lunes, 1 de agosto de 2016

Bloqueo de la extremidad superior / Upper extremity nerve block

Agosto 1, 2016. No. 2404





Bloqueo neural de la extremidad superior. ¿Cómo se puede beneficiar, mejorar su duración y seguridad? Una actualización
Upper extremity nerve block: how can benefit, duration, and safety be improved? An update.
F1000Res. 2016 May 18;5. pii: F1000 Faculty Rev-907. doi: 10.12688/f1000research.7292.1. eCollection 2016.
Abstract
Upper extremity blocks are useful as both sole anaesthesia and/or a supplement to general anaesthesia and they further provide effectivepostoperative analgesia, reducing the need for opioid analgesics. There is without doubt a renewed interest among anaesthesiologists in the interscalene, supraclavicular, infraclavicular, and axillary plexus blocks with the increasing use of ultrasound guidance. The ultrasound-guided technique visualising the needle tip and solution injected reduces the risk of side effects, accidental intravascular injection, and possibly also trauma to surrounding tissues. The ultrasound technique has also reduced the volume needed in order to gain effective block. Still, single-shot plexus block, although it produces effective anaesthesia, has a limited duration of postoperative analgesia and a number of adjuncts have been tested in order to prolong analgesia duration. The addition of steroids, midazolam, clonidine, dexmedetomidine, and buprenorphine has been studied, all being off-label when administered by perineural injection, and the potential neurotoxicity needs further study. The use of perineural catheters is an effective option to improve and prolong the postoperative analgesic effect. Upper extremity plexus blocks have an obvious place as a sole anaesthetic technique or as a powerful complement to general anaesthesia, reducing the need for analgesics and hypnotics intraoperatively, and provide effective early postoperative pain relief. Continuous perineural infusion is an effective option to prolong the effects and improve postoperative quality.
KEYWORDS: anaesthesia; axillary plexus; infraclavicular; interscalene; peripheral blocks; supraclavicular; ultra-sound guided; upper extremity block
PDF 
Curso de Especialidad en Algología 2017-2018
Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán
Universidad Nacional Autónoma de México

Comité Europeo de Enseñanza en Anestesiología
Curso de Actualización en Anestesiología
Anestesia por Especialidades y Simposio Anestesia y Cirugía Plástica Seguras
Agosto 5-7, 2016. Tijuana BC, México
Información Dr. Sergio Granados Tinajero granadosts@gmail.com 

16th World Congress of Anaesthesiologists

28 August - 2 September 2016 
Hong Kong Convention and Exhibition Centre
World Federation of Societies of Anaesthesiologists
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