Luis-Navarro J C, Seda-Guzmán M, Luis-Moreno C, López-Romero J L
Servicio de Anestesiología y Reanimación, Hospital Universitario Virgen del Rocío, Sevilla, España.
Servicio de Anestesiología y Reanimación, Hospital Universitario Virgen del Rocío, Sevilla, España.
Rev Esp Anestesiol Reanim (Engl Ed). 2018 Apr;65(4):204-208. doi: 10.1016/j.redar.2017.12.004. Epub 2018 Jan 11.
Multimodal anaesthesia, combining epidural catheter and general anaesthesia, is a common technique in thoracic surgery, however, epidural catheter placement is not always possible. Recently, erector spinae plane block has been described, which provides analgesia like that of the epidural block, although unilateral, and which has been used in various procedures at thoracic level. At present, there are no studies comparing the efficacy or safety of this block with those commonly used in thoracic surgery. However, its safety profile and contraindications seem different from those of the epidural catheter, since its placement is done under ultrasound view, the needle introduction is done in plane and the ultrasound target, the transverse process, is easily identifiable and is relatively remote from major neural or vascular structures and the pleura. Unlike other blockages made by anatomical references, erector spinae plane block can be done with the patient in different positions. We describe our experience with erector spinae plane block as part of a multimodal anaesthetic approach in thoracic surgery.
多模式麻醉，即联合硬膜外导管和全身麻醉，是胸外科手术中的常用技术，然而，硬膜外导管置入并非总是可行。最近，竖脊肌平面阻滞已被描述，它虽为单侧但能提供类似硬膜外阻滞的镇痛效果，并且已用于多种胸段手术。目前，尚无研究比较这种阻滞与胸外科常用阻滞方法的疗效或安全性。然而，其安全性和禁忌证似乎与硬膜外导管不同，因为它是在超声引导下进行置管，进针是在平面内，且超声目标——横突易于识别，相对远离主要神经、血管结构和胸膜。与其他基于解剖标志进行的阻滞不同，竖脊肌平面阻滞可在患者处于不同体位时进行。我们描述了我们在胸外科手术多模式麻醉方法中使用竖脊肌平面阻滞的经验。
