Whiteman M S, Rosenberg H, Haskin P H, Teplick S K
Radiology. 1986 Dec;161(3):836-8. doi: 10.1148/radiology.161.3.3786742.
The effectiveness of regional anesthesia for pain control during biliary manipulations was evaluated. Celiac plexus and/or thoracic epidural blockade was used for 48 procedures in 31 patients. All blockades were administered and patients monitored by anesthesiologists in the radiology department. Thoracic epidural blockade did not alleviate the deep visceral pain associated with biliary manipulations. Celiac plexus blockade in conjunction with local skin anesthesia markedly reduced pain, minimizing the need for intravenously administered narcotics. Two patients experienced transient hypotension during induction of regional anesthesia. There were no other complications. Twelve patients who had previous biliary manipulations with only intravenously administered analgesia reported excellent pain relief with regional anesthesia and expressed a preference for regional anesthesia should another procedure be necessary. The authors conclude that celiac plexus block is a desirable technique of providing analgesia, especially when major biliary interventions are undertaken.
评估了区域麻醉在胆道操作期间控制疼痛的效果。对31例患者的48项手术采用了腹腔神经丛阻滞和/或胸段硬膜外阻滞。所有阻滞均由放射科的麻醉医生实施并对患者进行监测。胸段硬膜外阻滞并不能减轻与胆道操作相关的深部内脏疼痛。腹腔神经丛阻滞联合局部皮肤麻醉可显著减轻疼痛，最大限度地减少静脉注射麻醉药的需求。两名患者在区域麻醉诱导期间出现短暂性低血压。无其他并发症。12例先前仅接受静脉镇痛进行胆道操作的患者报告区域麻醉后疼痛缓解良好，并表示若需再次手术，更倾向于区域麻醉。作者得出结论，腹腔神经丛阻滞是一种理想的镇痛技术，尤其是在进行重大胆道干预时。
