上顎歯肉癌手術で超音波ガイド下上顎神経ブロックおよび浅頸神経叢ブロックを行った1例

抄録

  A multimodal analgesia approach that combines acetaminophen, nonsteroidal anti-inflammatory drugs (NSAIDs), opioids, and local anesthesia is commonly used for postoperative pain management in head and neck surgery. However, the risk of complications should be considered when using NSAIDs and opioids. Reducing the amounts of these agents as much as possible reduces the risk of developing postoperative complications, leading to early postoperative recovery and improved patient prognosis. If a patient’s preoperative assessment suggests an increased risk of postoperative complications, anesthesia management should be planned to prevent such complications, leading to a good patient prognosis. Ultrasound-guided nerve blocks are considered an effective approach to reduce the required doses of NSAIDs and opioids. In addition, ultrasound-guided techniques also provide real-time confirmation of deep anatomy and the spread of local anesthesia from the needle tip. In the presently reported case, an ultrasound-guided maxillary nerve block and superficial cervical plexus block were performed in a patient with a high risk of postoperative complications who was scheduled to undergo a right partial maxillary resection and right neck dissection under general anesthesia. As a result, we were able to provide a good analgesic effect after surgery. An analgesic approach using a head and neck nerve block is not yet a common procedure, but it has the potential to provide effective postoperative analgesia as well as safe long-term analgesia for many maxillofacial surgical procedures.