Evaluation Of The Effectiveness Of a Pecs Blocks I Associated With A Supraclavicular Nerve Block To Ensure Analgesia When Placing A Pacemaker
Morressier, 2017
Online
unknown
Zugriff:
u201cEvaluation of the effectiveness of a Pecs Blocks I associated with a supraclavicular nerve block to ensure analgesia when placing a pacemakeru201dAnaesthetic techniques,regional, Analgesia,postoperative, Anaesthetics localFernandez Villarreal Wendy, MD ;Tabolcea, I, MD; Boudart, C; Chirade, ML, MD; EL Oumeri, B, MD; C, MD; Van Obbergh , L, MD PHD; Erasme Hospital, Brussels, Belgium.Service of Anesthesiology, Erasme Hospital - Brussels (Belgium)Background and Goal of Study: Pacemakers are currently placed at the Erasmus Hospital under local anesthesia performed by the surgeon, and the amount of local anesthetic agents sometimes reach the maximum permitted doses. Moreover, these patients often present an associated conduction block. This represents a contraindication to lidocaine 2% (local anesthestic frequently used). We hypothesized that using a Pecs Block I associated with a supraclavicular nerve block should require a smaller quantity of local anestheticMaterials and Methods: This is a prospective randomized study conducted over a period of 9 months. The patients scheduled for a pacemaker implantation were prospectively randomized in two groups: The group RA ( Pecs block I associated with a supraclavicular nerve block associated with ) or group LA (Local Anesthesia by a surgeon). In case of patient discomfort or failure of the techniques used, we allowed a second local infiltration of the tissues. A 50 mm needle Stimuplex 360 Braun was used in the RA group. If despite the second infiltration, the patient was still in pain, we increased the depth of sedation. The endpoint is the total amount of local anesthetics used. The secondary objectives are: evaluate the postoperative analgesia, the pain scores evaluated via the analog verbal scale (NRS) and the paracetamol consumption in postoperative. Comparisons were analyzed with the Chi-Square and the Mann Whitney test statistics.Results and Discussion:31 total patients were enrolled: 16 for the LA group and 15 for the RA group. There is a significant difference between the two groups: the RA received more local anesthetics volume. (RA with a mean volume of 27,5 ml vs LA with a mean volume of 19,9) P= 0,0003. Regarding the pain scores, there is no significant difference between the two groups. P= 0,12.Conclusion(s): There is a significant increase in the consumption of local anesthetics in the RA group and there is no significant difference regarding the pain scores. A supraclavicular nerve block associated with a PECS BLOCK I is not adequate to provide anesthesia for the implantation of a pacemaker.References (optional):Acknowledgements (optional):
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Evaluation Of The Effectiveness Of a Pecs Blocks I Associated With A Supraclavicular Nerve Block To Ensure Analgesia When Placing A Pacemaker
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Autor/in / Beteiligte Person: | Tabolcea, Ionut |
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Veröffentlichung: | Morressier, 2017 |
Medientyp: | unknown |
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