连续性脊束肌平面阻滞用于主动脉切除术胸廓切开术后的疼痛治疗

Journal of medical cases Pub Date : 2024-01-01 Epub Date: 2024-01-28 DOI:10.14740/jmc4177
Jay D Holladay, Christopher McKee, Olubukola O Nafiu, Joseph D Tobias, Ralph J Beltran
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引用次数: 0

摘要

胸廓切开术后疼痛是最严重的术后疼痛之一。胸廓切开术后疼痛可能会增加术后肺部并发症和术后死亡率的风险,延长住院时间,并增加医疗资源的使用。为了减轻这些影响,麻醉提供者通常采用连续硬膜外输液、椎旁阻滞和全身阿片类药物来控制疼痛和改善肺力学。我们报告了通过外周神经导管使用连续性竖脊肌平面阻滞(ESPB)对一名 18 岁患者进行术后疼痛管理的情况,该患者在心肺旁路的辅助下通过侧胸腔切开术接受了复杂的主动脉瓣闭锁修复术。事实证明,连续ESPB是一种可接受的术后疼痛控制替代方法,它能产生大量的多皮层感觉阻滞,从而实现充分的疼痛控制,减少阿片类药物的用量,并可能缩短住院时间。
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Continuous Erector Spinae Plane Block for Pain Management Following Thoracotomy for Aortic Coarctectomy.

Pain following thoracotomy is one of the most severe forms of postoperative pain. Post-thoracotomy pain may increase the risk of post-surgical pulmonary complications, postoperative mortality, prolong hospitalization, and increase utilization of healthcare resources. To mitigate these effects, anesthesia providers commonly employ continuous epidural infusions, paravertebral blocks, and systemic opioids for pain management and improvement of pulmonary mechanics. We report the use of a continuous erector spinae plane block (ESPB) via a peripheral nerve catheter for postoperative pain management of an 18-year-old patient who underwent complex aortic coarctation repair via lateral thoracotomy, aided by cardiopulmonary bypass. Continuous ESPB proved to be an acceptable alternative for postoperative pain control, producing a substantial multi-dermatomal sensory block, resulting in adequate pain control, reduced opioid consumption, and a potentially shorter hospital stay.

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