Ebook Handbook of clinical anesthesia (7/E): Part 2
➤ Gửi thông báo lỗi ⚠️ Báo cáo tài liệu vi phạmNội dung chi tiết: Ebook Handbook of clinical anesthesia (7/E): Part 2
Ebook Handbook of clinical anesthesia (7/E): Part 2
Anesthesia for Surgical Subspecialtiesc y yNPeripheral Nerve BlockadeRegional anesthesia enables site-specific, long-lasting, and effective anesthesia Ebook Handbook of clinical anesthesia (7/E): Part 2a and analgesia (Tsui BCH, Rosenquist RW. Peripheral nerve blockade. In: Barash PG. Cullen BE, Stocking RK. Cahalan MR. Ortega R, Stock MC, eds. Cìỉnicaì Anesthesia. Philadelphia: Lippincott Williams & Wilkins; 2013:937 995). Peripheral nerve blocks (PNBs) can be used as the only anesthetic, as a su Ebook Handbook of clinical anesthesia (7/E): Part 2pplement to provide analgesia and muscle relaxation along with general anesthesia, or as the initial step in the provision of prolonged postoperativeEbook Handbook of clinical anesthesia (7/E): Part 2
analgesia such as with intercostal blocks or continuous peripheral nerve catheters. The two most common techniques for nerve localization and block peAnesthesia for Surgical Subspecialtiesc y yNPeripheral Nerve BlockadeRegional anesthesia enables site-specific, long-lasting, and effective anesthesia Ebook Handbook of clinical anesthesia (7/E): Part 2regional anesthesia in recent years has been the introduction of anatomically based US imaging to visualize the target nerve. In many situations, it is prudent to combine the two technologies of NS and US imaging to achieve the goal of 100% success with all regional blocks.A.Setup and Monitoring (Ta Ebook Handbook of clinical anesthesia (7/E): Part 2ble 35-1)B.Common Techniques: Nerve Stimulation1. Basics of Technique and Equipment. A low-current electrical impulse applied to a peripheral nerve prEbook Handbook of clinical anesthesia (7/E): Part 2
oduces stimulation of motor fibers and theoretically identifies proximity to the nerve without actual needle contact of536 Anesthesia for Surgical SubAnesthesia for Surgical Subspecialtiesc y yNPeripheral Nerve BlockadeRegional anesthesia enables site-specific, long-lasting, and effective anesthesia Ebook Handbook of clinical anesthesia (7/E): Part 2ologist.The area should be of ample size to allow block performance, monitoring, and resuscitation of patients.There should be equipment for oxygen delivery, emergency airway management, and suction, and the area should have sufficient lighting.A practically organized equipment storage cart is desir Ebook Handbook of clinical anesthesia (7/E): Part 2able and should contain all of the necessary equipment (including equipment required for emergency procedures).A selection of sedatives, hypnotics, anEbook Handbook of clinical anesthesia (7/E): Part 2
d intravenous anesthetics should be immediately available to prepare patients for regional anesthesia.Emergency drugs (atropine, epinephrine, phenylepAnesthesia for Surgical Subspecialtiesc y yNPeripheral Nerve BlockadeRegional anesthesia enables site-specific, long-lasting, and effective anesthesia Ebook Handbook of clinical anesthesia (7/E): Part 2of regional anesthesia, it is vital to have skilled personnel monitor the patient at all times (electrocardiography, noninvasivc blood pressure, pulse oximetry, and level of consciousness of the patient should be gauged frequently using verbal contact because vasovagal episodes are common with many Ebook Handbook of clinical anesthesia (7/E): Part 2regional procedures).The patient should be closely observed for systematic toxicity (within 2 minutes for at least 30 minutes after the procedure).BefEbook Handbook of clinical anesthesia (7/E): Part 2
ore performing blocks with significant sympathetic effects, a baseline blood pressure reading should be obtained.proposed dose in divided aliquots. AfAnesthesia for Surgical Subspecialtiesc y yNPeripheral Nerve BlockadeRegional anesthesia enables site-specific, long-lasting, and effective anesthesia Ebook Handbook of clinical anesthesia (7/E): Part 2vision of continuous analgesia.c. Common Techniques: Ultrasound Imaging1. Basics of Technique and Equipment. US images reflect contours, including those of anatomic structures, based on differing acoustic impedances of tissue or fluids. The Doppler effect can be very useful for identifying bloodPeri Ebook Handbook of clinical anesthesia (7/E): Part 2pheral Nerve Blockade 537US-guided PNB, it is effective to first identify one or more reliable anatomic landmarks (bone or vessel) with a known relatiEbook Handbook of clinical anesthesia (7/E): Part 2
onship to the nerve structure (Table 35-2). The nerve structure is often placed in the center of the screen to guarantee that aligning the needle puncAnesthesia for Surgical Subspecialtiesc y yNPeripheral Nerve BlockadeRegional anesthesia enables site-specific, long-lasting, and effective anesthesia Ebook Handbook of clinical anesthesia (7/E): Part 2s), a 1- to 2-mL test dose of local anesthetic or dextrose 5% in water (D5W) can be injected to visualize the spread. The solution will be seen as a hypoechoic expansion and often illuminates the surrounding area, enabling better visibility of the nerves and block needle.D.Other Related Equipment1Ne Ebook Handbook of clinical anesthesia (7/E): Part 2edles used for regional techniques are often modified from standard injection needles. (Continuous blocks require larger bore needles to facilitate caEbook Handbook of clinical anesthesia (7/E): Part 2
theter introduction.)2Catheters amenable to stimulation (with an electrode placed into the catheter lip) may enable more accurate advancement of catheAnesthesia for Surgical Subspecialtiesc y yNPeripheral Nerve BlockadeRegional anesthesia enables site-specific, long-lasting, and effective anesthesia Ebook Handbook of clinical anesthesia (7/E): Part 2he incidence of some complications may be higher in PNB than other regional anesthesia or analgesia techniques, and these complications can be devastating. Choosing a suitable patient and applying the right dose of local anesthetic in the correct location arethe primary considerations. Follow-up bef Ebook Handbook of clinical anesthesia (7/E): Part 2ore and after discharge is equally important.IL SPECIFIC TECHNIQUES: HEAD AND NECK, UPPER EXTREMITIES, CHEST, AND ABDOMENA. Head and Neck (Figs. 35-1Ebook Handbook of clinical anesthesia (7/E): Part 2
to 35-4)1. Cervical Plexus Blocks. Anesthesia of the deep or superficial cervical plexus or both can be used for procedures of the lateral or anteriorAnesthesia for Surgical Subspecialtiesc y yNPeripheral Nerve BlockadeRegional anesthesia enables site-specific, long-lasting, and effective anesthesiaAnesthesia for Surgical Subspecialtiesc y yNPeripheral Nerve BlockadeRegional anesthesia enables site-specific, long-lasting, and effective anesthesiaGọi ngay
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