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腹部手术中的竖脊肌平面阻滞:病例系列

Erector spinae plane block in abdominal surgery: Case series.

作者信息

Luis-Navarro Juan Carlos, Seda-Guzmán María, Luis-Moreno Cristina, Chin Ki-Jinn

机构信息

Department of Anaesthesia, Virgen Del Rocío University Hospital, Seville, Spain.

Department of Anaesthesia, Toronto Western Hospital, University of Toronto, Toronto, Ontario, Canada.

出版信息

Indian J Anaesth. 2018 Jul;62(7):549-554. doi: 10.4103/ija.IJA_57_18.

Abstract

The aim of this study is to report 11 cases of erector spinae plane (ESP) block used for unilateral or bilateral abdominal surgery, adding to the overall limited experience with abdominal ESP block. The procedures were carried out at a teaching hospital in 11 patients (eight males, three females, ages 36-80 years) requiring abdominal surgery, including laparoscopic surgery. Each patient required surgery under different physical circumstances and likely different conceptions of what constituted pain. Two of the eleven patients were administered the ESP block and did not require general anaesthesia. Most of the patients with the ESP block maintained a numerical rating scale (NRS) for pain of 0-2/10 postoperatively. An occasional patient required paracetamol analgesia. There were no cases of opiate rescue. Obesity in a 46-year-old woman was believed to cause unclear ultrasonographic visualisation, interfering with entry of the ESP catheter. She, however, had no post-operative pain. She was given the usual intravenous metamizole 2 g for 10 h and required only analgesics at 16 h. ESP block, which produces analgesia by blocking trunk nerves, is an appropriate approach to patients requiring abdominal surgery, whether laparoscopic or open.

摘要

本研究旨在报告11例竖脊肌平面(ESP)阻滞用于单侧或双侧腹部手术的病例,以补充腹部ESP阻滞总体有限的经验。这些手术在一家教学医院对11例需要腹部手术(包括腹腔镜手术)的患者(8例男性,3例女性,年龄36 - 80岁)进行。每位患者在不同身体状况下接受手术,对疼痛的认知可能也不同。11例患者中有2例接受ESP阻滞后无需全身麻醉。大多数接受ESP阻滞的患者术后疼痛数字评分量表(NRS)为0 - 2/10。偶尔有患者需要对乙酰氨基酚镇痛。没有使用阿片类药物进行补救的情况。一名46岁女性的肥胖被认为导致超声图像不清晰,影响了ESP导管的置入。然而,她术后没有疼痛。她按常规静脉注射了2 g安乃近,持续10小时,仅在16小时时需要镇痛药。ESP阻滞通过阻滞躯体神经产生镇痛作用,对于需要腹部手术的患者,无论是腹腔镜手术还是开放手术,都是一种合适的方法。

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