Liu Yong, Yu Xiao, Sun Xingxing, Ling Qing, Wang Shaogang, Liu Jihong, Luo Ailin, Tian Yuke, Mei Wei
Department of Anesthesiology Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Medicine (Baltimore). 2016 Jul;95(28):e4156. doi: 10.1097/MD.0000000000004156.
Paravertebral block is often used to provide postoperative analgesia after renal surgery. In this case-series report, we present our experience with 3 patients in whom percutaneous nephrolithotomy was performed successfully under ultrasound-guided 3-segment lumbar-thoracic paravertebral block.
Three patients were scheduled for percutaneous nephrolithotomy. All 3 patients were high-risk cases for both general and neuraxial anesthesia. After due deliberation and with the consent of patient and his family, ultrasound-guided paravertebral block was performed. Seven to 10 mL of 0.5% ropivacaine was injected at T10/T11, T11/T12, and T12/L1 paravertebral place, respectively. Sensory loss to pinprick from T8 to L2 was achieved in all 3 patients 20 min after administration of block. Surgical procedures for all 3 patients were successful, and none of the patients complained of pain during the operation.
Ultrasound-guided multilevel paravertebral block may be an attractive option for anesthetic management of percutaneous nephrolithotomy in clinical practice.
椎旁阻滞常用于肾脏手术后的术后镇痛。在本病例系列报告中，我们介绍了3例在超声引导下3节段胸腰段椎旁阻滞成功实施经皮肾镜取石术的经验。
3例患者计划行经皮肾镜取石术。所有3例患者均为全身麻醉和椎管内麻醉的高危病例。经过充分考虑并征得患者及其家属同意后，实施了超声引导下椎旁阻滞。分别在T10/T11、T11/T12和T12/L1椎旁部位注射7至10毫升0.5%罗哌卡因。给药20分钟后，所有3例患者均出现从T8至L2的针刺感觉丧失。所有3例患者的手术均成功，且术中无一例患者主诉疼痛。
在临床实践中，超声引导下多级椎旁阻滞可能是经皮肾镜取石术麻醉管理的一个有吸引力的选择。
