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颈段硬膜外麻醉下巨大血管瘤切除术:全身麻醉的可行替代方案

Giant Haemangioma Excision Under Cervical Epidural Anaesthesia: A Viable Alternative to General Anaesthesia.

作者信息

Parua Samit, Choudhury Dipika, Nath Mridu Paban

机构信息

Student, Department of Anaesthesiology and Critical Care, Gauhati Medical College and Hospital , Guwahati, Assam, India .

Professor and Head, Department of Anaesthesiology and Critical Care, Gauhati Medical College and Hospital , Guwahati, Assam, India .

出版信息

J Clin Diagn Res. 2016 Nov;10(11):UD01-UD02. doi: 10.7860/JCDR/2016/22674.8857. Epub 2016 Nov 1.

Abstract

The cervical epidural anaesthesia is a safe anaesthetic technique with minimal morbidity and early postoperative recovery. Cervical epidural anaesthesia can be effectively used for neck, upper arm and chest surgeries. The technique avoids the adverse effects of general anaesthetics and airway instrumentation, especially in patients with cardio respiratory disorders. We preferred CEA for giant haemangioma neck excision in an adult female patient, having an associated laryngeal haemangioma, 10ml of 0.5% ropivacaine with 50μg Fentanyl (total 11 ml) was administered into the cervical epidural space through a 20G epidural catheter introduced via a 18G Tuohy needle at the level of C7-T1 space. Following initial dose a top up dose of 4ml 0.5% Ropivacaine was given after 60 minutes. The surgery lasted for 75 minutes. The cervical epidural anaesthesia allowed our patient to stay awake but comfortable, with stable haemodynamics and excellent postoperative pain relief with a continuous cervical epidural infusion of 0.25% Ropivacaine and 2μg/ml Fentanyl @ 2ml/h was achieved.

摘要

颈椎硬膜外麻醉是一种安全的麻醉技术,发病率极低,术后恢复快。颈椎硬膜外麻醉可有效用于颈部、上臂和胸部手术。该技术避免了全身麻醉和气道器械操作的不良反应,尤其是在患有心肺疾病的患者中。我们更倾向于对一名成年女性患者采用颈椎硬膜外麻醉进行巨大颈部血管瘤切除术,该患者伴有喉部血管瘤,通过在C7-T1间隙经18G Tuohy针置入的20G硬膜外导管,将10ml含50μg芬太尼的0.5%罗哌卡因(共11ml)注入颈椎硬膜外间隙。首次给药后60分钟给予4ml 0.5%罗哌卡因的追加剂量。手术持续了75分钟。颈椎硬膜外麻醉使我们的患者保持清醒但舒适,血流动力学稳定,通过持续颈椎硬膜外输注0.25%罗哌卡因和2μg/ml芬太尼(速度为2ml/h)实现了出色的术后疼痛缓解。

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本文引用的文献

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