kev bottleneck ntawm cov ntaub so ntswg sib sib zog nqus hlab ntsha thaiv los ntawm optimized ncha li technology thiab dual pov thawj mechanism. Lub siab -paj laser marking qauv ntawm stainless hlau koob nto txhim kho lub ultrasonic nthwv dej reflection efficiency, zoo tiv thaiv lub teeb liab attenuation cuam tshuam los ntawm cov rog sib sib zog nqus thiab cov leeg nqaij, thiab nthuav tawm meej thiab txuas ntxiv siab - ncha dluab nyob rau hauv qis- pom kev sib sib zog nqus cov ntaub so ntswg, realizing tag nrho - txheej txheem kev saib xyuas ntawm koob nkag. Lub tshuab hluav taws xob stimulation system muaj zog tiv thaiv - cuam tshuam kev ua haujlwm. Nws muaj peev xwm ruaj khov tso zis tsawg- zaus tam sim no los ua kom cov leeg qis qis qis hauv cov leeg nqaij cov lus teb raws li qhov kev ncua deb ntawm rab koob thiab cov hlab ntsha sib sib zog nqus xws li paj hlwb sciatic thiab femoral paj hlwb. Cov kws kho mob tuaj yeem txiav txim siab txog qhov kawg ntawm rab koob los ntawm cov hlab ntsha hluav taws xob tawm tswv yim, ywj siab ntawm ultrasound imaging clarity. Lub dual- hom kev siv thev naus laus zis ntawm kev pom thiab hluav taws xob teeb liab ua tiav daws qhov teeb meem ntawm qhov chaw nyuaj ntawm cov hlab ntsha sib sib zog nqus hauv kev phais qis.

3. Khoom Specification Classification thiab Matching

Lub hom phiaj ntawm qhov sib sib zog nqus puncture yam ntxwv ntawm qis qis hlab ntsha thaiv, echogenic koob tsim ib qho kev qhia tshwj xeeb. 8G-17G thickened enhanced echo specifications yog tshwj xeeb uas tsim los rau ultra- cov hlab ntsha sib sib zog nqus ntawm lub duav thiab pelvic phais thiab cov neeg mob rog, nrog tuab koob lub cev, muaj zog structural stability thiab zoo heev anti- attenuation imaging muaj peev xwm. 18G-20G cov lus sib sib zog nqus puncture specifications yog haum rau niaj hnub femoral paj hlwb thiab lateral femoral cutaneous hlab ntsha thaiv nyob rau hauv lub hauv caug thiab calf phais, ntsuas puncture yooj thiab ncha kev ua tau zoo. Tag nrho cov khoom siv lub zog siab kho mob stainless hlau, uas tsis yooj yim rau khoov thiab deform thaum sib sib zog nqus puncture. Tom qab electropolishing thiab kev kho kom tsis muaj menyuam, lawv muaj kev nyab xeeb thiab ruaj khov. Cov khoom txhawb kev hloov kho ntev thiab qhov loj me, thiab tuaj yeem txais cov txheej txheem thawv ntim lossis ntim ntim raws li cov neeg siv khoom xav tau, hloov mus rau ntau qhov sib sib zog nqus tshuaj loog scenarios.

4. Cov txheej txheem sib sib zog nqus puncture ua haujlwm

Ua ntej txo qis qis qis hauv cov hlab ntsha hauv qab, ntsuas tus neeg mob lub BMI, rog tuab thiab cov hlab ntsha qhov tob, thiab xaiv qhov kev sib sib zog nqus tob tob echogenic koob specifications. Txais yuav tsawg-frequency convex ultrasound sojntsuam haum rau cov ntaub so ntswg sib sib zog nqus imaging, kho qhov nce thiab qhov tob tsis zoo rau optimize cov paj hlwb sib sib zog nqus. Muab tus neeg mob tso rau hauv txoj hauj lwm sab nraud los yog supine, khij qhov khiav ntawm lub hom phiaj sib sib zog nqus paj hlwb thiab ib puag ncig cov txheej txheem vascular tseem ceeb. Txais yuav ruaj khov nyob rau hauv - hom phiaj dav hlau, ua ntej lub koob maj mam thiab sib npaug kom tsis txhob hloov qhov tob tam sim ntawd. Saib xyuas rab koob trajectory nyob rau lub sijhawm tiag tiag los ntawm ultrasound siab - ncha dluab, thiab tig lub paj hlwb rau kev kuaj xyuas. Zoo-kho lub koob txoj hauj lwm kom txog rau thaum lub hom phiaj ntawm cov leeg nqaij contraction yog induced, paub meej tias qhov tseeb koob qhov chaw. Tom qab qhov tsis zoo siab aspiration yog qhov tsis zoo, txhaj tshuaj loog hauv zos hauv cov khoom siv, saib xyuas qhov sib txawv ntawm cov tshuaj nyob ib ncig ntawm lub paj hlwb sib sib zog nqus, thiab ua kom tiav cov haujlwm thaiv tom qab lees tias tsis muaj kev phiv tshuaj.

5. Kev paub txog kev kho mob thiab kev txheeb xyuas

Clinical batch daim ntawv thov cov ntaub ntawv qhia tau hais tias echogenic koob muaj irreplaceable zoo nyob rau hauv qis extremity sib sib zog nqus paj hlwb. Rau cov neeg mob rog rog nrog BMI ntau dua 28, cov hlab ntsha sib sib zog nqus ua tiav ntawm cov koob zoo tib yam tsuas yog 63%, thaum siv cov koob tshuaj echogenic txhim kho nce qhov kev vam meej mus rau 96%. Lub anti- attenuation echo qauv daws qhov teeb meem ntawm qhov pom tsis pom lub taub hau hauv cov roj sib sib zog nqus, txo qhov kev hloov kho lub sijhawm ntau dua 70%. Lub dual-mode positioning thev naus laus zis ua kom tsis txhob muaj qhov muag tsis pom kev puas tsuaj rau cov hlab ntsha sib sib zog nqus thiab cov hlab ntsha, txo qhov tshwm sim ntawm hematoma thiab cov hlab ntsha raug mob los ntawm 68%. Qhov tseeb qhov chaw ua kom lub sij hawm siv tshuaj loog txo qis los ntawm 30%, ua rau kev siv tshuaj loog kom ruaj khov, thiab txo qhov ntau npaum li cas ntawm intraoperative cawm analgesics. Cov neeg mob tom qab phais muaj qhov mob qis dua, lub sij hawm ua kom muaj zog ua kom zoo dua qub, thiab txhim kho kev ua haujlwm zoo dua qub.

6. Summary thiab Technical Sublimation

Qhov qis qis ntawm cov hlab ntsha sib sib zog nqus ib txwm yog ib qho nyuaj rau kev tshuaj loog hauv cheeb tsam vim qhov chaw ntawm cov hlab ntsha sib sib zog nqus, cov ntaub so ntswg nyuaj thiab kev ua kom pom tseeb. Ib txwm siv ultrasound kev taw qhia thiab cov cuab yeej puncture zoo tib yam yog qhov nyuaj kom ua tau raws li qhov xav tau thiab kev nyab xeeb ntawm kev siv tshuaj loog sib sib zog nqus. Echogenic paj hlwb thaiv koob cia siab rau kev txhim kho laser echo technology thiab hluav taws xob paj hlwb stimulation dual pov thawj system kom tawg los ntawm cov kev txwv ntawm cov ntaub so ntswg sib sib zog nqus imaging thiab positioning. Nws paub qhov tseeb, muaj kev nyab xeeb thiab muaj txiaj ntsig zoo sib sib zog nqus paj hlwb, daws qhov mob ntawm qhov chaw kho mob ntawm qhov ua tau zoo tsawg thiab cov teeb meem siab ntawm cov tshuaj loog qis qis qis, thiab muab cov khoom lag luam lav rau kev ua haujlwm qis qis orthopedic phais tshuaj loog.

7. Cov kev cia siab rau yav tom ntej thiab cov lus qhia

Nrog rau kev nce ntawm cov neeg laus thiab cov neeg rog rog orthopedic, qhov kev thov kho mob rau cov hlab ntsha sib sib zog nqus block precision tshuaj loog yog nce xyoo los ntawm xyoo. Nws raug nquahu kom tsim kom muaj kev ua haujlwm tshwj xeeb tshwj xeeb rau qis qis qis hauv cov hlab ntsha sib sib zog nqus nrog cov koob echogenic, thiab ntxiv dag zog rau kev cob qhia rau cov kws tshuaj loog hauv qhov tob tob thiab tiv thaiv - kev cuam tshuam qhov chaw. Cov neeg tsim khoom yuav tsum ua kom zoo dua qhov sib sib zog nqus los tiv thaiv- ntu ntu ntu ntu ntawm cov tuab- ntsuas cov koob, txhim kho ultra- ntev tshwj xeeb tshwj xeeb rau pelvic thiab hip ultra- cov hlab ntsha sib sib zog nqus. Cov tsev kho mob yuav tsum ua kom tiav qhov kev hloov pauv ntawm cov koob sib sib zog nqus sib sib zog nqus sib sib zog nqus, tsim kom muaj cov txheej txheem kev siv tshuaj loog sib sib zog nqus, thiab txuas ntxiv txhim kho kev nyab xeeb thiab qhov tseeb ntawm qhov nyuaj qis qis ntawm cov hlab ntsha thaiv cov tshuaj loog.