氯丙卡因用于双侧臂丛阻滞治疗双侧桡骨骨折

IF 1.5 Q3 ANESTHESIOLOGY Local and Regional Anesthesia Pub Date : 2019-09-01 DOI:10.2147/LRA.S225471
Chanchal Mangla, H. Kamath, J. Yarmush
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引用次数: 3

摘要

摘要我们报告一例41岁男性,预期气道困难,在双侧臂丛神经阻滞下接受双侧桡骨骨折的修复。麻醉师不愿意进行双侧阻滞,因为担心并发症,如膈肌麻痹、局部麻醉剂(LA)毒性和肺气肿。我们建议,通过正确应用左心房药代动力学,仔细选择患者并使用超声,可以安全地进行双侧阻断。我们在其中一个区块中使用氯普鲁卡因作为LA,以减少毒性更强的LA所需的剂量。氯普鲁卡因的快速代谢也有助于我们防止不同LA的峰值血浆浓度重叠。据我们所知,这是文献中首次报道氯普鲁卡因用于双侧臂丛神经阻滞的病例。
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Bilateral Brachial Plexus Block Using Chloroprocaine For Surgery Of Bilateral Radial Fractures
Abstract We report a case of a 41-year-old male with anticipated difficult airway undergoing a repair of a bilateral radial fracture under bilateral sequential brachial plexus block. Anesthesiologists are reluctant to perform bilateral blocks because of the fear of complications like diaphragmatic paralysis, local anesthetic (LA) toxicity, and pneumothorax. We advise that with the correct application of LA pharmacokinetics, careful patient selection and usage of ultrasound, bilateral blocks can be done safely. We used chloroprocaine as an LA in one of the blocks to reduce the dose required for the more toxic LAs. chloroprocaine’s fast metabolism also helped us to prevent the overlapping of peak plasma concentration of different LAs. To our knowledge, this is the first reported case in the literature where chloroprocaine was used for bilateral brachial plexus block.
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来源期刊
CiteScore
6.30
自引率
0.00%
发文量
12
审稿时长
16 weeks
期刊最新文献
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