超声引导下用于清醒脊柱手术的竖脊肌平面阻滞:病例报告和文献综述。

IF 1.3 Q3 ANESTHESIOLOGY
Saudi Journal of Anaesthesia Pub Date : 2024-01-01 Epub Date: 2024-01-02 DOI:10.4103/sja.sja_548_23
Ashwini Reddy, Amiya K Barik, Nidhi Bhatia, Kajal Jain
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引用次数: 0

摘要

经皮内窥镜腰椎间盘切除术越来越多地被认为是治疗椎间盘突出症的开放式显微椎间盘切除术的替代方法。除了神经轴阻滞和全身麻醉外,有文献显示,内窥镜腰椎间盘切除术仅在局部麻醉浸润下进行。这一点尤为有利,因为清醒的病人可以通过言语协助外科医生,防止任何不慎造成的神经根损伤。然而,在内窥镜端口安装和椎管溶解等关键步骤中,也有明显疼痛的报道。竖脊肌平面(ESP)阻滞是一种筋膜间脊柱旁阻滞,可通过硬膜外扩散浸透脊神经根,为内窥镜椎间盘切除术提供良好的镇痛效果。ESP阻滞作为脊柱手术后围手术期镇痛技术的效用已得到证实,但目前还没有使用该阻滞成功进行内窥镜椎间盘切除术的报道。本文强调了ESP阻滞作为清醒状态下脊柱微创手术的唯一麻醉技术的实用性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Ultrasound-guided erector spinae plane block for awake spine surgery: A case report and review of the literature.

Percutaneous endoscopic lumbar discectomy is increasingly gaining recognition as an alternative to open microdiscectomy for the treatment of intervertebral disk herniation. Apart from the neuraxial blockade, and general anesthesia, there is literature demonstrating the performance of endoscopic lumbar discectomy under sole local anesthesia infiltration. This is particularly advantageous as an awake patient assists the surgeon by verbalizing and preventing any inadvertent nerve root damage. However, marked pain has been reported during key steps such as endoscope port installation and radiculolysis. The erector spinae plane (ESP) block is an interfascial paraspinal block that soaks the spinal nerve roots with epidural spread providing superior analgesia for endoscopic discectomy. The utility of ESP block as a perioperative analgesic technique following spine surgery is well established; there are no reports of successful endoscopic discectomy performed using this block. This article emphasizes the utility of ESP block as the sole anesthetic technique for minimally invasive spine surgery in the awake state.

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来源期刊
CiteScore
1.90
自引率
8.30%
发文量
141
审稿时长
36 weeks
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