RESUMO
La creación de un acceso arteriovenoso es obligatorio en pacientes con enfermedad renal terminal para tratamiento con hemodiálisis. Habitualmente implica disección a nivel axilar o en la parte superior de brazo, y la anestesia general es usada predominantemente debido a que la inervación axilar es compleja. Evitar la anestesia general podría ser beneficioso en estos pacientes de riesgo. Presentamos dos casos en los que se empleó el bloqueo serrato-intercostal/BRILMA, junto con bloqueo supraclavicular ecoguiado y analgesia multimodal para cirugía de acceso arteriovenoso axilar o de brazo proximal. La combinación de técnicas de anestesia regional mediante bloqueo supraclavicular y serrato-intercostal/BRILMA en cirugía de fístula arteriovenosa fue exitosa y debe ser considerada por el anestesiólogo con el fin de evitar la anestesia general
Arteriovenous access creation is mandatory in patients with end stage renal disease for hemodialysis treatment. It frequently involves upper arm or axillary dissection and general anesthesia is predominantly used as axillary compartment innervation is complex. Avoiding general anesthesia may be beneficial in these risk patients. We present two cases where serratus-intercostal plane block (SIPB/BRILMA) was used, along with ultrasound guided supraclavicular block and multimodal analgesia for proximal arm and axillary AV access surgery. Regional anesthesia combination of supraclavicular and serratus-intercostal/BRILMA block in arteriovenous fistula surgery was successful and should be considered by anesthesiologist in order to avoid general anesthesia
Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Bloqueio Nervoso/métodos , Anestesia por Condução/métodos , Nervos Intercostais/efeitos dos fármacos , Derivação Arteriovenosa Cirúrgica/métodos , Dispositivos de Acesso Vascular , Implante de Prótese Vascular/métodosRESUMO
ARTERIOVENOUS: access creation is mandatory in patients with end stage renal disease for hemodialysis treatment. It frequently involves upper arm or axillary dissection and general anesthesia is predominantly used as axillary compartment innervation is complex. Avoiding general anesthesia may be beneficial in these risk patients. We present two cases where serratus-intercostal plane block (SIPB/BRILMA) was used, along with ultrasound guided supraclavicular block and multimodal analgesia for proximal arm and axillary AV access surgery. Regional anesthesia combination of supraclavicular and serratus-intercostal/BRILMA block in arteriovenous fistula surgery was successful and should be considered by anesthesiologist in order to avoid general anesthesia.
Assuntos
Derivação Arteriovenosa Cirúrgica , Bloqueio do Plexo Braquial/métodos , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Nervos Intercostais , MasculinoRESUMO
No disponible
Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Cervicalgia/complicações , Cervicalgia/terapia , Glândula Tireoide/cirurgia , Glândulas Paratireoides/cirurgia , Adesivo Transdérmico , Terapia por Estimulação Elétrica/métodos , Estudos Prospectivos , Medição da Dor/métodos , Escala Visual Analógica , Intervalos de ConfiançaRESUMO
No disponible
Assuntos
Humanos , Feminino , Gravidez , Adulto , Trabalho de Parto , Analgesia , Anestesia Epidural , Anestesia Local , Analgesia Obstétrica/instrumentação , Congressos como Assunto , Estudos de Coortes , Índice de Apgar , Analgesia Obstétrica/tendências , Analgesia Obstétrica/métodos , Analgesia ObstétricaRESUMO
La enfermedad de McArdle es una miopatía metabólica que puede implicar graves complicaciones durante el acto anestésico. Exponemos el caso de una paciente sometida a mastectomía, diagnosticada previamente de enfermedad de McArdle. El conocimiento de la fisiopatología y la aplicación de medidas de prevención puede evitar complicaciones de posible desenlace fatal. Se describen las posibles complicaciones y las medidas de prevención y tratamiento (AU)
McArdle disease is a metabolic myopathy that can may lead to severe perioperative problems. A case is reported of a woman with a history of McArdle disease, who was scheduled for a mastectomy. An understanding of the physiology and pathology, and the application of appropriate preventive measures can avoid complications. A overview of the complications and the management are described (AU)
Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Doença de Depósito de Glicogênio Tipo V/tratamento farmacológico , Doença de Depósito de Glicogênio Tipo V/complicações , Mastectomia/métodos , Midazolam/uso terapêutico , Doença de Depósito de Glicogênio Tipo V/prevenção & controle , Intubação Intratraqueal/instrumentação , Diurese , Fentanila/uso terapêutico , Propofol/uso terapêutico , Albuterol/uso terapêuticoRESUMO
McArdle disease is a metabolic myopathy that can may lead to severe perioperative problems. A case is reported of a woman with a history of McArdle disease, who was scheduled for a mastectomy. An understanding of the physiology and pathology, and the application of appropriate preventive measures can avoid complications. A overview of the complications and the management are described.