#36494 Ultrasound-guided serratus posterior superior block in a case of multitrauma: first catheter application in the novel block

Serkan Tulgar, Dilan Akyurt, Caner Genc
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Abstract

Please confirm that an ethics committee approval has been applied for or granted: Not relevant (see information at the bottom of this page) Application for ESRA Abstract Prizes: I apply as an Anesthesiologist (Aged 35 years old or less)

Background and Aims

Ultrasound-guided Serratus posterior superior intercostal plane (SPSIP) block is a newly defined interfascial plane block and targets the shoulder and hemithorax. Ultrasound-guided Serratsu posterior superior plane (SPSIP) block is a newly defined interfascial plane block and targets the shoulder and hemithorax. Extensive spread was reported from C7 to T7 in the cadaveric study, and from C3 to T10 in clinical applications [1]. Herein, we report our SPSIP block and first catheterization in a critical patient.

Methods

A 48-year-old male patient presented with a fall, resulting in fractures of the left scapula, radius, pelvis, and acetabulum, along with multiple rib fractures and a pneumothorax.He had severe pain due to scapula and rib fractures, thoracic tube, and began to desaturate (88-90%) because he had difficulty in breathing deeply and atelectasis was developing.

Results

Despite routine analgesia, the patient started to deteriorate and left SPSIP block was applied with 40 mL of local anesthetic. Despite routine analgesia, the patient started to deteriorate and left SPSIP block was applied with 40 mL of local anesthetic. When asked about the patient‘s pain originating from the shoulder and thorax, he reported that his NRS decreased from 9 to 2. The next day, a catheter was inserted in the same plane. 20 ml of contrast was administered, allowing determination of the contrast spread from T1 to T4, reaching up to the anterior axillary line (figure 1).

Conclusions

Ultrasound-guided SPSIP block can effectively alleviate pain in the shoulder and hemithorax and may be beneficial in patients with scapula and rib fractures.
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超声引导下后上锯肌阻滞1例:导管在新型阻滞中的首次应用
摘要奖项:本人以麻醉师身份申请(年龄在35岁以下)背景与目的超声引导下锯肌后上肋间平面(SPSIP)阻滞是一种新定义的筋膜间平面阻滞,针对肩部和半胸。超声引导Serratsu后上平面阻滞(SPSIP)是一种新定义的筋膜间平面阻滞,主要作用于肩部和半胸。尸体研究报道从C7到T7的广泛传播,临床应用报道从C3到T10的广泛传播[1]。在此,我们报告了一例危重患者的SPSIP阻滞和首次置管。方法一名48岁男性患者因跌倒导致左肩胛骨、桡骨、骨盆和髋臼骨折,并伴有多处肋骨骨折和气胸。由于肩胛骨和肋骨骨折,他有严重的疼痛,胸管,并开始去饱和(88-90%),因为他呼吸困难和肺不张发展。结果在常规镇痛的情况下,患者病情开始恶化,左SPSIP阻滞应用局麻40ml。尽管常规镇痛,患者开始恶化,左SPSIP阻滞应用40ml局麻。当被问及患者源自肩部和胸部的疼痛时,他报告说他的NRS从9下降到2。第二天,在同一平面插入导管。给药20ml造影剂,测定造影剂从T1到T4的扩散,达到腋前线(图1)。结论超声引导下SPSIP阻滞可有效缓解肩部和半胸疼痛,对肩胛骨和肋骨骨折患者可能有益。
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