全身麻酔下にリアルタイム超音波ガイドを用いて腰部硬膜外カテーテル留置を行い，有効な鎮痛が得られた骨盤骨折の1症例

Real-Time Ultrasound-Guided Lumbar Epidural Catheterization under General Anesthesia：A Case of Pelvic Fracture with Effective Analgesia

要旨

　全身麻酔下でリアルタイム超音波ガイドを用いた腰部硬膜外カテーテルの留置により良好な鎮痛が得られた症例を経験した。今回のようにさまざまな制約から，全身麻酔下に硬膜外麻酔を行う必要がある場合，リアルタイム超音波ガイドを用いることで成功率が上昇し，合併症のリスクを低減できるかもしれない。

　We describe a case of effective analgesia during real-time ultrasound-guided lumbar epidural catheterization for adult patient with a pelvic fracture, under general anesthesia. Although coverage of both the lumbar plexus and sacral plexus was desired after posterior acetabular plate fixation, we were able to provide effective analgesia in this case. When an epidural catheter is being placed in a patient who is under general anesthesia due to various restrictions（as in the present case）, the use of real-time ultrasound guidance may increase the success rate and reduce the risk of complications. A further accumulation of similar cases is anticipated.