Brazilian Journal of Anesthesiology
https://bjan-sba.org/article/doi/10.1590/S0034-70942006000400010
Brazilian Journal of Anesthesiology
Clinical Information

Cateteres e soluções anestésicas em anestesia regional periférica: Quo Vadis? Relato de Casos

Catheters and anesthetic solutions in regional peripheral anesthesia: Quo Vadis? Case Reports

Karl Otto Geier

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Resumo

JUSTIFICATIVA E OBJETIVOS: Os desfechos clínicos de bloqueios anestésicos regionais periféricos nem sempre são os esperados. Ora resultam insuficientes, ora superdimensionados. Para o entendimento e aprendizado desses fenômenos, os meios de rádio-imagem tornam-se esclarecedores. O objetivo deste estudo foi demonstrar os diferentes trajetos e distribuições, respectivamente, de cateteres e de soluções anestésicas (anestésico local com contraste), utilizados em bloqueios regionais de membros superior e inferior. RELATO DOS CASOS: São apresentados três casos de bloqueios regionais periféricos, em que os efeitos clínicos inesperados foram esclarecidos por imagens radiográficas contrastadas. CONCLUSÕES: Com o intuito de certificar a posição de cateteres e esclarecer os efeitos anestésicos inesperados, os estudos de rádio-imagens contrastadas são de grande utilidade, pois correlacionam dispersões imprevisíveis de soluções anestésicas com sintomas e sinais dos bloqueios periféricos.

Palavras-chave

PROCEDIMENTOS DE DIAGNOSE E TERAPIA, TÉCNICAS ANESTÉSICAS, Regional

Abstract

BACKGROUND AND OBJECTIVES: The clinical results of regional peripheral blockades are not always what we hope for. Sometimes the results are short of our intent and sometimes are exaggerated. To understand and learn those phenomena, radioimaging techniques are very helpful. The objective of this study is to demonstrate the different trajectories and distribution of catheters and anesthetics (local anesthetic with contrast), respectively, used in regional blockades of the upper and lower limbs. CASE REPORTS: Three cases of peripheral regional blockade, in which unexpected clinical effects were solved using contrast X-rays, are presented. CONCLUSIONS: Contrast X-rays are very useful to verify the position of catheters and solve unexpected anesthetic effects, because they are able to relate the unpredictable dispersion of anesthetics to the signs and symptoms of peripheral blockades.

Keywords

ANESTHETIC TECHNIQUES, Regional, THERAPY AND DIAGNOSIS PROCEDURES

References

Rodriguez J, Barcena M, Alvarez J. Restricted infraclavicular distribution of the local anesthetic solution after infraclavicular brachial plexus block. Reg Anesth Pain Med. 2003;28:33-36.

Geier KO. Bloqueio "3 em 1" por via anterior: bloqueio parcial, completo ou superdimensionado? Correlação entre anatomia, clínica e rádio-imagens. Rev Bras Anestesiol. 2004;54:560-572.

Rathmell JP. Imaging in regional anesthesia and pain medicine: we have much to learn. Reg Anesth Pain Med. 2002;27:240-241.

Geier KO. Bloqueio do plexo braquial no trauma: analgesia regional prolongada por cateter axilar. Rev Bras Anestesiol. 1995;45:173-182.

Boezaart AP, de Beer JF, du Toit C. A new technique of continuous interscalene nerve block. Can J Anesth. 1999;46:275-281.

Winnie AP, Radonjic R, Akkineni SR. Factors influencing distribution of local anesthetic injected into the brachial plexus sheath. Anesth Analg. 1979;58:225-234.

Reuben SS, Steinberg RB. Continuous shoulder analgesia via an indwelling axillary brachial plexus catheter. J Clin Anesth. 2000;12:472-475.

Lennon RL, Gammel S. Horner's syndrome associated with brachial plexus anesthesia using an axillary catheter. Anesth Analg. 1992;74:311.

Cook LB. Unsuspected extradural catheterization in an interscalene block. Br J Anaesth. 1991;67:473-474.

Urmey WF, McDonald M. Hemidiaphragmatic paresis during interscalene brachial plexus block: effects on pulmonary function and chest wall mechanics. Anesth Analg. 1992;74:352-357.

Ajar AH, Rathmell JP, Mukherji SK. The subdural compartment. Reg Anesth Pain Med. 2002;27:72-76.

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