Humerus Lateral Kondil Kırığı Olan İki Yaşındaki Pediatrik Hastada İnfraklavikular Blok Deneyimimiz: Olgu Sunumu

Rejyonel anestezi yöntemi, pediatrik hastalarda erişkin hastalara nazaran daha az başvurulan bir anestezik yöntemdir. Ultrasonun klinik uygulamada artan popülaritesi ile beraber hedef sinirin ve lokal anestezik yayılımının doğrudan görüntülenebilmesi pediatrik hastalarda da rejyonel anestezi uygulamasına olanak sağlamıştır. Ancak klinik pratiğe ve literatür taramasına bakıldığında bu uygulamaların hala istenilen düzeyde olmadığı rahatlıkla söylenebilir. Bundan dolayı bu konudaki deneyimlerin bilimsel platformlarda daha çok tartışılıp paylaşılması gerektiğini düşünüyorum. Bu anlamda bir gün önce düşme sonucu Humerus lateral kondilinde kırık meydana gelen ve son bir haftada ağır bir üst solunum yolu hastalığı geçirme öyküsü olan 30 aylık bir çocukta ultrason rehberliğinde uyguladığım İnfraklavikular Brakiyal Pleksus bloğu yöntemi hakkındaki deneyimimi sunmak istedim.

Anahtar Kelimeler:

Brakial pleksus bloğu, infraklavikular blok, pediatrik anestezi, ultrason

Our Experience at Infraclavicular Block in A Two-Year Pediatric Patient With Fracture Of Humerus Lateral Condil: Case Report

The regional anesthesia method is an anesthetic method that is used less frequently in pediatric pa-tients than in adult patients. With the increasing popularity of ultrasound in clinical practice, direct imag-ing of the target nerve and local anesthetic spread has allowed the application of regional anesthesia in pediatric patients as well. However, when clinical practice and literature review are examined, it is seen that these applications are still not at the desired level and number. Therefore, we think that experi-ences on this subject should be discussed and shared more on scientific platforms. In this sense, we wanted to present our experience about the Infraclavicular Brachial Plexus block method, which we applied under ultrasound guidance in a 30-month-old child who had a fracture in the lateral humeral condyle as a result of a fall the day before and had a history of severe upper respiratory tract disease in the last week.

Keywords:

Infraclavicular block, Pediatric nerve block Ultrasound, Infraclavicular block, Pediatric nerve block, Ultrasound,

PDF

___

1. Tsui B, Suresh S. Ultrasound imaging for regional anesthesia in infants, children, and adolescents: a review of current literatüre and its application in the practice of extremity and trunk blocks. Anesthesiology 2010; 112: 473-92
2. Willschke H, Marhofer P, Machata AM, Lonnqvist PA. Current trends in paediatric regional anaesthesia. Anaesthesia 2010; 65 (Suppl 1): 97-104.
3. De Tran QH, Clemente A, Doan J, Finlayson RJ. Brachial plexus blocks: a review of approaches and techniques. Can J Anaesthesia 2007; 54(8):662-74.
4. Lee JH, Kim YR, Yu, HK, Cho SH, Kim SH, and Chae WS. Ultrasound-guided interscalene brachial plexus block in apediatric patient with acute hepatitis. Korean J Anesthesiol 2012 June 62(6): 568-570
5. Marhofer P, Sitzwohl C, Greher M, Kapral S. Ultrasound guidance for infraclavicular brachial plexus anaesthesia in children. Anaesthesia 2004;59:642–6.doi: 10.1111/j.1365-2044.2004.03669.x.
6. Oberndorfer U, Marhofer P, Bösenberg A, Willschke H, Felfernig M, Weintraud M. at al. Ultrasonographic guidance for sciatic and femoral nerve blocks in children. Br J Anaesth 2007; 98 (6):797-801. doi: 10.1093/bja/aem092.
7. Willschke H, Marhofer P, Bösenberg A, S Johnston, S Kettner, U Eichenberger et al. Ultrasonographic-guided ilioinguinal/iliohypogastric nerve block in pediatric anesthesia: what is the optimal volume? Br J Anaesth 2005; 95 (2):226–230. doi: 10.1093/bja/aei157.
8. Dadure C, Pirat P, Raux O, Troncin R, Rochette A, Ricard C, et al. Perioperative continuous peripheral nerve blocks with disposable infusion pumps in children: a prospective descriptive study. Anesth Analg 2003; 97: 687-90.