• Country: TAIWAN
  • Official Title: 主治醫師
  • Department: 臺中榮民總醫院麻醉部

Speech Title

New Kids in the Block? Nerve Block in Cardiac Surgery?
新勢力？心臟手術中的神經阻斷術？

心臟手術一直被視為神經阻斷術的禁區，而術後的疼痛管理常常只有在血流動力學穩定後才成為關注的焦點。圍術期抗凝血劑的使用、低血壓的風險以及氣胸的可能性，使得麻醉醫師對Neuroaxial麻醉的應用望而卻步。然而，隨著多模式止痛技術的興起，我們如何在心臟手術中找到有效的方法，來改善術後疼痛、減少嗎啡類藥物的使用，並促進病患的術後恢復？

讓我們一起見證「超音波導引周邊神經阻斷術」的新時代。在超音波技術日益普及的今天，周邊神經阻斷術已成為新一代麻醉醫師的必備技能。然而，在心臟手術這個充滿挑戰的領域，我們仍面臨著「在刀鋒上起舞」的難題：如何在高度緊張、生命徵象劇烈變化的環境中，以最安全的方式實現有效的止痛？ESP、PIFB、SAP這些周邊神經阻斷術的應用是否能在心臟手術中發揮其潛力？跟你分享臺中榮總的經驗。

Cardiac surgery has long been considered a no-go zone for nerve block techniques, with postoperative pain management often only addressed after hemodynamic stability is achieved. The use of anticoagulants during the perioperative period, the risk of hypotension, and the potential for pneumothorax have made anesthesiologists wary of applying Neuroaxial anesthesia. However, with the rise of multimodal analgesia, how can we find effective methods in cardiac surgery to alleviate postoperative pain, reduce opioid consumption, and promote patient recovery? Let’s witness the new era of “Ultrasound-Guided Peripheral Nerve Blocks.” As ultrasound technology becomes increasingly widespread, peripheral nerve blocks have become an essential skill for the new generation of anesthesiologists. Yet, in the challenging field of cardiac surgery, we still face the daunting task of “dancing on the edge”: how to safely and effectively achieve pain relief in an environment characterized by rapid pacing and dramatic fluctuations in vital signs. Can the application of ESP, PIFB, and SAP peripheral nerve blocks truly fulfill their potential in cardiac surgery? Join us as we share the experiences of Taichung Veterans General Hospital.