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 Görüntüleme 6
 İndirme 1
Our Ultrasound Guided Brachial Plexus Block Experiences for Upper Extremity Surgeries in Pediatric Patients
2020
Dergi:  
Şişli Etfal Hastanesi Tıp Bülteni
Yazar:  
Özet:

Objectives: Brachial plexus block is the most effective analgesia and anesthesia procedure for the upper extremity surgeries in pediatric patients. In recent years, ultrasound guidance for this procedure has reduced the fail and complications like pneumothorax, intravascular injection and nerve damage. However, the number of studies about brachial plexus block is not enough, particularly in pediatric patients, which remained under-researched. In our study, we aimed to discuss the efficacy and safety of the ultrasound-guided brachial plexus block in pediatric patients by retrospectively examining their data. Methods: We retrospectively reviewed the data of pediatric patients who underwent ultrasound-guided brachial block in our clinic between January 2015-January 2017. Demographic data, diagnosis, procedure and operation times, medications, motor and sensorial block times were recorded. Results: Between January 2015 and January 2017, the number of pediatric patients who underwent ultrasound-guided peripheral nerve block in our clinic was 24. In 15 of these patients, the supraclavicular block was applied in 15, and the infraclavicular block was applied in nine patients. The mean age of the patients was 9.6±3.12, with a male/female ratio 14/10. The mean duration of the procedure was 9.54±2.14 minutes in patients for the supraclavicular block and 12.9 ± 2.8 minutes for the infraclavicular block. The mean surgery time was 64±13.6 minutes. As a local anesthetic, bupivacaine was used in three patients; bupivacaine+lidocaine combination was used in 21 patients and adjuvants were added in eight patients. The block procedure was performed under general anesthesia in 12 patients and under sedation in 12 patients. The mean motor block time was 7.5±2 hours in patients who received supraclavicular block, and 7.4±1.5 hours in patients who received infraclavicular block. The mean sensorial block time was 10.5±1.7 hours in the supraclavicular block, and 10.45±1.15 hours in the infraclavicular block. The mean motor block period with added adjuvants was 7.7±0.5 hours, and the sensorial block period was 11.12±1.1 hours. No complications were seen during the procedure, intraoperative and postoperative follow-up. Conclusion: Ultrasound-guided brachial plexus block in pediatric patients is effective and safe, with longer analgesia duration and lower complication rates. Prospective studies with a larger number of patients are needed in this regard.

Anahtar Kelimeler:

Our Brakial Pleksus Block Applications in Ultrasound Guidance in High Extremity Surgery in Children
2020
Yazar:  
Özet:

Purpose: Brakial plexus blocks are the most effective analgesic and anesthetic method in upper end surgery in children. In recent years, making brakial plexus blocks accompanied by ultrasound has reduced the rate of major complications such as pnomotax, intravascular injection, nerve damage and process failure. However, studies on brakial plexus blocks, especially in children, are insufficient. In our study, we aimed to discuss the effectiveness and safety of the brakial plexus block in this patient group by reviewing the data of children who applied the brakial plexus block in our clinic with ultrasound accompaniment. Instruments and Methods: Data of children with brakial plexus block in ultrasound accompanied in our clinic between January 2015 and January 2017 were reviewed backwards. Demographic data, diagnoses, process and surgery times, drugs used, motor and sensory block times were recorded. Results: Between January 2015 and January 2017, the number of children patients who applied the upper extremity peripheral nerve block with ultrasound in our clinic was 24. In 15 of these patients, supraklavics were applied, and in 9 infraclavics block. The average age of patients was 9.6 ± 3.12. The E/K ratio was 14/10. The average duration of the procedure was 9,54±2,14 minutes in patients who were administered in the supraclavic bloc, and 12,9±2,8 minutes in the group who were administered in the infrared bloc. The operating time was an average of 64±13,6 minutes. In local anesthesia, 21 patients received bupivakain+lidokain, 3 patients received bupivakain, 8 patients received adjuvan. The procedure was administered in 12 patients under general anesthesia and in 12 patients under sedation. The average motor block duration was 7.5 ± 2 hours in patients with supraclavic block and 7.4 ± 1.5 hours in patients with infraclavic block. The average sensory block duration was 10.5±1.7 hours in patients with supraclavic block and 10.45±1.15 hours in patients with infrared block. The average motor block duration of patients added to the adjuvan is 7.7 ± 0.5 hours, the sensory block duration is 11.12 ± 1.1 hours. No complications were observed in any of the patients during the procedure, intraoperative and postoperative follow-up. The result is that the brakial plexus blocks accompanied by ultrasound in children are effective and safe with a long time of analgesy and low rates of complications. There is a need for more prospective studies with a larger number of patients. (SETB-2018-04-051)

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2020
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