Subdural Analgesia - Is there a role for that kind of analgesia?
Autor(a) principal: | |
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Data de Publicação: | 2015 |
Outros Autores: | , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | https://doi.org/10.25751/rspa.6306 |
Resumo: | Subdural injections remain a less well recognized complication of neuraxial anaesthesia. We performed a thoracic epidural block for analgesia after multiple rib fractures. A loading dose of ropivacaine 0.2% was given and an infusion started at 5 ml/h. Twenty minutes after, the patient presented symptoms of high sensory block, with no evidence of motor weakness. Subdural catheter position was radiologically confirmed by a thoracic x-ray. The catheter was left in subdural space and the infusion was changed to ropivacaine 0.1% at 2 ml/h and the patient remained hemodynamically stable, maintaining controlled pain, with no need for supplemental analgesia, and without any sedative effects or respiratory depression. There is evidence to support the use of inadvertently inserted subdural catheters to provide continued analgesia, since the attempt of an additional epidural placement may be unsuccessful and the subdural placement may recur. However, the anaesthetist must be aware of possible complications. |
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Subdural Analgesia - Is there a role for that kind of analgesia?Caso ClínicoSubdural injections remain a less well recognized complication of neuraxial anaesthesia. We performed a thoracic epidural block for analgesia after multiple rib fractures. A loading dose of ropivacaine 0.2% was given and an infusion started at 5 ml/h. Twenty minutes after, the patient presented symptoms of high sensory block, with no evidence of motor weakness. Subdural catheter position was radiologically confirmed by a thoracic x-ray. The catheter was left in subdural space and the infusion was changed to ropivacaine 0.1% at 2 ml/h and the patient remained hemodynamically stable, maintaining controlled pain, with no need for supplemental analgesia, and without any sedative effects or respiratory depression. There is evidence to support the use of inadvertently inserted subdural catheters to provide continued analgesia, since the attempt of an additional epidural placement may be unsuccessful and the subdural placement may recur. However, the anaesthetist must be aware of possible complications.Sociedade Portuguesa de Anestesiologia2015-09-08T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articlehttps://doi.org/10.25751/rspa.6306eng0871-6099Bezerra, ClaudiaSantos, ÂngelaLages, NeusaCorreia, Carlosinfo:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2022-09-23T15:34:38Zoai:ojs.revistas.rcaap.pt:article/6306Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T16:04:07.927107Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Subdural Analgesia - Is there a role for that kind of analgesia? |
title |
Subdural Analgesia - Is there a role for that kind of analgesia? |
spellingShingle |
Subdural Analgesia - Is there a role for that kind of analgesia? Bezerra, Claudia Caso Clínico |
title_short |
Subdural Analgesia - Is there a role for that kind of analgesia? |
title_full |
Subdural Analgesia - Is there a role for that kind of analgesia? |
title_fullStr |
Subdural Analgesia - Is there a role for that kind of analgesia? |
title_full_unstemmed |
Subdural Analgesia - Is there a role for that kind of analgesia? |
title_sort |
Subdural Analgesia - Is there a role for that kind of analgesia? |
author |
Bezerra, Claudia |
author_facet |
Bezerra, Claudia Santos, Ângela Lages, Neusa Correia, Carlos |
author_role |
author |
author2 |
Santos, Ângela Lages, Neusa Correia, Carlos |
author2_role |
author author author |
dc.contributor.author.fl_str_mv |
Bezerra, Claudia Santos, Ângela Lages, Neusa Correia, Carlos |
dc.subject.por.fl_str_mv |
Caso Clínico |
topic |
Caso Clínico |
description |
Subdural injections remain a less well recognized complication of neuraxial anaesthesia. We performed a thoracic epidural block for analgesia after multiple rib fractures. A loading dose of ropivacaine 0.2% was given and an infusion started at 5 ml/h. Twenty minutes after, the patient presented symptoms of high sensory block, with no evidence of motor weakness. Subdural catheter position was radiologically confirmed by a thoracic x-ray. The catheter was left in subdural space and the infusion was changed to ropivacaine 0.1% at 2 ml/h and the patient remained hemodynamically stable, maintaining controlled pain, with no need for supplemental analgesia, and without any sedative effects or respiratory depression. There is evidence to support the use of inadvertently inserted subdural catheters to provide continued analgesia, since the attempt of an additional epidural placement may be unsuccessful and the subdural placement may recur. However, the anaesthetist must be aware of possible complications. |
publishDate |
2015 |
dc.date.none.fl_str_mv |
2015-09-08T00:00:00Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://doi.org/10.25751/rspa.6306 |
url |
https://doi.org/10.25751/rspa.6306 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
0871-6099 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.publisher.none.fl_str_mv |
Sociedade Portuguesa de Anestesiologia |
publisher.none.fl_str_mv |
Sociedade Portuguesa de Anestesiologia |
dc.source.none.fl_str_mv |
reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
instname_str |
Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
instacron_str |
RCAAP |
institution |
RCAAP |
reponame_str |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
collection |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
repository.name.fl_str_mv |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
repository.mail.fl_str_mv |
|
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1799130504511881216 |