Premium
Ultrasound‐guided perineural catheter and local anesthetic infusion in the perioperative management of pediatric limb salvage: a case report
Author(s) -
LOLAND VANESSA J.,
ILFELD BRIAN M.,
ABRAMS REID A.,
MARIANO EDWARD R.
Publication year - 2009
Publication title -
pediatric anesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.704
H-Index - 82
eISSN - 1460-9592
pISSN - 1155-5645
DOI - 10.1111/j.1460-9592.2009.03103.x
Subject(s) - medicine , brachial plexus , ropivacaine , surgery , local anesthetic , anesthesia , amputation , catheter , forearm , perfusion , perioperative , radiology
Summary Local anesthetic perineural infusion has emerged as an effective analgesic technique in pediatric patients, but it can also complement surgical perioperative management in complex cases that require optimal tissue perfusion such as limb salvage. We report the successful use of brachial plexus perineural infusion in the care of a child following near‐amputation of her dominant hand. An ultrasound‐guided infraclavicular brachial plexus catheter was placed in the recovery room after complex reconstructive surgery and a continuous infusion of 0.2% ropivacaine maintained for 24 days. The resultant sympathectomy was integral to providing distal limb perfusion despite partial restenosis of the surgical revascularization.