Marrone Francesco, Failli Simone, Fabbri Fabio, Paventi Saverio, Lepre Luca, Virno Vincenzo, Pullano Carmine
From the Department of Anesthesia, Santo Spirito Hospital, Rome, Italy.
Department of Surgery, Santo Spirito Hospital, Rome, Italy.
A A Pract. 2025 Feb 3;19(2):e01918. doi: 10.1213/XAA.0000000000001918. eCollection 2025 Feb 1.
Fascial plane blocks of the posterior thoracic wall (erector spinae plane [ESP] and intertransverse plane [ITP]) may offer advantages for high-risk patients requiring open abdominal surgery in whom thoracic epidural analgesia (TEA) combined with general anesthesia (GA) may be relatively contraindicated. As a primary anesthesia method, ESP/ITP (paravertebral by proxy) blocks proved effective in a case of open gastrectomy by avoiding airway intervention, mechanical ventilation, and effectively managing visceral pain. This article highlights the use of ESP/ITP blocks in a high-risk patient for whom GA and TEA posed substantial risks, with the patient who experienced favorable perioperative outcomes.
胸后壁筋膜平面阻滞（竖脊肌平面[ESP]和横突间平面[ITP]）对于需要进行开腹手术的高危患者可能具有优势，因为这些患者相对禁忌使用胸段硬膜外镇痛（TEA）联合全身麻醉（GA）。作为一种主要的麻醉方法，ESP/ITP（替代椎旁阻滞）阻滞在一例开腹胃切除术病例中被证明是有效的，它避免了气道干预、机械通气，并有效控制了内脏疼痛。本文重点介绍了ESP/ITP阻滞在一名GA和TEA均存在重大风险的高危患者中的应用，该患者围手术期结局良好。
