Distal Radius Kırıklı Hastada Ultrason Rehberliğinde Bilateral İnfraklaviküler Blok

Periferik sinir blokajı, genel anestezi gerektirmeyen ya da yüksek riskli olan vakalar için iyi bir alternatif tekniktir. Vücudun birden fazla bölgesinde bölgesel anestezinin gerekli olduğu durumlarda lokal anestezik dozu arttıkça toksisite riski de orantılı olarak artmaktadır. Son yıllarda anestezik uygulamaların daha çeşitli hale gelmesi ve kliniklerde ultrasonografi ekipmanları gibi tıbbi araçlara daha kolay erişilebilmesi, gereken lokal anestezik dozunda önemli bir azalma sağlamıştır. Mevcut literatürün de gözden geçirildiği bu yazıda, bilateral distal radius kırığı olan bir hastaya düşük doz lokal anestezik ajan kullanılarak uygulanan bilateral infraklaviküler blok bildirilmiştir.

Ultrasound-Guided Bilateral Infraclavicular Block in a Patient with Distal Radius Fracture

Peripheral nerve blockade is a good alternative technique in cases where general anesthesia is not required or there are high risks. When regional anesthesia is required in more than one region in the body, the risk of toxicity will proportionally increase as the dose of the local anesthetics used is increased. In recent years, increased diversity of anesthetic applications and easier access in clinics to medical tools such as ultrasonography equipment have provided a significant decrease in the required doses of local anesthetics. Discussing in the light of the current literature, this paper reports a bilateral infraclavicular block performed on a patient with bilateral distal radius fracture by using low doses of local anesthetic agents.

PDF

___

1. Klein SM, Evans H, Nielsen K, Tucker M, Warner D, Steele S. Peripheral nerve block technique for ambulatory surgery. Anesth Analg. 2005;101:1663-76.
2. Marhofer P, Greher M, Kapral S. Ultrasound guidance in regional anaesthesia. Br J Anaesth. 2005;94:7-17.
3. Klaastad Ø, Smith HJ, Smedby O, Winther-Larssen EH, Brodal P, Breivik H, et al. A novel infraclavicular brachial plexus block: the lateral and sagittal technique, developed by magnetic resonance imaging studies. Anesth Analg. 2004;98(1):252-6.
4. Neal JM, Moore JM, Kopacz DJ, Liu SS, Kramer DJ, Plorde JJ. Quantitative analysis of respiratory, motor, and sensory function after supraclavicular block. Anesth Analg. 1998;86(6):1239-44.
5. Franco CD, Salahuddin Z, Rafizad A. Bilateral brachial plexus block. Anesth Analg. 2004;98(2):518-20.
6. Pai RV, Hegde HV, Santhosh M, Roopa S, Deshpande SS, Rao PR. Bilateral brachial plexus blocks in a patient of hypertrophic obstructive cardiomyopathy with hypertensive crisis. Indian J Anaesth. 2013;57(1):72-5.
7. Sandhu NS, Maharlouei B, Patel B, Erkulwater E, Medabalmi P. Simultaneous bilateral infraclavicular brachial plexus blocks with low-dose lidocaine using ultrasound guidance. Anesthesiology. 2006;104(1):199-201.
8. Tekin M, Gürkan Y, Baykal D, Solak M, Toker K. Ultrason rehberliğinde bilateral infraklavikular blok: olgu sunumu. Ağrı. 2010;22(1):41-3.
9. Maurer K, Ekatodramis G, Rentsch K, Borgeat A. Interscalene and infraclavicular block for bilateral distal radius fracture. Anesth Analg. 2002;94(2):450-2.