Bilateral ultrasound-guided supraclavicular block
| Autor: | Maria Patricia Gonzalez, Maria Isabel Vasquez, Ana María Jiménez, Ángela María Ríos, Oscar David Aguirre |
|---|---|
| Rok vydání: | 2012 |
| Předmět: |
Bupivacaine
medicine.medical_specialty business.industry Local anesthetic medicine.drug_class medicine.medical_treatment Analgesic Critical Care and Intensive Care Medicine Surgery Anesthesiology and Pain Medicine medicine.anatomical_structure Pain assessment Anesthesia Nerve block medicine Humerus business Brachial plexus medicine.drug Fixation (histology) |
| Zdroj: | Colombian Journal of Anesthesiology. 40:304-308 |
| ISSN: | 2256-2087 |
| Popis: | Analgesic management in patients with bilateral trauma to the shoulder or the proximal third of the arm is difficult. The multimodal strategy based on the administration of local analgesics to the brachial plexus appears to be the most effective; however, there are risks associated with bilateral blocks, including phrenic nerve palsy, toxicity due to local anesthetics, and bilateral pneumothorax. These risks may be diminished using an ultrasound-guided supraclavicular approach to the brachial plexus. This paper describes the management of a patient with bilateral injury to the shoulder and the proximal third of the humerus. The patient is taken to bilateral humeral fixation surgery and develops severe post-operative pain which does not respond to high-dose opioids and anti-inflammatory agents. He is managed initially with bilateral ultrasound-guided supraclavicular block using a low volume of a local anesthetic followed by continuous administration of bupivacaine. Pain assessment was 2/10 at 24 h and 3/10 at 48 h. We concluded that bilateral supraclavicular blockade is an option in the acute management of pain after surgery to the shoulder and the proximal third of the humerus. Continuous administration of local anesthetics to the brachial plexus helps maintain the analgesic response. |
| Databáze: | OpenAIRE |
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