ABSTRACT
La anestesia regional intravenosa (ARIV) es un método fiable, simple y costo-efectivo de administrar anestesia para procedimientos quirúrgicos menores de las extremidades. Las limitaciones de este bloqueo incluyen dolor con el torniquete, corta duración del bloqueo y ausencia de analgesia postoperatoria. Para mitigar estos efectos y mejorar la calidad del bloqueo se han añadido varios fármacos a los anestésicos locales. Presentamos el caso de un paciente con enfermedad de Dupuytren con quien utilizamos anestésicos locales de larga duración (ropivacaina) y dos adjuvantes (ketamina y ketorolaco) con el fin de mejorar la anestesia operatoria y prolongar la duración de la analgesia perioperatoria
Intravenous regional anesthesia (IVRA) is known to be a reliable, simple and a cost-effective method of providing anesthesia for minor surgical procedures to the extremities. Limitation of this block include tourniquet dolor, short duration of block and absence of post-operative analgesia. To mitigate these effects and improve the quality of the block various drugs have been added to local anesthetiscs. We present the case of a patient with Dupuytren's disease in which we ropivacaine and tow adjuncts (ketamine and ketorolaco) in terms of improving the operative anesthesia and get longer lasting perioperative analgesia
Subject(s)
Humans , Male , Aged , Anesthesia, Conduction/methods , Anesthesia, Intravenous/methods , Ropivacaine/administration & dosage , Ketamine/administration & dosage , Ketorolac/administration & dosage , Anesthetics, Local/administration & dosage , Adjuvants, Anesthesia/administration & dosage , Dupuytren Contracture/surgery , Treatment Outcome , Reproducibility of ResultsABSTRACT
Osteoblastoma is an infrequent primary osseous tumour. Its presentation in the upper extremities and more specifically in the carpal bones is unusual. We present a case of osteoblastoma localized in the hamate bone and review the treatment realized in this infrequent localization. A young male patient with pain and swelling in the back of his hand of one year's evolution, resistant to medical treatment. Complementary tests showed lytic tumefaction in the hamate bone with non-aggressive characteristics. It was treated by curettage and filling the iliac crest with autologous graft. The pathological anatomical study diagnosed that it was a case of osteoblastoma. The result was satisfactory, with total disappearance of the pain and a radiological image of complete restitution of the osseous defect, with no signs of recurrence after 4 years. The treatment should be curettage plus autologous graft. Conversely, resection of the affected bone can be considered in cases with aggressive data.
Subject(s)
Bone Neoplasms , Hamate Bone , Osteoblastoma , Adult , Bone Neoplasms/diagnosis , Bone Neoplasms/surgery , Humans , Male , Osteoblastoma/diagnosis , Osteoblastoma/surgeryABSTRACT
El osteoblastoma es un tumor óseo primario poco frecuente. Su presentación en la extremidad superior y más específicamente en los huesos carpianos es inusual. Se presenta un caso de osteoblastoma localizado en el hueso ganchoso y ser revisa el tratamiento realizado en esta infrecuente localización. Paciente varón joven con dolor y tumefacción en el dorso de la mano de un año de evolución, refractario al tratamiento médico. Las pruebas complementarias mostraron una tumoración lítica en el hueso ganchoso con características no agresivas. Fue tratado mediante curetaje y relleno con injerto autólogo de cresta ilíaca. El estudio de anatomía patológica diagnosticó que se trataba de un osteoblastoma. El resultado fue satisfactorio, con desaparición total del dolor e imagen radiológica de restitución completa del defecto óseo, sin signos de recidiva a los 4 años. El tratamiento debe ser el curetaje más injerto autólogo. En cambio, en los casos con datos agresivos se puede plantear la resección del hueso afectado (AU)
Osteoblastoma is an infrequent primary osseous tumour. Its presentation in the upper extremities and more specifically in the carpal bones is unusual. We present a case of osteoblastoma localized in the hamate bone and review the treatment realized in this infrequent localization. A young male patient with pain and swelling in the back of his hand of one year's evolution, resistant to medical treatment. Complementary tests showed lytic tumefaction in the hamate bone with non-aggressive characteristics. It was treated by curettage and filling the iliac crest with autologous graft. The pathological anatomical study diagnosed that it was a case of osteoblastoma. The result was satisfactory, with total disappearance of the pain and a radiological image of complete restitution of the osseous defect, with no signs of recurrence after 4 years. The treatment should be curettage plus autologous graft. Conversely, resection of the affected bone can be considered in cases with aggressive data (AU)
