RESUMO
A retrospective study of 30 patients who met the clinical criteria for saphenous nerve entrapment at the adductor canal is described. Patients experienced symptoms, usually anterior knee pain, for an average of 36 +/- 7 months. Each patient received an average of 1.9 +/- 0.4 saphenous nerve blocks at the adductor canal during treatment. Baseline pain level (measured by the visual analog scale) was 6.4 +/- 0.3. Final pain level at followup was significantly decreased (2.8 +/- 0.5, P less than 0.001). Eighty percent of patients had improved after a series of blocks. Age, medications taken, number of blocks performed, and length of followup were unrelated to outcome. Length of symptoms did significantly correlate with final pain level (r = 0.39, P less than 0.05). The diagnosis of this syndrome, description of the saphenous nerve block at the adductor canal, and the possible etiology are presented.
Assuntos
Bloqueio Nervoso , Síndromes de Compressão Nervosa/terapia , Manejo da Dor , Dor/fisiopatologia , Coxa da Perna/inervação , Adulto , Síndrome do Compartimento Anterior/fisiopatologia , Síndrome do Compartimento Anterior/terapia , Bupivacaína , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Síndromes de Compressão Nervosa/fisiopatologia , Medição da Dor , Estudos Retrospectivos , Limiar Sensorial , Coxa da Perna/fisiopatologia , Triancinolona/análogos & derivadosRESUMO
Cardiac transplantation has become an established part of the therapy of end-stage heart disease. The number of cardiac transplants performed, as well as the number of centers performing them, has increased dramatically in the past 2 years. A paucity of literature on the anesthetic management of patients undergoing cardiac transplantation prompted this survey of 46 United States and Canadian institutions. The report summarizes the perioperative anesthetic management of a total of 1,273 transplant recipients in 34 institutions. Generally, similar anesthetic techniques and agents were used. One notable exception was the percentage of institutions using perioperative pulmonary artery catheter monitoring. As determined from this survey, right ventricular failure remains the leading cause of inability to terminate cardiopulmonary bypass in this patient population. Further, in surveyed institutions, cardiac transplantation expends more physician as well as hospital resources per patient than coronary artery bypass surgery.
