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Single-shot lamina thoracic paravertebral block with ketofol for modified radical mastectomy

机译:单发椎板椎体胸椎旁阻滞合并酮咯酚用于改良根治性乳房切除术

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摘要

We describe the use of single-shot lamina thoracic paravertebral block (TPVB) with sedation for a 56-year-old female patient who had modified radical mastectomy with axillary clearance. Two years ago, she suffered vocal cord palsy post thyroidectomy, which was managed with tracheostomy. The tracheostomy tube was removed 8 months later, leaving the patient with persistent hoarseness of voice and left vocal cord palsy. She declined general anesthesia and consented for TPVB. The surgery lasted 95 minutes and was successfully completed with TPVB. Her vital signs were stable during the operation. She had low pain scores, minimal opioid use, early alimentation, and no postoperative nausea and vomiting and was discharged early. We present the anesthetic management of this case in our setting, where TPVB under ultrasound guidance and modern drug-delivery systems for sedation are unavailable.
机译:我们描述了对56岁女性患者进行单次椎板椎体椎旁阻滞(TPVB)镇静的方法,该患者已进行了根治性腋窝切除术。两年前,她在甲状腺切除术后遭受了声带麻痹,这是通过气管切开术进行的。 8个月后拔出气管造口管,使患者持续出现声音嘶哑和左声带麻痹。她拒绝全身麻醉,并同意使用TPVB。手术持续了95分钟,并通过TPVB成功完成。手术期间她的生命体征稳定。她的疼痛评分低,仅使用了少量阿片类药物,营养早,并且没有术后恶心和呕吐,并且早出院。在目前的情况下,我们无法提供这种情况下的麻醉管理,因为在超声引导下无法使用TPVB镇静,也无法使用用于镇静的现代药物输送系统。

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