Revista brasileira de anestesiologia
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Rev Bras Anestesiol · Oct 2006
[Intraventricular pneumocephalus after accidental perforation of the dura mater: case report.].
The loss of resistance to air to identify the epidural space is widely used. However, the accidental perforation of the dura mater is one of the possible complications of this procedure, with an estimated incidence between 1% and 2%. The objective of this report was to describe the case of a patient with intraventricular pneumocephalus after the accidental perforation of the dura mater using the loss of resistance with air technique. ⋯ Pneumocephalus after accidental perforation of the dura mater presented headache with the characteristics of headache secondary to loss of CSF, but with spontaneous resolution after the air was absorbed. Invasive measures, such as epidural blood patch, were not necessary.
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Rev Bras Anestesiol · Oct 2006
[Total spinal block after posterior lumbar plexus blockade: case report.].
Lumbar plexus blockade can be very useful in surgical procedures of the hip, thigh, and knee, but it should be performed by an experienced anesthesiologist due to potential complications. The current report presents a case of total spinal block after posterior lumbar plexus blockade and discusses the possible pathophysiological mechanisms. ⋯ To identify the psoas compartment, where the lumbar plexus blockade is located, the intensity of the current must be between 0.5 and 1 mA. Motor response with low current indicates that the needle may be inside the sheath that surrounds the nervous root and extends to the epidural and subarachnoid spaces, to where the anesthetic solution might spread. Despite the wide safety margin of the procedure, the anesthesiologist must have keen anatomy knowledge, training on the technique, and be constantly alert to perform a lumbar plexus blockade.
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Rev Bras Anestesiol · Oct 2006
[Effective volume of local anesthetics for fascia iliac compartment block: a double-blind, comparative study between 0.5% ropivacaine and 0.5% bupivacaine.].
Fascia iliac compartment block is widely used as one of the anesthetic techniques used for surgical interventions of the hip, thigh, and knee. The majority of the studies have used fixed volumes of ropivacaine or bupivacaine. The objective of this study was to calculate the effective volume of 0.5% ropivacaine and 0.5% bupivacaine in 50% (EV50%), 95% (EV95), and 99% (EV99) of the cases to achieve fascia iliac compartment block. ⋯ The volumes of 0.5% ropivacaine and 0.5% bupivacaine with adrenaline 1:200,000 for the fascia iliac block are similar.
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Rev Bras Anestesiol · Oct 2006
[Prevalence of diaphragmatic paralysis after brachial plexus blockade by the posterior approach with 0.2% ropivacaine.].
Brachial plexus blockade by the interscalene approach, described by Winnie, is one of the most effective techniques in promoting postoperative analgesia in surgeries of the shoulder. Diaphragmatic paralysis is one of the consequences of this technique. This paralysis can cause respiratory failure in patients with prior lung dysfunction. Brachial plexus blockade by the posterior approach has become increasingly more popular. The objective of this study was to determine the prevalence of diaphragmatic paralysis after interscalene brachial plexus blockade by the posterior approach with 0.2% ropivacaine. ⋯ We observed that brachial plexus blockade by the posterior approach is associated with a high prevalence of diaphragmatic paralysis, even with low concentrations of local anesthetics.