Abstract:
Transverse myelitis is a rare inflammatory condition typically presenting with symptoms like muscle weakness, sensory issues, and problems affecting bowel and bladder function. In this study, we describe the successful anesthesia management of an adult patient with transverse myelitis exhibiting spastic paralysis and compromised cardiopulmonary reserves, whose preferred resting position was lateral decubitus. Targeted anesthesia was administered via a supraclavicular approach to the brachial plexus block for wrist deformity fixation surgery, mitigating the pulmonary complications associated with general anesthesia, achieving earlier recovery, and avoiding the use of opioids. This case underscores the significance of customizing the patient\'s personalized positioning, while also highlighting the potential for effective regional anesthesia in atypical positions. We illustrate the successful use of supraclavicular brachial plexus block for left wrist deformity fixation and debridement surgery in the lateral decubitus, the most convenient position for the transverse myelitis patient with spastic paraplegia.
摘要:
横向脊髓炎是一种罕见的炎症性疾病,通常表现为肌肉无力等症状,感官问题,以及影响肠道和膀胱功能的问题。在这项研究中,我们描述了一名患有横贯性脊髓炎的成年患者的成功麻醉管理,该患者表现为痉挛性瘫痪和心肺储备受损。其首选的休息位置是侧卧位。通过锁骨上入路臂丛神经阻滞进行有针对性的麻醉,用于腕关节畸形固定手术,减轻与全身麻醉相关的肺部并发症,实现更早的复苏,避免使用阿片类药物。这个案例强调了定制患者个性化定位的重要性,同时也强调了在非典型位置进行有效区域麻醉的潜力。我们说明了在侧卧位中成功使用锁骨上臂丛神经阻滞进行左手腕畸形固定和清创手术,对于痉挛型截瘫的横贯性脊髓炎患者最方便的位置。