ABSTRACT
El bloqueo interescalénico del plexo braquial proporciona anestesia y/o analgesia a nivel del hombro, brazo y antebrazo. Es una técnica anestésica y/o analgésica muy habitual en la práctica clínica diaria, bastante sencilla y segura. Desde su descripción se han desarrollado varios métodos para su realización por referencias anatómicas, neuroestimulación y ecografía, así como diferentes abordajes. Revisamos de forma exhaustiva la anatomía y el abordaje ecoguiado del plexo braquial a nivel interescalénico. Esta técnica permite una localización sencilla, reproducible y mínimamente invasiva, con las ventajas que ello implica en el campo de acción de la anestesia regional. Asimismo, se realiza un análisis coste-eficiencia del uso de ropivacaína frente a levobupivacaína en dicho bloqueo, observándose con el uso de ropivacaína un ahorro económico considerable. El uso de dosis equipotentes de ropivacaína frente a levobupivacaína en dicho bloqueo representa un ahorro de un 50 % en el caso de la administración de una dosis única y de hasta un 66 % en el caso de los preparados para perfusiones continuas (AU)
The interscalene brachial plexus block provides anesthesia and/or analgesia at the shoulder, arm and forearm. The interscalene brachial plexus block is a fairly simple, safe and common anesthetic/ analgesic technique used in daily clinical practice Since its description, several methods have been developed to implement this block by means of anatomical landmarks, nerve stimulation and ultrasound-guidance, as well as the description of different technical approaches. This paper focuses on reviewing the anatomy and ultrasound-guided approach to brachial plexus at interscalene region. This technique allows a simple, reproducible and minimally invasive location, with the advantages that regional anesthesia imply. Moreover, a cost-efficiency comparison of the use of local anesthetics (ropivacaine versus levobupivacaine) in this block technique results in considerable economic savings from the use of ropivacaine. Use of equipotent doses of ropivacaine versus levobupivacaine in this technique represents a saving of 50 % in the case of administering a single dose and up to 66 % in the case of preparations for continuous infusions (AU)
Subject(s)
Humans , Ambulatory Surgical Procedures/methods , Anesthesia/methods , Brachial Plexus Block/methods , Cost of Illness , 50303ABSTRACT
No disponible
Subject(s)
Humans , Shoulder Impingement Syndrome/drug therapy , Analgesics/administration & dosage , Radiography, Interventional/methods , Analgesia/methodsABSTRACT
No disponible
Subject(s)
Humans , Sacrum/surgery , Spinal Fractures/surgery , Pain, Postoperative/drug therapy , Sacrum/injuries , Pain Management/methods , Bone Cements/standards , Pain, Postoperative/prevention & control , Extravasation of Diagnostic and Therapeutic Materials/prevention & controlABSTRACT
In recent years, there has been a considerable increase in the number of procedures carried out under regional anesthesia. The techniques used can be associated with a number of complications, which should be understood so that they can be recognized and managed appropriately. The overall incidence of reported complications associated with these techniques is low and therefore, with currently available data, we can only have an approximate idea of their incidence. The objective of this study is to systematically describe the complications that may arise from the use of neuraxial and peripheral regional anesthesia techniques.
Subject(s)
Anesthesia, Conduction/adverse effects , Nerve Block/adverse effects , HumansABSTRACT
En los últimos años se ha producido un incrementoconsiderable del número de procedimientos llevados acabo con técnicas de anestesia regional. Dichas técnicaspueden llevar asociadas una serie de complicacionescuyo conocimiento es importante para la identificación ycorrecto manejo de las mismas. La incidencia global decomplicaciones asociadas a la realización de dichas técnicases baja y por ello, y con los datos de que disponemosen la actualidad, sólo podemos aproximar su incidenciaexacta.En el presente trabajo se pretende ordenar esquemáticamentey describir las posibles complicaciones que sederivan de la realización de técnicas regionales tantoneuroaxiales como periféricas (AU)
In recent years, there has been a considerableincrease in the number of procedures carried out underregional anesthesia. The techniques used can beassociated with a number of complications, which shouldbe understood so that they can be recognized andmanaged appropriately. The overall incidence ofreported complications associated with these techniquesis low and therefore, with currently available data, wecan only have an approximate idea of their incidence.The objective of this study is to systematically describethe complications that may arise from the use ofneuraxial and peripheral regional anesthesia techniques (AU)
Subject(s)
Humans , Anesthesia, Conduction/adverse effects , Nerve Block/adverse effects , Trauma, Nervous System/complications , Headache/etiology , Heart Failure/etiology , Central Nervous System Infections/etiologyABSTRACT
No disponible
Subject(s)
Adult , Male , Humans , Intubation, Intratracheal , Nasopharynx , Prognathism , Pulmonary Atelectasis , Bronchoscopy , Adenoids , Hemorrhage , Intraoperative ComplicationsABSTRACT
OBJECTIVE: The increased use of the epidural route for administering opioids to treat chronic pain and the need to reduce complications as much as possible, has led some authors to recommend using micro filters to reduce catheter contamination. This study was motivated by the lack of technical information documenting epidural filters used routinely, as well as by the scarcity of literature describing their characteristics. Our aim was to investigate the true nature of the membrane pores, their characteristics and dimensions. MATERIAL AND METHOD: Samples from 30 epidural filters labelled "Porosity: 0.2 microns" from three different manufacturers were studied. Filters from Vygon, Braun and Abbot were labelled A, B and C, respectively. The samples were placed in six groups of five filters each, and 15 random studies were made of each sample. Three of the six groups were used to study prefiltration surfaces and the others to study postfiltration surfaces. Each sample was metalized with gold and its center was then studied by scanning electron microscope. Given that the pores were anfractuous, they were measured by taking the diameter of the largest circle fitting inside that could predict the size of the smallest spherical non elastic body that might be retained. The samples for measuring thickness were cryofractured for determining the number of filtration planes in the 15 filters. RESULTS: Prefiltration surface: Pore diameters were 0.70 (0.66 to 0.74), 0.45 (0.41 to 0.49), and 2.077 (2.01 to 2.15) microns on the filtration surfaces of manufacturers A, B and C, respectively. The differences were significant (p < 0.01) and the pore shapes were also different. Postfiltration surface: The function pores of filters from manufacturers A and B measured 0.26 (0.25 to 0.28) and 0.26 (0.24 to 0.28) microns, and the differences were not significant. The pores of filters from company C were significantly larger (p < 0.01), measuring 0.46 (0.43 to 0.49) microns. There were significant differences (p < 0.001) in pore size on the pre- and postfiltration surfaces from all three manufacturers. Gauge: The five A, B and C filters averaged 130, 118 and 165 microns thick, respectively, with an average number of 140, 220 and 210 filtration planes, respectively. CONCLUSION: The pores of filters for epidural use labelled "0.2 microns" actually had much larger pores on their prefiltration surfaces and throughout the membrane thickness. On the postfiltration surface, however, the diameters of pores on filters manufactured by Vygon and Braun approached 0.2 microns. Pores on filters manufactured by Abbot, however, were approximately 0.46 microns. We believe that in the future manufacturers should include more information in the documentation accompanying their filters.
