Revista espanola de anestesiologia y reanimacion · 2004
[Parascalene brachial plexus block: experience of 10 years].
Аннотация на английскомСтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Monzó Abad E, Baeza Gil C, Galindo Sánchez F, Hajro M, González Menéndez A, Kim-Darov V
Аннотация
OBJECTIVE: To study the efficacy and complications of a parascalene block over a period of 10 years of experience.
MATERIAL AND METHODS: Since 1993 we have been performing parascalene blocks with 18G, 45 mm needles with 30 degrees bevels using the aponeurotic click method. We administer 30 mL of 1.5% mepivacaine and then insert a flexible catheter into the sheath surrounding the plexus to provide additional doses of 1% mepivacaine to ensure the surgical block of the inferior nerve trunk and/or postoperative analgesia.
RESULTS: The parascalene block technique was used in 2810 patients for shoulder and arm surgery. The block succeeded in 2524 cases (89.82%) and failed in 286 (10.17%). Anesthetic efficacy was excellent in 1921 cases (76.10%), good in 289 cases (11.45%), and insufficient in 312 (12.36%). The most common complications were Bernard-Horner syndrome (71.31%), and ipsilateral hemidiaphragm paralysis (95.72%). Vasovagal events presented in 92 (4.65%) of the shoulder operations in semi-recumbent position. No cases of pneumothorax, respiratory insufficiency, arterial puncture, neuroaxial anesthesia, or medullary or radicular lesion occurred.
CONCLUSION: The parascalene block is a simple, safe, and effective technique. The probability of serious complications is lower than with most known supraclavicular techniques, mainly because the puncture is perpendicular to the horizontal plane. A neurostimulator or aponeurotic click technique is used and the nerve trunks can be found between 1,5 and 2 cm deep when the plexus is located in reference to the transverse processes.
MATERIAL AND METHODS: Since 1993 we have been performing parascalene blocks with 18G, 45 mm needles with 30 degrees bevels using the aponeurotic click method. We administer 30 mL of 1.5% mepivacaine and then insert a flexible catheter into the sheath surrounding the plexus to provide additional doses of 1% mepivacaine to ensure the surgical block of the inferior nerve trunk and/or postoperative analgesia.
RESULTS: The parascalene block technique was used in 2810 patients for shoulder and arm surgery. The block succeeded in 2524 cases (89.82%) and failed in 286 (10.17%). Anesthetic efficacy was excellent in 1921 cases (76.10%), good in 289 cases (11.45%), and insufficient in 312 (12.36%). The most common complications were Bernard-Horner syndrome (71.31%), and ipsilateral hemidiaphragm paralysis (95.72%). Vasovagal events presented in 92 (4.65%) of the shoulder operations in semi-recumbent position. No cases of pneumothorax, respiratory insufficiency, arterial puncture, neuroaxial anesthesia, or medullary or radicular lesion occurred.
CONCLUSION: The parascalene block is a simple, safe, and effective technique. The probability of serious complications is lower than with most known supraclavicular techniques, mainly because the puncture is perpendicular to the horizontal plane. A neurostimulator or aponeurotic click technique is used and the nerve trunks can be found between 1,5 and 2 cm deep when the plexus is located in reference to the transverse processes.