ABSTRACT
Inhaled anaesthetic induction with sevoflurane is very common in the pediatric population. Sevoflurane systemic effects are widely known, while not all the side effects are known. We present a four year-old child who developed a persistent supraventricular tachycardia after inhaled anaesthetic induction with sevoflurane. The arrhythmia did not end until sevoflurane was stopped and changed to an intravenous continuous perfusion of hypnotic drugs (propofol and remiphentanyl). The exact mechanism for such a causal relationship with sevoflurane administration is unknown, and possible diagnoses include atrioventricular nodal reentry tachycardia (AVNRT) and the existence of an accessory pathway. An episode of persistent supraventricular tachycardia with a clear causal relationship with sevoflurane administration is not found in the literature.
Subject(s)
Anesthetics , Tachycardia, Atrioventricular Nodal Reentry , Tachycardia, Supraventricular , Child , Child, Preschool , Humans , Sevoflurane/adverse effects , Tachycardia, Supraventricular/chemically inducedABSTRACT
Objetivos: Describir la eficacia del bloqueo supraescapular frente a otras técnicas de analgesia-anestesia en la reducción de las luxaciones de hombro en urgencias. Casos clínicos: Se utilizó el bloqueo supraescapular en el área de urgencias en diez pacientes con luxación glenohumeral que no había sido posible reducir mediante diferentes técnicas de sedoanalgesia/anestesia. Realizamos la técnica de este bloqueo siguiendo las referencias anatómicas. El bloqueo supraescapular fue muy efectivo en la disminución del dolor y consiguió una alta tasa de éxito en la reducción de la luxación glenohumeral. Conclusiones: El bloqueo supraescapular es una técnica eficaz en la reducción de la luxación de hombro con numerosas ventajas sobre otras, y es muy asequible al urgenciólogo (AU)
Objective: To describe the effective use of the suprascapular nerve block for anesthesia-analgesia during reduction of shoulder dislocation in the emergency department. Cases: We performed suprascapular nerve blocks in the emergency department on 10 patients with glenohumeraldis l ocation in whom treatment had not been possible under other techniques for sedation or anesthesia-analgesia. The block was performed following anatomical reference points. The suprascapular nerve blocks were highly effective inreducing pain and facilitated a high rate of successful repair of the glenohumeral dislocations. Conclusions: The suprascapular nerve block was effective for reduction of shoulder dislocation and offered numerous advantages over other techniques. It was feasible for emergency department use (AU)
