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连续竖脊肌平面阻滞用于小儿胸外科手术镇痛:一例报告

Continuous erector spinae plane block for analgesia in pediatric thoracic surgery: A case report.

作者信息

Gaio-Lima C, Costa C C, Moreira J B, Lemos T S, Trindade H L

机构信息

Servicio de Anestesiología, Hospital do Divino Espírito Santo de Ponta Delgada, EPE, São Miguel, Portugal.

Servicio de Anestesiología, Centro Hospitalar São João, EPE, Porto, Portugal.

出版信息

Rev Esp Anestesiol Reanim (Engl Ed). 2018 May;65(5):287-290. doi: 10.1016/j.redar.2017.11.010. Epub 2018 Jan 19.

Abstract

Erector spinae plane block has been recently described and it appears as a very promising regional analgesia technique. We report the first continuous erector spinae plane block performed in a pediatric patient for thoracic surgery. A 15-month-old boy, diagnosed with a paracardiac teratoma was scheduled for a tumor resection with a thoracotomy approach. After general anesthesia induction, a continuous erector spinae plane block at T5 level was performed with ropivacaine 0.2%. After surgery, a continuous thoracic interfascial infusion of ropivacaine 0.1% along with multimodal rescue analgesia was initiated. The patient tolerated the procedure well with no complications. It appears that this is a good alternative to thoracic epidural and paravertebral block, given the simple reproducibility and potential greater safety of this technique.

摘要

竖脊肌平面阻滞是最近被描述的一种区域镇痛技术,看起来非常有前景。我们报告了首例在小儿患者中用于胸外科手术的连续竖脊肌平面阻滞。一名15个月大的男孩,被诊断为心旁畸胎瘤,计划采用开胸手术进行肿瘤切除。全身麻醉诱导后,使用0.2%的罗哌卡因进行了T5水平的连续竖脊肌平面阻滞。术后,开始了0.1%罗哌卡因的连续胸段筋膜间输注以及多模式补救镇痛。患者对该操作耐受良好,无并发症发生。鉴于该技术操作简单、可重复性强且潜在安全性更高,它似乎是胸段硬膜外阻滞和椎旁阻滞的良好替代方法。

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