Yavuz GÜRKAN, Dilek ÖZDAMAR, Tülay HOŞTEN, Mine SOLAK, Kamil TOKER

Ultrasound guided lateral sagital infraclavicular block for pectoral flap release

Ultrason farklı nedenlerle sinir stimülasyonunun uygun olmadığı durumlarda sinir bloklarında etkili bir rehber olabilir. Bu yazıda lateral sajital infraklaviküler blokla pektoral flep ayrılması ameliyatı geçiren 28 yaşında, ASA I, erkek hasta sunuldu. Ultrason rehberliğinde toplam 30 ml lokal anestezik karışımı (15 ml levobupivacaine 5 mg/ml ile 5 µg/ml adrenalin içeren 15 ml lidokain 20 mg/ml) aksiller arterin dorsal bölgesine uygulandı. Vasküler ponksiyon ya da farklı bir komplikasyon gelişmedi. Blok başarılı oldu ve hasta uygulamadan 20 dakika sonra cerrahiye hazır oldu. Bu olgu, emniyetli bir şekilde rejyonal anestezi uygulamasında tek yolun ultrason rehberliği olduğu ve infraklaviküler blok uygulamasında sadece ultrason rehberliğinin etkinliğini gösteren bir örnektir.

Pektoral flep ayrılmasında ultrason rehberliğinde lateral sagital infraklavikular blok uygulaması

Ultrasound may provide effective guidance during nerve blocks in cases where nerve stimulation is not feasible for various reasons. We describe a 28-year-old, ASA physical status I, male patient who was operated for pectoral flap release under lateral sagittal infraclavicular block. Using ultrasound guidance alone, total volume of 30 ml of local anesthetic mixture (15 ml of levobupivacaine 5 mg/ml and 15 ml of lidocaine 20 mg/ml with 5 µg/ml epinephrine) was injected dorsal to the axillary artery. There was no vascular puncture or any other complication. The block was successful and the patient was ready for surgery 20 minutes after block performance. This case report is one of the examples that ultrasound guidance may be the only way to perform safe regional anesthesia; ultrasound guidance alone is an effective way of performing infraclavicular block.

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