Dispersão axilar de anestésico local após bloqueio interfascial torácico guiado por ultrassom - estudo radiológico e em cadáver

Translated title of the contribution: Axillary local anesthetic spread after the thoracic interfacial ultrasound block – a cadaveric and radiological evaluation

Patricia Alfaro de la Torre, Jerry Jones, Servando López Álvarez, Paula Diéguez Garcia, Francisco Javier Garcia de Miguel, Eva Maria Monzon Rubio, Federico Carol Boeris, Monir Kabiri Sacramento, Osmany Duany, Mario Fajardo Pérez, Borja de la Quintana Gordon

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Background Oral opioid analgesics have been used for management of peri‐ and postoperative analgesia in patients undergoing axillary dissection. The axillary region is a difficult zone to block and does not have a specific regional anesthesia technique published that offers its adequate blockade. Methods After institutional review board approval, anatomic and radiological studies were conducted to determine the deposition and spread of methylene blue and local anesthetic injected respectively into the axilla via the thoracic inter‐fascial plane. Magnetic Resonance Imaging studies were then conducted in 15 of 34 patients scheduled for unilateral breast surgery that entailed any of the following: axillary clearance, sentinel node biopsy, axillary node biopsy, or supernumerary breasts, to ascertain the deposition and time course of spread of solution within the thoracic interfascial plane in vivo. Results Radiological and cadaveric studies showed that the injection of local anesthetic and methylene blue via the thoracic inter‐fascial plane, using ultrasound guide technique, results in reliable deposition into the axilla. In patients, the injection of the local anesthetic produced a reliable axillary sensory block. This finding was supported by Magnetic Resonance Imaging studies that showed hyper‐intense signals in the axillary region. Conclusions These findings define the anatomic characteristics of the thoracic interfascial plane nerve block in the axillary region, and underline the clinical potential of this novel nerve block.

Original languagePortuguese
Pages (from-to)555-564
Number of pages10
JournalBrazilian Journal of Anesthesiology
Volume67
Issue number6
DOIs
StatePublished - Nov 1 2017

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Local Anesthetics
Thorax
Axilla
Nerve Block
Methylene Blue
Breast
Magnetic Resonance Imaging
Biopsy
Injections
Conduction Anesthesia
Research Ethics Committees
Analgesia
Opioid Analgesics
Dissection

All Science Journal Classification (ASJC) codes

  • Anesthesiology and Pain Medicine

Cite this

Dispersão axilar de anestésico local após bloqueio interfascial torácico guiado por ultrassom - estudo radiológico e em cadáver. / Torre, Patricia Alfaro de la; Jones, Jerry; Álvarez, Servando López; Garcia, Paula Diéguez; Miguel, Francisco Javier Garcia de; Rubio, Eva Maria Monzon; Boeris, Federico Carol; Sacramento, Monir Kabiri; Duany, Osmany; Pérez, Mario Fajardo; Gordon, Borja de la Quintana.

In: Brazilian Journal of Anesthesiology, Vol. 67, No. 6, 01.11.2017, p. 555-564.

Research output: Contribution to journalArticle

Torre, PADL, Jones, J, Álvarez, SL, Garcia, PD, Miguel, FJGD, Rubio, EMM, Boeris, FC, Sacramento, MK, Duany, O, Pérez, MF & Gordon, BDLQ 2017, 'Dispersão axilar de anestésico local após bloqueio interfascial torácico guiado por ultrassom - estudo radiológico e em cadáver', Brazilian Journal of Anesthesiology, vol. 67, no. 6, pp. 555-564. https://doi.org/10.1016/j.bjan.2016.10.009
Torre, Patricia Alfaro de la ; Jones, Jerry ; Álvarez, Servando López ; Garcia, Paula Diéguez ; Miguel, Francisco Javier Garcia de ; Rubio, Eva Maria Monzon ; Boeris, Federico Carol ; Sacramento, Monir Kabiri ; Duany, Osmany ; Pérez, Mario Fajardo ; Gordon, Borja de la Quintana. / Dispersão axilar de anestésico local após bloqueio interfascial torácico guiado por ultrassom - estudo radiológico e em cadáver. In: Brazilian Journal of Anesthesiology. 2017 ; Vol. 67, No. 6. pp. 555-564.
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abstract = "Background Oral opioid analgesics have been used for management of peri‐ and postoperative analgesia in patients undergoing axillary dissection. The axillary region is a difficult zone to block and does not have a specific regional anesthesia technique published that offers its adequate blockade. Methods After institutional review board approval, anatomic and radiological studies were conducted to determine the deposition and spread of methylene blue and local anesthetic injected respectively into the axilla via the thoracic inter‐fascial plane. Magnetic Resonance Imaging studies were then conducted in 15 of 34 patients scheduled for unilateral breast surgery that entailed any of the following: axillary clearance, sentinel node biopsy, axillary node biopsy, or supernumerary breasts, to ascertain the deposition and time course of spread of solution within the thoracic interfascial plane in vivo. Results Radiological and cadaveric studies showed that the injection of local anesthetic and methylene blue via the thoracic inter‐fascial plane, using ultrasound guide technique, results in reliable deposition into the axilla. In patients, the injection of the local anesthetic produced a reliable axillary sensory block. This finding was supported by Magnetic Resonance Imaging studies that showed hyper‐intense signals in the axillary region. Conclusions These findings define the anatomic characteristics of the thoracic interfascial plane nerve block in the axillary region, and underline the clinical potential of this novel nerve block.",
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