Department of Anaesthesia, Christchurch Hospital, Christchurch, New Zealand.
Anaesthesia. 2013 Apr;68(4):417-20. doi: 10.1111/anae.12108. Epub 2012 Dec 17.
This report describes the use of a transversus abdominis plane block as the main anaesthetic technique for the performance of a hemiarthroplasty in a patient with severe cardiac and respiratory dysfunction, for whom both general and spinal anaesthesia carried considerable risks. The block was performed in the triangle of Petit posterior to the mid-axillary line, using a landmark technique. A combination of lidocaine 1% (20 ml) and bupivacaine 0.5% (20 ml) was administered. A low-dose propofol infusion was used intra-operatively to relieve anxiety, although the patient breathed spontaneously throughout the procedure and responded to voice commands. The surgery was completed successfully without the need for further analgesia. The patient was alert and comfortable in recovery. First opioid administration was 12 h after surgery. The patient was subsequently discharged to a nursing home, where he succumbed to his primary respiratory disease six months later.
本报告描述了在一名患有严重心肺功能障碍的患者中使用腹横肌平面阻滞作为半髋关节置换术的主要麻醉技术，对于该患者，全身麻醉和脊髓麻醉都存在相当大的风险。阻滞在腋中线后小方肌的 Petit 三角内进行，使用体表标志技术。给予 1%利多卡因（20ml）和 0.5%布比卡因（20ml）的混合物。术中使用小剂量丙泊酚输注以缓解焦虑，但患者在整个过程中自主呼吸并对语音指令做出反应。手术顺利完成，无需进一步镇痛。患者在恢复过程中清醒且舒适。术后 12 小时首次给予阿片类药物。随后，患者出院到疗养院，六个月后死于原发性呼吸系统疾病。
