Implantación subcutánea de DCI-S mediante bloqueos del plano del músculo serrato y del músculo torácico transverso. Caso clínico / S-ICD implantation under the serratus plane block and transversus thoracis muscle plane block. A clinical case

Introducción: El desarrollo de un desfibrilador-cardioversor implantable subcutáneo (DCI-S), combinado con las comorbilidades normales del paciente crea nuevos retos en anestesia. Caso clínico: Varón joven, ASA II, propuesto para implantación de DCI-S, tras recuperarse de un episodio de parada cardiaca súbita. Realizamos anestesia regional con bloqueo en el plano del músculo serrato y bloqueo del plano del músculo torácico transverso con administración de mepivacaína y ropivacaína. La implantación de DCI-S se logró bajo anestesia regional. En el periodo perioperatorio el paciente permaneció hemodinámicamente estable, sin complicaciones ni dolor. Discusión: La implantación de DCI se produce en pacientes frágiles, con alto riesgo anestésico. En este caso, la asociación de bloqueo en el plano del músculo serrato y bloqueo del plano del músculo torácico transverso fue una técnica anestésica/analgésica efectiva, con ventajas en comparación con otras técnicas, y uso potencial en otros procedimientos.(AU)

Introduction: The development of a subcutaneous implantable cardioverter-defibrillator (S-ICD) combined with the typical patient comorbidities creates new challenges for anesthesia. Clinical case: A young male, ASA II, was proposed for S-ICD placement, after recovery from a sudden CRP episode. We performed regional anesthesia with a serratus plane block and transversus thoracic muscle plane block with administration of mepivacaine and ropivacaine. S-ICD placement was achieved under regional anesthesia. In the perioperative period, the patient remained hemodynamically stable, without any complications or pain. Discussion: The implantation of the ICD occurs in fragile patients, with high anesthetic risk. In this case, the association of serratus plane block and transversus thoracic muscle plane block was an effective anesthetic/analgesic approach, has advantages when compared with other techniques and has potential use in other procedures.(AU)

S-ICD implantation under the serratus plane block and transversus thoracis muscle plane block. A clinical case.

INTRODUCTION: The development of a subcutaneous implantable cardioverter-defibrillator (S-ICD) combined with the typical patient comorbidities creates new challenges for anaesthesia. CLINICAL CASE: A young male, ASA II, was proposed for S-ICD placement, after recovery from a sudden CRP episode. We performed regional anaesthesia with a serratus plane block (SPB) and transversus thoracic muscle plane block (TTPB) with administration of Mepivacaine and Ropivacaine. S-ICD placement was achieved under regional anaesthesia. In the perioperative period, the patient remained hemodynamically stable, without any complications or pain. DISCUSSION: The implantation of the ICD occurs in fragile patients, with high anaesthetic risk. In this case, the association of SPB and TTPB was an effective anaesthetic/analgesic approach, has advantages when compared with other techniques and has potential use in other procedures.

S-ICD implantation under the serratus plane block and transversus thoracis muscle plane block. A clinical case. / Implantación subcutánea de DCI-S mediante bloqueos del plano del músculo serrato y del músculo torácico transverso. Caso clínico.

INTRODUCTION: The development of a subcutaneous implantable cardioverter-defibrillator (S-ICD) combined with the typical patient comorbidities creates new challenges for anesthesia. CLINICAL CASE: A young male, ASA II, was proposed for S-ICD placement, after recovery from a sudden CRP episode. We performed regional anesthesia with a serratus plane block and transversus thoracic muscle plane block with administration of mepivacaine and ropivacaine. S-ICD placement was achieved under regional anesthesia. In the perioperative period, the patient remained hemodynamically stable, without any complications or pain. DISCUSSION: The implantation of the ICD occurs in fragile patients, with high anesthetic risk. In this case, the association of serratus plane block and transversus thoracic muscle plane block was an effective anesthetic/analgesic approach, has advantages when compared with other techniques and has potential use in other procedures.

Observations on the gastric mucosa of rheumatic patients before and after ibuprofen administration as studied by the pentagastrin test, endoscopy, and light and electron microscopy.

The initial results of a study set up to investigate the gastric mucosa in rheumatic patients receiving ibuprofen are described. The study involved seven male patients, aged between 17 to 70 years, suffering from various rheumatic diseases. All patients received a daily dose of 1200 mg of ibuprofen per os divided into three fractions and taken over periods of treatment ranging from one to six weeks. On the data obtained by the gastric secretion test, endoscopy, and specific histological and ultrastructure studies it is concluded that, in the cases investigated, ibuprofen could not be shown to be responsible for any significant modification of the gastric mucosa.