دورية أكاديمية
أعرض في EDS

Intraoperative ultrasound-guided pectoral nerve blocks for cardiac implantable device procedures.

التفاصيل البيبلوغرافية
العنوان: Intraoperative ultrasound-guided pectoral nerve blocks for cardiac implantable device procedures.
المؤلفون: Patel NA; Cardiac Electrophysiology, University of Pennsylvania, Philadelphia, PA, USA., Lin D; Cardiac Electrophysiology, University of Pennsylvania, Philadelphia, PA, USA., Ha B; Department of Anesthesiology, University of Pennsylvania, Philadelphia, PA, USA., Hyman MC; Cardiac Electrophysiology, University of Pennsylvania, Philadelphia, PA, USA., Nazarian S; Cardiac Electrophysiology, University of Pennsylvania, Philadelphia, PA, USA., Frankel DS; Cardiac Electrophysiology, University of Pennsylvania, Philadelphia, PA, USA., Epstein AE; Cardiac Electrophysiology, University of Pennsylvania, Philadelphia, PA, USA., Marchlinski FE; Cardiac Electrophysiology, University of Pennsylvania, Philadelphia, PA, USA., Markman TM; Cardiac Electrophysiology, University of Pennsylvania, Philadelphia, PA, USA. Timothy.markman@pennmedicine.upenn.edu.
المصدر: Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing [J Interv Card Electrophysiol] 2024 Sep; Vol. 67 (6), pp. 1353-1357. Date of Electronic Publication: 2023 Dec 18.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Springer Country of Publication: Netherlands NLM ID: 9708966 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1572-8595 (Electronic) Linking ISSN: 1383875X NLM ISO Abbreviation: J Interv Card Electrophysiol Subsets: MEDLINE
أسماء مطبوعة: Publication: Amsterdam : Springer
Original Publication: Norwell, MA : Kluwer Academic Publishers, c1997-
مواضيع طبية MeSH: Nerve Block*/methods , Defibrillators, Implantable* , Ultrasonography, Interventional* , Thoracic Nerves*, Humans ; Male ; Female ; Aged ; Pain, Postoperative/prevention & control ; Anesthetics, Local/administration & dosage ; Feasibility Studies ; Bupivacaine/administration & dosage ; Middle Aged ; Treatment Outcome ; Pain Measurement ; Lidocaine/administration & dosage ; Pacemaker, Artificial ; Pectoralis Muscles/innervation ; Pectoralis Muscles/surgery
مستخلص: Background: Pectoral nerve (PECs) blocks are established regional anesthesia techniques that can provide analgesia to the anterior chest wall. Although commonly performed preoperatively by anesthesiologists, the feasibility of electrophysiologist-performed PECs blocks from within cardiac implantable electronic device (CIED) pockets at the time of implantation has not been established. The objective of this study is to assess the feasibility of routine PECs blocks performed by the electrophysiologist from within the exposed device pocket at the time of CIED procedures.
Methods: Patients undergoing CIED procedures underwent a PECs I block (15 cc of 1% lidocaine/0.25% bupivacaine) injected between the pectoralis major and minor muscles guided by ultrasound placed in the device pocket, or PECs II block, which included a second injection (15 cc) between pectoralis minor and serratus anterior muscles. Postoperatively, pain was assessed on a numeric scale (0-10) at 1, 2, 4, and 24 h, and 2 weeks after the procedure.
Results: Among 20 patients (age 65 ± 16 years, 70% male, 55% with history of chronic pain), PECs I (75%) and PECs II (25%) blocks were performed. The procedures were de novo implantation (n = 17) or device revision (n = 3). The average pain score in the first 4 h was 0.4 ± 0.8 and 0.3 ± 0.6 at 24 h after the procedure. During the 24-h postoperative period, 4 patients received opioids. Two patients were discharged with opioids for pain unrelated to the procedure.
Conclusions: Intraoperative PECs blocks can be feasibly performed from within an exposed pocket at the time of CIED procedures with minimal postoperative pain.
(© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
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فهرسة مساهمة: Keywords: Cardiac implantable electronic device; PECs blocks; Pectoral nerve blocks; Postoperative pain; Regional anesthesia
المشرفين على المادة: 0 (Anesthetics, Local)
Y8335394RO (Bupivacaine)
98PI200987 (Lidocaine)
تواريخ الأحداث: Date Created: 20231217 Date Completed: 20240906 Latest Revision: 20240906
رمز التحديث: 20240906
DOI: 10.1007/s10840-023-01724-4
PMID: 38105353
قاعدة البيانات: MEDLINE
الوصف
تدمد:1572-8595
DOI:10.1007/s10840-023-01724-4