[超声引导下筋膜平面阻滞作为COVID-19时代全乳房切除术的独特麻醉技术：一例报告]
[Ultrasound-guided fascial plane blocks as unique anesthetic technique for total mastectomy in a covid-19 era: a case report].
作者信息
Días R, Mendes  B, Lages N, Machado H
机构信息
Serviço de Anestesiologia, Centro Hospitalar Universitário do Porto, Porto, Portugal.
Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal.
出版信息
Rev Esp Anestesiol Reanim. 2021 Aug-Sep;68(7):408-413. doi: 10.1016/j.redar.2020.09.010. Epub 2021 Jan 22.
INTRODUCTION
Regional anesthesia techniques were recently introduced to provide analgesia for breast surgery. These techniques are rarely used as the primary anesthesia due to the complexity of breast innervation, with numerous structures that can potentially be disrupted during breast surgery.
CASE REPORT
A female patient in her sixties diagnosed with invasive ductal carcinoma on her left breast was scheduled for a simple mastectomy. After anesthetic evaluation, identification of high risk perioperative cardiovascular complications, it was proposed to perform the surgery only with regional anesthesia. A combination of pectoral nerve block (Pecs II), pecto-intercostal fascial block (PIFB) and supraclavicular nerve block ultrasound-guided were successfully performed.
CONCLUSION
This is the first case reporting a novel approach in a patient with severe cardiopulmonary disease who underwent breast surgery in a COVID-19 era.
引言
区域麻醉技术最近被引入用于为乳腺手术提供镇痛。由于乳房神经支配的复杂性，这些技术很少被用作主要麻醉方式，因为在乳腺手术过程中有许多结构可能会受到潜在破坏。
病例报告
一名60多岁的女性患者被诊断为左乳浸润性导管癌，计划进行单纯乳房切除术。经过麻醉评估，确定围手术期心血管并发症风险较高后，建议仅采用区域麻醉进行手术。成功实施了超声引导下的胸神经阻滞（Pecs II）、胸-肋间筋膜阻滞（PIFB）和锁骨上神经阻滞联合麻醉。
结论
这是首例报告在新冠疫情时代为一名患有严重心肺疾病的患者进行乳腺手术的新方法。
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