Continuous Plexus Blockade for Improved Circulation in Microvascular Surgery

A Retrospective Review of Troubled Replantations

“…This may be related to the surgeon pre-empting the occurrence of a troubled replantation and requesting for the insertion of a nerve block, which has shown to improve the circulation in microvascular surgery. 16 As our study was a retrospective review, it was limited in the quality of data collected, making it difficult to stratify the severity of the troubled replantation or the record the rationale involved in the decision-making processes by the surgeons at the time of initial selection for replantation and the subsequent decision for re-exploration of troubled replantations. Further exploration of the topic with prospective studies would be helpful to observe the natural history and varying severities of the troubled replantation.…”

Importancia de la simpatectomía inducida por el bloqueo continuo del plexo braquial para la cirugía de reimplante digital en un paciente con cirrosis hepática: reporte de caso

“…Se han descrito complicaciones 2,11 en relación al bloqueo del plexo braquial como infecciones, hematomas 12 , retención de fragmentos del catéter, parestesias y toxicidad farmacológica 2,11 . El avance en el manejo de la ecografía ha permitido reducir la incidencia de lesiones neurovasculares 13 por la visualización directa de los nervios, la aguja, las estructuras adyacentes y principalmente el control de la distribución del anestésico local 6 .…”

The Effect of Epidural Anesthesia on Muscle Flap Tolerance to Venous Ischemia

“…9,10,[12][13][14][15][16]32 Use of a combined epidural anesthesia is recommended in addition to this in suitable cases. 13,14,16,33 Although the benefits of an epidural anesthesia are clinically known due to pain control and prevention of vasoconstriction (sympatholytic activity), there is controversy about the beneficial effect of epidural anesthesia on flap microcirculation. 12,14,28 Epidural anesthesia has beneficial effects on lower extremity venous hemodynamics.…”

“…However, with regard to regional anesthesia being an ideal method for anesthesia in microsurgery, there is ongoing debate, and controversial data exist in the literature. 9,10,[12][13][14][15][16] The objective of this study was to determine whether the positive effects of epidural anesthesia on microcirculation would improve circulation in flaps with venous ischemia.…”