Feasibility, efficacy, and safety of ultrasound‐guided axillary plexus blockade in pediatric patients with epidermolysis bullosa dystrophica

Heuvel, Ingeborg van den; Gottschalk, Antje; Langer, Martin; Hahnenkamp, Klaus; Ellger, Björn

doi:10.1111/pan.12860

Cited by 9 publications

(11 citation statements)

References 16 publications

(21 reference statements)

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“…6 In a study involving 19 patients, including children, regional anaesthesia was performed with axillary block anaesthesia such as pseudosyndactyly without any complications. 7,8 In cases where intubation is difficult, fiberoptic nasal intubation is preferred. 9,10 Propofol is preferred in patients with epidermolysis bullosa in intravenous induction.…”

Section: Discussionmentioning

confidence: 99%

Anesthetic Management in Patients with Epidermolysis Bullosa: Two Case Reports

Çelik¹,

Yıldırım²,

Çelik³

et al. 2018

Turkiye Klinikleri J Anest Reanim

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pidermolysis bullosa (EB) is a rare disease characterized by vesiculobullous lesions developed with minimal trauma to the skin and mucous membranes. It is observed at a frequency of 1/30 000. General characteristics of these patients: scars that limit the opening of the mouth, esophageal constriction, dehydration, malnutrition, anemia, hypoalbuminemia, electrolyte imbalance, thrombocytosis, and infections. 1 In addition, temporomandibular joint involvement, which is very important in terms of maintaining the airway opening, can be seen, and unwanted airway problems may be encountered due to the bullae that may

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Section: Discussionmentioning

confidence: 99%

Anesthetic Management in Patients with Epidermolysis Bullosa: Two Case Reports

Çelik¹,

Yıldırım²,

Çelik³

et al. 2018

Turkiye Klinikleri J Anest Reanim

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“…In recent years, there have been some reports of care with ultrasound-guided transversus abdominis plane block (TAPB) for the placement of a peritoneal dialysis catheter [4,8]. Moreover, utilizing ultrasound-guided regional anesthesia in patients with RDEB has also been reported [5,6]. In this case report, we describe the anesthetic management with ultrasound-guided subcostal TAPB for the replacement of a peritoneal dialysis catheter in a patient with RDEB.…”

Section: Introductionmentioning

confidence: 94%

“…After excluding intravascular injection, 20 mL of 0.5% lidocaine combined with epinephrine was injected. In patients with RDEB, particular caution is required to avoid causing new bulla formation through friction caused by the ultrasound probe [6]. To this end, we used sufficient amounts of gel and avoided performing sliding movements for as long as possible to minimize shearing force.…”

Section: Case Presentationmentioning

confidence: 99%

“…General anesthesia bears a high risk because airway manipulation can cause mucosal blister formation in the upper airway following critical airway obstruction. Furthermore, potential difficult airway may prevent gentle airway manipulation and increase the risk [5,6]. Neuraxial anesthesia should be avoided if the skin lesions at the potential site of puncture [2].…”

Section: Introductionmentioning

confidence: 99%

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Anesthetic management with subcostal transversus abdominis plane block in recessive dystrophic epidermolysis bullosa for peritoneal dialysis catheter replacement: a case report

2018

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Background: Recessive dystrophic epidermolysis bullosa (RDEB) is a rare, hereditary mucocutaneous disorder that can involve renal insufficiency. If a vascular access for hemodialysis is unavailable, peritoneal dialysis can be utilized. This report describes an anesthetic management with ultrasound-guided transversus abdominis plane block (TAPB) in a patient with RDEB for peritoneal dialysis catheter replacement. Case presentation: A 49-year-old woman with RDEB needed to undergo peritoneal dialysis catheter replacement. As general, neuraxial and local infiltration anesthesia can lead to serious complications; we planned anesthetic management with subcostal TAPB as the primary analgesia modality. In the operating theater, surgery was initiated after performing left-sided subcostal TAPB. The patient complained of moderate pain at some points during surgery, and the pain was controlled with intravenous or local anesthetics without serious complications. Conclusions: In summary, subcostal TAPB could be a useful option for peritoneal dialysis catheter surgery in patients with RDEB.

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“…The US axillary nerve block is becoming a viable technique for children affected by connective tissue disease, where muscular twitches elicited by the nerve stimulator could be harmful. 14 Avoid forceful pressure on the skin, as this could impede visualisation of the highly compressible axillary vein.…”

Section: Clinical Tipsmentioning

confidence: 99%

Ultrasound-guided upper and lower extremity nerve blocks in children

Merella

Mossetti

2020

BJA Education

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Discuss the role of ultrasound-guided regional anaesthesia in paediatric practice. Summarise the acute postoperative benefits of regional anaesthesia and its role in chronic pain management. Identify the appropriate surgical indications for peripheral nerve blocks in children and their potential complications. Demonstrate the key anatomical aspects and technical steps for performing peripheral nerve blocks in children safely. Paediatric regional anaesthesia (RA) has become an integral part of the current paediatric anaesthetic care. Although Dalens had established the first paediatric RA teaching programme in France by the early 1980s, its scope in the paediatric anaesthetic practice has significantly expanded as a result of the recent enhancement in the ultrasound (US) image quality. 1 Despite the paucity of randomised controlled studies in paediatric compared with adults, evidence of the benefits of RA in children has started to emerge. 2 In infants, RA improves haemodynamic stability, reduces the incidence of postoperative respiratory complications, decreases catecholamine production and the metabolic stress response to surgery and promotes a fast return of gut function and feeding. 3 Studies in older children have also shown that RA reduces postoperative opioid consumption. 4e7 Updates from the latest North America Pediatric Regional Anesthesia Network (PRAN) registry of more than 100,000 nerve blocks showed that RA in children has an acceptable level of safety comparable with adult practice, with US technology progressively replacing nerve stimulator techniques and with the majority of nerve blocks being performed under general anaesthesia. 8 Neuraxial blocks are gradually abandoned in favour of single-shot or continuous peripheral nerve blocks (PNBs). This article briefly discusses the consent process for RA in children, and illustrates the clinical indications (Table 1) and technical aspects of the most common and less traditional single-injection US-guided peripheral limb nerve blocks and the indications for and management of continuous peripheral nerve catheters.

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Feasibility, efficacy, and safety of ultrasound‐guided axillary plexus blockade in pediatric patients with epidermolysis bullosa dystrophica

Abstract: Ultrasound-guided plexus axillaris block in DEB patients undergoing hand surgery in our institution has been feasible, effective, and safe.

Cited by 9 publications

References 16 publications

Anesthetic Management in Patients with Epidermolysis Bullosa: Two Case Reports

Anesthetic Management in Patients with Epidermolysis Bullosa: Two Case Reports

Anesthetic management with subcostal transversus abdominis plane block in recessive dystrophic epidermolysis bullosa for peritoneal dialysis catheter replacement: a case report

Ultrasound-guided upper and lower extremity nerve blocks in children

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