■本研究旨在评估竖脊肌平面阻滞对左右乳内动脉和桡动脉的直径和横截面积的交感神经切除术效果。
■这项前瞻性研究共包括25名患者(14名男性,11名女性;平均年龄:67岁;范围,23至75岁),在2020年6月1日至2021年3月1日期间接受了美国麻醉医师协会III级的竖脊肌平面阻滞,并接受了非体外循环冠状动脉旁路移植术。使用手术前和手术后45分钟拍摄的超声图像评估了竖脊肌平面阻滞对左右乳内动脉和radial动脉的直径和横截面积的影响。从第三个开始,第四,左、右乳内动脉的第五肋间空间,桡动脉从腕部近3厘米处。
■与竖脊肌平面阻滞后的基线值相比,左右乳内动脉和桡动脉的直径和横截面积显着增加(p<0.05)。术前、术后心率和平均动脉压值无显著差异(p>0.05)。
■双侧竖脊肌平面阻滞,在T5级别执行,提供左,右乳内动脉和radial动脉的血管舒张,而不会引起心率和平均动脉压的任何显着差异。这些发现表明,由竖脊肌平面阻滞产生的交感神经阻滞可以通过预防动脉痉挛来促进更好的手术条件。因此,双侧竖脊肌平面阻滞可能是实现非体外循环冠状动脉旁路移植术区域麻醉的一种有前途的技术。
UNASSIGNED: This study aims to evaluate the sympathectomy effects of erector spinae plane block on the diameters and cross-sectional areas of the left and right internal mammary arteries and of the radial arteries.
UNASSIGNED: This prospective study included a total of 25 patients (14 males, 11 females; median age: 67 years; range, 23 to 75 years) who underwent erector spinae plane block categorized as the American Society of Anesthesiologists Class III and underwent off-pump coronary artery bypass grafting between June 01, 2020 and March 01, 2021. The effects of erector spinae plane block on the diameters and cross-sectional areas of the left and right internal mammary arteries and radial arteries were assessed using ultrasonography images taken both before and 45 min after the procedure, from the third, fourth, and fifth intercostal spaces for the left and right internal mammary arteries and from 3 cm proximal to the wrist for the radial arteries.
UNASSIGNED: The diameters and cross-sectional areas of the left and right internal mammary arteries and radial arteries significantly increased compared to baseline values after the erector spinae plane block (p<0.05). There was no significant difference in the pre- and post-procedural heart rate and mean arterial pressure values (p>0.05).
UNASSIGNED: The bilateral erector spinae plane block, which was performed at the T5 level, provided vasodilatation of the left and right internal mammary arteries and radial arteries without causing any significant difference in the heart rate and mean arterial pressure. These findings indicate that the sympathetic block produced by the erector spinae plane block may facilitate better surgical conditions by preventing arterial spasms. Thus, bilateral erector spinae plane block may be a promising technique to achieve regional anesthesia for off-pump coronary artery bypass grafting.