Kovacs Peter L, Deutch Zachary, Castillo Daniel
Department of Anesthesiology, University of Florida College of Medicine, Jacksonville, USA.
Cureus. 2022 Dec 28;14(12):e33068. doi: 10.7759/cureus.33068. eCollection 2022 Dec.
In this case, we present a lesser-known application of regional anesthesia, specifically, managing a patient with vasospasm and retained radial artery (RA) vascular sheath after coronary angiography. Providing an ultrasound-guided supraclavicular block, in combination with general anesthesia, allowed the proceduralist to remove the retained sheath after several hours of failed treatment and manipulation. Severe arterial spasm was alleviated by eliciting a sympathectomy, along with analgesia of the right upper extremity, and maintaining this post-procedure. The block optimized arterial flow through the RA post-intervention and helped manage the patients' pain from manipulation.
在这种情况下，我们展示了区域麻醉一种鲜为人知的应用，具体而言，是在冠状动脉造影术后管理一名患有血管痉挛且桡动脉（RA）血管鞘留置的患者。在全身麻醉的基础上进行超声引导下锁骨上阻滞，使术者在经过数小时的治疗和操作失败后成功移除了留置的鞘管。通过引发交感神经切除术，缓解了严重的动脉痉挛，同时实现了右上肢镇痛，并在术后维持了这种状态。该阻滞优化了干预后通过桡动脉的血流，并有助于控制患者因操作引起的疼痛。
