Simultaneous Brachial Plexus Block and Combined Two-Segment Spinal-Epidural Anesthesia with Fixation of an Epidural Catheter in the Subcutaneous Canal in a Patient with Polytrauma
The article reports an example of the simultaneous use of brachial plexus block and combined two-segment spinal-epidural anesthesia with fixation of an epidural catheter in the subcutaneous canal in an 81-year-old patient after receiving a household injury - closed fracture of the olecranon of the r...
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| Format: | Article |
| Language: | Russian |
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Sklifosovsky Research Institute for Emergency Medicine, Public Healthcare Institution of Moscow Healthcare Department
2021-11-01
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| Series: | Неотложная медицинская помощь |
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| Online Access: | https://www.jnmp.ru/jour/article/view/1226 |
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| author | A. P. Marchenko O. N. Yamshikov S. A. Yemelyanov S. A. Mordovin A. N. Petrukhin |
| author_facet | A. P. Marchenko O. N. Yamshikov S. A. Yemelyanov S. A. Mordovin A. N. Petrukhin |
| author_sort | A. P. Marchenko |
| collection | DOAJ |
| description | The article reports an example of the simultaneous use of brachial plexus block and combined two-segment spinal-epidural anesthesia with fixation of an epidural catheter in the subcutaneous canal in an 81-year-old patient after receiving a household injury - closed fracture of the olecranon of the right ulna with displacement of fragments and closed transtrochanteric fracture with a fracture of the right femur fragments. After preoperative preparation and examination, the patient underwent two consecutive surgical interventions within a day: open reduction of comminuted transtrochanteric fracture of the right hip, dynamic femoral screw osteosynthesis and open reduction of fracture of the right olecranon, Weber’s osteosynthesis. Surgical interventions were carried out under regional anesthesia: block of the brachial plexus via supraclavicular access and combined two-segment spinal-epidural anesthesia with a method developed in our clinic for fixing an epidural catheter in the subcutaneous canal using a modified spinal needle. After the operation, the patient underwent postoperative pain relief in the form of epidural analgesia for 72 hours. The postoperative period passed without complications. On the 13th day, the patient was discharged for outpatient treatment by a traumatologist. The use of local anesthesia in the form of two methods of regional anesthesia during two consecutive surgical interventions, in an elderly patient with a high anesthetic risk, followed by long-term postoperative anesthesia in the form of epidural analgesia with a reliable method of epidural catheter fixation in the subcutaneous canal without the use of narcotic analgesics, contributed to the successful carrying out two surgical interventions at once, early activation of the patient, absence of complications in the postoperative period. Reliable catheter fixation is very important for the quality of epidural analgesia. Dislocation of catheters by more than 2 cm can lead to migration of catheters from the epidural space, changing the course of anesthesia, deteriorating its quality, or even interrupting it altogether. The new method of catheter fixation in the subcutaneous canal developed by us made it possible to prevent catheter dislocation. |
| format | Article |
| id | doaj-art-19876869b0564bd0a935e67a0df1b121 |
| institution | Kabale University |
| issn | 2223-9022 2541-8017 |
| language | Russian |
| publishDate | 2021-11-01 |
| publisher | Sklifosovsky Research Institute for Emergency Medicine, Public Healthcare Institution of Moscow Healthcare Department |
| record_format | Article |
| series | Неотложная медицинская помощь |
| spelling | doaj-art-19876869b0564bd0a935e67a0df1b1212025-08-20T03:43:21ZrusSklifosovsky Research Institute for Emergency Medicine, Public Healthcare Institution of Moscow Healthcare DepartmentНеотложная медицинская помощь2223-90222541-80172021-11-0110360460910.23934/2223-9022-2021-10-3-604-609721Simultaneous Brachial Plexus Block and Combined Two-Segment Spinal-Epidural Anesthesia with Fixation of an Epidural Catheter in the Subcutaneous Canal in a Patient with PolytraumaA. P. Marchenko0O. N. Yamshikov1S. A. Yemelyanov2S. A. Mordovin3A. N. Petrukhin4G.R. Derzhavin Tambov State University Medical Institute; City Clinical Hospital of KotovskG.R. Derzhavin Tambov State University Medical Institute; City Clinical Hospital of KotovskG.R. Derzhavin Tambov State University Medical Institute; City Clinical Hospital of KotovskG.R. Derzhavin Tambov State University Medical Institute; City Clinical Hospital of KotovskG.R. Derzhavin Tambov State University Medical Institute; City Clinical Hospital of KotovskThe article reports an example of the simultaneous use of brachial plexus block and combined two-segment spinal-epidural anesthesia with fixation of an epidural catheter in the subcutaneous canal in an 81-year-old patient after receiving a household injury - closed fracture of the olecranon of the right ulna with displacement of fragments and closed transtrochanteric fracture with a fracture of the right femur fragments. After preoperative preparation and examination, the patient underwent two consecutive surgical interventions within a day: open reduction of comminuted transtrochanteric fracture of the right hip, dynamic femoral screw osteosynthesis and open reduction of fracture of the right olecranon, Weber’s osteosynthesis. Surgical interventions were carried out under regional anesthesia: block of the brachial plexus via supraclavicular access and combined two-segment spinal-epidural anesthesia with a method developed in our clinic for fixing an epidural catheter in the subcutaneous canal using a modified spinal needle. After the operation, the patient underwent postoperative pain relief in the form of epidural analgesia for 72 hours. The postoperative period passed without complications. On the 13th day, the patient was discharged for outpatient treatment by a traumatologist. The use of local anesthesia in the form of two methods of regional anesthesia during two consecutive surgical interventions, in an elderly patient with a high anesthetic risk, followed by long-term postoperative anesthesia in the form of epidural analgesia with a reliable method of epidural catheter fixation in the subcutaneous canal without the use of narcotic analgesics, contributed to the successful carrying out two surgical interventions at once, early activation of the patient, absence of complications in the postoperative period. Reliable catheter fixation is very important for the quality of epidural analgesia. Dislocation of catheters by more than 2 cm can lead to migration of catheters from the epidural space, changing the course of anesthesia, deteriorating its quality, or even interrupting it altogether. The new method of catheter fixation in the subcutaneous canal developed by us made it possible to prevent catheter dislocation.https://www.jnmp.ru/jour/article/view/1226regional anesthesiaplexus blockcombined two-segment spinal-epidural anesthesia |
| spellingShingle | A. P. Marchenko O. N. Yamshikov S. A. Yemelyanov S. A. Mordovin A. N. Petrukhin Simultaneous Brachial Plexus Block and Combined Two-Segment Spinal-Epidural Anesthesia with Fixation of an Epidural Catheter in the Subcutaneous Canal in a Patient with Polytrauma Неотложная медицинская помощь regional anesthesia plexus block combined two-segment spinal-epidural anesthesia |
| title | Simultaneous Brachial Plexus Block and Combined Two-Segment Spinal-Epidural Anesthesia with Fixation of an Epidural Catheter in the Subcutaneous Canal in a Patient with Polytrauma |
| title_full | Simultaneous Brachial Plexus Block and Combined Two-Segment Spinal-Epidural Anesthesia with Fixation of an Epidural Catheter in the Subcutaneous Canal in a Patient with Polytrauma |
| title_fullStr | Simultaneous Brachial Plexus Block and Combined Two-Segment Spinal-Epidural Anesthesia with Fixation of an Epidural Catheter in the Subcutaneous Canal in a Patient with Polytrauma |
| title_full_unstemmed | Simultaneous Brachial Plexus Block and Combined Two-Segment Spinal-Epidural Anesthesia with Fixation of an Epidural Catheter in the Subcutaneous Canal in a Patient with Polytrauma |
| title_short | Simultaneous Brachial Plexus Block and Combined Two-Segment Spinal-Epidural Anesthesia with Fixation of an Epidural Catheter in the Subcutaneous Canal in a Patient with Polytrauma |
| title_sort | simultaneous brachial plexus block and combined two segment spinal epidural anesthesia with fixation of an epidural catheter in the subcutaneous canal in a patient with polytrauma |
| topic | regional anesthesia plexus block combined two-segment spinal-epidural anesthesia |
| url | https://www.jnmp.ru/jour/article/view/1226 |
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