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用于肩部手术后疼痛管理的独特膈神经保留区域麻醉技术。

Unique Phrenic Nerve-Sparing Regional Anesthetic Technique for Pain Management after Shoulder Surgery.

作者信息

Panchamia Jason K, Olsen David A, Amundson Adam W

机构信息

Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, USA.

出版信息

Case Rep Anesthesiol. 2017;2017:1294913. doi: 10.1155/2017/1294913. Epub 2017 Dec 19.

DOI:10.1155/2017/1294913
PMID:29410922
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5749212/
Abstract

BACKGROUND

Ipsilateral phrenic nerve blockade is a common adverse event after an interscalene brachial plexus block, which can result in respiratory deterioration in patients with preexisting pulmonary conditions. Diaphragm-sparing nerve block techniques are continuing to evolve, with the intention of providing satisfactory postoperative analgesia while minimizing hemidiaphragmatic paralysis after shoulder surgery.

CASE REPORT

We report the successful application of a combined ultrasound-guided infraclavicular brachial plexus block and suprascapular nerve block in a patient with a complicated pulmonary history undergoing a total shoulder replacement.

CONCLUSION

This case report briefly reviews the important innervations to the shoulder joint and examines the utility of the infraclavicular brachial plexus block for postoperative pain management.

摘要

背景

同侧膈神经阻滞是肌间沟臂丛神经阻滞术后常见的不良事件，可导致已有肺部疾病患者的呼吸功能恶化。保留膈肌的神经阻滞技术不断发展，旨在在肩部手术后提供满意的术后镇痛，同时将半膈肌麻痹降至最低。

病例报告

我们报告了超声引导下锁骨下臂丛神经阻滞联合肩胛上神经阻滞在一名有复杂肺部病史的患者行全肩关节置换术中的成功应用。

结论

本病例报告简要回顾了肩关节的重要神经支配，并探讨了锁骨下臂丛神经阻滞在术后疼痛管理中的效用。

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本文引用的文献

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Reg Anesth Pain Med. 2017 Mar/Apr;42(2):184-196. doi: 10.1097/AAP.0000000000000564.
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Diaphragm-Sparing Nerve Blocks for Shoulder Surgery.用于肩部手术的保留膈肌神经阻滞
Reg Anesth Pain Med. 2017 Jan/Feb;42(1):32-38. doi: 10.1097/AAP.0000000000000529.
3
A Comparison of Combined Suprascapular and Axillary Nerve Blocks to Interscalene Nerve Block for Analgesia in Arthroscopic Shoulder Surgery: An Equivalence Study.关节镜下肩部手术中联合肩胛上神经和腋神经阻滞与肌间沟神经阻滞用于镇痛的比较：一项等效性研究
Reg Anesth Pain Med. 2016 Sep-Oct;41(5):564-71. doi: 10.1097/AAP.0000000000000436.
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Benefits of the costoclavicular space for ultrasound-guided infraclavicular brachial plexus block: description of a costoclavicular approach.锁骨下间隙在超声引导下锁骨下臂丛神经阻滞中的优势：锁骨下途径的描述
Reg Anesth Pain Med. 2015 May-Jun;40(3):287-8. doi: 10.1097/AAP.0000000000000232.
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Hemidiaphragmatic paralysis following ultrasound-guided supraclavicular versus infraclavicular brachial plexus blockade: a randomized clinical trial.超声引导锁骨上与锁骨下入路臂丛神经阻滞后面横膈神经麻痹：一项随机临床试验。
Reg Anesth Pain Med. 2015 Mar-Apr;40(2):133-8. doi: 10.1097/AAP.0000000000000215.
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Continuous interscalene brachial plexus block versus parenteral analgesia for postoperative pain relief after major shoulder surgery.连续肌间沟臂丛神经阻滞与胃肠外镇痛用于肩部大手术后的术后疼痛缓解
Cochrane Database Syst Rev. 2014 Feb 4;2014(2):CD007080. doi: 10.1002/14651858.CD007080.pub2.
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