Mahajan R, Gulati S, Gupta K, Jain K, Bloria S, JItendra M
Department of Anesthesia, ICU and Pain Medicine Government Medical College Jammu India.
Department of Radiodiagnosis and Imaging Government Medical College Jammu India.
Anaesth Rep. 2021 Apr 27;9(1):81-84. doi: 10.1002/anr3.12116. eCollection 2021 Jan-Jun.
Peri-operative pain management in the neonate with a sacrococcygeal teratoma poses significant challenges to the anaesthetist. Involvement of the sacrococcygeal area by the tumour often prevents the use of conventional regional anaesthetic techniques such as caudal or epidural analgesia, with a subsequent reliance on intravenous opioids and paracetamol. Since opioids are associated with respiratory depression, constipation and urinary retention, there is high incidence of opiophobia with consequent inappropriate dosage prescription, particularly in the paediatric population. We describe the use of an ultrasound-guided sacral multifidus plane block in two neonates undergoing surgical excision of sacrococcygeal teratoma. The block is technically easy to perform and also avoids traversing critical structures. Hence, it may be regarded as a promising analgesic technique for painful interventions in the sacrococcygeal area.
对于患有骶尾部畸胎瘤的新生儿，围手术期疼痛管理给麻醉医生带来了重大挑战。肿瘤累及骶尾部区域常常使得无法使用传统的区域麻醉技术，如骶管或硬膜外镇痛，因此只能依赖静脉注射阿片类药物和对乙酰氨基酚。由于阿片类药物会导致呼吸抑制、便秘和尿潴留，对阿片类药物恐惧的发生率很高，从而导致剂量处方不当，尤其是在儿科人群中。我们描述了在两名接受骶尾部畸胎瘤手术切除的新生儿中使用超声引导下骶多裂肌平面阻滞的情况。该阻滞技术操作简单，还避免穿过关键结构。因此，它可能被视为骶尾部区域疼痛干预的一种有前景的镇痛技术。
