Acta Academiae Medicinae Sinica

Acta Academiae Medicinae Sinica

Acta Academiae Medicinae Sinica ›› 2017, Vol. 39 ›› Issue (5): 688-692.doi: 10.3881/j.issn.1000-503X.2017.05.015

• Orginal Article • Previous Articles     Next Articles

Ultrasound-guided Selective Cervical Nerve Root Block Plus Superficial Cervical Plexus Block for Minimally Invasive Parathyroidectomy

Xu LI1, Minna LI1, Xulei CUI1(), Shuai TANG1, Ya HU2, Quan LIAO2, Yuguang HUANG1   

  1. 1Department of Anesthesiology,PUMC Hospital,CAMS and PUMC,Beijing 100730,China
    2Department of General Surgery, PUMC Hospital,CAMS and PUMC,Beijing 100730,China
  • Received:2017-03-07 Online:2017-10-30 Published:2017-10-30
  • Supported by:
    Supported by the Peking Union Medical College Innovative Team Development Program

Abstract:

Objective To explore the efficacy and safety of ultrasound-guided cervical root block (CRB) in patients undergoing minimally invasive parathyroidectomy (MIP).Methods We enrolled 35 patients with hyperparathyroidism undergoing MIP in Peking Union Medical College Hospital.C4-7 nerve roots were identified in ultrasound imaging by the shape of the transverse process.A 50 mm insulated needle was gently introduced by an in-plane approach toward the posterior edge of the nerve root located at the inside of the posterior tubercle.After careful aspiration,a total of 3-4 ml of a mixture of 0.5% ropivacaine and 1% lidocaine was slowly injected.The superficial block was administered at the midpoint of the posterior border of the sternocleidomastoid by injecting 5-6 ml of the same mixture.The patients were administrated with dexmedetomidine during the surgery.All patients were assessed for sensory following the procedure and for pain after the surgery.Results Totally 35 patients successfully received MIP under ultrasound-guided CRB plus superficial block.There was no conversion to general anesthesia,no toxic reaction of local anesthetics,and no intravertebral injection.Hoarseness occurred in 6 patients (17.1%) and Horner syndrome occurred in 3 patients (8.6%).The median cold sensory visual analogue scale score was 1.2 [0,5] points at 10 minutes after the procedure.Patient’s satisfaction score was 9.5 points.Conclusion Ultrasound-guided CRB plus superficial block can achieve accurate and safe anesthesia,and it provides lasting analgesic effect during and after MIP.

Key words: ultrasound-guided, cervical nerve root block, parathyroidectomy

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