Nair Shrijit, McGuinness Siobhan, Masood Fouad, Boylan John F, Conlon Niamh P
From the Department of Anesthesia and Intensive Care Medicine, St Vincent's University Hospital, Elm Park, Dublin, Ireland.
A A Pract. 2019 Nov 1;13(9):332-334. doi: 10.1213/XAA.0000000000001069.
Hepatopancreaticobiliary (HPB) surgery is major upper abdominal surgery with considerable risk of pulmonary complications related to postoperative pain. While epidural analgesia remains an effective analgesic technique for upper abdominal surgery, HPB surgery poses challenges to its use due to coagulopathy. Erector spinae plane (ESP) blocks are a promising alternative to epidurals. Injection of local anesthetic deep to the erector spinae muscle plane and placement of a catheter for prolonged effect provide both somatic and visceral analgesia for both thoracic and abdominal surgery. We describe a series of 3 cases that illustrate the efficacy of ESP blocks after major HPB surgery.
肝胰胆（HPB）手术是一种上腹部大手术，术后疼痛导致肺部并发症的风险相当高。虽然硬膜外镇痛仍是上腹部手术有效的镇痛技术，但由于凝血功能障碍，HPB手术在使用该技术时面临挑战。竖脊肌平面（ESP）阻滞是硬膜外阻滞的一种有前景的替代方法。在竖脊肌平面深部注射局部麻醉药并放置导管以延长作用时间，可为胸腹部手术提供躯体和内脏镇痛。我们描述了一系列3例病例，以说明ESP阻滞在HPB大手术后的疗效。
