Radiological study to evaluate the spreading of two volumes (10 vs. 20ml) of radiological contrast in the block of cutaneous branches of intercostal nerves in medial axillary line (BRILMA) in a porcine experimental model.

Autor: Varela O; Servicio de Anestesiología, Reanimación y Terapéutica del Dolor, Hospital General Universitario Gregorio Marañón, Madrid, España. Electronic address: olallava@hotmail.com., Melone A; Servicio de Anestesiología, Reanimación y Terapéutica del Dolor, Hospital General Universitario Gregorio Marañón, Madrid, España., López-Menchaca R; Servicio de Anestesiología, Reanimación y Terapéutica del Dolor, Hospital General Universitario Gregorio Marañón, Madrid, España., Sevilla R; Servicio de Anestesiología, Reanimación y Terapéutica del Dolor, Hospital General Universitario Gregorio Marañón, Madrid, España., Callejo D; Servicio de Anestesiología, Reanimación y Terapéutica del Dolor, Hospital General Universitario Gregorio Marañón, Madrid, España., López-Álvarez S; Servicio de Anestesiología, Reanimación y Terapéutica del Dolor, Complejo Hospitalario Universitario de A Coruña (CHUAC), A Coruña, España., Román Fernández A; Servicio de Anestesiología, Reanimación y Terapéutica del Dolor, Complejo Hospitalario Universitario Álvaro Cunqueiro, Vigo, España., García S; Servicio de Anestesiología, Reanimación y Terapéutica del Dolor, Hospital General Universitario Gregorio Marañón, Madrid, España., Mantilla I; Servicio de Anestesiología, Reanimación y Terapéutica del Dolor, Hospital General Universitario Gregorio Marañón, Madrid, España., Zaballos M; Servicio de Anestesiología, Reanimación y Terapéutica del Dolor, Hospital General Universitario Gregorio Marañón, Madrid, España; Universidad Complutense de Madrid, Madrid, España.
Jazyk: English; Spanish; Castilian
Zdroj: Revista espanola de anestesiologia y reanimacion [Rev Esp Anestesiol Reanim (Engl Ed)] 2018 Oct; Vol. 65 (8), pp. 441-446. Date of Electronic Publication: 2018 Jun 07.
DOI: 10.1016/j.redar.2018.05.001
Abstrakt: Objective: Interfascial blocks of the thoracic wall are being developed as an alternative to central blocks in breast surgery. However, there are few studies that have evaluated the anatomical extension of the local anaesthetic. The objective of this study was to analyse, using fluoroscopy, the spreading of two volumes (10 vs. 20ml) of radiological contrast in the serratus-intercostal plane block in an experimental pig model.
Material and Methods: Ten Large-White breed pigs were selected to have a bilateral ultrasound serratus-intercostal plane block performed, with the administering of 10ml and 20ml of iopamidol in the right and left hemithorax, respectively. The spreading of contrast was analysed by fluoroscopy. The Spearman test correlation was used to evaluate the relationship between the administered volume and radiological spreading. A value of P<.05 was considered significant.
Results: Twenty anaesthetic blocks were performed, being able to analyse 18 of them. The administration of 10ml of contrast was associated with a mean spreading of 2.28±0.31 (95% CI; 2.01-2.54) intercostal spaces, while the administration of 20ml showed a spreading of 3±0.25 (95% CI; 2.81-3.18) intercostal spaces. There was a significant correlation between the injected volume and the spreading of the contrast (Spearman correlation coefficient of 0.81; P=.0001).
Conclusion: The results showed a spreading of volume subject to the serratus-intercostal plane block, although not maintaining a 1:1 ratio. Doubling the volume increased the blocked segments by 31%. These findings, if corroborated in the clinical practice, would allow a more precise adjustment in the anaesthetic volume administered.
(Copyright © 2018 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.)
Databáze: MEDLINE
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