首页|经脊柱椎间隙穿刺蛛网膜下腔脑桥前池置管药物输注技术应用指南

经脊柱椎间隙穿刺蛛网膜下腔脑桥前池置管药物输注技术应用指南

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目的:鞘内镇痛药物的分布特点和目前置管技术的限制使传统的鞘内镇痛方法对头面部难治性疼痛无法发挥作用.本技术应用指南的制订旨在促进经脊柱椎间隙穿刺蛛网膜下腔脑桥前池置管药物输注技术的推广和规范、安全应用.方法:工作小组采用改良德尔菲法,邀请本技术领域的10名专家对脑桥前池药物输注技术的相关议题进行3轮电子邮件函询及3轮现场会议讨论.结果:针对脑桥前池药物输注技术的有效性和安全性,在技术原理、适应证和禁忌证、患者准备、脑桥前池置管手术规范、镇痛药物选择和剂量衔接、术后镇痛管理和并发症防治共7个议题形成一致意见(同意率≥80%).结论:脑桥前池药物输注镇痛技术应用于头面部难治性疼痛患者具有微创、安全、有效的优点,既可减轻长期罹受疼痛患者的痛苦,也能帮助一些患者保持人生最后一程的生活质量和生命尊严,值得在国内外相关专业领域推广和规范应用.
Technical guideline for intra-prepontine cisternal drug delivery via spinal puncture through subarachnoid catheterization
Objective:The distribution characteristics of intrathecal drugs and the limitation of current catheterization techniques make traditional intrathecal analgesic treatment nearly useless for refractory craniofacial pain,such as trigemina neuralgia.This technical guideline aims to promote the widespread and standardize the application of intra-prepontine cisternal drug delivery via spinal puncture and catheterization.Methods:A modified Delphi approach was used to work for this guideline.On the issues related to the intra-prepontine cisternal targeted drug delivery technique,the working group consulted 10 experts from the field with 3 rounds of email feedback and 3 rounds of conference discussion.Results:For the efficacy and safety of the intra-prepontine cisternal targeted drug delivery technique,a consensus was formed on 7 topics(with an agreement rate of more than 80%),including the principles of the technique,indications and contraindications,patient preparation,surgical specifications for intra-prepontine cisternal catheter placement,analgesic dosage coordination,analgesic management,and prevention and treatment of complications.Conclusion:Utilizing the intra-prepontine cisternal drug infusion system to manage refractory craniofacial pain could provide advantages in terms of minimally invasive,secure,and effective treatment.This application can not only alleviate the suffering of individuals experiencing the prolonged pain but also support the maintenance of quality of life and dignity in their final moments,justifiing its widespread dissemination and standardized adoption in domestic and international professional fields.

intrathecal drug deliveryprepontine cisterncancer painneuropathic painrefractory paincraniofacial painmodified Delphi

李欣宁、王亚平、邹定全、张伟、李欣、贺佩瑶、周浩宬、杨彤飚、朱钧、洪波、张宇、肖艳英

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中南大学湘雅二医院疼痛科,长沙 410011

湖南省疼痛临床医学研究中心,长沙 410011

中南大学湘雅三医院疼痛科,长沙 410013

永州市中心医院疼痛科,湖南 永州 425002

怀化市第一人民医院疼痛科,湖南 怀化 418099

岳阳市中医医院疼痛科,湖南 岳阳 414021

湖南省人民医院疼痛科,长沙 410005

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鞘内药物输注 脑桥前池 癌性疼痛 神经病理性疼痛 难治性疼痛 头面部疼痛 改良德尔菲法

湖南省重点研发计划湖南省卫生健康委科研项目湖南省重点研发计划

2020SK20792021041123042020SK2097

2024

中南大学学报(医学版)
中南大学

中南大学学报(医学版)

CSTPCD北大核心
影响因子:1.459
ISSN:1672-7347
年,卷(期):2024.49(1)
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