超声引导下竖脊肌平面阻滞?的临床应用Р首都医科大学附属北京朝阳医院麻醉科马丹旭Р2017-8-12Р内容Р一、筋膜和筋膜平面阻滞概况?二、竖脊肌平面阻滞在胸科手术的应用三、竖脊肌平面阻滞在腹部手术的应用四、竖脊肌平面阻滞在脊柱手术的应用Р筋膜平面阻滞 Fascial plane blocksРPECS block?Quadratus lumborum block?Serratus plane block?Transversus abdominis plane blockРThe erector spinae plane block: plane and simple. El-Boghdadly K, Pawa A. Anaesthesia. 2017 Apr;72(4):434-438.Р“诡异的筋膜”Р麻醉Р为筋膜平面阻滞提供空间Р疼痛Р人Р体生物力学调控Р胸腰筋膜Р麻醉腰方肌阻滞竖脊肌平面阻滞?胸腰筋膜平面阻滞Р疼痛调节腰臀部和脊柱相关软组织张力肌筋膜炎(急性腰肌扭伤) 神经病理性疼痛Р超声引导下竖脊肌平面阻滞在胸科手术的?临床应用Р超声引导下竖脊肌平面阻滞РForero M, Adhikary SD, Lopez H, et al. The Erector Spinae Plane Block: A Novel Analgesic Technique in Thoracic Neuropathic Pain. Reg Anesth Pain Med. 2016,41(5):621-627.РT5横突竖脊肌平面阻滞范围РT5横突竖脊肌平面阻滞范围Р验证竖脊肌平面阻滞的有效性和安全性——随机对照研究Р持续竖脊肌平面阻滞Р首次剂量 25ml 0.5%罗哌卡因;镇痛泵 8ml/h 0.2%?罗哌卡因,bolus 5ml ,锁定60min