Anestesia para bypass vascular em membro inferior com bloqueio de nervos periféricos

Guimarães, Jordana de Fraga; Angonese, Cristine Formighieri; Gomes, Rafael Klein; Miranda, Vasco; Farias, Carlos

doi:10.1016/j.bjan.2015.12.003

Cited by 4 publications

(6 citation statements)

References 2 publications

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“…Carrying out "blind" blockades significantly increases the failure rate during anesthesia. In addition, according to the latest information, neurostimulation, which was assumed to be the "golden standard" in the past, is not able to ensure an adequate level of nerve block [28]. Currently, ultrasound navigation allows the anesthesiologist to accurately position the needle and monitor the distribution of local anesthetic in the perineural area [29].…”

Section: Research Results and Discussionmentioning

confidence: 99%

The problem of choosing anesthesia method for surgical interventions on the lower limbs in young patients

Georgiyants

Popsuishapka

Ryndenko

et al. 2021

SR:MS

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The relevance of the topic is due to the prevalence of lower limbs injuries in people of working age, the complexity of the methods of their surgical treatment and the problem of finding the optimal method of anesthesia in terms of efficiency and safety. Objective of the study: to conduct a systematic analysis of modern scientific literature data on the possibility of using anesthesia methods during surgical interventions and in the case of anesthesia for injuries of the lower limbs in people of working age. Materials and methods. A search for scientific sources was carried out in the scientometric databases Scopus and Web of Science, Google Scholar, archives of journals using the keywords "general anesthesia", "regional anesthesia", "injuries of the lower limbs", "young people", "general anesthesia". The search depth was 8 years. Conclusions. The problem of choosing the method of anesthesia during traumatological surgeries in people of working age has no final solution. In general, both general and regional anesthesia can be used, despite their advantages and the possibility of complications in each case. However, in clinical practice over the past decade, general anesthesia is not always the best method of pain relief. But regional methods have less effect on the vital functions of the body, and the use of ultrasound navigation and modern local anesthetics in a minimum sufficient amount makes anesthesia conduction more effective and safe. The disadvantages of regional anesthesia can be avoided by combining it with general anesthesia. However, in the available literature, there are no recommendations on the differentiated choice of the method of anesthesia for surgical interventions on the lower limbs in people of working age and the factors that influence this

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Section: Research Results and Discussionmentioning

confidence: 99%

The problem of choosing anesthesia method for surgical interventions on the lower limbs in young patients

Georgiyants

Popsuishapka

Ryndenko

et al. 2021

SR:MS

View full text Add to dashboard Cite

show abstract

“…Regional anesthesia may let high-risk patients have safer anesthesia devoid of any pulmonary and cardiovascular adverse changes. Chronic arterial occlusion is a pathology which may need revascularization therapies [ 1 ]. These operations can be performed under general, spinal, or epidural anesthesia.…”

Section: Discussionmentioning

confidence: 99%

“…Regional blockade techniques are found superior to general anesthesia regarding postoperative analgesia and suppression of the response to surgical stress leading to hypercoagulability. However, in most cases, patients receive anticoagulant or thrombolytic medications which question the safety of spinal and epidural anesthesia [ 1 , 4 ]. The European Society of Anaesthesiology recommends using superficial blocks such as axillary femoral or distal sciatic nerve blocks which may be applied to anticoagulant therapies.…”

Section: Discussionmentioning

confidence: 99%

“…Regional anesthesia techniques are used for varying reasons including postoperative analgesia, surgical procedures, and chronic pain treatment with a single injection or continuous methods. They can be a convenient choice for surgeries of complicated high-risk patients with vascular and cardiopulmonary diseases in which general anesthesia may deteriorate their current delicate status [ 1 ]. Regional anesthesia, preferably in a combined form, could be a secure choice for this group of patients.…”

Section: Introductionmentioning

confidence: 99%

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Use of Femoral and Sciatic Nerve Block Combination in Severe Emphysematous Lung Disease for Femoral Popliteal Arterial Bypass Surgery

Selvi

Bayserke

Tulgar

2018

Cureus

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Regional anesthesia is a widely used anesthesia technique for high-risk patients with severe vascular or pulmonary diseases in which general anesthesia is considered harmful and should be avoided. In this case, we present the use of femoral-sciatic nerve block combination for a 65-year-old, ASA IV, male patient who had severe emphysematous lung disease and was planned for a right femoral-popliteal arterial bypass surgery. He had severe pulmonary disease, hypertension, peripheral vascular disease, and was on clopidogrel treatment. Due to his existing comorbidities, regional anesthesia was considered the right method. The combination of femoral and sciatic nerve block was successfully used for the operation, which lasted for one hour and fifty minutes under sedation, and was continuously supplied with a propofol infusion. The patient was safely discharged to the surgical ward with no pain. The femoral block and sciatic block combination is described as one of the most useful, and at the same time, the most ignored anesthetic method. This technique is considered a standard technique and is often taught early in training; however, its use seems to be underestimated as there are only a few cases documented in Turkey. The aim of this case is to serve as a reminder of its significant value in patients who are not appropriate for general anesthesia and neuraxial blocks.

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“…General anesthesia (GA) and regional anesthesia (RA) have both been successfully used for PVR [1]. Peripheral nerve blocks may provide an alternative to GA and regional neuraxial blocks where contraindicated as per international guidelines [2,3]. In our institution, when feasible, the preference is to perform procedures under spontaneous ventilation with epidural anesthesia, spinal block, or a combination of both.…”

Section: Introductionmentioning

confidence: 99%

Alternative Postoperative Analgesia Technique for Peripheral Vascular Revascularization: A Case Report

Almeida¹,

Arantes²,

Carvalho³

et al. 2023

Cureus

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Peripheral arterial disease (PAD) patients often require surgical peripheral vascular revascularization (PVR), in which postoperative pain management can be challenging. This case report details a 43-year-old female patient with PAD who underwent urgent femoral popliteal bypass with an inverted ipsilateral great saphenous vein and left femoral endarterectomy. Due to contraindications for neuraxial anesthesia and the necessity for continuous anticoagulation, the procedure was performed under general anesthesia (GA) and an unconventional technique with intraoperative perineural catheter (PC) placement to guarantee adequate postoperative analgesia. The surgeon inserted the PC in the vicinity of the femoral nerve under direct visualization before surgical closure. Postoperative analgesia was successfully managed, demonstrating the effectiveness of this approach as part of a multimodal analgesia strategy. This case report suggests that such a technique, supervised by an anesthesiologist and supported by a multidisciplinary team, can provide effective postoperative pain control in PAD patients without interrupting perioperative anticoagulation. Formal protocols for similar procedures can arise, incorporating this analgesic option.

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Anestesia para bypass vascular em membro inferior com bloqueio de nervos periféricos

Cited by 4 publications

References 2 publications

The problem of choosing anesthesia method for surgical interventions on the lower limbs in young patients

The problem of choosing anesthesia method for surgical interventions on the lower limbs in young patients

Use of Femoral and Sciatic Nerve Block Combination in Severe Emphysematous Lung Disease for Femoral Popliteal Arterial Bypass Surgery

Alternative Postoperative Analgesia Technique for Peripheral Vascular Revascularization: A Case Report

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