Ultrasound Guided Loco-regional Anaesthesia is Predictable, Safe and Effective in High Risk Patien

2013 ◽  
Vol 2 ◽  
pp. 92
Author(s):  
G Gagliardi ◽  
M Tedesco ◽  
G Sepolvere ◽  
G Costagliola ◽  
V Mazza ◽  
...  
Keyword(s):  
High Risk ◽  
Regional Anaesthesia ◽  
Ultrasound Guided

scholarly journals Successful Conduction of Mid-Humeral Fracture Surgery Under Ultrasound- Guided Supraclavicular Block an a Case of Cervical Scoliosis with Fixed Contracture Deformity Neck and Multiple Comorbidities

2021 ◽  
Vol 7 (3) ◽  
Author(s):  
Poonam Darswal ◽  
Kashika Jha
Keyword(s):  
High Risk ◽  
General Anaesthesia ◽  
Regional Anaesthesia ◽  
Humeral Fracture ◽  
Ultrasound Guided ◽  
Steep Learning Curve ◽  
High Risk Factors ◽  
Increased Risk ◽  
Safety Case ◽  
Supraclavicular Block

Introduction: Regional anaesthesia has been proven lifesaver in many tough anaesthetic situations that demand good operative conditions yet are prone to put the patient under increased risk of post-operative complications including prolonged ICU stays even increasing overall mortality when general anaesthesia is chosen as primary anaesthesia modality. Use of ultrasound has revolutionised our approach to regional anaesthesia and many cases which would otherwise be deemed unfit for usual anatomy based approaches can now be conducted with enhanced precision and safety. Case presentation: We present on such case in a 69-year-old male patient with multiple high-risk factors that precluded safe conduction of general anaesthesia, with the presence of cervical scoliosis with fixed contracture neck making anatomy impossible for a blind approach to brachial plexus. Even with help of ultrasound interscalene level was not accessible due to contracture. The successful supraclavicular block was made possible as we could make a clear distinction between vessels, pleura and rib at that level although the cords appeared haphazardly placed and stretched not conforming to usual anatomy at the level. Conclusion: This case highlights the importance of regional anaesthesia under ultrasound guidance in such complex high-risk cases. As the experience with ultrasound-guided regional anaesthesia continues to grow internationally, we are on our steep learning curve appreciating the benefits and respecting the limitations of this developing technology.

Ultrasound-Guided Regional Anaesthesia: A Safer Option than General Anaesthesia?

Clinical Risk ◽  
2012 ◽  
Vol 18 (6) ◽  
pp. 224-228
Author(s):  
Nicholas Goddard ◽  
Stuart Batistich ◽  
Zoë Smith ◽  
Jim Turner ◽  
Peter Tomlinson
Keyword(s):  
General Anaesthesia ◽  
Regional Anaesthesia ◽  
Ultrasound Guided

Ultrasound-Guided Combined Lumbar Plexus Block and Sciatic Plexus Block in a High Risk Patient With Alterated Response to Nerve Stimulation

2008 ◽  
Vol 33 (Sup 1) ◽  
pp. e119
Author(s):  
R. Ortiz de la Tabla González ◽  
Martínez Á. Navas ◽  
J.L. Laguillo Cadenas ◽  
Vázquez T. Gutierrez ◽  
Echevarría M. Moreno
Keyword(s):  
High Risk ◽  
Nerve Stimulation ◽  
High Risk Patient ◽  
Lumbar Plexus ◽  
Risk Patient ◽  
Ultrasound Guided ◽  
Lumbar Plexus Block ◽  
Plexus Block

scholarly journals Corrected Scoliosis, Cholinesterase Deficiency, and Cesarean Section: A Case Report

2009 ◽  
Vol 2009 ◽  
pp. 1-3 ◽  
Author(s):  
Roy Somers ◽  
Yves Jacquemyn ◽  
Luc Sermeus ◽  
Marcel Vercauteren
Keyword(s):  
Case Report ◽  
Caesarean Section ◽  
Cesarean Section ◽  
General Anaesthesia ◽  
Spinal Anaesthesia ◽  
Regional Anaesthesia ◽  
Previous Caesarean Section ◽  
Corrective Surgery ◽  
Ultrasound Guided ◽  
Severe Scoliosis

We describe a patient with severe scoliosis for which corrective surgery was performed at the age of 12. During a previous caesarean section under general anaesthesia pseudocholinesterase deficiency was discovered. Ultrasound guided spinal anaesthesia was performed enabling a second caesarean section under loco-regional anaesthesia.

scholarly journals Efficacy of ultrasound-guided forearm nerve block versus forearm intravenous regional anaesthesia in patients undergoing carpal tunnel release: A randomized controlled trial

PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0246863
Author(s):  
Hassanin Jalil ◽  
Florence Polfliet ◽  
Kristof Nijs ◽  
Liesbeth Bruckers ◽  
Gerrit De Wachter ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Pain Intensity ◽  
Nerve Block ◽  
Carpal Tunnel ◽  
Regional Anaesthesia ◽  
Carpal Tunnel Release ◽  
Ultrasound Guided ◽  
Surgical Time ◽  
Randomized Controlled ◽  
Intravenous Regional Anaesthesia

Background and objectives Distal upper extremity surgery is commonly performed under regional anaesthesia, including intravenous regional anaesthesia (IVRA) and ultrasound-guided forearm nerve block. This study aimed to investigate if ultrasound-guided forearm nerve block is superior to forearm IVRA in producing a surgical block in patients undergoing carpal tunnel release. Methods In this observer-blinded, randomized controlled superiority trial, 100 patients undergoing carpal tunnel release were randomized to receive ultrasound-guided forearm nerve block (n = 50) or forearm IVRA (n = 50). The primary outcome was anaesthetic efficacy evaluated by classifying the blocks as complete vs incomplete. Complete anaesthesia was defined as total sensory block, incomplete anaesthesia as mild pain requiring more analgesics or need of general anaesthesia. Pain intensity on a numeric rating scale (0–10) was recorded. Surgeon satisfaction with hemostasis, surgical time, and OR stay time were recorded. Patient satisfaction with the quality of the block was assessed at POD 1. Results In total, 43 (86%) of the forearm nerve blocks were evaluated as complete, compared to 33 (66%) of the forearm IVRA (p = 0.019). After the forearm nerve block, pain intensity was lower at discharge (-1.76 points lower, 95% CI (-2.92, -0.59), p = 0.0006) compared to patients treated with forearm IVRA. No differences in pain experienced at the start of the surgery, during surgery, and at POD1, nor in surgical time or total OR stay were observed between groups. Surgeon (p = 0.0016) and patient satisfaction (p = 0.0023) were slightly higher after forearm nerve block. Conclusion An ultrasound-guided forearm nerve block is superior compared to forearm IVRA in providing a surgical block in patients undergoing carpal tunnel release. Trial registration This trial was registered as NCT03411551.

Presurgical, ultrasound-guided anchor-wire marking of impalpable cervical lymph nodes

2005 ◽  
Vol 119 (8) ◽  
pp. 627-628 ◽  
Author(s):  
J A Bryant ◽  
N J Siddiqi ◽  
E J Loveday ◽  
G H Irvine
Keyword(s):  
Lymph Node ◽  
High Risk ◽  
Lymph Nodes ◽  
Cervical Lymph Node ◽  
Ultrasound Guidance ◽  
Operating Time ◽  
High Risk Patient ◽  
Wire Localization ◽  
Ultrasound Guided ◽  
Cervical Lymph Nodes

This case illustrates the surgical use of wire localization, a well tried technique from a different field of surgery, in the removal of an ultrasound-detected, impalpable deep lower cervical lymph node in a high-risk patient. A localization needle with an echogenic tip was placed freehand under ultrasound guidance, immediately before surgery. The imaging and marking of the impalpable cervical lymph node resulted in a precise surgical dissection and a reduction in operating time whilst minimizing risks to the patient and staff.

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