[竖脊肌平面阻滞作为开放食管切除术的多导管技术：一例病例报告]
[Erector spinae plane block as a multiple catheter technique for open esophagectomy: a case report].
作者信息
De Cassai Alessandro, Tonetti Tommaso, Galligioni Helmut, Ori Carlo
机构信息
University of Padova, Section of Anesthesiology and Intensive Care, Department of Medicine (Dimed), Padova, Itália.
University of Padova, Section of Anesthesiology and Intensive Care, Department of Medicine (Dimed), Padova, Itália.
出版信息
Braz J Anesthesiol. 2019 Jan-Feb;69(1):95-98. doi: 10.1016/j.bjan.2018.06.001. Epub 2018 Nov 17.
BACKGROUND AND OBJECTIVE
Erector spinae plane block is a valid technique to provide simultaneously analgesia for combined thoracic and abdominal surgery.
CASE REPORT
A patient underwent open esophagectomy followed by reconstructive esophagogastroplasty but refused thoracic epidural analgesia; a multi-modal analgesia with a multiple erector spinae plane block was then planned. Three erector spinae plane catheters (T5 and T10 on the right side and T9 on the left side) for continuous analgesia were placed before surgery. During the first 48 h pain was never reported in the thoracic area but the patient reported multiple times to feel a pain well localized in epigastrium, but never localized in any other abdominal quadrant.
DISCUSSION
Erector spinae plane block is a valid technique to provide analgesia simultaneously for combined thoracic and abdominal surgery and could be a valid alternative strategy if the use of epidural analgesia is contraindicated.
背景与目的
竖脊肌平面阻滞是一种为胸腹部联合手术同时提供镇痛的有效技术。
病例报告
一名患者接受了开放性食管切除术及重建性食管胃成形术，但拒绝胸段硬膜外镇痛；随后计划采用多模式镇痛及多次竖脊肌平面阻滞。术前放置了三根用于持续镇痛的竖脊肌平面导管（右侧T5和T10以及左侧T9）。在最初的48小时内，患者胸部未报告疼痛，但多次报告感到上腹部有明确的疼痛，且未在其他任何腹部象限定位到疼痛。
讨论
竖脊肌平面阻滞是为胸腹部联合手术同时提供镇痛的有效技术，并且如果硬膜外镇痛存在禁忌，它可能是一种有效的替代策略。
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