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交感二重奏:星状神经节阻滞与胸段硬膜外镇痛联合应用成功终止心室风暴

Sympathetic Duet: Simultaneous Stellate Ganglion Block and Thoracic Epidural Analgesia in the Successful Termination of Ventricular Storm.

作者信息

Heiberger Garret, Busch Clayton, Havlik Steven, Gunawan Antonius, Woodin Timothy, Bryant Richard

机构信息

Anesthesiology, Kansas City University of Medicine and Biosciences, Kansas City, USA.

Anesthesiology, The Ohio State University Wexner Medical Center, Columbus, USA.

出版信息

Cureus. 2024 May 8;16(5):e59867. doi: 10.7759/cureus.59867. eCollection 2024 May.

Abstract

This article discusses the management of ventricular storm (VS), a condition characterized by recurrent episodes of sustained ventricular tachycardia or fibrillation, which poses a significant risk of mortality. Prompt intervention is crucial, yet surgical options are often limited due to the patient's unstable condition. This case report presents a 47-year-old female who experienced VS during a planned surgical procedure. Despite initial stabilization, she continued to experience life-threatening arrhythmias, prompting the implementation of simultaneous stellate ganglion block (SGB) and thoracic epidural analgesia (TEA) catheters. This combined approach successfully controlled the arrhythmias, allowing for subsequent surgical interventions. The article emphasizes the potential of SGB and TEA as a bridge to definitive therapies for refractory VS, highlighting the need for further research to solidify their role in clinical practice.

摘要

本文讨论了心室风暴(VS)的管理,这是一种以反复发作的持续性室性心动过速或颤动为特征的疾病,具有重大的死亡风险。及时干预至关重要,但由于患者病情不稳定,手术选择往往有限。本病例报告介绍了一名47岁女性,她在一次计划中的外科手术过程中发生了心室风暴。尽管最初病情得到了稳定,但她仍持续出现危及生命的心律失常,促使实施了星状神经节阻滞(SGB)和胸段硬膜外镇痛(TEA)导管同步置入。这种联合方法成功地控制了心律失常,从而得以进行后续的手术干预。本文强调了星状神经节阻滞和胸段硬膜外镇痛作为难治性心室风暴确定性治疗桥梁的潜力,突出了进一步研究以巩固它们在临床实践中作用的必要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/857c/11157637/5716a1a6c154/cureus-0016-00000059867-i01.jpg

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