Petrucci Emiliano, Marinangeli Franco, Pizzi Barbara, Sciorio Francesco, Marrocco Gioele, Innamorato Massimo Antonio, Cascella Marco, Vittori Alessandro
Department of Anesthesia and Intensive Care Unit, San Salvatore Academic Hospital of L'Aquila, Via Vetoio 48, 67100 L'Aquila, Italy.
Department of Anesthesiology, Intensive Care and Pain Treatment, University of L'Aquila, Piazzale Salvatore Tommasi 1, Coppito, 67100 L'Aquila, Italy.
J Clin Med. 2022 May 8;11(9):2646. doi: 10.3390/jcm11092646.
This case report describes a modified approach for a thoracic paravertebral block by performing a bilateral ultrasound-assisted injection of 12 mL of 0.5% levobupivacaine near the thoracic intervertebral foramen, combined with general anesthesia, in a patient who underwent emergent laparotomy for small intestinal volvulus. Two continuous catheter sets were used for a bilateral continuous block with levobupivacaine 0.25% at a rate of 5-8 mL/h. No complications during the execution of the block were recorded. No supplemental opioids were administered and the patient was hemodynamically stable, requiring no pharmacological cardiovascular support during surgery. At the end of the surgical procedure, the patient received a continuous flow of 0.2% levobupivacaine as postoperative analgesia, at a basal flow of 4 mL/h per each side, a bolus of 4 mL, and a lockout time of 60 min was used. The postoperative pain on the Numeric Rating Scale was 2 at rest and it was 4 in motion, without neurological or respiratory sequelae due to block in the first 72 h after surgery.
本病例报告描述了一种改良的胸椎旁阻滞方法，该方法是在一名因小肠扭转接受急诊剖腹手术的患者中，通过在胸椎椎间孔附近双侧超声引导下注射12毫升0.5%左旋布比卡因，并联合全身麻醉来进行的。使用两组连续导管进行双侧连续阻滞，注入0.25%左旋布比卡因，速率为5-8毫升/小时。阻滞实施过程中未记录到并发症。未给予补充阿片类药物，患者血流动力学稳定，手术期间无需药物性心血管支持。手术结束时，患者接受0.2%左旋布比卡因持续输注作为术后镇痛，每侧基础流速为4毫升/小时，推注量为4毫升，锁定时间为60分钟。术后数字评分量表显示静息时疼痛为2分，活动时为4分，术后72小时内未出现因阻滞导致的神经或呼吸后遗症。
