腹腔镜胃切除术后 Retro 上肋横突间韧带阻滞作为一种有效的镇痛方法：一例报告。
Retro superior costotransverse ligament space block as an effective analgesia after laparoscopic gastrectomy -a case report.
机构信息
Department of Anesthesiology and Pain Medicine, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Daejeon, Korea.
Department of Anesthesiology and Pain Medicine, The Catholic University of Korea, Seoul, Korea.
出版信息
Korean J Anesthesiol. 2024 Aug;77(4):480-483. doi: 10.4097/kja.23870. Epub 2024 Apr 15.
BACKGROUND
The retro superior costotransverse ligament space (RSS) block, reported as a novel target in paraspinal block, involves the spreading of local anesthetics into the thoracic paravertebral space through slits around the superior costotransverse ligament . This blocks not only the dorsal rami but also the ventral rami, achieving a reliable complete sensory blockade.
CASE
We performed an RSS block at the T5, T7, and T9 levels on both sides for postoperative analgesia in two patients who underwent laparoscopic gastrectomy. Both patients showed complete sensory blockade from T4 to L1 on the anterior, lateral, and posterior chest walls in the recovery room. The resting and dynamic pain scores were 0 at 30 min and 6 h postoperatively. The pain score consistently remained below 3 throughout postoperative period.
CONCLUSIONS
The RSS block provided effective postoperative analgesia in laparoscopic gastrectomy through definitive complete sensory blockade.
背景
后路肩胛横突韧带上间隙（RSS）阻滞，作为一种新的脊柱旁阻滞靶点，通过肩胛横突韧带上的裂隙使局部麻醉剂扩散到胸椎椎旁间隙。这种阻滞不仅可以阻滞背支神经，还可以阻滞腹支神经，从而实现可靠的完全感觉阻滞。
病例
我们对 2 例行腹腔镜胃切除术的患者在双侧 T5、T7 和 T9 水平行 RSS 阻滞以进行术后镇痛。两名患者在恢复室时在前胸、侧胸和后胸壁上从 T4 到 L1 均出现完全的感觉阻滞。静息和动态疼痛评分在术后 30 分钟和 6 小时均为 0。术后整个时期疼痛评分均持续低于 3。
结论
RSS 阻滞通过明确的完全感觉阻滞为腹腔镜胃切除术提供了有效的术后镇痛。
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