Cowgill A E, Womack J, Powell L
Department of Anaesthesia Royal Victoria Infirmary Newcastle-upon-Tyne UK.
Anaesth Rep. 2022 Oct 14;10(2):e12188. doi: 10.1002/anr3.12188. eCollection 2022 Jul-Dec.
Scapulectomy is performed as a limb-sparing procedure in the management of tumours of the proximal humerus and shoulder girdle. Analgesic outcomes following this procedure are poorly documented in the literature. In our case, satisfactory analgesia following extended scapulectomy and free-flap reconstruction was achieved with a combination of multi-site continuous nerve block catheters and patient-controlled analgesia, for a patient with chronic pain who had a high pre-operative opioid requirement. Multiple continuous nerve block catheters were used, including interscalene and paravertebral catheters to provide analgesia for the shoulder resection, with a fascia iliaca compartment catheter providing analgesia to free-flap donor site on the the anterolateral thigh. These continuous nerve block catheters contributed to effective postoperative analgesia and low postoperative intravenous opioid requirements in this case.
肩胛切除作为一种保肢手术，用于治疗近端肱骨和肩胛带肿瘤。该手术后的镇痛效果在文献中的记载较少。在我们的病例中，对于一名术前阿片类药物需求量高且患有慢性疼痛的患者，通过多部位连续神经阻滞导管和患者自控镇痛相结合的方法，在扩大肩胛切除和游离皮瓣重建术后实现了满意的镇痛效果。使用了多个连续神经阻滞导管，包括肌间沟和椎旁导管为肩部切除术提供镇痛，而髂筋膜间隙导管为大腿前外侧的游离皮瓣供区提供镇痛。在该病例中，这些连续神经阻滞导管有助于术后有效镇痛并降低术后静脉用阿片类药物的需求量。
