55: Thoracic paravertebral nerve block as the sole anaesthesia for open cholecystectomy in high risk patients

2007 ◽  
Vol 32 (5) ◽  
pp. 118-118
Author(s):  
I SERPETINIS ◽  
E LYKOUDI ◽  
K AVGERINOS ◽  
D LYTRAS ◽  
C DERVENIS ◽  
...  
Keyword(s):  
High Risk ◽  
Nerve Block ◽  
Open Cholecystectomy ◽  
High Risk Patients ◽  
Risk Patients

Thoracic paravertebral nerve block as the sole anaesthesia for open cholecystectomy in high risk patients

2007 ◽  
Vol 32 (Suppl. 1) ◽  
pp. 118
Author(s):  
I. Serpetinis ◽  
E. Lykoudi ◽  
K. Avgerinos ◽  
D. Lytras ◽  
C. Dervenis ◽  
...  
Keyword(s):  
High Risk ◽  
Nerve Block ◽  
Open Cholecystectomy ◽  
High Risk Patients ◽  
Risk Patients

scholarly journals Percutaneous Cholecystostomy for Severe Acute Cholecystitis: A Useful Procedure in High-Risk Patients for Surgery

2018 ◽  
Vol 108 (2) ◽  
pp. 124-129 ◽  
Author(s):  
S. Aroori ◽  
C. Mangan ◽  
L. Reza ◽  
N. Gafoor
Keyword(s):  
High Risk ◽  
Acute Cholecystitis ◽  
Open Cholecystectomy ◽  
Length Of Hospital Stay ◽  
Acalculous Cholecystitis ◽  
Percutaneous Cholecystostomy ◽  
High Risk Patients ◽  
Risk Patients ◽  
Physiological Reserve ◽  
American Society

Background: Acute cholecystitis has the potential to cause sepsis and death, particularly in patients with poor physiological reserve. The gold standard treatment of acute cholecystitis (cholecystectomy) is often not safe in high-risk patients and recourse is made to percutaneous cholecystostomy as either definite treatment or temporizing measure. The aim of this study is to evaluate early and late outcomes following percutaneous cholecystostomy in patients with acute cholecystitis treated at our institution. Methods: All patients who underwent percutaneous cholecystostomy for acute cholecystitis (excluding patients with malignancy) between January 2005 and September 2014 were included in the study. Results: A total of 53 patients (22 female, median age, 74 years; range, 27–95 years) underwent percutaneous cholecystostomy during the study period. In total, 12 patients (22.6%) had acalculous cholecystitis. The main indications for percutaneous cholecystostomy were significant co-morbidities (n = 28, 52.8%) and patients too unstable for surgery (n = 21, 39.6%). The median time to percutaneous cholecystostomy from diagnosis of acute cholecystitis was 3.6 days (range, 0–45 days). The median length of hospital stay was 27 (range, 4–87) days. The overall 90-day mortality was 9.3% with two further deaths at 12-month follow up. The mortality was significantly higher in patients with American Society of Anesthesiology grade 4–5 (18% vs 0% in American Society of Anesthesiology grade 2–3, p = 0.026) and in patients with acalculous cholecystitis (25% vs 4.5%, p = 0.035). The overall readmission rate was 18%. A total of 24 (45.2%) patients had surgery: laparoscopic cholecystectomy, n = 11; laparoscopic converted to open, n = 5; open total cholecystectomy, n = 5; open cholecystectomy, n = 1; laparotomy and washout, n = 1; laparotomy partial cholecystectomy and closure of perforated small intestine and gastrostomy, n = 1. Conclusion: Percutaneous cholecystostomy is a useful temporary or permanent procedure in patients with acute cholecystitis of both calculous and acalculous origin, who are unfit for surgery.

scholarly journals Ropivacaine 0.25% is as Effective as Bupivacaine 0.25% in Providing Surgical Anaesthesia for Lumbar Plexus and Sciatic Nerve Block in High-Risk Patients: Preliminary Report

2007 ◽  
Vol 35 (4) ◽  
pp. 510-514 ◽  
Author(s):  
A. Kocum ◽  
A. Turkoz ◽  
H. Ulger ◽  
M. Sener ◽  
G. Arslan
Keyword(s):  
High Risk ◽  
Sciatic Nerve ◽  
Nerve Block ◽  
Sciatic Nerve Block ◽  
Lumbar Plexus ◽  
Analgesic Requirement ◽  
Rescue Analgesia ◽  
High Risk Patients ◽  
Significant Difference ◽  
Risk Patients

Ropivacaine is potentially less cardiotoxic and neurotoxic than bupivacaine. The aim of this study was to compare the effectiveness of ropivacaine 0.25% and bupivacaine 0.25% for surgical anaesthesia and postoperative analgesia during lumbar plexus and sciatic nerve block in high-risk patients. We performed combined lumbar plexus and sciatic nerve blockade on 62 consecutive ASA III or IV patients undergoing unilateral hip or femur surgery. The first 30 patients received bupivacaine (Group 1) and the remaining 32 patients received ropivacaine (Group 2). Perioperative management was otherwise similar. The groups were compared for the time of onset of the block, additional analgesics and sedatives required, time from end of surgery to the first analgesic requirement and the need for rescue analgesia. Ninety percent (29/32) of the patients in the ropivacaine group and 86% (26/30) of the patients in the bupivacaine group reached surgical anaesthesia. The time from the end of the surgery to the first analgesic requirement was similar between the two groups (10.3±5.2 hours for ropivacaine, 11.2±4.6 hours for bupivacaine). There was no statistically significant difference between the two groups in any of the measured variables (P>0.05). The results of this preliminary study suggest that ropivacaine 0.25% is as effective as bupivacaine 0.25% when used for blocking lumbar plexus and sciatic nerve in high-risk patients undergoing hip or femur surgery.

scholarly journals Popliteal Nerve Block as an Alternative to Spinal Anaesthesia for Ankle Surgery in Comorbid Patient- A Case Report

2021 ◽  
Author(s):  
Priya Kishnani ◽  
Dharmishthaben Chakarani ◽  
Jigisha Mehta ◽  
Malini Mehta
Keyword(s):  
Case Report ◽  
High Risk ◽  
Peripheral Nerve ◽  
General Anaesthesia ◽  
Nerve Block ◽  
Nerve Blocks ◽  
Neuraxial Blockade ◽  
High Risk Patients ◽  
Neuraxial Block ◽  
Risk Patients

In high-risk patients with significant cardiovascular and other systemic disorders, administration of central neuraxial block or general anaesthesia is usually associated with adverse haemodynamic effects and high perioperative mortality. This case report is about a 57-year-old male patient with known case of Diabetes Mellitus (DM) posted for lower limb debridement. He had comorbidities like cellulitis, sepsis, uncontrolled diabetes, multiorgan dysfunction and was haemodynamically unstable. Peripheral nerve blockade keeps the haemodynamic more stable as compared to central neuraxial blockade and general anaesthesia. Therefore, popliteal nerve block was given to the patient in prone position. Peripheral nerve locator was used and after eliciting the response of foot twitch local anaesthetic drug was deposited. Adequate sensory motor block was achieved and surgery was carried out uneventfully. Patient was vitally stable throughout the surgery. Thus, it was seen that peripheral nerve blocks are an effective alternative to central neuraxial blockade and general anaesthesia in high risk patients undergoing below knee surgeries.

Sign in / Sign up

Export Citation Format

Share Document