Naslov
The application of a paravertebral block with low-dose local anesthetic in a patient with bilateral occlusion of internal carotid arteries: a case report.

Autori
Župčić, Miroslav ; Graf-Župčić, Sandra ; Rudman, Franjo ; Vlajčić, Zlatko ; Đuzel, Viktor ; Šimurina, Tatjana ; Barišin, Stjepan ; Korušić Anđelko

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, znanstveni

Izvornik
Regional Anesthesia and Pain Medicine, Supllement 1 / Huntoon, Marc A - Philadelphia (PA) : Wolters Kluwer, 2017, 198-198

Skup
The 36th Annual ESRA Congress 2017

Mjesto i datum
Lugano, Švicarska, 13.09.2017. - 16.09.2017

Vrsta sudjelovanja
Poster

Vrsta recenzije
Međunarodna recenzija

Ključne riječi
paravertebral block, local anesthetic

Sažetak
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 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, deafnes and glaucma. 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, Th 3, 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. Conclusion The application of the ultrasound and neurostimulators 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.

Izvorni jezik
Engleski

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