From the Departments of Anesthesiology.
Pediatrics, University of Minnesota School of Medicine, Minneapolis, Minnesota.
A A Pract. 2021 Sep 17;15(9):e01520. doi: 10.1213/XAA.0000000000001520.
Subcutaneous implantable cardioverter-defibrillator (S-ICD) placement may cause significant postoperative pain. Limited research exists on regional anesthesia for pediatric S-ICD placement. This case series examined transversus thoracic plane blocks (TTPBs), pectointercostal fascial plane blocks (PIFBs), pectoralis nerve I and II blocks, paravertebral, serratus anterior plane, and erector spinae plane blocks (ESPBs) in 10 children receiving S-ICDs. Parasternal nerve blocks consisting of TTPB or PIFB and left ESPB appeared to provide adequate pain control. These children had reduced opioid consumption, lower mean pain scores, longer delay in first postoperative analgesic, and no complications. Regional anesthesia may reduce pain after pediatric S-ICD implantation.
皮下植入式心律转复除颤器（S-ICD）的植入可能会导致明显的术后疼痛。目前针对儿科 S-ICD 植入术的局部麻醉的研究有限。本病例系列研究了 10 例接受 S-ICD 治疗的儿童中采用经胸壁平面阻滞（TTPB）、肋间筋膜平面阻滞（PIFB）、胸肌神经 I 和 II 阻滞、椎旁阻滞、前锯肌平面阻滞和竖脊肌平面阻滞（ESPB）的效果。由 TTPB 或 PIFB 加左 ESPB 组成的胸骨旁神经阻滞似乎可以提供足够的疼痛控制。这些患儿的阿片类药物用量减少，平均疼痛评分降低，首次术后镇痛的延迟时间延长，且无并发症发生。局部麻醉可能会减轻儿科 S-ICD 植入术后的疼痛。
