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单孔胸腔镜手术治疗原发性自发性气胸时的新型椎旁阻滞

Novel paravertebral block during single-incision thoracoscopic surgery for primary spontaneous pneumothorax.

作者信息

Tsuboshima Kenji, Nagata Machiko, Wakahara Teppei, Matoba Yasumi, Nishio Wataru, Maniwa Yoshimasa

机构信息

Department of Thoracic Surgery, Takasago Municipal Hospital, 33-1 Kamimachi, Arai Town, Takasago, Hyogo, 676-8585, Japan.

Department of Thoracic Surgery, Hyogo Cancer Center, Akashi, Japan.

出版信息

Gen Thorac Cardiovasc Surg. 2016 Jan;64(1):58-61. doi: 10.1007/s11748-015-0584-1. Epub 2015 Sep 7.

Abstract

Recently, the use of paravertebral block (PVB) during thoracic surgery has been re-evaluated, as it is not inferior to epidural anaesthesia for postoperative pain control, and has been associated with fewer complications (e.g., hematoma of epidural, hypotension, urinary retention, postoperative nausea and vomiting). No reports have described intraoperative catheterization for PVB during single-incision thoracoscopic surgery (SITS) as distinct from thoracotomy or multi-ports video-assisted thoracoscopic surgery. We describe a case of SITS bullectomy using a chest wall pulley for lung excision to treat primary spontaneous pneumothorax and 25 catheterizations for PVB during SITS that have been performed since June 2013. Our novel technique is both easy and safe. It is ideal to combine PVB with SITS because both methods are less invasive.

摘要

最近,胸段手术中椎旁阻滞(PVB)的应用已被重新评估,因为其在术后疼痛控制方面并不逊色于硬膜外麻醉,且并发症较少(如硬膜外血肿、低血压、尿潴留、术后恶心和呕吐)。尚无报告描述单孔胸腔镜手术(SITS)中与开胸手术或多孔电视辅助胸腔镜手术不同的PVB术中置管情况。我们描述了1例自2013年6月以来使用胸壁滑轮进行肺切除的SITS肺大疱切除术治疗原发性自发性气胸的病例,以及SITS期间进行的25次PVB置管。我们的新技术既简单又安全。将PVB与SITS相结合是理想的,因为这两种方法的侵入性都较小。

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