scholarly journals Ultrasound-Guided Local Anesthetic Nerve Blocks in a Forehead Flap Reconstructive Maxillofacial Procedure

2020 ◽  
Vol 67 (3) ◽  
pp. 164-169
Author(s):  
Yuki Kojima ◽  
Kiichi Furuse ◽  
Takeshi Murouchi ◽  
Kazuya Hirabayashi ◽  
Motoi Kato ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Local Anesthetic ◽  
Reconstructive Surgery ◽  
Postoperative Delirium ◽  
Anesthetic Management ◽  
Forehead Flap ◽  
Ultrasound Guided ◽  
Nerve Blocks ◽  
Tissue Flaps ◽  
The Right

Head and neck reconstructive surgery involving tissue flaps is often complex requiring the development of an individualized anesthetic plan. The following case report describes the anesthetic management of an 87-year-old man considered at high risk for postoperative delirium due to advanced age and blindness undergoing general anesthesia for resection of squamous cell carcinoma of the right side of the nose and reconstructive surgery with a scalping forehead flap. Ultrasound-guided local anesthetic maxillary and supraorbital nerve blocks were successfully used perioperatively to reduce the need for alternative analgesics associated with higher risks of complications such as postoperative nausea, vomiting, and delirium.

Incidence of Local Anesthetic Systemic Toxicity and Postoperative Neurologic Symptoms Associated With 12,668 Ultrasound-Guided Nerve Blocks

2012 ◽  
Vol 37 (5) ◽  
pp. 478-482 ◽  
Author(s):  
Brian Daniel Sites ◽  
Andreas H. Taenzer ◽  
Michael D. Herrick ◽  
Constance Gilloon ◽  
John Antonakakis ◽  
...  
Keyword(s):  
Local Anesthetic ◽  
Systemic Toxicity ◽  
Ultrasound Guided ◽  
Nerve Blocks ◽  
Neurologic Symptoms ◽  
Local Anesthetic Systemic Toxicity

scholarly journals Ultrasound-Guided Sciatic and Femoral Block in Patient with Recent Embolism Stroke Undergo Amputation Above the Knee

2021 ◽  
Vol 2 (3) ◽  
pp. 116-119
Author(s):  
Propan Hanggada Satyamakti Mubarak ◽  
Keyword(s):  
Peripheral Nerve ◽  
Femoral Nerve Block ◽  
Femoral Nerve ◽  
Lower Extremities ◽  
Major Surgery ◽  
Anesthetic Technique ◽  
Ultrasound Guided ◽  
Nerve Blocks ◽  
Peripheral Nerve Blocks ◽  
The Right

Background: Patients undergoing amputation of the lower extremities usually have poor circulation and other comorbidities and, therefore, present a challenge to the anesthesiologist. The combination of sciatic and femoral nerve block is reported to be an effective anesthetic technique for patients undergoing knee surgery, and it is known to be an effective method of postoperative analgesia in patients undergoing major surgery on the subject's lower extremities. Case: A 70-year-old man with a recent embolism stroke, death of his limb on the right cruris region, and underwent an amputation above the knee. Preoperative physical examination showed GCS E4 V, motor aphasia M6, blood pressure 131/82 mmHg, pulse 114 bpm, RR 20 times/minute with bodyweight 70 kg, height 160 cm, SpO2 97%. There was cyanosis in the right cruric region with motor power of 1/5 1/5. The value of leukocytes 18,600/ul, platelets 309,000/ul, Prothrombin Time (PT) 15.8 seconds, Activated partial thromboplastin time (APTT) 25.9 seconds, International normalized ratio (INR) 1,330, neutrophils 81.7%, lymphocytes 12.6%, creatinine 1.8 mg/dl, urea 137 mg /dl, blood sugar at the time 258 mg/dl, Cl 95 mmol/l. This case report suggests that ultrasound-guided peripheral nerve blocks may be useful for major lower extremity surgery in patients with severe hemodynamic impairment. Conclusion: Perioperative management of embolism stroke patients undergoing above-knee amputation requires special attention in selecting anesthetics. Ultrasound-guided peripheral nerve blocks minimize patient hemodynamic changes and provide better postoperative pain control.

Magnetic Resonance Imaging Analysis of the Spread of Local Anesthetic Solution after Ultrasound-guided Lateral Thoracic Paravertebral Blockade

2013 ◽  
Vol 118 (5) ◽  
pp. 1106-1112 ◽  
Author(s):  
Daniela Marhofer ◽  
Peter Marhofer ◽  
Stephan C. Kettner ◽  
Edith Fleischmann ◽  
Daniela Prayer ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Local Anesthetic ◽  
Three Dimensional ◽  
Contralateral Side ◽  
Interquartile Range ◽  
Single Shot ◽  
Resonance Imaging ◽  
Ultrasound Guided ◽  
The Right

Abstract Background: This study was designed to examine the spread of local anesthetic (LA) via magnetic resonance imaging after a standardized ultrasound-guided thoracic paravertebral blockade. Methods: Ten volunteers were enrolled in the study. We performed ultrasound-guided single-shot paravertebral blocks with 20 ml mepivacaine 1% at the thoracic six level at both sides on two consecutive days. After each paravertebral blockade, a magnetic resonance imaging investigation was performed to investigate the three-dimensional spread of the LA. In addition, sensory spread of blockade was evaluated via pinprick testing. Results: The median (interquartile range) cranial and caudal distribution of the LA relative to the thoracic six puncture level was 1.0 (2.5) and 3.0 (0.75) [=4.0 vertebral levels] for the left and 0.5 (1.0) and 3.0 (0.75) [=3.5 vertebral levels] for the right side. Accordingly, the LA distributed more caudally than cranially. The median (interquartile range) number of sensory dermatomes which were affected by the thoracic paravertebral blockade was 9.8 (6.5) for the left and 10.7 (8.8) for the right side. The sensory distribution of thoracic paravertebral blockade was significantly larger compared with the spread of LA. Conclusions: Although the spread of LA was reproducible, the anesthetic effect was unpredictable, even with a standardized ultrasound-guided technique in volunteers. While it can be assumed that approximately 4 vertebral levels are covered by 20 ml LA, the somatic distribution of the thoracic paravertebral blockade remains unpredictable. In a significant percentage, the LA distributes into the epidural space, prevertebral, or to the contralateral side.

scholarly journals A Standardized Method for 4D Ultrasound-Guided Peripheral Nerve Blockade and Catheter Placement

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
N. J. Clendenen ◽  
C. B. Robards ◽  
S. R. Clendenen
Keyword(s):  
Peripheral Nerve ◽  
Local Anesthetic ◽  
Spatial Information ◽  
Two Dimensional ◽  
Ultrasound Guided ◽  
Nerve Blocks ◽  
Peripheral Nerve Blocks ◽  
4D Ultrasound ◽  
Peripheral Nerve Blockade ◽  
Standardized Method

We present a standardized method for using four-dimensional ultrasound (4D US) guidance for peripheral nerve blocks. 4D US allows for needle tracking in multiple planes simultaneously and accurate measurement of the local anesthetic volume surrounding the nerve following injection. Additionally, the morphology and proximity of local anesthetic spread around the target nerve is clearly seen with the described technique. This method provides additional spatial information in real time compared to standard two-dimensional ultrasound.

scholarly journals Ultrasound-Guided Femoral and Sciatic Nerve Blocks for Repair of Tibia and Fibula Fractures in a Bennett’s Wallaby (Macropus rufogriseus)

2016 ◽  
Vol 2016 ◽  
pp. 1-4 ◽  
Author(s):  
Paolo Monticelli ◽  
Luis Campoy ◽  
Chiara Adami
Keyword(s):  
Sciatic Nerve ◽  
Anesthetic Management ◽  
Femoral Nerve ◽  
Anesthetic Techniques ◽  
Detailed Knowledge ◽  
Ultrasound Images ◽  
Ultrasound Guided ◽  
Nerve Blocks ◽  
Locoregional Anesthesia ◽  
Proximal Thigh

Locoregional anesthetic techniques may be a very useful tool for the anesthetic management of wallabies with injuries of the pelvic limbs and may help to prevent capture myopathies resulting from stress and systemic opioids’ administration. This report describes the use of ultrasound-guided femoral and sciatic nerve blocks in Bennett’s wallaby (Macropus rufogriseus) referred for orthopaedic surgery. Ultrasound-guided femoral and sciatic nerve blocks were attempted at the femoral triangle and proximal thigh level, respectively. Whilst the sciatic nerve could be easily visualised, the femoral nerve could not be readily identified. Only the sciatic nerve was therefore blocked with ropivacaine, and methadone was administered as rescue analgesic. The ultrasound images were stored and sent for external review. Anesthesia and recovery were uneventful and the wallaby was discharged two days postoperatively. At the time of writing, it is challenging to provide safe and effective analgesia to Macropods. Detailed knowledge of the anatomy of these species is at the basis of successful locoregional anesthesia. The development of novel analgesic techniques suitable for wallabies would represent an important step forward in this field and help the clinicians dealing with these species to improve their perianesthetic management.

Nerve Puncture and Apparent Intraneural Injection during Ultrasound-guided Axillary Block Does Not Invariably Result in Neurologic Injury

2006 ◽  
Vol 105 (4) ◽  
pp. 779-783 ◽  
Author(s):  
Paul E. Bigeleisen
Keyword(s):  
Local Anesthetic ◽  
Neurologic Deficit ◽  
Ultrasound Guided ◽  
Neurologic Injury ◽  
Becton Dickinson ◽  
Nerve Blocks ◽  
Entire Cohort ◽  
Motor Testing ◽  
Intraneural Injection ◽  
Plexus Block

Background Nerve puncture by the block needle and intraneural injection of local anesthetic are thought to be major risk factors leading to neurologic injury after peripheral nerve blocks. In this study, the author sought to determine the needle-nerve relation and location of the injectate during ultrasound-guided axillary plexus block. Methods Using ultrasound-guided axillary plexus block (10-MHz linear transducer, SonoSite, Bothel, WA; 22-gauge B-bevel needle, Becton Dickinson, Franklin Parks, NJ), the incidence of apparent nerve puncture and intraneural injection of local anesthetic was prospectively studied in 26 patients. To determine the onset, success rate, and any residual neurologic deficit, qualitative sensory and quantitative motor testing were performed before and 5 and 20 min after block placement. At a follow-up 6 months after the blocks, the patients were examined for any neurologic deficit. Results Twenty-two of 26 patients had nerve puncture of at least one nerve, and 21 of 26 patients had intraneural injection of at least one nerve. In the entire cohort, 72 of a total of 104 nerves had intraneural injection. Sensory and motor testing before and 6 months after the nerve injections were unchanged. Conclusions Under the conditions of this study, puncturing of the peripheral nerves and apparent intraneural injection during axillary plexus block did not lead to a neurologic injury.

scholarly journals Ultrasound-guided perioperative management of 28-month-old patient with congenital diaphragmatic eventration

2019 ◽  
Vol 7 ◽  
pp. 2050313X1982773
Author(s):  
Hyemin Kang ◽  
Sangmin Lee ◽  
Hyunwoo Park ◽  
Yeojung Kim ◽  
YoungKwon Ko ◽  
...  
Keyword(s):  
Case Report ◽  
General Anesthesia ◽  
Perioperative Management ◽  
Anesthetic Management ◽  
Male Infant ◽  
Lung Ultrasonography ◽  
Ultrasound Guided ◽  
Distal Ulna ◽  
Diaphragmatic Eventration ◽  
The Right

Diaphragmatic eventration is a rare anomaly. When patients with this condition undergo general anesthesia, anesthetic management should be performed with particular care owing to the risk of diaphragmatic rupture. Such a rupture can be perioperatively diagnosed using multiple tools including lung ultrasonography. This case report describes the anesthetic management of a male infant with osteochondroma in the distal ulna, presenting with diaphragmatic eventration on the right side.

scholarly journals Ultrasound-guided percutaneous intercostal nerve cryoneurolysis for analgesia following traumatic rib fracture -a case series-

2020 ◽  
Vol 73 (5) ◽  
pp. 455-459 ◽  
Author(s):  
John J. Finneran IV ◽  
Rodney A. Gabriel ◽  
Matthew W. Swisher ◽  
Allison E. Berndtson ◽  
Laura N. Godat ◽  
...  
Keyword(s):  
Pain Relief ◽  
Local Anesthetic ◽  
Single Injection ◽  
Case Series ◽  
Intercostal Nerve ◽  
Rib Fractures ◽  
Trauma Patients ◽  
Significant Morbidity ◽  
Ultrasound Guided ◽  
Nerve Blocks

Background: Rib fractures are a common injury in trauma patients and account for significant morbidity and mortality within this population. Local anesthetic-based nerve blocks have been demonstrated to provide significant pain relief and reduce complications. However, the analgesia provided by these blocks is limited to hours for single injection blocks or days for continuous infusions, while the duration of this pain often lasts weeks. Case: This case series describes five patients with rib fractures whose pain was successfully treated with cryoneurolysis. Conclusions: Ultrasound-guided percutaneous cryoneurolysis is a modality that has the potential to provide analgesia matching the duration of pain following rib fractures.

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