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根治性乳房切除术中的竖脊肌平面阻滞:一种新的适应证?

Erector spinae plane block for radical mastectomy: A new indication?

作者信息

Veiga M, Costa D, Brazão I

机构信息

Servicio de Anestesiología, Hospital Central do Funchal, Funchal, Portugal.

Servicio de Anestesiología, Hospital Central do Funchal, Funchal, Portugal.

出版信息

Rev Esp Anestesiol Reanim (Engl Ed). 2018 Feb;65(2):112-115. doi: 10.1016/j.redar.2017.08.004. Epub 2017 Nov 2.

Abstract

The erector spinae plane block is a technique recently described by Forero et al. in September 2016. It has applications in the control of chronic pain with neuropathic component of the chest wall, and for pain control in thoracoscopic surgery. In this article, we describe the use of this technique as part of a multimodal analgesic approach in a 40-year-old woman, who underwent radical mastectomy due to breast cancer. By performing this block before anesthetic induction, we have achieved an opioid sparing effect, avoiding a possible immunomodulatory effect, although not yet proven in humans. During hospitalization, the patient reported no pain (0/10 in numeric scale), without resorting to rescue analgesia. The easy, fast and safe execution of erector spinae plane block makes it a promising technique in the context of surgical pain during radical mastectomy.

摘要

竖脊肌平面阻滞是Forero等人于2016年9月最近描述的一种技术。它可用于控制伴有胸壁神经病理性成分的慢性疼痛,以及用于胸腔镜手术中的疼痛控制。在本文中,我们描述了在一名因乳腺癌接受根治性乳房切除术的40岁女性中,将该技术用作多模式镇痛方法的一部分。通过在麻醉诱导前进行这种阻滞,我们实现了阿片类药物节省效应,避免了可能的免疫调节作用,尽管这在人类中尚未得到证实。住院期间,患者报告无疼痛(数字评分法为0/10),无需使用补救性镇痛。竖脊肌平面阻滞操作简便、快速且安全,使其在根治性乳房切除术手术疼痛的背景下成为一种有前景的技术。

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