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无阿片类麻醉-右美托咪定作为竖脊肌平面阻滞的辅助剂:病例系列。

Opioid-free anesthesia-dexmedetomidine as adjuvant in erector spinae plane block: a case series.

机构信息

Department of Anesthesiology and Intensive Care Medicine, Policlinico - Federico II University Hospital, 80100, Naples, Italy.

出版信息

J Med Case Rep. 2021 May 29;15(1):276. doi: 10.1186/s13256-021-02868-5.

Abstract

BACKGROUND

Laparoscopic pain is related to the stretching of the peritoneum and peritoneal irritation caused by insufflation of the parietal peritoneum with carbon dioxide. In 2017, erector spinae plane block (ESPB) was described for management of postoperative pain following open and laparoscopic abdominal surgery. The use of multimodal anesthesia reduces both intraoperative and postoperative opioid use and improves analgesia. The addition of dexmedetomidine to the anesthetic mixture significantly prolongs analgesia, without clinically significant side effects.

CASE PRESENTATION

We describe a series of three Caucasian women cases that illustrate the efficacy of bilateral ESPB performed at the level of the T7 transverse process to provide intraoperative and postoperative analgesia for laparoscopic gynecological surgery.

CONCLUSION

Further investigation is recommended to establish the potential for ESPB with dexmedetomidine as adjuvant as an opioid-free anesthetic modality in laparoscopic gynecological surgery.

摘要

背景

腹腔镜疼痛与二氧化碳充气引起的壁腹膜拉伸和腹膜刺激有关。2017 年,竖脊肌平面阻滞(ESPB)被描述用于管理开腹和腹腔镜腹部手术后的术后疼痛。多模式麻醉的使用减少了术中及术后阿片类药物的使用,并改善了镇痛效果。将右美托咪定加入麻醉混合物中可显著延长镇痛时间,且无临床显著副作用。

病例介绍

我们描述了一系列 3 例白人女性病例,这些病例说明了在 T7 横突水平进行双侧 ESPB 的效果,可提供腹腔镜妇科手术的术中及术后镇痛。

结论

建议进一步研究以确定 ESPB 联合右美托咪定为辅助剂作为腹腔镜妇科手术中无阿片类药物的麻醉方式的潜力。

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