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Selective Trunk Block combined with Superficial Cervical Plexus Block for Humeral Surgery: Report of two cases
Anesthesia and Analgesia ; 133(3 SUPPL 2):1705, 2021.
Article in English | EMBASE | ID: covidwho-1445071
ABSTRACT

Introduction:

Regional techniques are valuable tools in this specific pandemic context, inclusive in terms of patient and team safety. The authors report the ultrasound-guided selective trunk block (STB) of the brachial plexus with superficial cervical plexus (SCP) for proximal humeral fracture surgery. Case reports Case 1 52-year-old male proposed for open reduction and fixation (ORF) of the humerus. Case 2 53-year-old male proposed for ORF of oblique fracture of the humeral shaft. Both patients were obese, had a hypertensive disease, and a positive test for SARS-COV2. The procedures were performed under ultrasound-guided STB and SCPB using 15 + 3 mL of 0.5% ropivacaine and 10 + 3 mL of lidocaine 1,5%. Intraoperatively, dexamethasone 4 mg, propofol IV perfusion titrated for BIS 60-70, and paracetamol 1g were administered. None of the patients experienced pain, desaturation, or any other complications. Postoperatively, there was no need for rescue analgesia. They had no complications on discharge and globally were satisfied with the technique.

Discussion:

When a patient with a positive test for SARS-COV2 needs surgery, regional anesthesia allows minimal aerosolization without airway manipulation, but also adds advantages in terms of hemodynamic stability, postoperative analgesia with decreased opioid consumption, and patient's recovery time. In these case reports, SCPB with Selective Trunk Block (upper trunk - C5 and C6, middle trunk - C7, and inferior trunk - C8-T1) allow the ideal target for a safe and effective block, avoiding unwanted side effects.
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Collection: Databases of international organizations Database: EMBASE Language: English Journal: Anesthesia and Analgesia Year: 2021 Document Type: Article

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Collection: Databases of international organizations Database: EMBASE Language: English Journal: Anesthesia and Analgesia Year: 2021 Document Type: Article