Departamento de Anestesia y Reanimación, Hospital Universitario de Burgos, Burgos, España.
Departamento de Anestesia y Reanimación, Hospital Universitario de Burgos, Burgos, España.
Rev Esp Anestesiol Reanim (Engl Ed). 2020 Jun-Jul;67(6):343-346. doi: 10.1016/j.redar.2019.10.011. Epub 2020 May 18.
access creation is mandatory in patients with end stage renal disease for hemodialysis treatment. It frequently involves upper arm or axillary dissection and general anesthesia is predominantly used as axillary compartment innervation is complex. Avoiding general anesthesia may be beneficial in these risk patients. We present two cases where serratus-intercostal plane block (SIPB/BRILMA) was used, along with ultrasound guided supraclavicular block and multimodal analgesia for proximal arm and axillary AV access surgery. Regional anesthesia combination of supraclavicular and serratus-intercostal/BRILMA block in arteriovenous fistula surgery was successful and should be considered by anesthesiologist in order to avoid general anesthesia.
对于需要接受血液透析治疗的终末期肾病患者，建立动静脉通路是必需的。该手术常涉及上臂或腋窝解剖，由于腋窝部位的神经支配复杂，通常采用全身麻醉。对于这些高风险患者，避免全身麻醉可能有益。我们介绍了两例患者，他们在超声引导锁骨上阻滞和多模式镇痛的基础上，使用了肋间肌-前锯肌平面阻滞（SIPB/BRILMA），成功完成了近臂和腋窝动静脉内瘘术。锁骨上阻滞联合肋间肌-前锯肌/BRILMA 阻滞的区域麻醉方法可成功应用于动静脉内瘘手术，麻醉医生应考虑采用这种方法以避免全身麻醉。
