Diana Ávila Reyes, Bayron David García P., Guillermo Salazar Gutierrez, J. G. Gómez González, David Ricardo Echeverry Piedrahita, J. C. Galvis, Mateo Aguirre-Flórez
COVID-19-associated infection leads to a pathology of yet unknown clinical behavior, confronting the clinician with various challenges. An extensive search was conducted based on review articles on SARS-CoV-2 infection and studies including mechanical ventilation management strategies in order to complete this narrative review. Evidenced-based treatment for SARS-CoV2 infection is still in the works. We have some tools from our knowledge from past experiences indicating that a step-wise management approach should be used, without neglecting other joint therapeutic measures for improved clinical outcomes of a condition with a high mortality. The current recommendations indicate that patients with severe acute respiratory failure due to SARS-CoV-2 should be managed with protective mechanical ventilation measures. No strong evidence is yet available on the individualization of mechanical ventilation therapy according to phenotypes.
{"title":"Mechanical ventilation in SARS-CoV-2 patients: state of art","authors":"Diana Ávila Reyes, Bayron David García P., Guillermo Salazar Gutierrez, J. G. Gómez González, David Ricardo Echeverry Piedrahita, J. C. Galvis, Mateo Aguirre-Flórez","doi":"10.5554/22562087.E971","DOIUrl":"https://doi.org/10.5554/22562087.E971","url":null,"abstract":"COVID-19-associated infection leads to a pathology of yet unknown clinical behavior, confronting the clinician with various challenges. An extensive search was conducted based on review articles on SARS-CoV-2 infection and studies including mechanical ventilation management strategies in order to complete this narrative review. Evidenced-based treatment for SARS-CoV2 infection is still in the works. We have some tools from our knowledge from past experiences indicating that a step-wise management approach should be used, without neglecting other joint therapeutic measures for improved clinical outcomes of a condition with a high mortality. The current recommendations indicate that patients with severe acute respiratory failure due to SARS-CoV-2 should be managed with protective mechanical ventilation measures. No strong evidence is yet available on the individualization of mechanical ventilation therapy according to phenotypes.","PeriodicalId":36529,"journal":{"name":"Colombian Journal of Anesthesiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44448910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Beatriz Flores Cajal, Begoña Ortolá Rocher, Laura Betolaza Weimer, D. Gil Mayo, María León Núñez, Paloma Repáraz Grávalos, M. Gómez Rojo, Guillermo Bartolomé Rubio
The new coronavirus 2019-nCov or SARS-Cov-2 is responsible for the most important pandemic in the 21st century: the coronavirus disease (COVID-19). The 2019-nCov infection elicits a hyper-coagulable state, conditioning a worse outcome in these patients. The pathophysiology of the exaggerated coagulation activation in these patients is still unknown, and probably involves several mechanisms, different from those involved in sepsis-associated coagulopathy. This article discusses the case of a patient with no remarkable medical history, who after 7 days of fever, diarrhea and epigastric pain was diagnosed with COVID-19 bilateral pneumonia, further aggravated by severe Acute Respiratory Distress Syndrome. In this context, the patient experienced a massive acute pulmonary thromboembolism accompanied by an acute thrombus in the heart’s right ventricle, leading to hemodynamic instability. For the first time in our center in these patients, systemic fibrinolysis was successfully performed, with resolution of the intracavitary thrombus and the acute hemodynamic shock.
{"title":"Successful systemic fibrinolysis in a patient with Covid- 19: Case report","authors":"Beatriz Flores Cajal, Begoña Ortolá Rocher, Laura Betolaza Weimer, D. Gil Mayo, María León Núñez, Paloma Repáraz Grávalos, M. Gómez Rojo, Guillermo Bartolomé Rubio","doi":"10.5554/22562087.E969","DOIUrl":"https://doi.org/10.5554/22562087.E969","url":null,"abstract":"The new coronavirus 2019-nCov or SARS-Cov-2 is responsible for the most important pandemic in the 21st century: the coronavirus disease (COVID-19). \u0000The 2019-nCov infection elicits a hyper-coagulable state, conditioning a worse outcome in these patients. The pathophysiology of the exaggerated coagulation activation in these patients is still unknown, and probably involves several mechanisms, different from those involved in sepsis-associated coagulopathy. \u0000This article discusses the case of a patient with no remarkable medical history, who after 7 days of fever, diarrhea and epigastric pain was diagnosed with COVID-19 bilateral pneumonia, further aggravated by severe Acute Respiratory Distress Syndrome. In this context, the patient experienced a massive acute pulmonary thromboembolism accompanied by an acute thrombus in the heart’s right ventricle, leading to hemodynamic instability. For the first time in our center in these patients, systemic fibrinolysis was successfully performed, with resolution of the intracavitary thrombus and the acute hemodynamic shock.","PeriodicalId":36529,"journal":{"name":"Colombian Journal of Anesthesiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42731824","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: In-line positioning of an ultrasound image provides higher success rates and less time to completion for radial arterial cannulation. But preferable size and distance of ultrasound display has not been previously discussed. Objective: To assess the ideal visual distance and display size when using a smart phone or tablet as the ultrasound image display. Methods: Four smart phones or tablets were used as ultrasound displays in six different configurations in a simulated radial artery puncture. In a questionnaire, 116 anaesthesiologists working in Ibaraki Prefecture, Japan, were asked which of the six configurations was preferable for radial artery cannulation. Results: Sixty anaesthesiologists answered the questionnaire. About half (53%) preferred the smaller display (4- or 5.5-inch) fixed at a distance of 30 to 40 cm, and most of the rest (44%) preferred the larger display (7.9- or 9.7-inch) placed posterior to the probe with a visual distance of 45 to 60 cm. Conclusions: Among the anaesthesiologists, the preferable size and visual distance for ultrasound-guided radial artery cannulation varied using a smart phone or tablet for in-line display.
{"title":"Preferred display size and visual distance for ultrasound-guided radial artery cannulation","authors":"T. Hoshi","doi":"10.5554/22562087.E968","DOIUrl":"https://doi.org/10.5554/22562087.E968","url":null,"abstract":"Introduction: In-line positioning of an ultrasound image provides higher success rates and less time to completion for radial arterial cannulation. But preferable size and distance of ultrasound display has not been previously discussed. \u0000Objective: To assess the ideal visual distance and display size when using a smart phone or tablet as the ultrasound image display. \u0000Methods: Four smart phones or tablets were used as ultrasound displays in six different configurations in a simulated radial artery puncture. In a questionnaire, 116 anaesthesiologists working in Ibaraki Prefecture, Japan, were asked which of the six configurations was preferable for radial artery cannulation. \u0000Results: Sixty anaesthesiologists answered the questionnaire. About half (53%) preferred the smaller display (4- or 5.5-inch) fixed at a distance of 30 to 40 cm, and most of the rest (44%) preferred the larger display (7.9- or 9.7-inch) placed posterior to the probe with a visual distance of 45 to 60 cm. \u0000Conclusions: Among the anaesthesiologists, the preferable size and visual distance for ultrasound-guided radial artery cannulation varied using a smart phone or tablet for in-line display.","PeriodicalId":36529,"journal":{"name":"Colombian Journal of Anesthesiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47511172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Several findings paved the way to the use of the spinal approach for anesthesia. Information about the originators and dates of their discoveries is controversial. According to personal communications, doctors Juan Bautista Montoya y Florez, in Medellin, and Lisandro Leyva, in Bogota, in 1904 and 1905 respectively, would appear to be the pioneers of spinal anesthesia in Colombia. Pioneering cases of this procedure carried out in 1901 by doctor Juan Evangelista Manrique and which continued to be performed by his colleagues and assistants of the medical community at the time are documented in the Corporis Fabrica dissertation collection of the National University of Colombia.
一些发现为使用脊柱入路进行麻醉铺平了道路。关于发明者和发现日期的信息存在争议。根据个人通讯，麦德林的Juan Bautista Montoya y Florez医生和波哥大的Lisandro Leyva医生分别于1904年和1905年，似乎是哥伦比亚脊柱麻醉的先驱。1901年，Juan Evangelista Manrique医生进行了这种手术，当时他的同事和医学界助理继续进行这种手术，这些开创性病例记录在哥伦比亚国立大学的Corporis Fabrica论文集中。
{"title":"Juan Evangelista Manrique, the true pioneer of spinal anesthesia in Colombia","authors":"P. Herrera, Herley Aguirre Serrano","doi":"10.5554/22562087.E967","DOIUrl":"https://doi.org/10.5554/22562087.E967","url":null,"abstract":"Several findings paved the way to the use of the spinal approach for anesthesia. Information about the originators and dates of their discoveries is controversial. According to personal communications, doctors Juan Bautista Montoya y Florez, in Medellin, and Lisandro Leyva, in Bogota, in 1904 and 1905 respectively, would appear to be the pioneers of spinal anesthesia in Colombia. Pioneering cases of this procedure carried out in 1901 by doctor Juan Evangelista Manrique and which continued to be performed by his colleagues and assistants of the medical community at the time are documented in the Corporis Fabrica dissertation collection of the National University of Colombia.","PeriodicalId":36529,"journal":{"name":"Colombian Journal of Anesthesiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45763200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. P. González-Obregón, Miguel Andrés Bedoya-López, A. Ramirez, Esteban Onésimo Vallejo-Agudelo
Optimum pain management, minimizing chronic complications and ensuring a good safety profile, is growing in importance day by day. Lidocaine infusion has an adequate safety profile and several desirable characteristics in the clinical setting. This review describes the characteristics of this drug, as well as its potential indications. Moreover, it describes the basic concepts around lidocaine use, mechanisms of action and clinical applications, as well as the use of infusions in acute pain and repercussions in chronic pain. A review of the literature in English and Spanish was conducted in several databases, with no publication date limit. Articles considered relevant, without including the grey literature, were selected independently. Lidocaine infusion is an option for acute postoperative pain control in major surgery and contributes to opioid sparing and reduced length of stay, with ample evidence in abdominal surgery, rendering it an option to recommend in various protocols. It has an acceptable safety profile in special populations and it is considered useful to diminish the incidence of persistent, chronic and neuropathic pain related to the surgical procedure.
{"title":"Lidocaine infusion, basics and clinical issues","authors":"M. P. González-Obregón, Miguel Andrés Bedoya-López, A. Ramirez, Esteban Onésimo Vallejo-Agudelo","doi":"10.5554/22562087.E966","DOIUrl":"https://doi.org/10.5554/22562087.E966","url":null,"abstract":"Optimum pain management, minimizing chronic complications and ensuring a good safety profile, is growing in importance day by day. Lidocaine infusion has an adequate safety profile and several desirable characteristics in the clinical setting. This review describes the characteristics of this drug, as well as its potential indications. Moreover, it describes the basic concepts around lidocaine use, mechanisms of action and clinical applications, as well as the use of infusions in acute pain and repercussions in chronic pain. A review of the literature in English and Spanish was conducted in several databases, with no publication date limit. Articles considered relevant, without including the grey literature, were selected independently. Lidocaine infusion is an option for acute postoperative pain control in major surgery and contributes to opioid sparing and reduced length of stay, with ample evidence in abdominal surgery, rendering it an option to recommend in various protocols. It has an acceptable safety profile in special populations and it is considered useful to diminish the incidence of persistent, chronic and neuropathic pain related to the surgical procedure.","PeriodicalId":36529,"journal":{"name":"Colombian Journal of Anesthesiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46297046","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Giant pulmonary artery aneurysms","authors":"S. Khanna, T. Ong, C. Chow, Carlos Trombetta","doi":"10.5554/22562087.E959","DOIUrl":"https://doi.org/10.5554/22562087.E959","url":null,"abstract":"","PeriodicalId":36529,"journal":{"name":"Colombian Journal of Anesthesiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43762248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: The use of intravenous lidocaine infusion has increased over the past decade as part of a multimodal approach to analgesia in adults; however, information about its safety and tolerability in the pediatric population is limited. Methods: Acute pain management using lidocaine infusion in eleven patients treated in the pediatric intensive care unit. Results: Five cases of postoperative abdominal pain and six cases of non-operative abdominal pain. Two cases were cancer patients affected by neutropenic colitis. Analgesic control achieved was good. Conclusion: Lidocaine infusions are apparently a safe option for the management of acute pain, either post-operative or not, in the pediatric population.
{"title":"Intravenous lidocaine infusion for the treatment of acute pain in the pediatric intensive care unit: case series","authors":"L. Izquierdo, N. Moreno, S. Ruiz","doi":"10.5554/22562087.E965","DOIUrl":"https://doi.org/10.5554/22562087.E965","url":null,"abstract":"Introduction: The use of intravenous lidocaine infusion has increased over the past decade as part of a multimodal approach to analgesia in adults; however, information about its safety and tolerability in the pediatric population is limited. \u0000Methods: Acute pain management using lidocaine infusion in eleven patients treated in the pediatric intensive care unit. \u0000Results: Five cases of postoperative abdominal pain and six cases of non-operative abdominal pain. Two cases were cancer patients affected by neutropenic colitis. Analgesic control achieved was good. \u0000Conclusion: Lidocaine infusions are apparently a safe option for the management of acute pain, either post-operative or not, in the pediatric population.","PeriodicalId":36529,"journal":{"name":"Colombian Journal of Anesthesiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48294624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
• Actively participate during, and after the pandemic, in reorganizing the work of the anesthesiologist in an organized and safe manner (10), and avoid the patients' "avalanche" effect Calabrese G Update on biological risk for anesthetists taking care of patients affected by SARS-CoV2, COVID19 (10) These are some of the new working conditions for anesthesiologists in Latin America, albeit the inequalities: • More frequent exposure to SARS-CoV-2/ COVID-19 patients, and to asymptomatic carriers Calabrese G The "new occupational normality" for anesthetists: beyond the SARS-CoV-2 COVID19 pandemic [Extracted from the article] Copyright of Colombian Journal of Anesthesiology / Revista Colombiana de Anestesiología is the property of Sociedad Colombiana de Anestesiologia y Reanimacion and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission However, users may print, download, or email articles for individual use This abstract may be abridged No warranty is given about the accuracy of the copy Users should refer to the original published version of the material for the full abstract (Copyright applies to all Abstracts )
•在大流行期间和之后，积极参与以有组织和安全的方式重组麻醉师的工作(10)，避免患者的“雪崩”效应(10)。Calabrese G关于麻醉师照顾受SARS-CoV2和covid - 19影响的患者的生物风险的最新情况(10)以下是拉丁美洲麻醉师的一些新的工作条件，尽管存在不平等:•更频繁地接触SARS-CoV-2/ COVID-19患者和无症状携带者。版权归哥伦比亚麻醉学杂志/ Revista Colombiana de Anestesiología所有，未经版权所有者明确书面许可，不得将其内容复制或通过电子邮件发送到多个网站或发布到listserv。本摘要可能被删节，不保证副本的准确性，用户应参考材料的原始出版版本(版权适用于所有摘要)
{"title":"The current COVID-19 Pandemic legacy for Latin American anesthesiologists","authors":"G. Calabrese","doi":"10.5554/22562087.E960","DOIUrl":"https://doi.org/10.5554/22562087.E960","url":null,"abstract":"• Actively participate during, and after the pandemic, in reorganizing the work of the anesthesiologist in an organized and safe manner (10), and avoid the patients' \"avalanche\" effect Calabrese G Update on biological risk for anesthetists taking care of patients affected by SARS-CoV2, COVID19 (10) These are some of the new working conditions for anesthesiologists in Latin America, albeit the inequalities: • More frequent exposure to SARS-CoV-2/ COVID-19 patients, and to asymptomatic carriers Calabrese G The \"new occupational normality\" for anesthetists: beyond the SARS-CoV-2 COVID19 pandemic [Extracted from the article] Copyright of Colombian Journal of Anesthesiology / Revista Colombiana de Anestesiología is the property of Sociedad Colombiana de Anestesiologia y Reanimacion and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission However, users may print, download, or email articles for individual use This abstract may be abridged No warranty is given about the accuracy of the copy Users should refer to the original published version of the material for the full abstract (Copyright applies to all Abstracts )","PeriodicalId":36529,"journal":{"name":"Colombian Journal of Anesthesiology","volume":"49 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42969674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Radical penectomy (RP) is infrequently performed as it is reserved for specific cases of penile cancer, hence the paucity of reports regarding surgical and anesthetic considerations. Acute postoperative pain, chronic post-surgical pain, concomitant mood disorders as well as a profound impact on the patient’s quality of life have been documented. This case is of a patient with diabetes and coronary heart disease, who presented with advanced, overinfected penile cancer, depressive disorder and a history of pain of neuropathic characteristics. The patient underwent radical penectomy using a combined spinal-epidural technique for anesthesia. Preoperatively, the patient was treated with pregabalin and magnesium sulphate, and later received a blood transfusion due to intraoperative blood loss. Adequate intra and postoperative analgesia was achieved with L-bupivacaine given through a peridural catheter during one week. Recovery was good, pain was stabilized to preoperative levels and the patient received pharmacological support and follow-up by psychiatry and the pain team.
{"title":"Anesthetic considerations and postoperative pain management in radical penectomy: Case report","authors":"M. Ghiringhelli, M. Lopez","doi":"10.5554/22562087.E964","DOIUrl":"https://doi.org/10.5554/22562087.E964","url":null,"abstract":"Radical penectomy (RP) is infrequently performed as it is reserved for specific cases of penile cancer, hence the paucity of reports regarding surgical and anesthetic considerations. Acute postoperative pain, chronic post-surgical pain, concomitant mood disorders as well as a profound impact on the patient’s quality of life have been documented. This case is of a patient with diabetes and coronary heart disease, who presented with advanced, overinfected penile cancer, depressive disorder and a history of pain of neuropathic characteristics. The patient underwent radical penectomy using a combined spinal-epidural technique for anesthesia. Preoperatively, the patient was treated with pregabalin and magnesium sulphate, and later received a blood transfusion due to intraoperative blood loss. Adequate intra and postoperative analgesia was achieved with L-bupivacaine given through a peridural catheter during one week. Recovery was good, pain was stabilized to preoperative levels and the patient received pharmacological support and follow-up by psychiatry and the pain team.","PeriodicalId":36529,"journal":{"name":"Colombian Journal of Anesthesiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44087140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Alejandro Tovar-Gutiérrez, Julio Ernesto Camelo-Rincón, O. I. Vásquez-Gómez, Adriana Cadavid-Puentes
Introduction: Hip fracture pain is frequently acute and disabling and increases perioperative complications in the patient; hence it requires a multimodal analgesia approach. This case series describes the continuous erector spinae plane block at the lumbar level for hip fracture analgesia. Methods: A search was conducted of patients with hip fracture referred to the pain service of Hospital Universitario San Vicente Fundacion (HUSVF) from August 2019 to March 2020, who had undergone continuous erector spinae plane block as part of their analgesic regimen. Results: A total of 6 patients, 4 females and 2 males with an average age of 75 years were identified. A reduction in pain intensity from acute to mild or absent was observed in every case, up to 24 hours after the initial injection. 66 % experienced a relapse of severe pain after 24 hours and 2 patients the catheter functionality failed after 24 hours. One patient underwent dermatome pinprick assessment. Conclusions: The continuous erector spinae plane block with a single injection provided analgesic efficacy similar to other single injection peripheral blocks, although continuous analgesia for more than 24 hours was not achieved. Some variations in the block technique described may improve the analgesic effectiveness in patients with hip fracture pain.
{"title":"Continuous erector spinae plane block at lumbar level for relief of severe pain due to hip fracture: case series","authors":"Alejandro Tovar-Gutiérrez, Julio Ernesto Camelo-Rincón, O. I. Vásquez-Gómez, Adriana Cadavid-Puentes","doi":"10.5554/22562087.E962","DOIUrl":"https://doi.org/10.5554/22562087.E962","url":null,"abstract":"Introduction: Hip fracture pain is frequently acute and disabling and increases perioperative complications in the patient; hence it requires a multimodal analgesia approach. This case series describes the continuous erector spinae plane block at the lumbar level for hip fracture analgesia. \u0000Methods: A search was conducted of patients with hip fracture referred to the pain service of Hospital Universitario San Vicente Fundacion (HUSVF) from August 2019 to March 2020, who had undergone continuous erector spinae plane block as part of their analgesic regimen. \u0000Results: A total of 6 patients, 4 females and 2 males with an average age of 75 years were identified. A reduction in pain intensity from acute to mild or absent was observed in every case, up to 24 hours after the initial injection. 66 % experienced a relapse of severe pain after 24 hours and 2 patients the catheter functionality failed after 24 hours. One patient underwent dermatome pinprick assessment. \u0000Conclusions: The continuous erector spinae plane block with a single injection provided analgesic efficacy similar to other single injection peripheral blocks, although continuous analgesia for more than 24 hours was not achieved. Some variations in the block technique described may improve the analgesic effectiveness in patients with hip fracture pain.","PeriodicalId":36529,"journal":{"name":"Colombian Journal of Anesthesiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42552720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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