Anestesia geral associada a bloqueio do plano do músculo eretor da espinha para encerramento de persistência de canal arterial: dois relatos de caso

Carvalho, Erica Viviana Guimarães; Marques, Joana Luísa Borges; Santos, Maria Joana

doi:10.1016/j.bjan.2020.01.001

Cited by 3 publications

(1 citation statement)

References 5 publications

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“…[2][3][4] Only single injection ESP blocks, which provide analgesia of limited duration, have been reported in preterm neonates that presented for thoracic surgery. [5][6][7][8] A continuous block is desirable for these patients to allow the provision of several days of opioid-sparing analgesia. However, continuous ESP blocks may require large volume local anaesthetic infusions to be efficacious, which presents an additional challenge in this population due to immature hepatic metabolism and increased susceptibility to the cardiotoxic and neurotoxic effect of aminoamide local anaesthetics.…”

Section: Introductionmentioning

confidence: 99%

Erector spinae catheter for post-thoracotomy pain control in a premature neonate

et al. 2020

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Ensuring respiratory stability with early tracheal extubation and adequate pain control is challenging in premature neonates after thoracotomy. Continuous erector spinae plane (ESP) block, a relatively new truncal nerve block, has the potential to provide analgesia for thoracic surgeries while reducing opioid use. However, there have been only a few reports utilising this technique in infants, and none in preterm neonates. We present the perioperative pain management of a preterm neonate requiring thoracotomy. Epidural analgesia was deemed contraindicated due to coexisting coagulopathy; therefore, an ESP catheter was placed. The patient was extubated at the end of the surgery and had excellent pain control with rectal acetaminophen, chloroprocaine infusion via the ESP catheter and with minimal opioid requirement. Continuous ESP block may be safe and effective for postoperative pain management in coagulopathic premature neonates. Chloroprocaine is an effective local anaesthetic in the erector spinae compartment, which has not been previously reported.

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Section: Introductionmentioning

confidence: 99%

Erector spinae catheter for post-thoracotomy pain control in a premature neonate

et al. 2020

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On-table Extubation Facilitated by Regional Analgesic Techniques Combined with General Anesthesia for PDA Ligation: A Case-series and Literature Review

Magoon

Jose

Kaushal

et al. 2023

JCCC

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Background: An increasing embracement of safer regional techniques as pivotal components of multimodal analgesia regimen has made fast-tracking possible following pediatric cardiac surgery. Speaking of fast-tracking in pediatrics, the feasibility of on-table extubation (OTE), and its’ potential benefits are also being ardently researched with simultaneous emphasis on appropriate patient selection and adequate perioperative safety. Case Series: We report eight consecutive pediatric cases featuring a combination of serratus anterior plane block (SAPB) or erector spinae plane block (ESPB) to general anesthesia (GA) for patent ductus arteriosus (PDA) ligation through a left thoracotomy incision. Following induction of GA, the left-sided SAPB was performed in five patients and the other three patients received left-sided ESPB, each with 0.5 mL/kg of 0.2% ropivacaine. Demonstrating a mean intraoperative fentanyl requirement of 3.25 ± 0.71 µg/kg, OTE could be successfully contemplated in all the 8 patients. Subsequently, the post-operative face, leg, activity, cry, and consolability (FLACC) score was recorded at 1, 2, 4, 6, 8, and 12 h. Meanwhile, all the patients depicted acceptable pain scores till 4 h, administration of 0.5 µg/Kg rescue fentanyl was necessitated in three patients each at 6-h and 8-h postoperatively (given FLACC scores ≥4), amounting to a mean 0.375 ± 0.23 µg/kg post-operative fentanyl requirement. All patients received intravenous paracetamol at 8-h postoperatively. No block-related complication or need for reintubation was discovered. Conclusion: Incorporation of fascial plane blocks (SAPB or ESPB) to the conduct of GA for PDA ligation, allowed for safe OTE in our experience, due to an opioid-sparing potential.

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Anestesia geral associada a bloqueio do plano do músculo eretor da espinha para encerramento de persistência de canal arterial: dois relatos de caso

Cited by 3 publications

References 5 publications

Erector spinae catheter for post-thoracotomy pain control in a premature neonate

Erector spinae catheter for post-thoracotomy pain control in a premature neonate

Ibuprofen

On-table Extubation Facilitated by Regional Analgesic Techniques Combined with General Anesthesia for PDA Ligation: A Case-series and Literature Review

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