BRILMA block for costal cartilage excision: Case report.

Autor: Silva Pereira T; Departamento de Anestesiología, Centro Hospitalar Universitário Lisboa Norte, Lisboa, Portugal. Electronic address: teresasrspereira@gmail.com., Rodrigues Silva C; Departamento de Anestesiología, Centro Hospitalar Universitário Lisboa Norte, Lisboa, Portugal., Veiga NF; Departamento de Anestesiología, Instituto Português de Oncologia de Lisboa Francisco Gentil, Lisboa, Portugal., Alfaro de la Torre P; Departamento de Anestesia, Reanimación y Tratamiento del Dolor, Hospital Joan XXIII, Tarragona, España., Kabiri-Sacramento M; Departamento de Anestesiología, Hospital Infanta Leonor, Madrid, España.
Jazyk: English; Spanish; Castilian
Zdroj: Revista espanola de anestesiologia y reanimacion [Rev Esp Anestesiol Reanim (Engl Ed)] 2020 May; Vol. 67 (5), pp. 271-274. Date of Electronic Publication: 2020 Mar 03.
DOI: 10.1016/j.redar.2020.01.009
Abstrakt: The block of the lateral branches of the intercostal nerves in the middle axillary line (BRILMA) is an interfascial ultrasound-guided block for analgesia in thoracic wall and upper abdominal surgery, presenting as an adequate alternative to neuraxial techniques. We present the case of a 49-year-old female scheduled for idiopathic subglottic stenosis repair with a costal cartilage graft from the 10 th rib and tracheotomy. At the end of the surgery, unilateral ultrasound-guided BRILMA block with 20ml of ropivacaine 0.2% was performed at the level of the 6 th rib, uneventfully. Postoperatively, the patient referred a maximum level of pain of 3/10. There was no opioid consumption after the 2 nd postoperative day, although a subcostal incision may produce considerable pain. BRILMA is a superficial block, easily reproducible in most patients. It diminishes the number of punctures needed in the thoracic wall, as well as the risk for pneumothorax and local anesthetic toxicity.
(Copyright © 2020 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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