Sato Nanako, Sugiura Takahiro, Takahashi Kyosuke, Kato Go, Kamada Takaaki, Mori Yosuke, Kobayashi Yoshiro
Masui. 2014 Jun;63(6):640-3.
Paraplegia is a serious complication after thoracoabdominal aortic aneurysm repair. Therefore, maintenance of spinal cord perfusion pressure, drainage of cerebrospinal fluid, and avoidance of opioids are important for prevention of paraplegia Management of acute post-thoracotomy pain is necessary not only to keep the patient comfortable but also to minimize postoperative complications. However, epidural analgesia, a common method of pain control, is hard to use because of existing postoperative coagulopathy and avoidance of spinal cord ischemia Although both paravertebral block and epidural analgesia provide comparable pain relief after thoracic surgery, paravertebral block has lesser detrimental effects on spinal cord perfusion and better preserves the possibility to monitor neurologic function than epidural analgesia. We report 7 cases in which paravertebral blockade was used for analgesia in patients who underwent thoracoabdominal aneurysm repair.
截瘫是胸腹主动脉瘤修复术后的一种严重并发症。因此，维持脊髓灌注压、引流脑脊液以及避免使用阿片类药物对于预防截瘫至关重要。急性开胸术后疼痛的管理不仅对于让患者保持舒适很有必要，而且对于将术后并发症降至最低也很有必要。然而，硬膜外镇痛作为一种常用的疼痛控制方法，由于存在术后凝血功能障碍以及避免脊髓缺血而难以使用。尽管椎旁阻滞和硬膜外镇痛在胸科手术后提供的疼痛缓解效果相当，但与硬膜外镇痛相比，椎旁阻滞对脊髓灌注的有害影响较小，并且更好地保留了监测神经功能的可能性。我们报告了7例在接受胸腹主动脉瘤修复术的患者中使用椎旁阻滞进行镇痛的病例。
