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Gonçalves D, Sousa CP, Graça R, Miguelez MP, Sampaio C. Clavipectoral Fascia Plane Block Combined With Superficial Cervical Plexus Block for the Removal of Osteosynthesis Material From Clavicle Fracture. Cureus 2023; 15:e43146. [PMID: 37692707 PMCID: PMC10484238 DOI: 10.7759/cureus.43146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/08/2023] [Indexed: 09/12/2023] Open
Abstract
Clavipectoral fascial plane block combined with superficial cervical plexus block has been used as an anesthetic and analgesic technique in mid-clavicle fracture surgeries. The authors describe two cases in which patients underwent extraction of osteosynthesis material from the clavicle, using clavipectoral fascial plane block combined with superficial cervical plexus block as an anesthetic and analgesic technique in the postoperative period. The mentioned block presented itself as an easy-to-perform technique, apparently safe and effective, allowing to obtain satisfactory results.
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Affiliation(s)
- Delilah Gonçalves
- Anesthesiology Department, Centro Hospitalar Trás-os-Montes e Alto Douro, Vila Real, PRT
| | - Cristina P Sousa
- Anesthesiology Department, Centro Hospitalar Trás-os-Montes e Alto Douro, Vila Real, PRT
| | - Rita Graça
- Anesthesiology Department, Centro Hospitalar Trás-os-Montes e Alto Douro, Vila Real, PRT
| | - Maria P Miguelez
- Anesthesiology Department, Centro Hospitalar Trás-os-Montes e Alto Douro, Vila Real, PRT
| | - Catarina Sampaio
- Anesthesiology Department, Centro Hospitalar Trás-os-Montes e Alto Douro, Vila Real, PRT
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Roriz D, Brandão J, Graça R, Caramelo S, Correia C, Abrunhosa R. S-ICD implantation under the serratus plane block and transversus thoracis muscle plane block. A clinical case. Rev Esp Anestesiol Reanim (Engl Ed) 2022; 69:102-104. [PMID: 35168918 DOI: 10.1016/j.redare.2020.11.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 11/03/2020] [Indexed: 06/14/2023]
Abstract
INTRODUCTION The development of a subcutaneous implantable cardioverter-defibrillator (S-ICD) combined with the typical patient comorbidities creates new challenges for anaesthesia. CLINICAL CASE A young male, ASA II, was proposed for S-ICD placement, after recovery from a sudden CRP episode. We performed regional anaesthesia with a serratus plane block (SPB) and transversus thoracic muscle plane block (TTPB) with administration of Mepivacaine and Ropivacaine. S-ICD placement was achieved under regional anaesthesia. In the perioperative period, the patient remained hemodynamically stable, without any complications or pain. DISCUSSION The implantation of the ICD occurs in fragile patients, with high anaesthetic risk. In this case, the association of SPB and TTPB was an effective anaesthetic/analgesic approach, has advantages when compared with other techniques and has potential use in other procedures.
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Affiliation(s)
- D Roriz
- Department of Anesthesiology and Pain Therapy, Centro Hospitalar de trás-os-Montes e Alto Douro, EPE, Vila Real, Portugal.
| | - J Brandão
- Department of Anesthesiology and Pain Therapy, Centro Hospitalar de trás-os-Montes e Alto Douro, EPE, Vila Real, Portugal
| | - R Graça
- Department of Anesthesiology and Pain Therapy, Centro Hospitalar de trás-os-Montes e Alto Douro, EPE, Vila Real, Portugal
| | - S Caramelo
- Department of Anesthesiology and Pain Therapy, Centro Hospitalar de trás-os-Montes e Alto Douro, EPE, Vila Real, Portugal
| | - C Correia
- Department of Anesthesiology and Pain Therapy, Centro Hospitalar de trás-os-Montes e Alto Douro, EPE, Vila Real, Portugal
| | - R Abrunhosa
- Department of Anesthesiology and Pain Therapy, Centro Hospitalar de trás-os-Montes e Alto Douro, EPE, Vila Real, Portugal
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Graça R, Fernandes R, Alves A, Menezes J, Romão L, Bourbon M. Characterisation of LDLR variants in the initiation codon. Atherosclerosis 2021. [DOI: 10.1016/j.atherosclerosis.2021.06.571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Roriz D, Brandão J, Graça R, Caramelo S, Correia C, Abrunhosa R. S-ICD implantation under the serratus plane block and transversus thoracis muscle plane block. A clinical case. Rev Esp Anestesiol Reanim (Engl Ed) 2021; 69:S0034-9356(20)30323-6. [PMID: 34127280 DOI: 10.1016/j.redar.2020.11.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 10/28/2020] [Accepted: 11/03/2020] [Indexed: 06/12/2023]
Abstract
INTRODUCTION The development of a subcutaneous implantable cardioverter-defibrillator (S-ICD) combined with the typical patient comorbidities creates new challenges for anesthesia. CLINICAL CASE A young male, ASA II, was proposed for S-ICD placement, after recovery from a sudden CRP episode. We performed regional anesthesia with a serratus plane block and transversus thoracic muscle plane block with administration of mepivacaine and ropivacaine. S-ICD placement was achieved under regional anesthesia. In the perioperative period, the patient remained hemodynamically stable, without any complications or pain. DISCUSSION The implantation of the ICD occurs in fragile patients, with high anesthetic risk. In this case, the association of serratus plane block and transversus thoracic muscle plane block was an effective anesthetic/analgesic approach, has advantages when compared with other techniques and has potential use in other procedures.
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Affiliation(s)
- D Roriz
- Department of Anesthesiology and Pain Therapy, Centro Hospitalar de tras-os-Montes e Alto Douro, EPE, Vila Real, Portugal.
| | - J Brandão
- Department of Anesthesiology and Pain Therapy, Centro Hospitalar de tras-os-Montes e Alto Douro, EPE, Vila Real, Portugal
| | - R Graça
- Department of Anesthesiology and Pain Therapy, Centro Hospitalar de tras-os-Montes e Alto Douro, EPE, Vila Real, Portugal
| | - S Caramelo
- Department of Anesthesiology and Pain Therapy, Centro Hospitalar de tras-os-Montes e Alto Douro, EPE, Vila Real, Portugal
| | - C Correia
- Department of Anesthesiology and Pain Therapy, Centro Hospitalar de tras-os-Montes e Alto Douro, EPE, Vila Real, Portugal
| | - R Abrunhosa
- Department of Anesthesiology and Pain Therapy, Centro Hospitalar de tras-os-Montes e Alto Douro, EPE, Vila Real, Portugal
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Brandão J, Graça R, Sá M, Cardoso JM, Caramelo S, Correia C. Lumbar erector spinae plane block: Successful control of acute pain after lumbar spine surgery - A clinical report. ACTA ACUST UNITED AC 2018; 66:167-171. [PMID: 30522818 DOI: 10.1016/j.redar.2018.10.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2018] [Revised: 09/26/2018] [Accepted: 10/09/2018] [Indexed: 11/30/2022]
Abstract
We report the successful clinical case of a patient scheduled for lumbar spine surgery in which we performed a bilateral single-shot erector spinae plane block as part of a multimodal analgesic strategy for pain control. Performing the block preoperatively dismissed the need for extra intraoperative opioids other than those for intubation, and enabled the use of paracetamol for analgesia only. Further, there was no need for hypotensive techniques, as the block provided satisfactory sympathetic blockade and regional vasodilation with a clear surgical field. Postoperatively, the patient had minor opioid consumption and was able to freely move without any motor impairment or pain from early on in the Post Anaesthesia Care Unit. The use of single-shot erector spinae plane block at the lumbar level for lumbar spine surgery analgesia emphasises its wide application and analgesic efficacy.
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Affiliation(s)
- J Brandão
- Departamento de Anestesiología y Terapia del Dolor, Centro Hospitalar de Trás-Os-Montes e Alto Douro, EPE, Vila Real, Portugal.
| | - R Graça
- Departamento de Anestesiología y Terapia del Dolor, Centro Hospitalar de Trás-Os-Montes e Alto Douro, EPE, Vila Real, Portugal
| | - M Sá
- Departamento de Anestesiología y Terapia del Dolor, Centro Hospitalar de Trás-Os-Montes e Alto Douro, EPE, Vila Real, Portugal
| | - J M Cardoso
- Departamento de Anestesiología y Terapia del Dolor, Centro Hospitalar de Trás-Os-Montes e Alto Douro, EPE, Vila Real, Portugal
| | - S Caramelo
- Departamento de Anestesiología y Terapia del Dolor, Centro Hospitalar de Trás-Os-Montes e Alto Douro, EPE, Vila Real, Portugal
| | - C Correia
- Departamento de Anestesiología y Terapia del Dolor, Centro Hospitalar de Trás-Os-Montes e Alto Douro, EPE, Vila Real, Portugal
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Alves A, Graça R, Raimundo A, Sequeira S, Moldovan O, Lobarinhas G, Mansilha H, Duarte S, Gaspar A, Guerra A, Travessa A, Ferreira A, Bourbon M. Study of rare familial monogenic dyslipidaemias in Portugal. Atherosclerosis 2018. [DOI: 10.1016/j.atherosclerosis.2018.06.715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Graça R, Abrantes L, Rossi N, Alves A, Medeiros A, Zimon M, Rausch T, Benes V, Pepperkok R, Bourbon M. The importance to track variants in a genes causing recessive disorders within the family: A FH/Sitosterolemia clinical case. Atherosclerosis 2018. [DOI: 10.1016/j.atherosclerosis.2018.06.220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Graça R, Rossi N, Alves A, Medeiros A, Zimon M, Raush T, Benes V, Pepperkok R, Bourbon M. Improving familial dyslipidaemia diagnosis. Atherosclerosis 2018. [DOI: 10.1016/j.atherosclerosis.2018.06.270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Graça R, Miguelez P, Cardoso JM, Sá M, Brandão J, Pinheiro C, Machado D. [Continuous quadratus lumborum type II block in partial nephrectomy]. Rev Bras Anestesiol 2018; 68:653-656. [PMID: 29784431 DOI: 10.1016/j.bjan.2018.03.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Revised: 03/01/2018] [Accepted: 03/31/2018] [Indexed: 10/16/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Quadratus lumborum block was first described in 2007 and currently there are descriptions of its achievement through four different injection points. This blockage provides abdominal wall and visceral analgesia, and one of its mechanisms is the dispersion of the local anesthetic into the paravertebral space. We describe the performance of a continuous quadratus lumborum type II block for postoperative analgesia in a partial nephrectomy. CASE REPORT A 64-year-old woman, scheduled for partial left laparoscopic nephrectomy. During the procedure, due to technical difficulties, an incision was made in the left flank to facilitate the surgical approach. In the early postoperative period, a continuous quadratus lumborum type II block was performed using ultrasonography as part of the multimodal analgesic strategy. Initially, 20ml of 0.2% ropivacaine was administered and 3cm of catheter were introduced into the interfascial space. Subsequently, a continuous infusion of 5.2mL.h-1 of 0.2% ropivacaine was given for 48hours. In the first 24 postoperative hours, the patient reported no pain at rest or on movement. In the following 24hours, she was free of pain at rest and only a slight pain (2/10) on movement. CONCLUSIONS Continuous quadratus lumborum type II block was an effective postoperative analgesic option. Blocking of somatic nerves and visceral afferent pathways provided abdominal and visceral wall analgesia, allowing the reduction of opioid consumption. We consider relevant to explore the analgesic capacity of the quadratus lumborum block and its different approaches, as well as the possibility of it becoming an alternative in patients scheduled for kidney surgery.
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Affiliation(s)
- Rita Graça
- Centro Hospitalar de Trás-os-Montes e Alto Douro, Departamento de Anestesiologia e Terapêutica da Dor, Vila Real, Portugal.
| | - Pilar Miguelez
- Centro Hospitalar de Trás-os-Montes e Alto Douro, Departamento de Anestesiologia e Terapêutica da Dor, Vila Real, Portugal
| | - José Miguel Cardoso
- Centro Hospitalar de Trás-os-Montes e Alto Douro, Departamento de Anestesiologia e Terapêutica da Dor, Vila Real, Portugal
| | - Miguel Sá
- Centro Hospitalar de Trás-os-Montes e Alto Douro, Departamento de Anestesiologia e Terapêutica da Dor, Vila Real, Portugal
| | - Joana Brandão
- Centro Hospitalar de Trás-os-Montes e Alto Douro, Departamento de Anestesiologia e Terapêutica da Dor, Vila Real, Portugal
| | - Célia Pinheiro
- Centro Hospitalar de Trás-os-Montes e Alto Douro, Departamento de Anestesiologia e Terapêutica da Dor, Vila Real, Portugal
| | - Duarte Machado
- Centro Hospitalar de Trás-os-Montes e Alto Douro, Departamento de Anestesiologia e Terapêutica da Dor, Vila Real, Portugal
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Sá M, Graça R, Reis H, Cardoso JM, Sampaio J, Pinheiro C, Machado D. [Superior gluteal nerve: a new block on the block?]. Rev Bras Anestesiol 2017; 68:400-403. [PMID: 28551063 DOI: 10.1016/j.bjan.2016.11.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Accepted: 11/25/2016] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND AND OBJECTIVES The superior gluteal nerve is responsible for innervating the gluteus medius, gluteus minimus and tensor fascia latae muscles, all of which can be injured during surgical procedures. We describe an ultrasound-guided approach to block the superior gluteal nerve which allowed us to provide efficient analgesia and anesthesia for two orthopedic procedures, in a patient who had significant risk factors for neuraxial techniques and deep peripheral nerve blocks. CLINICAL REPORT An 84-year-old female whose regular use of clopidogrel contraindicated neuraxial techniques or deep peripheral nerve blocks presented for urgent bipolar hemiarthroplasty in our hospital. Taking into consideration the surgical approach chosen by the orthopedic team, we set to use a combination of general anesthesia and superficial peripheral nerve blocks (femoral, lateral cutaneous of thigh and superior gluteal nerve) for the procedure. A month and a half post-discharge the patient was re-admitted for debriding and correction of suture dehiscence; we performed the same blocks and light sedation. She remained comfortable in both cases, and reported no pain in the post-operative period. CONCLUSIONS Deep understanding of anatomy and innervation empowers anesthesiologists to solve potentially complex cases with safer, albeit creative, approaches. The relevance of this block in this case arises from its innervation of the gluteus medius muscle and posterolateral portion of the hip joint. To the best of our knowledge, this is the first report of an ultrasound-guided superior gluteal nerve block with an analgesic and anesthetic goal, which was successfully achieved.
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Affiliation(s)
- Miguel Sá
- Centro Hospitalar de Trás-dos-Montes e Alto Douro, Departamento de Anestesiologia e Terapêutica da Dor, Vila Real, Portugal.
| | - Rita Graça
- Centro Hospitalar de Trás-dos-Montes e Alto Douro, Departamento de Anestesiologia e Terapêutica da Dor, Vila Real, Portugal
| | - Hugo Reis
- Centro Hospitalar de Trás-dos-Montes e Alto Douro, Departamento de Anestesiologia e Terapêutica da Dor, Vila Real, Portugal
| | - José Miguel Cardoso
- Centro Hospitalar de Trás-dos-Montes e Alto Douro, Departamento de Anestesiologia e Terapêutica da Dor, Vila Real, Portugal
| | - José Sampaio
- Centro Hospitalar de Trás-dos-Montes e Alto Douro, Departamento de Anestesiologia e Terapêutica da Dor, Vila Real, Portugal
| | - Célia Pinheiro
- Centro Hospitalar de Trás-dos-Montes e Alto Douro, Departamento de Anestesiologia e Terapêutica da Dor, Vila Real, Portugal
| | - Duarte Machado
- Centro Hospitalar de Trás-dos-Montes e Alto Douro, Departamento de Anestesiologia e Terapêutica da Dor, Vila Real, Portugal
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Cardoso JM, Sá M, Graça R, Reis H, Almeida L, Pinheiro C, Machado D. Bloqueio do gânglio esfenopalatino para cefaleia pós‐punção dural em contexto de ambulatório. Braz J Anesthesiol 2017; 67:311-313. [DOI: 10.1016/j.bjan.2017.02.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Revised: 08/18/2016] [Accepted: 09/12/2016] [Indexed: 11/25/2022] Open
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Almeida J, Levy L, Graça R, Ferreira A, Diogo N, Silva J, Silva e Costa J. Comparative double-blind study of the antiasthenic agent DMGG and placebo for assessing physical and biochemical performance in 60 athletes. Curr Ther Res Clin Exp 1993. [DOI: 10.1016/s0011-393x(05)80636-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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