New Concept of Fusion Technics in Regional Anesthesia
The aim of this review article is to introduce a newer approach to multimodal anesthesia. In addition to the usual combination of epidural catheter and general anesthesia as standard techniques in surgical procedures accompanied by intense postoperative pain, we want to encourage reflection on th...
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Sestre Milosrdnice University hospital, Institute of Clinical Medical Research
2022-01-01
|
| Series: | Acta Clinica Croatica |
| Subjects: | |
| Online Access: | https://hrcak.srce.hr/file/411625 |
| _version_ | 1828342320636887040 |
|---|---|
| author | Lada Kalagac Fabris Maša Biberić Siniša Zrna |
| author_facet | Lada Kalagac Fabris Maša Biberić Siniša Zrna |
| author_sort | Lada Kalagac Fabris |
| collection | DOAJ |
| description | The aim of this review article is to introduce a newer approach to multimodal anesthesia.
In addition to the usual combination of epidural catheter and general anesthesia as standard
techniques in surgical procedures accompanied by intense postoperative pain, we want to encourage
reflection on the application of various regional techniques in equally complex surgical conditions. By
simply modifying the standard neuraxial technique with a higher thoracic approach, excellent abdominal
surgery can be performed to awake the patient. However, placement of an epidural catheter is not
always possible due to technical difficulties or patient-related conditions that contraindicate its insertion.
Trunk-level fascia blocks (PVB, ESPB, RLB) are simple, safe alternative to an epidural catheter
because the transverse process, which is the target of ultrasound, is easily visualized and the injection
site is away from neuroaxis, pleura, and large vascular structures. In addition, extensive craniocaudal
diffusion of anesthetics allows wide coverage with a single injection. It has been confirmed that
PVB, ESPB, RLB blocks act on visceral and somatic pain. Therefore, their ultrasound-guided use in
laparoscopic and other abdominal surgeries may be useful. With a well-designed fusion of regional
techniques in operations of the upper and lower abdomen, it is possible to achieve hemodynamically
and respiratory stable anesthesia in an awake patient with reduced postoperative pain. |
| first_indexed | 2024-04-13T23:28:10Z |
| format | Article |
| id | doaj.art-b24712b8f10c43ee870b55989dce03b4 |
| institution | Directory Open Access Journal |
| issn | 0353-9466 1333-9451 |
| language | English |
| last_indexed | 2024-04-13T23:28:10Z |
| publishDate | 2022-01-01 |
| publisher | Sestre Milosrdnice University hospital, Institute of Clinical Medical Research |
| record_format | Article |
| series | Acta Clinica Croatica |
| spelling | doaj.art-b24712b8f10c43ee870b55989dce03b42022-12-22T02:25:00ZengSestre Milosrdnice University hospital, Institute of Clinical Medical ResearchActa Clinica Croatica0353-94661333-94512022-01-0161.Supplement 2135144New Concept of Fusion Technics in Regional AnesthesiaLada Kalagac Fabris0Maša Biberić1Siniša Zrna2Department of Anesthesiology, Intensive Medicine and Pain Therapy General Hospital Pula, Pula, CroatiaDepartment of Anesthesiology, Intensive Medicine and Pain Therapy General Hospital Pula, Pula, CroatiaDepartment of Anesthesiology, Intensive Medicine and Pain Therapy General Hospital Pula, Pula, CroatiaThe aim of this review article is to introduce a newer approach to multimodal anesthesia. In addition to the usual combination of epidural catheter and general anesthesia as standard techniques in surgical procedures accompanied by intense postoperative pain, we want to encourage reflection on the application of various regional techniques in equally complex surgical conditions. By simply modifying the standard neuraxial technique with a higher thoracic approach, excellent abdominal surgery can be performed to awake the patient. However, placement of an epidural catheter is not always possible due to technical difficulties or patient-related conditions that contraindicate its insertion. Trunk-level fascia blocks (PVB, ESPB, RLB) are simple, safe alternative to an epidural catheter because the transverse process, which is the target of ultrasound, is easily visualized and the injection site is away from neuroaxis, pleura, and large vascular structures. In addition, extensive craniocaudal diffusion of anesthetics allows wide coverage with a single injection. It has been confirmed that PVB, ESPB, RLB blocks act on visceral and somatic pain. Therefore, their ultrasound-guided use in laparoscopic and other abdominal surgeries may be useful. With a well-designed fusion of regional techniques in operations of the upper and lower abdomen, it is possible to achieve hemodynamically and respiratory stable anesthesia in an awake patient with reduced postoperative pain.https://hrcak.srce.hr/file/411625SpinalEpiduralUS guided blockPVBESPRLB |
| spellingShingle | Lada Kalagac Fabris Maša Biberić Siniša Zrna New Concept of Fusion Technics in Regional Anesthesia Acta Clinica Croatica Spinal Epidural US guided block PVB ESP RLB |
| title | New Concept of Fusion Technics in Regional Anesthesia |
| title_full | New Concept of Fusion Technics in Regional Anesthesia |
| title_fullStr | New Concept of Fusion Technics in Regional Anesthesia |
| title_full_unstemmed | New Concept of Fusion Technics in Regional Anesthesia |
| title_short | New Concept of Fusion Technics in Regional Anesthesia |
| title_sort | new concept of fusion technics in regional anesthesia |
| topic | Spinal Epidural US guided block PVB ESP RLB |
| url | https://hrcak.srce.hr/file/411625 |
| work_keys_str_mv | AT ladakalagacfabris newconceptoffusiontechnicsinregionalanesthesia AT masabiberic newconceptoffusiontechnicsinregionalanesthesia AT sinisazrna newconceptoffusiontechnicsinregionalanesthesia |