RESUMO
Interscalene block can induce by itself anesthesia for shoulder surgery, if the opening does not reach the delto-pectoral site nor the shoulder-blade, but medical indications must be thoroughly talked over on account of the risk of phrenic paralysis with patients suffering from breezing trouble, and the surgical position that may disturb the anesthesiologist in case he has to increase anesthesia. A superficial cervical plexus block is required in anesthesia of the upper part of the shoulder. Regional anesthesia is quite useful too as a complement to general anesthesia, for it provides excellent postsurgical analgesia. A catheter may be inserted at the end of the surgical process through a nerve stimulator, but the patient does not tolerate it long, its efficiency greatly diminishes after the first day, and paresthesias may occur as after-effects. Today we prefer set interscalene block before the patient is anaesthetized, searching for paresthesias with a thin needle: this process does not take long to install, it is relatively painless and provides excellent analgesia during the per and post-surgical period, until the next day with long acting local anesthetics. Not any complication happened in fifty patients for one year.
Assuntos
Plexo Cervical , Bloqueio Nervoso , Ortopedia , Articulação do Ombro/cirurgia , Estudos de Avaliação como Assunto , Feminino , Humanos , Masculino , Dor Pós-Operatória/prevenção & controle , Estudos Retrospectivos , Inquéritos e QuestionáriosAssuntos
Bupivacaína/uso terapêutico , Dor Pós-Operatória/prevenção & controle , Ombro/cirurgia , Acrômio/cirurgia , Bupivacaína/administração & dosagem , Cateteres de Demora , Feminino , Humanos , Masculino , Satisfação do Paciente , Manguito Rotador/cirurgia , Luxação do Ombro/cirurgia , Inquéritos e QuestionáriosAssuntos
Raquianestesia/métodos , Bupivacaína , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Álcalis/administração & dosagem , Álcalis/farmacologia , Bupivacaína/administração & dosagem , Bupivacaína/farmacologia , Humanos , Concentração de Íons de Hidrogênio , Perna (Membro)/cirurgia , Pessoa de Meia-Idade , Pressão , Estudos Prospectivos , Fatores de TempoRESUMO
A technique of regional anaesthesia of the foot for forefoot surgery (ingrowing toe-nail, hallux valgus, amputation, etc.) is described. It consists of a block of the superficial peroneal nerve at the ankle combined with a block of the posterior tibial nerve behind the medial malleolus. A volume of 5-6 ml of 1% lidocaine or 1% mepivacaine is injected. A pneumatic tourniquet was placed on the upper part of the thigh after the patient had been given an intramuscular premedication. The results of 52 such blocks carried out in 40 patients are discussed.
Assuntos
Pé/cirurgia , Bloqueio Nervoso/métodos , Adolescente , Adulto , Idoso , Feminino , Pé/inervação , Doenças do Pé/cirurgia , Humanos , Lidocaína/administração & dosagem , Masculino , Mepivacaína/administração & dosagem , Pessoa de Meia-Idade , Nervo Musculocutâneo/efeitos dos fármacos , Pré-Medicação , Nervo Tibial/efeitos dos fármacosRESUMO
The authors report their experience of regional block using anaesthesia of the brachial plexus by the axillary approach. 1 500 axillary blocks have been done since 1976. They perfect their technology and report their results. Because of the innocuity of regional block and its simplicity, they use it in seventy per cent of superior limb acute or regular surgery.