胸椎旁阻滞-肌间沟阻滞联合用于改良根治性乳房切除术的原发性麻醉：病例报告。
Combined Thoracic Paravertebral Block-Interscalene Block as a Primary Anesthetic for Modified Radical Mastectomy: A Case Report.
机构信息
Department of Anesthesiology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.
出版信息
Med Arch. 2023;77(4):326-328. doi: 10.5455/medarh.2023.77.326-328.
BACKGROUND
Regional anesthesia as a primary anesthetic can offer merits over general anesthesia for patients having multiple comorbidities who are at a high risk of perioperative morbidity and mortality. Thoracic paravertebral block (TPVB) and interscalene block (ISB) have been used widely to improve the quality of postoperative analgesia after breast surgery.
OBJECTIVE
There are limited data on the feasibility of combining TPVB-ISB as a sole anesthetic technique for extensive breast surgery with axillary lymph nodes dissection.
CASE PRESENTATION
In this report, the author presented a successful use of a combined TPVB and ISB as a sole anesthetic with conscious sedation in a 52-year-old patient with multiple comorbidities, including heart failure with reduced ejection fraction, who underwent modified radical mastectomy with left axillary lymph nodes dissection.
CONCLUSION
Combining TPVB-ISB can be used as a sole anesthetic for extensive breast surgery in patients with a high risk for general anesthesia.
背景
对于患有多种合并症且围手术期发病率和死亡率高的高危患者，区域麻醉作为主要麻醉方式比全身麻醉具有优势。胸椎旁神经阻滞（TPVB）和锁骨上神经阻滞（ISB）已广泛用于改善乳腺癌手术后的术后镇痛质量。
目的
关于将 TPVB-ISB 联合用作广泛乳腺手术伴腋窝淋巴结清扫的单一麻醉技术的可行性，相关数据有限。
病例介绍
在本报告中，作者介绍了一例 52 岁合并多种疾病（包括射血分数降低的心力衰竭）的患者，成功地使用了联合 TPVB 和 ISB 联合全身麻醉和清醒镇静作为单一麻醉技术，进行改良根治性乳房切除术伴左侧腋窝淋巴结清扫。
结论
对于全身麻醉高危患者，TPVB-ISB 联合可作为广泛乳腺手术的单一麻醉方法。
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