肩胛上神经阻滞联合竖脊肌平面阻滞用于治疗与Klippel-Feil综合征相关的Sprengel畸形的肩胛Y形截骨术的麻醉管理：一例报告
Anesthetic management of scapular Y-osteotomy using a combination of suprascapular nerve block and erector spinae plane block for Sprengel deformity associated with Klippel-Feil syndrome: a case report.
作者信息
Okada Mizuho, Tanaka Nobuhiro, Suzuka Takanori, Kadoya Yuma, Saisu Takashi, Kawaguchi Masahiko
机构信息
Department of Anesthesiology, Nara Medical University, 840 Shijo-Cho, Kashihara, Nara, 634-8522, Japan.
Chiba Child & Adult Orthopaedic Clinic, 3-24-2 Ayumino Minami, Chiba, Midori-ku, 266-0033, Japan.
出版信息
JA Clin Rep. 2023 Aug 29;9(1):55. doi: 10.1186/s40981-023-00647-3.
BACKGROUND
Klippel-Feil syndrome (KFS) occurs in 1/40,000 individuals and is characterized by cervical fusion. Thirty percent of patients with KFS present with Sprengel deformity, leading to orthopedic problems and limited shoulder abduction. No reports exist regarding anesthetic procedures for pediatric scapular osteotomies.
CASE PRESENTATION
We report a case of a 4-year-and-7-month-old boy (95.6 cm, 14.7 kg) who underwent left scapular osteotomy. At the age of 8 months, he also underwent a right lower lobectomy due to a congenital pulmonary airway malformation. We decided to use a combination of suprascapular nerve block (SSNB), erector spinae plane block (ESPB), and general anesthesia. He received regular acetaminophen administration and fentanyl 5-10 μg/hour intravenously until 20 h postoperatively and remained on ≤ 2/10 in the Wong-Baker Face Scale (0: no hurt; 10: hurts worst).
CONCLUSION
The combination of SSNB and ESPB could be an option for perioperative analgesia for scapular osteotomies.
背景
克-费综合征（KFS）的发病率为1/40000，其特征为颈椎融合。30%的KFS患者伴有先天性高肩胛症，会导致骨科问题和肩部外展受限。目前尚无关于小儿肩胛截骨术麻醉方法的报道。
病例报告
我们报告一例4岁7个月大的男孩（身高95.6厘米，体重14.7千克）接受了左肩胛截骨术。8个月大时，他因先天性肺气道畸形接受了右下肺叶切除术。我们决定采用肩胛上神经阻滞（SSNB）、竖脊肌平面阻滞（ESPB）和全身麻醉相结合的方法。术后20小时内，他定期接受对乙酰氨基酚治疗，并静脉注射5-10微克/小时的芬太尼，面部表情评分（0：无疼痛；10：最疼）维持在≤2/10。
结论
SSNB和ESPB联合应用可为肩胛截骨术的围手术期镇痛提供一种选择。
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