ABSTRACT
OBJECTIVE: The objective of this study was to know the current reality of Uruguayan anesthesiologists in terms of the frequency of peripheral nerve blocks, which is the most used neurolocation method, the most frequent blockages and which has been the main source of training in this zone. METHODS: After the approval of the institutional ethics committee, it sent a survey through the SurveyMonkey® server to all the anesthesiologists partners of the Uruguayan Society of Anesthesiology whose design was based on the completion in 2016 by Corvetto et al., modifying it and using only the questions referred to peripheral regional blocks to make the data comparable. Data is processed anonymously. RESULTS: The survey was sent to 404 anesthesiologists, responding to the same 201 participants (49.8%), of these 66.2% performed peripheral nerve blocks, interscalenic (40.9%), femoral (46%), axillary and ankle (6.6%) respectively. The most used neurolocation technique is ultrasound either as a single technique (45.1%) or combined with neurostimulation (34.5%). The primary source of training is self-training (42.7%) followed by residency programs (31.7%) and workshops (19.5%). CONCLUSIONS: There is an improvement in our environment regarding the use of peripheral nerve blocks by anesthesiologists with a growing use of ultrasound as the main method of neurolocation.
OBJETIVO: Conocer la realidad actual de los anestesiólogos uruguayos en cuanto a la realización de bloqueos nerviosos periféricos, método de neurolocalización más utilizado, bloqueos más frecuentes y cuál ha sido la principal fuente de formación en esta área. MÉTODO: Tras la aprobación del comité de ética institucional, se envió una encuesta a través del servidor SurveyMonkey® a todos los anestesiólogos socios de la Sociedad Uruguaya de Anestesiología cuyo diseño se basó en la realizada en 2016 por Corvetto y cols, modificando la misma y utilizando sólo las preguntas referidas a los bloqueos regionales periféricos para hacer los datos comparables. Los datos se procesaron de forma anónima. RESULTADOS: La encuesta fue enviada a 404 anestesiólogos, respondiendo la misma 201 participantes (49,8%), de estos 66,2% afirmó realizar bloqueos de nervio periférico, dentro de estos: interescalénico (40,9%), femoral (46%), axilar y tobillo (6,6%) respectivamente. La técnica de neurolocalizacion más utilizada es el ultrasonido ya sea como técnica única (45,1%) o combinada con neuroestimulación (34,5%). La fuente primaria de formación es la autoformación (42,7%) seguido de los programas de residencia (31,7%) y los workshops (19,5%). CONCLUSIONES: Existe una mejora en nuestro medio respecto al uso de los bloqueos nerviosos periféricos por parte de los anestesiólogos con una creciente utilización del ultrasonido como principal método de neurolocalización.
Subject(s)
Humans , Male , Female , Peripheral Nerves , Anesthetics/administration & dosage , Nerve Block/statistics & numerical data , Uruguay , Surveys and Questionnaires , Ultrasonography, Interventional , Anesthetics, Local/administration & dosage , Nerve Block/methodsABSTRACT
Chronic thoracic pain is one of the most encountered problem in patients having malignancy.ln addition to drug therapy there are different interventional techniques for management of this pain. The aim of this work is to evaluate the analgesic efficacy of the paravertebral block versus multiple level intercostals block in the management of chronic malignant thoracic pain and to study the radiological spread of the dye in both techniques putting into consideration the effect on the pulmonary function and haemodynamics, and the sympathetic block. This study was conducted in the pain clinic in the National Cancer Institute on 60 patients of both sexes having chronic thoracic pain of malignant origin on oral opioid therapy. The patients were randomly allocated into 2 groups each group 30 patients.Group A received paravertebral single injection, whereas group B received three level intercostals blocK.Each group is further subdivided into 2 subgroups to receive either 8 or 12 ml of bupivacaine 0.25%. The study showed that in group a spread of the dye was to 2-4 intercostal spaces with both epidural and contralateral spread whereas in group B the dye was restricted to each intercostal space. Sympathetic blockade in group A lasted 16-17 hours and was absent in group B. Systolic, diastolic blood pressure and heart rate were the same in both groups. Pulmonary function was moderetly higher in group A. There was low VAS score in group A. Paravertebral is better than intercostals block in response to chronic thoracic pain as the injected drug spread for more than one intercostal space with both epidural and contralateral spread and with sympathetic blockade. Paravertebral technique cannot be used as a sole technique for management of this pain
Subject(s)
Humans , Male , Female , Chronic Pain , Nerve Block/statistics & numerical data , Pain Measurement , Bupivacaine , Comparative StudyABSTRACT
La anestesia regional en pediatría es una de las "viejas nuevas novedades" en el tratamiento del dolor postoperatorio tanto en pediatría como en otras edades. El presente artículo revisa algunos conceptos que fundamentan su uso, sus beneficios y desventajas. Se llama la atención de la utilidad tanto diagnóstica como terapeútica de alguna de esas técnicas. Se recuerdan algunas características anatómicas e indicaciones de los bloqueos utilizados por los autores con más frecuencia a nivel de plexos, troncos y nervios periféricoas.