在微创心脏外科手术后,手臂结块 (Brachial Plexus Block) 继结块 (Serratus Anterior Plane Block) 之后使用对比X射线识别:一个病例报告
Yuna Sato1, Michio Kumagai2, Yusuke Takei1
1Department of Anesthesiology and Perioperative Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan, tohoku.ac.jp.
Case reports in anesthesiology
|January 8, 2026
概括
状前面平面阻塞 (SAPB) 可能导致罕见的神经复杂症. 本案例研究显示,在微创心脏外科手术中SAPB后的上肢症状,强调了仔细的导管监测.
科学领域:
- 麻醉学 麻醉学
- 疼痛管理 疼痛管理
- 神经外科 神经外科
背景情况:
- 在微创心脏手术 (MICS) 后,Serratus前面平面阻塞 (SAPB) 有效控制疼痛.
- 报道了与SAPB相关的罕见神经复杂症.
- 精确的导管放置对于有效和安全的区域麻醉至关重要.
研究的目的:
- 报告一个上肢神经症状的病例,在SAPB之后,在MICS之后.
- 为了说明对非典型的SAPB导管传播的成像和监测的重要性.
- 突出SAPB的潜在并发症和管理策略.
主要方法:
- 一个74岁的妇女通过小胸口切除术进行了主动脉置换.
- 在手术前,将SAPB导管深深地放置在前额肌 (SAM) 中.
- 术后对比X射线成像以可视化导管分布和编程间歇性玻尿注射 (PIBI).
主要成果:
- 对比成像揭示了从胸壁向右上臂的非典型传播,这表明了导管迁移.
- 患者在PIBI启动后,右臂握力减弱和感觉缺陷.
- 在停止PIBI时神经症状消失,表明可能与导管相关的原因.
结论:
- 在SAPB中非典型的对比传播模式可能表明导管迁移和神经复发症的风险.
- 密切监测神经症状是必不可少的,特别是当观察到异常对比分布时.
- 确认导管放置和及时管理对于区域麻醉患者的安全至关重要.
相关概念视频
Depolarizing Blockers: Pharmocokinetics
Depolarizing blockers are administered through intravenous injection. Succinylcholine is the most common choice of depolarizing blockers in emergency clinical practices. Although they have a rapid onset, they readily diffuse away from the motor end plate into the extracellular fluid. They are metabolized by enzymes such as liver butyrylcholinesterase and plasma pseudocholinesterases. This produces a short duration of action, typically 5-10 minutes long, unlike nondepolarizing blockers, which...
Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia
Intravenous regional anesthesia or the Bier block technique is used to anesthetize a specific limb or extremity. It uses exsanguinated or blood-drained vessels to transport local anesthetics or LAs to the peripheral nerve trunks. Lidocaine without vasoconstrictors like epinephrine is most commonly used for this technique. Other drugs used are prilocaine, ropivacaine, and chloroprocaine. Bupivacaine is not recommended for this technique due to its high cardiac toxicity.
One of the advantages of...
One of the advantages of...
Spinal Nerves: Plexus I
Nerve plexuses are networks of interlacing nerves that serve as communication hubs to distribute and organize nerve action across various body regions. The nerve plexuses are organized into the cervical plexus located in the neck region, brachial plexus in the shoulder area, lumbar plexus found in the lower back, sacral plexus situated in the pelvis, and coccygeal plexus located in the coccygeal region.
The Cervical Plexus
The cervical plexus, formed by the anterior rami of the first four...
The Cervical Plexus
The cervical plexus, formed by the anterior rami of the first four...


