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连续竖脊肌平面阻滞用于主动脉缩窄切除术开胸术后的疼痛管理。

Continuous Erector Spinae Plane Block for Pain Management Following Thoracotomy for Aortic Coarctectomy.

作者信息

Holladay Jay D, McKee Christopher, Nafiu Olubukola O, Tobias Joseph D, Beltran Ralph J

机构信息

Department of Anesthesiology and Pain Medicine, Nationwide Children's Hospital, Columbus, OH 43205, USA.

Department of Anesthesiology and Pain Medicine, The Ohio State University College of Medicine, Columbus, OH, USA.

出版信息

J Med Cases. 2024 Jan;15(1):26-30. doi: 10.14740/jmc4177. Epub 2024 Jan 28.

Abstract

Pain following thoracotomy is one of the most severe forms of postoperative pain. Post-thoracotomy pain may increase the risk of post-surgical pulmonary complications, postoperative mortality, prolong hospitalization, and increase utilization of healthcare resources. To mitigate these effects, anesthesia providers commonly employ continuous epidural infusions, paravertebral blocks, and systemic opioids for pain management and improvement of pulmonary mechanics. We report the use of a continuous erector spinae plane block (ESPB) via a peripheral nerve catheter for postoperative pain management of an 18-year-old patient who underwent complex aortic coarctation repair via lateral thoracotomy, aided by cardiopulmonary bypass. Continuous ESPB proved to be an acceptable alternative for postoperative pain control, producing a substantial multi-dermatomal sensory block, resulting in adequate pain control, reduced opioid consumption, and a potentially shorter hospital stay.

摘要

开胸术后疼痛是术后疼痛最严重的形式之一。开胸术后疼痛可能会增加术后肺部并发症、术后死亡率、延长住院时间以及增加医疗资源利用的风险。为减轻这些影响,麻醉医生通常采用持续硬膜外输注、椎旁阻滞和全身性阿片类药物来进行疼痛管理并改善肺力学。我们报告了通过外周神经导管进行持续竖脊肌平面阻滞(ESPB)用于一名18岁患者的术后疼痛管理,该患者在体外循环辅助下经侧胸壁切口接受了复杂的主动脉缩窄修复术。持续ESPB被证明是术后疼痛控制的一种可接受的替代方法,可产生显著的多节段感觉阻滞,从而实现充分的疼痛控制、减少阿片类药物消耗并可能缩短住院时间。

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