Revista brasileira de anestesiologia
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Rev Bras Anestesiol · Jan 2019
Case Reports[Continuous erector spinae plane block for postoperative analgesia of multiple rib fracture surgery: case report].
The erector spinae plane block is a newly described and effective interfascial plane block for thoracic and abdominal surgery. This case report describes a patient with multiple rib fractures undergoing ultrasound-guided continuous erector spinae plane block for analgesia. ⋯ The erector spinae plane block is an alternative to paravertebral, intercostal, epidural or other regional techniques. It may be a suitable technique in anesthesia and algology practice due to providing analgesia in the postoperative period with a catheter in the erector spinae plane.
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Rev Bras Anestesiol · Jan 2019
Case Reports[Erector spinae plane block as a multiple catheter technique for open esophagectomy: a case report].
Erector spinae plane block is a valid technique to provide simultaneously analgesia for combined thoracic and abdominal surgery. ⋯ Erector spinae plane block is a valid technique to provide analgesia simultaneously for combined thoracic and abdominal surgery and could be a valid alternative strategy if the use of epidural analgesia is contraindicated.
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Rev Bras Anestesiol · Jan 2019
Case Reports[Supraclavicular nerve and superior trunk block for surgical treatment of clavicle fracture in a patient with Steinert's disease - Case report].
Ultrasound-guided upper limb blocks may provide great benefits to patients with serious diseases. Patients with Steinert's disease have muscle weakness and risk of triggering myotony or malignant hyperthermia due to the use of anesthetic agents and surgical stress. The objective of this report was to demonstrate a viable alternative for clavicle fracture surgery with upper trunk and supraclavicular nerve block, thus reducing the spread of local anesthetic to the phrenic nerve in a patient with muscular dystrophy. ⋯ The superior trunk and cervical plexus block associated with venous anesthesia under laryngeal mask, without the use of opioids, proved to be adequate in the case of a patient with clavicle fracture and Steinert's disease. With the use of ultrasonography in regional anesthesia it is possible to perform increasingly selective blocks, thus allowing greater security for the anesthetic-surgical procedure and lower morbidity for the patient.
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Rev Bras Anestesiol · Jan 2019
Randomized Controlled Trial Comparative Study[Effect of magnesium sulphate and milrinone on cerebral vasospasm after aneurysmal subarachnoid hemorrhage: a randomized study].
Aneurysmal subarachnoid hemorrhage is an important cause of premature death and disability worldwide. Magnesium sulphate is shown to have a neuroprotective effect and it reverses cerebral vasospasm. Milrinone is also used in the treatment of cerebral vasospasm. The aim of the present study was to compare the effect of prophylactic magnesium sulphate and milrinone on the incidence of cerebral vasospasm after subarachnoid hemorrhage. ⋯ The incidence of cerebral vasospasm after aneurysmal subarachnoid hemorrhage was significantly lower and Glasgow coma scale significantly better with magnesium when compared to milrinone. Milrinone was associated with a higher incidence of hypotension and requirement for dopamine and norepinephrine when compared to magnesium.
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Rev Bras Anestesiol · Jan 2019
Case Reports[Continuous serratus anterior plane block provides analgesia in multiple rib fractures: a case report].
Thoracic trauma with rib fractures is a challenging condition due to the severe associated pain. Uncontrolled pain impairs breathing and an adequate pain control is necessary to provide comfort and to avoid further complications. Serratus Anterior Plane block is a procedure safe and easy to accomplish. ⋯ Pain control was only achieved after performing a Serratus Anterior Plane block. The technique was done as described in the medical literature with placement of a catheter. Pain relief was achieved with a low concentration infusion of local anesthetic.