[Ultrasound-guided interscalene block in a patient with supraclavicular anatomical abnormalities due to radiotherapy and surgery]. / Bloqueo interescalénico guiado por ecografía en un paciente con alteraciones anatómicas de la región supraclavicular secundarias a radioterapia y cirugía.

Regional blocks can be difficult in surgical patients with certain superficial anatomical abnormalities. Such blocks may be possible, however, under ultrasound guidance. We report a case in which a man with a fractured right humerus required an ultrasound-guided interscalene brachial plexus block. Secondary to radiotherapy, the patient had right cervical and facial abnormalities that had altered the location of external anatomical landmarks. We describe the approach used to insert the catheter and the exploration of the region by ultrasound. Nerve stimulation was not used to avoid painful contractions. Analgesia was excellent during surgery and over the following 24 hours.

Bloqueo interescalénico guiado por ecografía en un paciente con alteraciones anatómicas de la región supraclavicular secundarias a radioterapia y cirugía / Ultrasound-guided interscalene block in a patient with supraclavicular anatomical abnormalities due to radiotherapy and surgery

Los bloqueos anestésicos regionales para anestesia quirúrgica pueden resultar difíciles en pacientes con determinadas alteraciones de la anatomía de superficie. Los ultrasonidos para anestesia regional pueden permitir el acceso en estos casos. Presentamos un paciente que sufrió una fractura de húmero derecho al que se realizó un bloqueo del plexo braquial interescalénico guiado por ultrasonidos. El paciente presentaba alteraciones secundarias a radioterapia en la zona cervicofacial derecha que alteraban las referencias externas. Se describe la técnica de abordaje para insertar un catéter, y las características de la exploración ecográfica. No emplear neuroestimulación evitó contracciones dolorosas. La analgesia intra y postoperatoria durante 24 horas fueron óptimas(AU)

Regional blocks can be difficult in surgical patients with certain superficial anatomical abnormalities. Such blocks may be possible, however, under ultrasound guidance. We report a case in which a man with a fractured right humerus required an ultrasound-guided interscalene brachial plexus block. Secondary to radiotherapy, the patient had right cervical and facial abnormalities that had altered the location of external anatomical landmarks. We describe the approach used to insert the catheter and the exploration of the region by ultrasound. Nerve stimulation was not used to avoid painful contractions. Analgesia was excellent during surgery and over the following 24 hours(AU)