Kalava Arun, Pribish Abby M
From the Department of Anesthesiology, Tampa General Hospital, Tampa, Florida.
University of South Florida Morsani College of Medicine, Tampa, Florida.
A A Pract. 2018 Jul 1;11(1):1-3. doi: 10.1213/XAA.0000000000000698.
While it has been shown that a paravertebral block provides effective postoperative analgesia for patients undergoing thoracic surgeries, including first rib resection, this is the first reported case of a paravertebral catheter used for perioperative analgesia in a patient undergoing first rib resection. We present the case of a 76-year-old woman with right upper extremity swelling who underwent infraclavicular first rib resection for venous thoracic outlet syndrome. Continuous infusion of ropivacaine through a T1 paravertebral catheter, which was placed before induction of general anesthesia but after T1 and T2 paravertebral blocks, provided effective postoperative pain control. Our experience suggests that paravertebral catheter infusions of local anesthetics may be effective adjuncts to general anesthesia in patients undergoing first rib resection and warrants further investigation.
虽然已经表明，椎旁阻滞可为包括第一肋骨切除在内的胸科手术患者提供有效的术后镇痛，但这是首次报道在接受第一肋骨切除的患者中使用椎旁导管进行围手术期镇痛的病例。我们报告了一例76岁女性患者，因静脉性胸廓出口综合征接受锁骨下第一肋骨切除术，该患者右上肢肿胀。在全身麻醉诱导前但在T1和T2椎旁阻滞之后放置T1椎旁导管，持续输注罗哌卡因，提供了有效的术后疼痛控制。我们的经验表明，在接受第一肋骨切除的患者中，局部麻醉药的椎旁导管输注可能是全身麻醉的有效辅助手段，值得进一步研究。
