Brazilian Journal of Anesthesiology
https://bjan-sba.org/article/doi/10.1016/j.bjane.2021.01.004
Brazilian Journal of Anesthesiology
Case Report

Ultrasound-guided continuous costoclavicular block through retrograde stimulating catheter technique for postoperative analgesia in shoulder surgery: a case series

Bloqueio costoclavicular contínuo guiado por ultrassom pela técnica do cateter de estimulação retrógrada para analgesia pós-operatória em cirurgia do ombro: uma série de casos

Sandeep Diwan, Divya Sethi, Parag Sancheti, Abhijit Nair

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Abstract

In 5 patient undergoing surgery for proximal humerus fracture we investigated into postoperative analgesia provided by continuous costoclavicular block using continuous stimulating catheter. The postoperative pain scores were less than 4 in all patients except in two patients who required intravenous tramadol 50 mg as a rescue analgesic. The radiocontrast dye study executed in two patients revealed contiguous contrast spread through the brachial plexus sheath with the catheter tip in the interscalene space. We propose that a continuous costoclavicular block with a retrograde stimulating catheter is a feasible alternative regional anesthesia technique for postoperative analgesia in shoulder surgery.

Keywords

Ultrasonography;  Regional anesthesia;  Shoulder;  Costoclavicular

Resumo

Em 5 pacientes submetidos à cirurgia de fratura proximal do úmero, investigamos a analgesia pós-operatória fornecida pelo bloqueio costoclavicular contínuo usando cateter de estimulação contínua. Os escores de dor pós-operatória foram inferiores a 4 em todos os pacientes, exceto em dois pacientes que necessitaram de tramadol 50 mg intravenoso como analgésico de resgate. O estudo com radiocontraste realizado em dois pacientes revelou contraste contíguo espalhado pela bainha do plexo braquial com a ponta do cateter no espaço interescalênico. Propomos que um bloqueio costoclavicular contínuo com um cateter de estimulação retrógrada é uma técnica de anestesia regional alternativa viável para analgesia pós-operatória em cirurgia do ombro.

Palavras-chave

Ultrassonografia; Anestesia regional; Ombro; Costoclavicular

References

1. J.W. Li, B. Songthamwat, W. Samy, et al. Ultrasound-guided costoclavicular brachial plexus block: sonoanatomy, technique, and block dynamics Reg Anesth Pain Med., 42 (2017), pp. 233-240

2. X. Sala-Blanch, M.A. Reina, P. Pangthipampai, et al. Anatomic Basis for Brachial Plexus Block at the Costoclavicular Space: A Cadaver Anatomic Study Reg Anesth Pain Med., 41 (2016), pp. 387-391

3. D.Q. Tran, S. Layera, D. Bravo, et al. Diaphragm-sparing nerve blocks for shoulder surgery, revisited Reg Anesth Pain Med. (2019), 10.1136/rapm-2019-100908 [ahead of print]

4. C. García-Vitoria, J. Vizuete, A.M. López Navarro, et al. Costoclavicular Space: A Reliable Gate for Continuous Regional Anesthesia Catheter Insertion Anesthesiology., 127 (2017), p. 712

5. R. Aldwinckle Costoclavicular Approach to the Supraclavicular Fossa: Journey behind the Dark Side of the Moon (Clavicle) Anesthesiology., 128 (2018), p. 1259
 


Submitted date:
09/14/2020

Accepted date:
01/01/2021

6036c6eba953955b501a9ec3 rba Articles
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Braz J Anesthesiol

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