A Novel Nerve Block Technique for a Patient Undergoing Cardiac Device Implantation

Antiperovitch, Pavel; Mokhtar, Ahmed T.; Mian, M. Firoz; Yee, Raymond; Khan, Harun

doi:10.1016/j.jaccas.2022.08.028

Cited by 2 publications

(2 citation statements)

References 10 publications

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“…As described previously, 15 the technique focuses on performing a painless incision and pocket formation in the infraclavicular region without the use of LA. The infraclavicular skin is supplied by the SCN, which is a sensory nerve that originates from the C3‐C4 nerve roots of the superficial cervical plexus 18 .…”

Section: Methodsmentioning

confidence: 99%

“…In this study, we use the novel combination of PECS1, and supraclavicular nerve (SCN) blocks to provide complete coverage of the CIED implantation zone, which has been recently described in detail. 15 The SCN block involves superficial injection of LA into the lateral neck area by visualizing the nerve. It is not to be confused with the "supraclavicular block", which refers to the brachial plexus block.…”

Section: Introductionmentioning

confidence: 99%

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Efficacy and safety of supraclavicular and pectoralis nerve blocks as primary peri‐procedural analgesia for cardiac electronic device implantation: A pilot study

Antiperovitch,

Mokhtar,

Yee

et al. 2023

Pacing Clinical Electrophis

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BackgroundCardiac implantable electronic devices (CIEDs) are routinely implanted using intravenous drugs for sedation. However, some patients are poor candidates for intravenous sedation.ObjectiveWe present a case series demonstrating the safety and efficacy of a novel, ultrasound‐guided nerve block technique that allows for pre‐pectoral CIED implantation. The targets are the supraclavicular nerve (SCN) and pectoral nerve (PECS1).MethodsWe enrolled 20 patients who were planned for new CIED implantation. Following US‐localization of the SCN and PECS1, local anesthetic (LA) was instilled at least 30–60 min pre‐procedure. Successful nerve block was determined if < 5 mL of intraprocedural LA was used, along with lack of sensation with skin and deep tissue pinprick. Optional sedation was offered to patients’ pre‐procedure if discomfort was reported.ResultsSeventeen patients (85%) had a successful periprocedural nerve block, with only three patients exceeding 5 mL of LA. SCN and PECS1 success occurred in 19 (95%) and 18 (90%) patients, respectively. The overall success of nerve block by fulfilling all the criteria was demonstrated in 17 out of 20 patients (85%). Patients who reported no pain (VAS score = 0) were distributed as follows: 13 patients (65%) in the immediate post‐procedure interval, 18 patients (90%) at the 1 h post‐implant interval, and 14 patients (70%) at the 24 h post‐ implant interval. The median cumulative VAS score was 0 (IQR = 0 ‐ 1). There were no reported significant adverse effects.ConclusionSCN and PECS1 nerve blocks are safe and effective for patients undergoing CIED implantation to minimize or eliminate the use of intravenous sedation.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Efficacy and safety of supraclavicular and pectoralis nerve blocks as primary peri‐procedural analgesia for cardiac electronic device implantation: A pilot study

Antiperovitch,

Mokhtar,

Yee

et al. 2023

Pacing Clinical Electrophis

Self Cite

View full text Add to dashboard Cite

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Ultrasound utilization for implantation of cardiac implantable electronic devices

Mian

Khan

2023

Wien Klin Wochenschr

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SummaryUltrasound (US) guidance for implantation of cardiac implantable electronic devices (CIED) is currently not routine practice. This article sought to review published data on the use of ultrasound in each of the major surgical steps involved in implantation of CIEDs, including achieving anesthesia, obtaining venous access and implantation of leads. A literature review was performed, revealing a total of 20 peer-reviewed studies that assessed US guidance for CIED implantation; 3 of these were randomized trials while the remainder were mostly feasibility studies. The available data suggest that ultrasound can be useful in guiding implantation of CIEDs, with a trend towards less complication rates; however, more high-quality studies that compare US guidance to traditional techniques in CIED implantation are required.

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A Novel Nerve Block Technique for a Patient Undergoing Cardiac Device Implantation

Cited by 2 publications

References 10 publications

Efficacy and safety of supraclavicular and pectoralis nerve blocks as primary peri‐procedural analgesia for cardiac electronic device implantation: A pilot study

Efficacy and safety of supraclavicular and pectoralis nerve blocks as primary peri‐procedural analgesia for cardiac electronic device implantation: A pilot study

Ultrasound utilization for implantation of cardiac implantable electronic devices

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