The sulcus formed by the division between the longissimus and the iliocostal muscles is a simple, direct, and easy-to-identify landmark for posterior lumbar plexus block in children.
Total intravenous anesthesia with propofol and remifentanil administered by continuous infusion without neuromuscular blockers is a safe and effective option for DMD patients.
BACKGROUND AND OBJECTIVES:The importance of postoperative analgesia has increased over the years. Plexular catheters represent a good option for high quality analgesia with reduced systemic repercussions. The objective of the present study was to evaluate the incidence of side effects and complications in postoperative analgesia with plexular catheters and identify risk factors for bacterial colonization of the catheters.
METHODS: Patients undergoing orthopedic surgeries betweenMarch of 2005 and January of 2007 received analgesia via plexular catheters. The incidence of side effects and complications of this technique were evaluated. In some of the cases, the catheter tip was cultured.
RESULTS:Four hundred and thirty-three patients were evaluated. Urinary retention and nausea/vomiting had an incidence of 1.3 and 16.6%, respectively. Of 280 catheters examined, 8.6% were colonized. Infections, nerve lesions, or systemic repercussion were not observed.
CONCLUSIONS:The use of antibiotics preoperatively and the type of needle were the risk factors of infection identified.
Although rare, subcutaneous emphysema can have serious repercussions. Manual lymphatic drainage can be an option for the treatment of this aesthetical complication.
Neurolytic block is an efficient technique to control pain in cancer patients who have no possibilities with standard treatment, especially when properly indicated and following well established routines.
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