Anesthesia Management with "Interscalene, Cervical, Clavipectoral Block" in Patient with Clavicle Fracture

Yıl 2024, Cilt: 6 Sayı: 2, 402 - 408, 25.08.2024

Tuba Çatak , Mehmet Şerif Alp , Alper Çıraklı , Kaptanıderya Tayfur , İsmail Senih Aksu , Nilay Taş

Öz

We aimed to operate on a high-risk patient with multiple comorbidities (Diabetes Mellitus, Hypertension, Alzheimer's onset, Heart Failure and Asthma) and widespread clavicle fracture, with a triple plane block without applying general anesthesia. The patient's electrocardiogram (ECG), non-invasive arterial blood pressure and arterial blood oxygen saturation were monitored with a pulse oximeter. The patient was informed about the procedure to be performed. The head of the patient, who was in the supine position, was lifted 45 degrees and turned to the opposite side of the area to be operated on. The patient's neck, clavicle area and ultrasound probe were prepared under sterile conditions. The 68 years old female patient underwent USG-guided Interscalene Brachial Plexus Block, Superficial Cervical Block and Clavipectoral Fascial Plane Block, respectively. Horner syndrome developed after the triple block applied to the patient. The patient had ptosis in the right eye and no other complications developed. Ptosis resolved without sequelae at the 8th postoperative hour. The surgical procedure was completed without the patient feeling intraoperative pain and without deteriorating vital signs. Horner syndrome was observed in the first minutes after block application. The patient had ptosis in the right eye and no other complications occurred. Intraoperative anesthesia and postoperative analgesia were performed successfully.

Anahtar Kelimeler

Block, Clavicle, Anesthesia.

Klavikula Kırığı Olan Hastada “İnterskalen, Servikal, Klavipektoral Blok” ile Anestezi Yönetimi

Öz

Çoklu komorbiditesi olan (Diabetes Mellitus, Hipertansiyon, Alzheimer başlangıcı, Kalp Yetmezliği ve Astım) ve yaygın klavikula kırığı olan yüksek riskli hastayı, genel anestezi uygulamadan üçlü plan bloğu ile opere etmeyi amaçladık. Hastanın elektrokardiyogram (EKG)’ı, non-invaziv arteriyel kan basıncı ve arteriyel kanda oksijen satürasyonu puls oksimetre ile monitörize edildi. Yapılacak işlem hakkında hastaya bilgi verildi. Supin pozisyonda olan hastanın başı 45 derece kaldırılıp, cerrahi yapılacak alanın aksi tarafına çevrildi. Hastanın boynu, klavikula bölgesi ve ultrason probu steril şartlarda hazırlandı. 68 yaşındaki kadın hastaya, ultrason (USG) eşliğinde sırasıyla İnterskalen Brakial Pleksus Blok, Yüzeyel Servikal Blok ve Klavipektoral Fasial Düzlem Bloğu yapıldı. Hastaya uygulanan üçlü blok sonrası horner sendromu gelişti. Sağ gözünde pitozis olan hastada başka bir komplikasyon gelişmedi. Pitozis postoperatif 8. saate sekelsiz düzeldi. Hasta intraoperatif ağrı hissetmeden ve vital bulguları bozulmadan cerrahi işlem tamamlandı. Blok uygulaması sonrası ilk dakikalarda horner sendromu görüldü. Hastada başka komplikasyon yaşanmadı. İntraoperatif anestezi ve postoperatif analjezi başarıyla gerçekleştirildi.

Anahtar Kelimeler

Blok, Klavikula, Anestezi.

Kaynakça

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