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首页> 外文期刊>The Open Anesthesia Journal >CASE REPORT - -Combined General and Spinal Anesthesia for Lumbar decompression in anOpioid-intolerant Patient: Intra-operative Administration of IntrathecalBupivacaine via the Surgical Incision
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CASE REPORT - -Combined General and Spinal Anesthesia for Lumbar decompression in anOpioid-intolerant Patient: Intra-operative Administration of IntrathecalBupivacaine via the Surgical Incision

机译：病例报告-阿片类药物耐受性患者腰椎减压联合全身麻醉和脊柱麻醉：通过外科手术切口术中给予鞘内注射布比卡因

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摘要

We illustrate repeat dosing of spinal anesthesia as a means to avoid opioids during lumbar surgery for a patientintolerant of opioids. A patient required redo lumbar surgery but had a marked history of nausea, vomiting and retching in response to opioids.A propofol-based anesthetic was supplemented with intravenous ketamine and intrathecal bupivacaine. The first dose ofbupivacaine receded during the lengthy surgical procedure but was supplemented by means of a 25-gauge pencil-pointneedle passed through the exposed dura. Postoperatively, there was no spinal fluid leak, no headache, and no nausea.Supplementation of intrathecal anesthesia under direct dural vision during lengthy lumbar surgery is facile, can help toobviate a need for opioids, and can aid in avoidance of postoperative nausea and vomiting.
机译：我们举例说明脊椎麻醉的重复给药，以作为腰椎手术期间对患者不耐受阿片类药物的一种避免阿片类药物的方法。一名患者需要重做腰椎手术，但对阿片类药物有明显的恶心，呕吐和呕吐史。以丙泊酚为基础的麻醉剂补充静脉内氯胺酮和鞘内布比卡因。布比卡因的第一剂在冗长的外科手术过程中逐渐消退，但通过一根25号针头针头穿过暴露的硬脑膜来补充。术后无脊液渗漏，无头痛，无恶心。在长期腰椎手术中直接硬膜外视野下鞘内麻醉的补充很容易，可帮助消除对阿片类药物的需求，并有助于避免术后恶心和呕吐。

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