Combined femoral and sciatic nerve block with Levobupivacaine in Brugada syndrome patient: A case report

Introduction: Brugada syndrome is a rare arrhythmic disorder associated to ventricular fibrillation and sudden cardiac death. General recommendations in Brugada syndrome patient are focused on avoiding increases in vagal tone and precipitating agents such as electrolyte disorders, hypo/hyperthermia and drugs. Anesthetic management in Brugada syndrome patient has been described in many case reports, however it is still unknown which anesthesia is the safest. Local anesthetic may have a theoretical arrhythmogenic risk, but currently there is no clear evidence and their risk is still debated. Peripheral nerve block avoids autonomic nervous system changes that occur with other anesthetic techniques and it is associated to a lower level in the plasma concentration of the local anesthetic compared with neuraxial anesthesia. Case Report: We report a case of a 38-year-old man patient with Brugada syndrome who underwent urgent orthopedic surgery which was managed with a combined femoral and sciatic nerve blocks using levobupivacaine without any complications. Conclusions: Peripheral nerve block with levobupivacaine provided good analgesia, hemodynamic and cardiac stability in Brugada syndrome patient. Keywords: Brugada syndrome, Anesthesia, Levobupivacaine, Peripheral nerve block, Regional anesthesia

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Relation between Functional Deficit and Intraneural Local Anesthetic during Peripheral Nerve Block

Anesthesiology ◽

10.1097/00000542-199509000-00018 ◽

1995 ◽

Vol 83 (3) ◽

pp. 583-592. ◽

Cited By ~ 46

Author(s):

F. A. Popitz-Bergez ◽

S. Leeson ◽

G. R. Strichartz ◽

J. G. Thalhammer

Keyword(s):

Steady State ◽

Sciatic Nerve ◽

Peripheral Nerve ◽

Nerve Block ◽

Local Anesthetic ◽

Peripheral Nerve Block ◽

Longitudinal Distribution ◽

Functional Block

Background During peripheral nerve block, local anesthetic (LA) penetrates within and along the nerve to produce the observed functional deficits. Although much is known about the kinetics and steady-state relation for LA inhibition of impulse activity in vitro in isolated nerve, little is known about the relation between functional loss and intraneural LA content in vivo. This study was undertaken to investigate the relation of functional change to intraneural LA. Methods A sciatic nerve block was performed in rats with 0.1 ml 1% lidocaine radiolabeled with 14C. The total intraneural uptake of LA was determined at different times after injection, and the distribution of lidocaine along the nerve was assayed at different stages of functional block. Drug content was also compared with equilibrium lidocaine uptake in the isolated rat sciatic nerve. Results Total intraneural lidocaine in vivo increased to near steady-state in about 3 min, stabilizing at approximately 14.3 nmol/mg wet tissue for about 12 min before decreasing to zero at 70 min after injection. Although intraneural lidocaine was 1.6% of the injected dose during full block, only 0.3% was left when deep pain sensation returned and 0.065% was still detected when functions fully recovered. Despite these large differences in total lidocaine content, the longitudinal distribution remained constant. Intraneural lidocaine concentrations obtained at full block and partial recovery could be achieved in vitro by equilibration in 0.7-0.9 and 0.2-0.3 mM lidocaine, respectively. Conclusions During peripheral nerve block only a small amount of injected LA penetrates into the nerve. The intraneural content of LA correlates with the depth of functional block.

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Faculty Opinions recommendation of Serum ropivacaine concentrations and systemic local anesthetic toxicity in trauma patients receiving long-term continuous peripheral nerve block catheters.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.2456961.2093059 ◽

2010 ◽

Author(s):

Bernadette Veering ◽

Bas-Jan Kostering

Keyword(s):

Peripheral Nerve ◽

Nerve Block ◽

Local Anesthetic ◽

Peripheral Nerve Block ◽

Trauma Patients ◽

Local Anesthetic Toxicity ◽

Continuous Peripheral Nerve Block

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HOW TO CHOOSE A LOCAL ANESTHETIC FOR PERIPHERAL NERVE BLOCK

InPharma ◽

10.1007/bf03290795 ◽

1980 ◽

Vol 262 (1) ◽

pp. 5-5

Keyword(s):

Peripheral Nerve ◽

Nerve Block ◽

Local Anesthetic ◽

Peripheral Nerve Block

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Combined epidural anesthesia and ultrasound guided peripheral nerve block for wound revision in a patient with peripartum cardiomyopathy -A case report-

Korean Journal of Anesthesiology ◽

10.4097/kjae.2010.59.5.353 ◽

2010 ◽

Vol 59 (5) ◽

pp. 353 ◽

Cited By ~ 1

Author(s):

Tai Kyung Gong ◽

Seong Su Kim

Keyword(s):

Case Report ◽

Peripheral Nerve ◽

Nerve Block ◽

Epidural Anesthesia ◽

Peripheral Nerve Block ◽

Peripartum Cardiomyopathy ◽

Ultrasound Guided

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Greater occipital nerve block in migraine prophylaxis: Narrative review

Cephalalgia ◽

10.1177/0333102418821669 ◽

2019 ◽

Vol 39 (7) ◽

pp. 908-920 ◽

Cited By ~ 5

Author(s):

Levent Ertugrul Inan ◽

Nurten Inan ◽

Hanzade Aybuke Unal-Artık ◽

Ceyla Atac ◽

Gulcin Babaoglu

Keyword(s):

Peripheral Nerve ◽

Nerve Block ◽

Peripheral Nerve Block ◽

Case Reports ◽

Migraine Treatment ◽

Occipital Nerve ◽

Randomized Controlled ◽

Greater Occipital Nerve Block ◽

Greater Occipital Nerve ◽

Occipital Nerve Block

Objectives The importance and popularity of peripheral nerve block procedures have increased in the treatment of migraine. Greater occipital nerve (GON) block is a commonly used peripheral nerve block method, and there are numerous researches on its use in migraine treatment. Materials and methods A search of PubMed for English-language randomized controlled trials (RCT) and open studies on greater occipital nerve block between 1995 and 2018 was performed using greater occipital nerve, headache, and migraine as keywords. Results In total, 242 potentially relevant PubMed studies were found. A sum of 228 of them which were non-English articles and reviews, case reports, letters and meta-analyses were excluded. The remaining articles were reviewed, and 14 clinical trials, seven of which were randomized-controlled on greater occipital nerve block in migraine patients, were identified and reviewed. Conclusions Although clinicians commonly use greater occipital nerve block in migraine patients, the procedure has yet to be standardized. The present study reviewed the techniques, drugs and dosages, the frequency of administration, side effects, and efficacy of greater occipital nerve block in migraine patients.

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