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双侧竖脊肌平面阻滞在脊柱侧凸手术中的应用:病例系列研究。

Bilateral erector spinae plane block for scoliosis surgery: Case series.

机构信息

Sancheti Hospital, Pune, India.

Outcomes Research Department, Anesthesiology Institute, Cleveland Clinic, Ohio, EE. UU.; Department of Anesthesiology and Reanimation, Istanbul University-Cerrahpaşa, Cerrahpasa Medical Faculty, Estambul, Turquía.

出版信息

Rev Esp Anestesiol Reanim (Engl Ed). 2020 Mar;67(3):153-158. doi: 10.1016/j.redar.2019.11.012. Epub 2020 Feb 11.

Abstract

Spinal correction surgery is a very invasive surgical procedure and results in severe postoperative pain. We report six cases in which Bilateral Erector Spinae Plane Block was performed for scoliosis surgery. Our aim was to provide an effective perioperative pain management and to achieve intraoperative hemodynamic stability with no interference on neuromonitoring. The technical challenges are also highlighted. An ultrasound guided scout scan is necessarry to identify the bony prominences and determine the possible multiple injection points. Erector Spinae Plane Block in scoliosis surgery is an easier and safer technique compared to epidural anesthesia and can use instrumented complex spinal surgery. This block seems to have a role in perioperative pain pathway complementing the multimodal analgesic regimen and not have interference with evocated potentials in adults. However the diffusion mechanism of the this block is not well known hence it should be awake regarding local anesthetic toxicity.

摘要

脊柱矫正手术是一种非常有创的手术,术后会产生严重的疼痛。我们报告了 6 例在脊柱侧凸手术中实施双侧竖脊肌平面阻滞的病例。我们的目的是提供有效的围手术期疼痛管理,并实现术中血流动力学的稳定,同时不干扰神经监测。技术挑战也得到了强调。需要进行超声引导的探查扫描,以识别骨性突起并确定可能的多个注射点。与硬膜外麻醉相比,脊柱侧凸手术中的竖脊肌平面阻滞是一种更简单、更安全的技术,可用于器械复杂的脊柱手术。这种阻滞在补充多模式镇痛方案的围手术期疼痛通路方面可能具有作用,并且不会对成人的诱发电位产生干扰。然而,这种阻滞的扩散机制尚不清楚,因此应该注意局部麻醉毒性。

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