Save
THE APPLICATION OF A PARAVERTEBRAL BLOCK WITH LOW- DOSE LOCAL ANESTHETIC IN A PATIENT WITH BILATERAL OCCLUSION OF INTERNAL CAROTID ARTERIES: A CASE REPORT
Author(s): ,
Zupcic, M.*
Affiliations:
„J. J. Strossmayer“ University- Faculty of Medicine Osijek- University Hospital Dubrava-, Clinic of Anesthesiology- Reanimatology and Intensive Care Medicine, Zagreb, Croatia
,
Graf Zupcic, S.
Affiliations:
„J. J. Strossmayer“ University- University Hospital “Sveti Duh“, Clinic of Neurology, Zagreb, Croatia
,
Rudman, F.
Affiliations:
University of Zagreb, Clinic of Plastic Surgery, Zagreb, Croatia
,
Vlajcic, Z.
Affiliations:
J. J. Strossmayer“ University- School of Medicine Osijek- University Hospital Dubrava, Clinic for Plastic- Reconstructive and Aesthetic Surgery, Zagreb, Croatia
,
Duzel, V.
Affiliations:
Barking- Havering and Redbridge University Hospitals NHS Trust, Department of Anaesthesia, London, United Kingdom
,
Simurina, T.
Affiliations:
„J. J. Strossmayer“University- Faculty of Medicine- Osijek, Depatment of Health Studies University of Zadar- Department of Anesthesiology and Intensive Care Medicine, Zadar, Croatia
,
Barisin, S.
Affiliations:
„J. J. Strossmayer“ University- Faculty of Medicine Osijek- University Hospital Dubrava-, Clinic of Anesthesiology- Reanimatology and Intensive Care Medicine, Zagreb, Croatia
Korusic, A.
Affiliations:
„J. J. Strossmayer“ University- Faculty of Medicine Osijek- University Hospital Dubrava-, Clinic of Anesthesiology- Reanimatology and Intensive Care Medicine, Zagreb, Croatia
ESRA Academy. zupcic m. Sep 13, 2017; 190948
Topic: Thoracic Paravertebral and Intercostal Blocks
Disclosure(s): Nothing to declare
Dr. miroslav zupcic
Dr. miroslav zupcic

Access to Premium content is currently a membership benefit.


Click here to join ESRA or renew your membership.

Abstract
Discussion Forum (0)
Rate & Comment (0)
Background and Aims:

Most breast surgeries are performed under general anesthesia; therefore, patients with present significant cardiovascular problems are at high risk for the development of hemodynamic and neurological disorders. Here we show the American Society of Anesthesiologist (ASA) IV patient scheduled for surgical quadrantectomy with the bilateral occlusion of internal carotid arteries. Due to a high risk for general anesthesia, we decided to apply unilateral paravertebral block.

Methods:

83-year-old female, ASA IV, was scheduled for surgical quadrantectomy with ipsilateral axillar lymphadenectomy of her left breast. The patient had bilateral occlusion of internal carotid arteries, arterial hypertension, dizziness syndrome, deafness and glaucoma. The patient had a stroke thirteen years ago with a consequent left - sided hemiparesis. During the preparation for the surgery, an invasive blood pressure measurement was set while the paravertebral space was identified with the neurostimulator using the linear ultrasound probe of 8 Hertz. The anesthetic 0.5% levobupivacaine was applied in levels of Thoracic (Th) 2, Th3, Th4 and Th5 (3 milliliters per level). We used 1% lidocaine for local infiltration at the site of the block.

Results:

Sensory blockade occurred after 30 minutes and lasted for about 10 hours with normal perioperative period and hemodynamic parameters without accompanying complications.

Conclusions:

The application of the ultrasound and neurostimulator in the paravertebral block enabled us to achieve high precision. Such administration of small doses of long-acting local anesthetic at multiple levels has resulted in a satisfactory anesthesia and analgesia without hemodynamic and neurological complications.

Code of conduct/disclaimer available in General Terms & Conditions
Anonymous User Privacy Preferences

Strictly Necessary Cookies (Always Active)

MULTILEARNING platforms and tools hereinafter referred as “MLG SOFTWARE” are provided to you as pure educational platforms/services requiring cookies to operate. In the case of the MLG SOFTWARE, cookies are essential for the Platform to function properly for the provision of education. If these cookies are disabled, a large subset of the functionality provided by the Platform will either be unavailable or cease to work as expected. The MLG SOFTWARE do not capture non-essential activities such as menu items and listings you click on or pages viewed.


Performance Cookies

Performance cookies are used to analyse how visitors use a website in order to provide a better user experience.



Google Analytics is used for user behavior tracking/reporting. Google Analytics works in parallel and independently from MLG’s features. Google Analytics relies on cookies and these cookies can be used by Google to track users across different platforms/services.


Save Settings