Semantic Scholar extracted view of "Bloqueo del plexo braquial por vía supraclavicular y axilar guiados por ultrasonido" by Francisco Javier Lenis Chacón et al. PDF | Patients with Chronic Obstructive Pulmonary Disease (COPD) have a higher risk Bloqueio do plexo braquial, por via infraclavicular vertical, em paciente com doença clavicular brachial plexus blockade with % ropivacaine 30 mL. Parálisis diafragmática secundaria a bloqueo de plexo braquial vía infraclavicular para Article (PDF Available) in Revista Colombiana de Anestesiologia 39(4)– . tratados por la vía supraclavicular, como resulta-.
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lução para bloqueios de plexo braquial parece ser bem indicada. .. Bloqueo del Plexo Braquial por Vía Supraclavicular: Estudio Clínico. Comparativo entre. Supraclavicular Brachial Plexus Block: A Comparative Clinical Study between Bupivacaine and LevobupivacaineBloqueio do Plexo Braquial por Via. Bloqueo supraclavicular ecoguiado por abordaje perivascular medial. ba ˜ nando la totalidad del plexo braquial, tanto en la reconstrucción tomográfica como namic alterations can be measured non-invasively via the skin.
The procedures were conducted by anaesthetists with experience equal to or greater than 5 years conducting this type of procedure. Transoperative analgesia was adequate in all cases.
The CO2 curve, respiratory rate, and oxygen saturation were not modified during the entire surgery; also, there was neither dyspnoea nor any evidence of respiratory failure during the transanaesthetic or the mediate postoperative periods. Case 1: bilateral interscalene block Female patient of 70 years, ASA II, with a diagnosis of subacromial impingement, scheduled for bilateral shoulder arthroscopy biceps tenotomy, subacromial decompression, acromioplasty, and distal end resection of bilateral clavicle , history of systemic hypertension, who did not accept general anaesthetics, therefore local anaesthetics were chosen.
The procedure was conducted first on the left side. The transducer was placed for a cross-section approach, and the procedure was conducted on the long axis with an insulated needle of 50mm B Braun Melsungen AG, Stimuplex A50, Germany ; neurostimulation started once the nerve trunks were visualised and the needle tip was perineural, resulting in a muscular response, the contraction of the deltoid muscle, with a current intensity of 0.
An adequate circumferential diffusion was visualised, with root displacement Fig. The local anaesthetic used was ropivacaine 7.
A chest X-ray was taken upon completion to assess the hemidiaphragms, which were not compromised Fig. Figure 1. Ultrasound of the brachial plexus at the interscalene level.
Figure 2. Post-bilateral interscalene block chest X-ray case 1 where the hemidiaphragms are not affected, indicating there was no phrenic nerve block on either side the plate was taken at the end of surgery.
Case 2: bilateral supraclavicular block Female patient of 53 years, ASA III, with a diagnosis of bilateral radius fracture, scheduled for osteosynthesis of distal radius.
History of obesity BMI Regional anaesthetics were chosen due to her co-morbidities.
Brachial plexus block has dde been considered a safe method when proper technique is observed, which includes monitoring and patient selection. ZahnSabera HossainCarol A. Br J Anesth, ; Levobupivacaine for epidural anaesthesia and postoperative analgesia in hip surgery Prof.
This lack of consensus was the basis for this study, i. The primary objectives of the present study included comparing the latency and prevalence of failure of the motor blockade of racemic bupivacaine and levobupivacaine in subclavian perivascular brachial plexus block.
The use of levobupivacaine in brachial plexus block seems promising considering the lower toxicity and the need of large volumes. Significant differences in anthropometric data and physical status were not observed between both groups Table Idemonstrating that the study groups were comparable.
Acta Anaesthesiol Belg, ; Only two studies compared racemic bupivacaine and levobupivacaine 17,21 while the other studies in the literature compared levobupivacaine and ropivacaine 19,20 or evaluated different volumes, doses, concentrations, and routes of administration of levobupivacaine 18, A double-blind, randomised controlled trial.
Local anesthetics and mode of delivery: To assess the degree of the motor blockade, the following classification was used: References Publications referenced by this paper.
Systematic review A systematic review was preferred for the review of medical and scientific literature, as we believed that the traditional review was not adequate since the studies published in the latter were limited to the assessment or justification of a position adopted by the authors, and there is no critical assessment of the literature.
Search strategy The search was conducted from 1 January, , until 30 June, The following keywords in Spanish and English were used: bilateral brachial plexus block, bilateral interscalene block, bilateral infraclavicular block, bilateral supraclavicular block, bilateral lateral supraclavicular block, bilateral axillary block, ultrasound guided bilateral brachial plexus block.
Bloqueo del plexo braquial por vía supraclavicular y axilar guiados por ultrasonido
The question that the systemic review attempted to answer was whether the bilateral block of the brachial plexus is a technique that may be routinely conducted, and a total of articles were obtained, 16 of which were selected Fig. Flow diagram of information review. The studies were selected based on the following grounds: 1 studies reporting the bilateral block technique for the brachial plexus; 2 location will be conducted with any technique paraesthesia, neurostimulation, ultrasound ; 3 any type of upper-limb surgery; 4 in English or Spanish language; 5 studies on humans; 6 patients of both sexes; 7 patients of any age; and 8 with any co-morbidity.
Once selected, they were evaluated to assess their methodological quality. Since all were case reports, the STROBE tool was used in order to issue a degree of recommendation on the application of these techniques. It is believed that the triggering mechanisms are generally caused by the rostral and ventral shape of the local anaesthetic diffusion due to the volume of local anaesthetic, which goes from 20 to 40ml, and guided with the neurostimulation technique.
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Kessler et al. The phrenic nerve has its origin in C4, with a variable contribution from the roots of C3 and C5; it descends vertically leaning on the anterior scalene muscle.
Additionally, the accessory phrenic nerve, which is present in In cases where the phrenic nerve cannot be visualised, it is sufficient that the local anaesthetic does not go beyond the fascia of the anterior scalene. These provide sufficient ventilation and avoid the patient presenting evidence of respiratory failure.
Toxicity by local anaesthetics is not present if the dose of total anaesthetic is calculated according to the body weight, and it is necessary to divide it between both procedures, waiting for some minutes between one procedure and the next to avoid a peak in the plasmatic concentration of anaesthetics and to avoid toxic levels of anaesthetic.
Ultrasound-Guided Axillary Brachial Plexus Block
Regional anaesthetic was applied in the 4 cases presented in this study, since general anaesthetic was not possible due to patient refusal or because it was deemed difficult for intubation.Berthier F, Lepage D, Henry Y, Vuillier F, et al: Anatomical basis for ultrasoundguided regional anaesthesia at the junction of the axilla and the upper arm. Table 1. Regional Anesthesia and Pain Medicine. Eur J Anaesthesiol. Fisher exact test was applied for assessment of quality of block.
Furthermore, the neurovascular structures in the infraclavicular region exhibit important metric relationships with adjacent bone structures.
Figure 3. Three muscles surround the neurovascular bundle: the biceps anterior and superficial , the wedge-shaped coracobrachialis anterior and deep , and the conjoined tendon of the teres major and latissimus dorsi medial and posterior.
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