Central nerve blocks最新文献

{"title":"59 Continuous spinal anesthesia – a newborn technique for times of need?","authors":"S. Moreira, I. Neri, R. Silva","doi":"10.1136/rapm-2021-esra.59","DOIUrl":"https://doi.org/10.1136/rapm-2021-esra.59","url":null,"abstract":"Background and AimsDescribed during World War II, continuous spinal anesthesia (CSA) enables continuous administration of intrathecal drugs, offering several anesthetic options versus single shot technique, although underutilised.Here we present 4 cases of CSA performed for patients undergoing urgent upper abdominal and lower extremity orthopedic surgery during the COVID-19 pandemic. Our patients were ranked between 90–100 years old with ASA score IV, in which we highlight the presence of ischemic heart disease and chronic obstructive pulmonary disease.MethodsInvasive hemodynamic measurement was performed before CSA technique. Given the lack of microcatheter-over-the-needle kits in our center, we performed the technique using Perifix® Complete Set – B Braun, with full aseptic technique. The 18G Tuohy needle was introduced via a midline approach until CSF was encountered. The 20G catheter was then introduced 3cm into the subarachnoid space. In all situations we opted for the administration of sufentanil 0.0025 mg plus subsequent aliquots of hyperbaric bupivacaine 0.125%, guided by sensory assessment of block level.ResultsAll surgeries were successfully concluded with minimal haemodynamic variation and avoidance of mechanical invasive ventilation. Patients were admitted in the PACU, where spinal catheters were removed, and continued their recovery at the speciality yard. No complications were observed, particularly post-dural puncture headache, neurologic or infectious events.ConclusionsCSA is a useful anesthetic technique with a low failure rate. Its best role is likely to be in high-risk surgical patients, as it can provide excellent blockade conditions, with small doses of LA and little haemodynamic variation frequently seen with single shot techniques.","PeriodicalId":403463,"journal":{"name":"Central nerve blocks","volume":"31 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127939706","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"55 Continuous spinal anesthesia for open cholecystectomy: customized anaesthetic management in a challenging patient","authors":"C. Lopes, D. Zuzarte, M. Correia","doi":"10.1136/rapm-2021-esra.55","DOIUrl":"https://doi.org/10.1136/rapm-2021-esra.55","url":null,"abstract":"istered if the MAP dropped by 10% of the initial value. The number of bolused episodes was recorded. All patients received an IV balanced crystalloid (10 ml/kg) at SAB insertion, followed by an infusion. Pain scores (VAS) were documented perioperatively. Results Conclusions 1. Slowly titrated, low–dose SAB in elderly patients with mild– moderate, asymptotic AS did not develop precipitous hypotension. 2. MAP was relatively easily maintained with boluses of Phenylephrine (50mcg/ml). 3. US–guided SIFI FICB is an effective analgesic adjunct.","PeriodicalId":403463,"journal":{"name":"Central nerve blocks","volume":"50 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127206445","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"47 Incidence and management of post-dural puncture headache and accidental dural puncture from an oncology hospital: a 5-year retrospective analysis","authors":"S. Dias, M. Ferreira, J. Oliveira, S. Serra, P. Alves, M. Gacio, Leonardo S. Miranda","doi":"10.1136/rapm-2021-esra.47","DOIUrl":"https://doi.org/10.1136/rapm-2021-esra.47","url":null,"abstract":"","PeriodicalId":403463,"journal":{"name":"Central nerve blocks","volume":"31 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126908545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"49 Comparison of anti-shivering effect of intravenous versus intrathecal tramadol in patients undergoing lower limb surgery under spinal anaesthesia","authors":"EMohamed Abd El Azeem, M. Abdel-Ghaffar, SA Al-Touny","doi":"10.1136/rapm-2021-esra.49","DOIUrl":"https://doi.org/10.1136/rapm-2021-esra.49","url":null,"abstract":"","PeriodicalId":403463,"journal":{"name":"Central nerve blocks","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130775025","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"56 Temporary meningeal symptoms after epidural blood patch","authors":"E. Oreshnikov, S. Oreshnikova, L. Kashaeva","doi":"10.1136/rapm-2021-esra.56","DOIUrl":"https://doi.org/10.1136/rapm-2021-esra.56","url":null,"abstract":"","PeriodicalId":403463,"journal":{"name":"Central nerve blocks","volume":"47 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132959805","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"38 185 neuraxial drug administration errors from 40 countries – practical issues and human factors","authors":"S. Patel, R. Paskaleva, D. Agrawal","doi":"10.1136/rapm-2021-esra.38","DOIUrl":"https://doi.org/10.1136/rapm-2021-esra.38","url":null,"abstract":"","PeriodicalId":403463,"journal":{"name":"Central nerve blocks","volume":"17 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126813858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"53 Predicting epidural space spread using ultrasound color doppler imaging in interlaminar epidural steroid injection: a prospective observational study","authors":"Y. Kim, H. R. Kim, H-J Kim, Wu Koh","doi":"10.1136/rapm-2021-esra.53","DOIUrl":"https://doi.org/10.1136/rapm-2021-esra.53","url":null,"abstract":"Background and Aims While the use of fluoroscopy-guided transforaminal epidural steroid injection (TFESI) to help spread the injectate toward the ventral side has increased, this procedure entails a radiation risk. Recently, ultrasound has been widely applied in the medical field; among ultrasound methods, color Doppler is useful for predicting the direction of the injectate. This study describes a novel technique employing color Doppler to help predict epidural space spread in interlaminar epidural steroid injection (ILESI)","PeriodicalId":403463,"journal":{"name":"Central nerve blocks","volume":"42 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133579115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"50 The use of short-acting spinal anaesthesia to improve recovery in colorectal surgery","authors":"S. Dean, M. Gorecha, M. Pais, K. Dasgupta, Z. Aslam","doi":"10.1136/rapm-2021-esra.50","DOIUrl":"https://doi.org/10.1136/rapm-2021-esra.50","url":null,"abstract":"49 Table 1 Patient characteristics of the two groups Abstract 49 Table 2 Post-operative complications among the two groups Abstracts Reg Anesth Pain Med 2021;70(Suppl 1):A1–A127 A29 on D ecem er 3, 2021 by gest. P rocted by coright. htt//rapm bm jcom / R eg A nsth P in M d: frst pulished as 10.136/rapm -221-E S R A 50 on 9 S etem er 221. D ow nladed fom without the side effects of a long-acting spinal block and makes it more favourable in modern enhanced recovery programmes. 51 HEMODYNAMIC STABILITY BETWEEN SPINAL AND GENERAL ANAESTHESIA IN PATIENT UNDERGOING PRIMARY TOTAL KNEE ARTHROPLASTY: A RETROSPECTIVE STUDY T Jeandin*, E Albrecht, J Wegrzyn, M Cachemaille. Department of Anaesthesia, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland; Department of Orthopaedics and Traumatology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland 10.1136/rapm-2021-ESRA.51 Background and Aims Total knee arthroplasty is a very common surgical procedure in daily practice and its number is constantly increasing. Some studies have reported that general anaesthesia was associated with greater hemodynamic instability, but this paradigm has since been disputed. The aim of this study is to evaluate intraoperative hemodynamic stability during total knee arthroplasty according to the type of anaesthesia. The hypothesis is that hemodynamic stability is better preserved during spinal anaesthesia (SA) compared to general anaesthesia (GA). Methods Adults undergoing primary total knee arthroplasty were retrospectively selected over a period of 10 years. Primary outcome was the presence of a hemodynamic instability defined by a norepinephrine infusion started when the variation of patient‘s blood pressure exceeded 30% of its baseline value for more than 5 minutes. Secondary outcomes included mean intraoperative dose of ephedrine, mean blood loss, and mean volume of fluid administered. Demographic data and anaesthetic strategy were extracted. Patients receiving SA versus GA were compared for the different variables. Results Demographic data are displayed in table 1. Patients under SA received less ephedrine (p<0.0001), less infusion of norepinephrine (p<0.0001) and less intraoperative fluids (p<0.0001) than patients under GA, while blood loss was similar between groups (p=0.29) (table 2). Conclusions Patients under SA have a better intraoperative hemodynamic stability, as they required less vasopressors than patients under GA. 52 LOSS OF CONSCIOUSNESS WITHOUT HEMODYNAMIC AND RESPIRATORY DISTURBANCES FOLLOWING SPINAL ANESTHESIA FOR CESAREAN SECTION: A CASE REPORT AAGPS Jaya*, AR Tantri, P Pryambodho. Universitas Indonesia/Dr. Cipto Mangunkusumo Hospital, Department of Anesthesiology and Intensive Care, Faculty of Medicine, Jakarta","PeriodicalId":403463,"journal":{"name":"Central nerve blocks","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132535071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"68 1% Chloroprocaine spinal anesthesia for short duration surgical procedures","authors":"A. Strumia, F. Costa, R. Cataldo, F. Gargano, L. Remore, C. Pantanelli, F. Agrò","doi":"10.1136/rapm-2021-esra.68","DOIUrl":"https://doi.org/10.1136/rapm-2021-esra.68","url":null,"abstract":"","PeriodicalId":403463,"journal":{"name":"Central nerve blocks","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115428738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"67 Subaracnoid block with lumbar ultrasound in geriatric patients: preliminary study results","authors":"A. Şahin, S. Özkan, A. Temizyürek","doi":"10.1136/rapm-2021-esra.67","DOIUrl":"https://doi.org/10.1136/rapm-2021-esra.67","url":null,"abstract":"","PeriodicalId":403463,"journal":{"name":"Central nerve blocks","volume":"605 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126592358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}