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Separated Graft Technique for Emergency Vascular Disorders: A Systemic Review of Bilateral Selective Antegrade Cerebral Perfusion (BSACP) for Painful Aortic Dissection


台灣疼痛醫學雜誌第27卷第1期(2016-09-01)
 陳逸忠(I-Chung Chen);黃奭毓(Shih-Yu Huang);侯紹敏(Shaw-Min Hou)
摘要
Meticulous aortic replacement is the cornerstone of emergency aortic dissection and the provision of sufficient cerebral protection and pain control during aortic repair is a major challenge. The standard technique for brain protection in aortic arch replacement is still controversial. Previous studies show that bilateral selective antegrade cerebral perfusion can save operation time in arch repair, cause less neurological dysfunction, and achieve better pain control after surgery. This article reviews the special operative protocols, selective analgesics, advantages, and the risks involved in separated graft technique and selective antegrade cerebral perfusion in this painful vascular disorder.
並列摘要
精細的主動脈弓置換手術是急性主動脈剝離在治療上的基石,而此手術的主要挑戰是在於主動脈弓置換手術期間,經常難以提供適當的疼痛控制和足夠血流來保護腦部循環。目前在針對主動脈弓置換手術上用來提供足夠腦部循環的標準術式仍有不少爭議。最近有研究顯示順行選擇性腦灌注可以節省主動脈弓置換手術時間,並且提供更少神經功能的障礙缺失和達到更好術後疼痛的控制。本文回顧了分離移植手術運用雙側選擇性順行腦灌注技術的特殊方式、相關疼痛藥物選擇、優點、和風險在此種相對疼痛的血管障礙疾病。

 

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