From the Department of Anesthesiology, Perioperative, and Pain Medicine, Lucile Packard Children's Hospital at Stanford, Stanford, California.
Department of Otolaryngology-Head & Neck, Lucile Packard Children's Hospital at Stanford, Stanford, California.
A A Pract. 2021 Aug 16;15(8):e01502. doi: 10.1213/XAA.0000000000001502.
Adenotonsillectomies are one of the most common otolaryngologic surgeries performed to alleviate obstructive sleep-disordered breathing and apnea in children. The pain management following adenotonsillectomy continues to be a challenge for both pediatric anesthesiologists and otolaryngologists due to the mortality that stems from the use of opioid pain medications in children who have an increased baseline risk airway obstruction and apnea that is exacerbated by any exposure to opioids. We present a case utilizing bilateral suprazygomatic maxillary nerve (SZMN) blocks or, more accurately, suprazygomatic infratemporal-pterygopalatine fossa injections to achieve opioid-free perioperative analgesia for pediatric adenotonsillectomy with nasal turbinate reduction.
腺样体扁桃体切除术是耳鼻喉科最常见的手术之一,旨在缓解儿童阻塞性睡眠呼吸暂停。由于使用阿片类药物会增加基线风险气道阻塞和呼吸暂停的儿童死亡率,因此儿科麻醉师和耳鼻喉科医生在腺样体扁桃体切除术后的疼痛管理方面仍然面临挑战。我们提出了一个利用双侧颧弓上上颌神经(SZMN)阻滞或更准确地说是颧弓下颞下翼腭窝注射的案例,以实现小儿腺样体扁桃体切除术伴鼻甲减少术的无阿片类围手术期镇痛。