English (United Kingdom)

https://curated-unify.zendy.io/wp-json/zendy-region/v1/featured_content/oa?rat=en

https://curated-unify.zendy.io/wp-json/zendy-region/v1/highlighted_journal/

Global: Zendy Plus annual

Presents the access of premium content as premium feature

Premium Content

Presents the keyphrase highlighting as premium feature

Keyphrase Highlighting

Presents the summarisation as premium feature

Summarisation

Insights

Presents the pdf analysis as premium feature

PDF Analysis

Presents the zaia usage as premium feature

ZAIA

Global: Zendy Tools annual

Global: Zendy Free Plan

Global: Zendy Tools monthly

Global: Zendy Plus monthly

La tecnica analgesica de eleccion para el control del dolor postoperatorio tras una cirugia de torax sigue siendo la analgesia epidural. En los ultimos 10 anos, varios estudios han presentado al bloqueo paravertebral continuo como igualmente efectivo e incluso mas seguro con pocas complicaciones graves asociadas. Presentamos el caso de una paciente de 73 anos, ASA III, sometida a cirugia de reseccion pulmonar con colocacion de un cateter paravertebral por vision directa del cirujano para analgesia postoperatoria. 5 horas mas tarde la paciente presento clinica de bloqueo epidural alto (sensitivo hasta T1, motor hasta T4). Se detuvo la infusion de anestesico local, y se confirmo la localizacion de la punta del cateter mediante imagen radiologica con contraste. En este caso, la migracion del cateter cuestiona la sensacion de mayor seguridad de esta tecnica y hace enfasis en la necesidad de mantener una monitorizacion estricta de cualquier procedimiento que realicemos. ABSTRACT High epidural block after migration of paravertebral catheter placed by surgeon’s direct vision for post-thoracotomy analgesia The analgesic technique of choice for postoperative pain control after thoracic surgery remains a thoracic epidural analgesia. In the last 10 years, many studies have shown continuous paravertebral block as equally effective and even safer, with few cases of serious associated complications. We present the case of a 73-year-old female, ASA III, undergoing a left atypical pulmonary resection with intraoperative placement of a paravertebral catheter by surgeon’s direct vision for postoperative analgesia.5 hours later she presented a high epidural block (T1 sensitive, T4 motor). Local anaesthetic infusion was stopped, and the epidural catheter’s tip location was confirmed by contrast radiological image. In our case, catheter’s migration questions the sense of greater safety of this technique and emphasizes the mandatory need of strict monitoring in any performed procedure.

Bloqueo epidural alto por migración de un catéter paravertebral colocado mediante visión directa del cirujano para control analgésico tras toracotomía