将双侧颈浅神经丛阻滞作为慢性肾病患者甲状旁腺手术的唯一麻醉方式

Dr. Kanika Agarwal, Dr. Nidhi Sharma, Dr. Aseem Sharma, Dr. Manish Banjare
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引用次数: 0

摘要

慢性肾脏病(CKD),尤其是接受甲状旁腺切除手术的 III、IV 和 V 期患者,在麻醉方面需要特别注意。他们的肾病限制了可用于全身麻醉诱导和管理的药物选择。在超声引导下进行双侧颈浅神经丛阻滞(SCPB)可作为此类患者甲状旁腺手术的替代麻醉方式。本病例系列旨在评估在接受甲状旁腺手术的 CKD(III、IV、V 期)患者中使用双侧 SCPB 在血液动力学稳定性、术中和术后镇痛以及外科医生满意度方面的有效性。在本病例系列中,在无菌预防措施下进行了 USG 引导下的双侧 SCPB,并在每侧注射了 10 毫升局麻药。用湿棉签和钝针刺确认效果。然后,患者被移交给外科医生。对患者进行了连续的血流动力学监测,并记录了首次镇痛抢救的时间。事实证明,对于接受甲状旁腺手术的慢性肾功能衰竭(III、IV、V期)患者来说,双侧SCPB是一种很好的替代麻醉方式。
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Bilateral superficial cervical plexus block as sole anesthesia for parathyroid surgeries in chronic kidney disease patients
Chronic kidney disease (CKD), especially in stages III, IV, V patients presenting for surgical removal of parathyroid glands, has special concerns regarding anesthesia. Their renal disease restricts the choice of drugs that can be used for general anesthesia induction and management. Bilateral superficial cervical plexus block (SCPB) under ultrasound guidance can be an alternative mode of anesthesia in parathyroid surgeries in these patients. The aim of the present case series was to evaluate the effectiveness of bilateral SCPB in CKD (stages III, IV, V) patients undergoing parathyroid surgeries in terms of hemodynamic stability, intraoperative and post-operative analgesia, and surgeon’s satisfaction. In the present case series, USG-guided bilateral SCPB was performed under aseptic precautions and 10 mL of local anesthetic was injected on each side. Effect was confirmed with wet swab and blunt pin prick. Then, patient was handed over to the surgeon. Continuous hemodynamic monitoring was done and time of first rescue analgesia was noted. Bilateral SCPB proved to be a good alternative mode of anesthesia for CKD (stages III, IV, V) patients undergoing parathyroid surgeries.
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