BACKGROUND Cases of obturator nerve impingement(ONI)caused by osteophytes resulting from bone hyperplasia on the sacroiliac articular surface have never been reported.This paper presents such a case in a patient in wh...BACKGROUND Cases of obturator nerve impingement(ONI)caused by osteophytes resulting from bone hyperplasia on the sacroiliac articular surface have never been reported.This paper presents such a case in a patient in whom severe lower limb pain was caused by osteophyte compression of the sacroiliac joint on the obturator nerve.CASE SUMMARY A 65-year-old Asian man presented with severe pain and numbness in his left lower limb,which became aggravated during walking and showed intermittent claudication.The physical examination revealed that the muscle strength of the left lower limb had decreased and that the passive knee flexion test result was positive.Computed tomography(CT)and 3D reconstruction showed a large osteophyte located in the anterior lower part of the left sacroiliac joint.The results of electrophysiological examination showed peripheral neuropathy.A CT-guided obturator nerve block significantly reduced the severity of pain in this patient.According to the above findings,ONI caused by the osteophyte in the sacroiliac joint was diagnosed.This patient underwent an operation to remove the bone spur and symptomatic treatment.After therapy,the patient's pain and numbness were significantly relieved.The last follow-up was performed 6 mo after the operation,and the patient recovered well without other complications,returned to work,and resumed his normal lifestyle.CONCLUSION Osteophytes of the sacroiliac joint can cause ONI,which leads to symptoms including severe radiative pain in the lower limb in patients.The diagnosis and differentiation of this disease should attract the attention of clinicians.Surgical excision of osteophytes should be considered when conservative treatment is not effective.展开更多
Objective: To observe the advantage of total intravenous anesthesia for transurethral resection of bladder tumor (TURBT). Methods.. Sixty ASA Ⅰ-Ⅱ patients undergoing TURBT were randomly assigned to 2 groups. Spin...Objective: To observe the advantage of total intravenous anesthesia for transurethral resection of bladder tumor (TURBT). Methods.. Sixty ASA Ⅰ-Ⅱ patients undergoing TURBT were randomly assigned to 2 groups. Spinal anesthesia with 0. 75% pure bupivacaine (8-12 rag) was applied to patients in Group Ⅰ (n= 30). Patients in Group Ⅱ (n=30) received total intravenous anesthesia with continuous infusion of Propofol and Remifentanil ; and a laryngeal mask was used to ensure the airway and ventilation. BP, HR, SPO2 and pertinent side effects were monitored and recorded. Results : The patients in group Ⅱ experienced more stable hemodynamics than those in group Ⅰ . Obturator nerve reflex was observed in 15 (50. 0%) patients in Group Ⅰ , but none (0%) in Group Ⅱ (P〈0. 01). Conclusion.. Total intravenous anesthesia with laryngeal mask is a safe, reliable, controllable and simple manual for patient undergoing TURBT.展开更多
文摘BACKGROUND Cases of obturator nerve impingement(ONI)caused by osteophytes resulting from bone hyperplasia on the sacroiliac articular surface have never been reported.This paper presents such a case in a patient in whom severe lower limb pain was caused by osteophyte compression of the sacroiliac joint on the obturator nerve.CASE SUMMARY A 65-year-old Asian man presented with severe pain and numbness in his left lower limb,which became aggravated during walking and showed intermittent claudication.The physical examination revealed that the muscle strength of the left lower limb had decreased and that the passive knee flexion test result was positive.Computed tomography(CT)and 3D reconstruction showed a large osteophyte located in the anterior lower part of the left sacroiliac joint.The results of electrophysiological examination showed peripheral neuropathy.A CT-guided obturator nerve block significantly reduced the severity of pain in this patient.According to the above findings,ONI caused by the osteophyte in the sacroiliac joint was diagnosed.This patient underwent an operation to remove the bone spur and symptomatic treatment.After therapy,the patient's pain and numbness were significantly relieved.The last follow-up was performed 6 mo after the operation,and the patient recovered well without other complications,returned to work,and resumed his normal lifestyle.CONCLUSION Osteophytes of the sacroiliac joint can cause ONI,which leads to symptoms including severe radiative pain in the lower limb in patients.The diagnosis and differentiation of this disease should attract the attention of clinicians.Surgical excision of osteophytes should be considered when conservative treatment is not effective.
文摘Objective: To observe the advantage of total intravenous anesthesia for transurethral resection of bladder tumor (TURBT). Methods.. Sixty ASA Ⅰ-Ⅱ patients undergoing TURBT were randomly assigned to 2 groups. Spinal anesthesia with 0. 75% pure bupivacaine (8-12 rag) was applied to patients in Group Ⅰ (n= 30). Patients in Group Ⅱ (n=30) received total intravenous anesthesia with continuous infusion of Propofol and Remifentanil ; and a laryngeal mask was used to ensure the airway and ventilation. BP, HR, SPO2 and pertinent side effects were monitored and recorded. Results : The patients in group Ⅱ experienced more stable hemodynamics than those in group Ⅰ . Obturator nerve reflex was observed in 15 (50. 0%) patients in Group Ⅰ , but none (0%) in Group Ⅱ (P〈0. 01). Conclusion.. Total intravenous anesthesia with laryngeal mask is a safe, reliable, controllable and simple manual for patient undergoing TURBT.