Kimachi Pedro Paulo, Martins Elaine Gomes, Peng Philip, Forero Mauricio
From the Department of Anesthesia, Instituto de Ensino e Pesquisa, Hospital Sírio Libanês, São Paulo, Brazil.
Department of Anesthesia and Pain Management, University Health Network, Toronto, Ontario, Canada.
A A Pract. 2018 Oct 1;11(7):186-188. doi: 10.1213/XAA.0000000000000777.
We described the first ultrasound-guided erector spinae plane block that provided complete surgical anesthesia for a right-sided mastectomy and axillary dissection in a patient with high cardiovascular risk. The block targeted at T5, and 20 mL of 0.5% ropivacaine with epinephrine 1:200,000 and dexamethasone 8 mg was administered. Complete anesthesia was accomplished in 20 minutes, and the patient received propofol infusion for sedation. The patient reported no pain and remained hemodynamically stable throughout the 2.5-hour procedure. At the end of the surgery, patient received morphine 2 mg and dipyrone 2 g intravenously, and demanded no analgesic until 24 hours after the procedure.
我们描述了首例超声引导下竖脊肌平面阻滞,该阻滞为一名心血管风险高的患者的右侧乳房切除术和腋窝清扫术提供了完全的手术麻醉。阻滞靶点为T5,给予20毫升含1:200,000肾上腺素和8毫克地塞米松的0.5%罗哌卡因。20分钟内实现了完全麻醉,患者接受丙泊酚输注以镇静。在整个2.5小时的手术过程中,患者报告无疼痛,血流动力学保持稳定。手术结束时,患者静脉注射了2毫克吗啡和2克安乃近,术后24小时内无需镇痛。