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单侧竖脊肌平面(ESP)阻滞术后意外硬膜外扩散:一例报告。

Unintended Epidural Spread Following Unilateral Erector Spinae Plane (ESP) Block: A Case Report.

作者信息

Fiume Diego, Arciuolo Michele, Baldelli Beatrice, Carlini Silvia, Galletti Massimo

机构信息

Department of Anesthesiology and Critical Care, UniCamillus - Saint Camillus International University of Health and Medical Sciences, Rome, ITA.

Department of Anesthesiology, Sant'Eugenio Hospital, Rome, ITA.

出版信息

Cureus. 2025 Jul 14;17(7):e87888. doi: 10.7759/cureus.87888. eCollection 2025 Jul.

DOI:10.7759/cureus.87888
PMID:40809641
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12345068/
Abstract

The erector spinae plane block (ESPB) is a fascial block that consists of the injection of local anesthetic into the space between the erector spinae muscle and the transverse process of the vertebrae. The clinical case presented concerns the execution of an ESPB to control perioperative pain in a patient undergoing breast surgery and the side effects we encountered. Although the block is very effective and easy to perform, it has unpredictable side effects, which are still the subject of numerous clinical studies. ESPB is used all over the world; it is important to know more about the complications that can occur with this block. This case report aims to improve knowledge in this regard.

摘要

竖脊肌平面阻滞(ESPB)是一种筋膜阻滞,通过将局麻药注射到竖脊肌与椎骨横突之间的间隙来实现。本文介绍的临床病例涉及对一名接受乳房手术的患者实施ESPB以控制围手术期疼痛以及我们所遇到的副作用。尽管该阻滞非常有效且易于实施,但其副作用不可预测,仍是众多临床研究的主题。ESPB在全球范围内都有应用;了解更多关于这种阻滞可能出现的并发症非常重要。本病例报告旨在增进这方面的认识。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/00db/12345068/a8da93e58a24/cureus-0017-00000087888-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/00db/12345068/a69845b44a89/cureus-0017-00000087888-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/00db/12345068/a8da93e58a24/cureus-0017-00000087888-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/00db/12345068/a69845b44a89/cureus-0017-00000087888-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/00db/12345068/a8da93e58a24/cureus-0017-00000087888-i02.jpg

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本文引用的文献

1
Unexpected motor block after ultrasound-guided lumbar erector Spinae plane block.超声引导下腰方肌平面阻滞致意外运动阻滞。
Agri. 2023 Apr;35(2):112-114. doi: 10.14744/agri.2021.80947.
2
Motor block and hypotension following a high thoracic erector spinae plane block.高位胸椎竖脊肌平面阻滞后的运动阻滞和低血压
J Anaesthesiol Clin Pharmacol. 2022 Oct-Dec;38(4):678-679. doi: 10.4103/joacp.JOACP_657_20. Epub 2022 May 2.
3
Erector spinae plane block: the ultimate 'plan A' block?竖脊肌平面阻滞:终极的“首选”阻滞?
Br J Anaesth. 2023 May;130(5):497-502. doi: 10.1016/j.bja.2023.01.012. Epub 2023 Feb 10.
4
Lumbar erector spinae plane block obtunding knee and ankle reflexes.腰竖脊肌平面阻滞可减弱膝反射和踝反射。
Saudi J Anaesth. 2021 Apr-Jun;15(2):222-224. doi: 10.4103/sja.SJA_79_20. Epub 2021 Apr 1.
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Mechanisms of action of the erector spinae plane (ESP) block: a narrative review.竖脊肌平面(ESP)阻滞的作用机制:叙述性综述。
Can J Anaesth. 2021 Mar;68(3):387-408. doi: 10.1007/s12630-020-01875-2. Epub 2021 Jan 6.
6
Anatomical basis of erector spinae plane block: a dissection and histotopographic pilot study.竖脊肌平面阻滞的解剖学基础:一项解剖和组织学初步研究。
J Anesth. 2021 Feb;35(1):102-111. doi: 10.1007/s00540-020-02881-w. Epub 2020 Dec 19.
7
Efficacy of erector spinae plane block for analgesia in breast surgery: a systematic review and meta-analysis.竖脊肌平面阻滞在乳腺手术中的镇痛效果:系统评价和荟萃分析。
Anaesthesia. 2021 Mar;76(3):404-413. doi: 10.1111/anae.15164. Epub 2020 Jul 1.
8
Effects of erector spinae plane block on postoperative pain and side-effects in adult patients underwent surgery: A systematic review and meta-analysis of randomized controlled trials.竖脊肌平面阻滞对成年手术患者术后疼痛和副作用的影响:随机对照试验的系统评价和荟萃分析。
Int J Surg. 2020 Aug;80:107-116. doi: 10.1016/j.ijsu.2020.05.038. Epub 2020 May 24.
9
A magnetic resonance imaging study of local anesthetic spread in patients receiving an erector spinae plane block.一项接受竖脊肌平面阻滞的患者中局部麻醉药扩散的磁共振成像研究。
Can J Anaesth. 2020 Aug;67(8):942-948. doi: 10.1007/s12630-020-01613-8. Epub 2020 Mar 9.
10
Motor block following bilateral ESP block.双侧竖脊肌平面阻滞(ESP)后的运动阻滞。
J Clin Anesth. 2020 Mar;60:23. doi: 10.1016/j.jclinane.2019.08.029. Epub 2019 Aug 19.