两阶段双侧超声引导竖脊肌平面阻滞用于脊柱后凸矫正手术——病例报告
Two-level bilateral ultrasound-guided erector spinae plane block for kyphosis corrective surgery - A case report.
作者信息
Sinha Chandni, Kumar Amarjeet, Kumar Ajeet, Kumari Poonam, Agrawal Prabhat, Sk Arun
机构信息
Department of Anesthesiology, All India Institute of Medical Sciences, Patna, India.
Department of Trauma and Emergency, All India Institute of Medical Sciences, Patna, India.
出版信息
Anesth Pain Med (Seoul). 2022 Jul;17(3):327-330. doi: 10.17085/apm.21107. Epub 2022 Mar 25.
BACKGROUND
Ultrasound-guided erector spinae plane (ESP) block has been used to provide lumbar analgesia. The craniocaudal spread of local anesthetic in this block can be unpredictable in patients with kyphosis due to backward curvature of the spine, which might prevent longitudinal spread.
CASE
This is a case of a 33-year-old male (60 kg) diagnosed with type 3b kyphosis of the thoracolumbar region at the level of L1 who underwent extended pedicle subtraction osteotomy. ESP block was administered at two different levels, one at T12 (above the angle of the kyphosis L1) and another at L3 (below the angle of kyphosis L1), as the curvature of kyphosis can hinder the longitudinal spread of local anesthetic.
CONCLUSIONS
Two-level ESP block results in better craniocaudal spread of local anesthetic in a patient undergoing kyphosis correction surgery.
背景
超声引导下竖脊肌平面（ESP）阻滞已用于提供腰部镇痛。由于脊柱向后弯曲导致脊柱后凸，该阻滞中局部麻醉药的头尾扩散在脊柱后凸患者中可能不可预测，这可能会阻止纵向扩散。
病例
这是一名33岁男性（60kg）的病例，该患者被诊断为胸腰段L1水平的3b型脊柱后凸，接受了扩大椎弓根截骨术。由于脊柱后凸的曲率会阻碍局部麻醉药的纵向扩散，因此在两个不同水平进行了ESP阻滞，一个在T12（L1脊柱后凸角上方），另一个在L3（L1脊柱后凸角下方）。
结论
在接受脊柱后凸矫正手术的患者中，两级ESP阻滞可使局部麻醉药获得更好的头尾扩散。
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