ALPER KILIÇASLAN, ATİLLA EROL, Ahmet TOPAL, Muhammed Nebil SELİMOGLU, ŞEREF OTELCİOĞLU

Combined use of ultrasound guided infraclavicular block and lateral femoral cutaneous nerve block in upper extremity reconstruction requiring large skin graft: Case report

Üst ve alt ekstremite bloklarının aynı ameliyat içinde kombine kullanımı lokal anestetiklerin sistemik toksisite riskinden dolayı nadi- ren uygulanmaktadır. Bu yüzden bu tür ameliyatlarda genellikle genel anestezi tercih edilmektedir. Ancak ultrason kullanımı sinir- lerin etrafında güvenilir anestezik birikimi sağlayarak, imkan dahilinde anestezik ihtiyacı azaltır. Bu yazıda, ultrason rehberliğinde infraklaviküler brakiyal pleksus bloğu ve lateral femoral kütanöz sinir bloğuyla, 44 yaşında erkek, ASA fziksel durumu I, yan uyluk bölgesinden alınacak olan deri greftiyle üst ekstremite rekonstriksiyonu yapılan bir hasta sunuldu. Blok başarılı oldu ve bloğa bağlı komplikasyon görülmedi. Biz ultrason rehberliğinde infraklavikuler brakiyal pleksus bloğu ile lateral femoral kutaneus sinir bloğunun kombine edilmesinin klinik olarak kullanışlı ve güvenli bir teknik olduğunu ve üst ekstremitenin deri grefti gerektiren rekonstriksiyon- larında alternatif bir anestezi metodu olduğunu düşünmekteyiz.

Geniş cilt grefti gerektiren üst ekstremite rekonstrüksiyonunda ultrason rehberliğinde infraklavikular blok ve lateral femoral kutanöz sinir blok uygulamasının kombine kullanımı: Olgu sunumu

Combined nerve blocks of the upper extremity and lower limb in same operation rarely performed due to the risk of systemic toxicity of local anesthetics. Terefore, general anesthesia is generally preferred in this operations. However, use of ultrasound allows reliable deposition of the anesthetic around the nerves, potentially lowering the local anesthetic requirement. In this case report, we present a 44-year-old, ASA physical status I, male patient who was operated for upper extremity reconstruc- tion requiring skin graft from anterolateral thigh region under ultrasound-guided infraclavicular brachial plexus block and lateral femoral cutaneous nerve block. Te block was successful and no block-related complications were noted. We think that combining an ultrasound guided infraclavicular brachial plexus block and a lateral femoral cutaneous nerve block is a clinically useful and safe technique and an alternative anesthetic method for procedures requiring skin grafts for the upper extremity.

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