An indication for continuous cervical paravertebral block (posterior approach to the interscalene space).
Identifieur interne : 000E54 ( Ncbi/Checkpoint ); précédent : 000E53; suivant : 000E55An indication for continuous cervical paravertebral block (posterior approach to the interscalene space).
Auteurs : Steven C. Borene [États-Unis] ; Richard W. Rosenquist ; Robert Koorn ; Naeem Haider ; André P. BoezaartSource :
- Anesthesia and analgesia [ 0003-2999 ] ; 2003.
Descripteurs français
- KwdFr :
- MESH :
- anatomopathologie : Tumeurs du sein.
- étiologie : Scapulalgie.
- Adulte d'âge moyen, Anesthésie générale, Bloc nerveux, Femelle, Humains, Plexus brachial, Scapulalgie, Tumeurs du sein, Électrothérapie, Épaule.
English descriptors
- KwdEn :
- MESH :
- complications : Breast Neoplasms.
- etiology : Shoulder Pain.
- pathology : Breast Neoplasms.
- surgery : Shoulder, Shoulder Pain.
- Anesthesia, General, Brachial Plexus, Electric Stimulation Therapy, Female, Humans, Middle Aged, Nerve Block.
Abstract
We present a patient who required perioperative analgesia with continuous nerve block for shoulder disarticulation, for whom the only approach possible to the brachial plexus was from posterior. A 51-yr-old woman was suffering from intractable upper extremity pain and dysfunction as a result of severe lymphedema after metastatic spread of breast cancer to the axilla. Her pain was poorly controlled despite aggressive treatment with oral, systemic, and intrathecal opiates. She presented for amputation of her arm as a last resort for management of pain. In order to provide optimal postoperative analgesia, continuous peripheral nerve block was selected in consultation with the patient, and due to anatomic disfigurement and tumor invasion, a continuous cervical paravertebral block was placed preoperatively and shoulder disarticulation was performed using a combined regional/general anesthesia technique. The patient had an uneventful recovery without pain for the 6 postoperative days that the catheter was in place and 0.25% bupivacaine was infused at 5 mL/h. Because of anatomic considerations, which precluded the use of all other approaches to the brachial plexus, the posterior cervical paravertebral approach provided an effective means of pain control in this difficult clinical situation.
PubMed: 12933425
Affiliations:
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Rosenquist</name></author><author><name sortKey="Koorn, Robert" sort="Koorn, Robert" uniqKey="Koorn R" first="Robert" last="Koorn">Robert Koorn</name></author><author><name sortKey="Haider, Naeem" sort="Haider, Naeem" uniqKey="Haider N" first="Naeem" last="Haider">Naeem Haider</name></author><author><name sortKey="Boezaart, Andre P" sort="Boezaart, Andre P" uniqKey="Boezaart A" first="André P" last="Boezaart">André P. Boezaart</name></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2003">2003</date><idno type="RBID">pubmed:12933425</idno><idno type="pmid">12933425</idno><idno type="wicri:Area/PubMed/Corpus">004190</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Corpus" wicri:corpus="PubMed">004190</idno><idno type="wicri:Area/PubMed/Curation">004190</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Curation">004190</idno><idno type="wicri:Area/PubMed/Checkpoint">004190</idno><idno type="wicri:explorRef" wicri:stream="Checkpoint" wicri:step="PubMed">004190</idno><idno type="wicri:Area/Ncbi/Merge">000E54</idno><idno type="wicri:Area/Ncbi/Curation">000E54</idno><idno type="wicri:Area/Ncbi/Checkpoint">000E54</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">An indication for continuous cervical paravertebral block (posterior approach to the interscalene space).</title><author><name sortKey="Borene, Steven C" sort="Borene, Steven C" uniqKey="Borene S" first="Steven C" last="Borene">Steven C. Borene</name><affiliation wicri:level="4"><nlm:affiliation>Department of Anesthesia, University of Iowa, Iowa City, Iowa, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Anesthesia, University of Iowa, Iowa City, Iowa</wicri:regionArea><placeName><region type="state">Iowa</region><settlement type="city">Iowa City</settlement></placeName><orgName type="university">Université de l'Iowa</orgName></affiliation></author><author><name sortKey="Rosenquist, Richard W" sort="Rosenquist, Richard W" uniqKey="Rosenquist R" first="Richard W" last="Rosenquist">Richard W. Rosenquist</name></author><author><name sortKey="Koorn, Robert" sort="Koorn, Robert" uniqKey="Koorn R" first="Robert" last="Koorn">Robert Koorn</name></author><author><name sortKey="Haider, Naeem" sort="Haider, Naeem" uniqKey="Haider N" first="Naeem" last="Haider">Naeem Haider</name></author><author><name sortKey="Boezaart, Andre P" sort="Boezaart, Andre P" uniqKey="Boezaart A" first="André P" last="Boezaart">André P. Boezaart</name></author></analytic><series><title level="j">Anesthesia and analgesia</title><idno type="ISSN">0003-2999</idno><imprint><date when="2003" type="published">2003</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Anesthesia, General</term><term>Brachial Plexus</term><term>Breast Neoplasms (complications)</term><term>Breast Neoplasms (pathology)</term><term>Electric Stimulation Therapy</term><term>Female</term><term>Humans</term><term>Middle Aged</term><term>Nerve Block</term><term>Shoulder (surgery)</term><term>Shoulder Pain (etiology)</term><term>Shoulder Pain (surgery)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adulte d'âge moyen</term><term>Anesthésie générale</term><term>Bloc nerveux</term><term>Femelle</term><term>Humains</term><term>Plexus brachial</term><term>Scapulalgie ()</term><term>Scapulalgie (étiologie)</term><term>Tumeurs du sein ()</term><term>Tumeurs du sein (anatomopathologie)</term><term>Électrothérapie</term><term>Épaule ()</term></keywords><keywords scheme="MESH" qualifier="anatomopathologie" xml:lang="fr"><term>Tumeurs du sein</term></keywords><keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Breast Neoplasms</term></keywords><keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Shoulder Pain</term></keywords><keywords scheme="MESH" qualifier="pathology" xml:lang="en"><term>Breast Neoplasms</term></keywords><keywords scheme="MESH" qualifier="surgery" xml:lang="en"><term>Shoulder</term><term>Shoulder Pain</term></keywords><keywords scheme="MESH" qualifier="étiologie" xml:lang="fr"><term>Scapulalgie</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Anesthesia, General</term><term>Brachial Plexus</term><term>Electric Stimulation Therapy</term><term>Female</term><term>Humans</term><term>Middle Aged</term><term>Nerve Block</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adulte d'âge moyen</term><term>Anesthésie générale</term><term>Bloc nerveux</term><term>Femelle</term><term>Humains</term><term>Plexus brachial</term><term>Scapulalgie</term><term>Tumeurs du sein</term><term>Électrothérapie</term><term>Épaule</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">We present a patient who required perioperative analgesia with continuous nerve block for shoulder disarticulation, for whom the only approach possible to the brachial plexus was from posterior. A 51-yr-old woman was suffering from intractable upper extremity pain and dysfunction as a result of severe lymphedema after metastatic spread of breast cancer to the axilla. Her pain was poorly controlled despite aggressive treatment with oral, systemic, and intrathecal opiates. She presented for amputation of her arm as a last resort for management of pain. In order to provide optimal postoperative analgesia, continuous peripheral nerve block was selected in consultation with the patient, and due to anatomic disfigurement and tumor invasion, a continuous cervical paravertebral block was placed preoperatively and shoulder disarticulation was performed using a combined regional/general anesthesia technique. The patient had an uneventful recovery without pain for the 6 postoperative days that the catheter was in place and 0.25% bupivacaine was infused at 5 mL/h. Because of anatomic considerations, which precluded the use of all other approaches to the brachial plexus, the posterior cervical paravertebral approach provided an effective means of pain control in this difficult clinical situation.</div></front></TEI><affiliations><list><country><li>États-Unis</li></country><region><li>Iowa</li></region><settlement><li>Iowa City</li></settlement><orgName><li>Université de l'Iowa</li></orgName></list><tree><noCountry><name sortKey="Boezaart, Andre P" sort="Boezaart, Andre P" uniqKey="Boezaart A" first="André P" last="Boezaart">André P. Boezaart</name><name sortKey="Haider, Naeem" sort="Haider, Naeem" uniqKey="Haider N" first="Naeem" last="Haider">Naeem Haider</name><name sortKey="Koorn, Robert" sort="Koorn, Robert" uniqKey="Koorn R" first="Robert" last="Koorn">Robert Koorn</name><name sortKey="Rosenquist, Richard W" sort="Rosenquist, Richard W" uniqKey="Rosenquist R" first="Richard W" last="Rosenquist">Richard W. Rosenquist</name></noCountry><country name="États-Unis"><region name="Iowa"><name sortKey="Borene, Steven C" sort="Borene, Steven C" uniqKey="Borene S" first="Steven C" last="Borene">Steven C. Borene</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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