Le-Wendling Linda, Ihnatsenka Barys, Maurer Adrian J, Zasimovich Yury
Anesthesiology, University of Florida College of Medicine, Gainesville, USA.
Cureus. 2021 Feb 13;13(2):e13330. doi: 10.7759/cureus.13330.
The mechanism of ipsilateral shoulder pain (ISP) after thoracic surgery remains unexplained definitively in the literature. Regional techniques targeting specific nerves more precisely will provide practitioners with a better understanding of the pain source. We report the case of a 51-year-old woman who underwent robotic-assisted plication of the right hemidiaphragm. ISP was adequately managed using a low-volume infusion through a continuous phrenic nerve block in addition to a thoracic epidural for her chest pain. ISP after thoracic surgery likely originates from diaphragm manipulation. Phrenic nerve blockade is a successful strategy that does not worsen subjective dyspnea in this setting.
胸外科手术后同侧肩部疼痛（ISP）的机制在文献中仍未得到确切解释。更精确地针对特定神经的区域技术将使从业者更好地了解疼痛来源。我们报告了一例51岁女性接受机器人辅助右半膈折叠术的病例。除了使用胸段硬膜外阻滞治疗胸痛外，通过持续膈神经阻滞进行小容量输注，ISP得到了充分控制。胸外科手术后的ISP可能源于膈肌操作。在这种情况下，膈神经阻滞是一种成功的策略，不会加重主观呼吸困难。
