Volume 7, Issue 2, December 2019, Page: 35-37
Continuous ESP Block Technique for an Open Thoracotomy in Neurofibromatosis Patient
Matheus de Castro Abi-Ramia Chimelli, Department of Anesthesiology, Hospital Federal da Lagoa, Rio de Janeiro, Brazil
Amanda Caroline Figueiredo Gomes Andrade, Department of Anesthesiology, Hospital Federal da Lagoa, Rio de Janeiro, Brazil
Marcelo Grisólia Gonçalo, Department of Anesthesiology, Hospital Federal da Lagoa, Rio de Janeiro, Brazil
Clarissa Mayara de Sales Guimarães, Department of Anesthesiology, Hospital Federal da Lagoa, Rio de Janeiro, Brazil
Carlos Frederico Panisset Lanhas La Cava, Department of Anesthesiology, Hospital Federal da Lagoa, Rio de Janeiro, Brazil
Carlos Darcy Alves Bersot, Department of Anesthesiology, Hospital Federal da Lagoa, Rio de Janeiro, Brazil
Received: Nov. 9, 2019;       Accepted: Dec. 17, 2019;       Published: Dec. 30, 2019
DOI: 10.11648/j.ass.20190702.12      View  29      Downloads  18
Abstract
Neurofibromatosis remains a challenge for the anesthesiologist as it brings issues especially regarding safety of anesthetic management such as airway management and neuraxial anesthesia. We report a case of a 60 year-old woman with controlled clinical comorbidities and neurofibromatosis, admitted for an open thoracotomy for excision of a growing pulmonary lesion, highly suspicious for malignancy. She had cutaneous tumors covering the majority of her skin. No neuroimage was available to exclude neuraxial or intracranial tumors, ensuring the safety for neuraxial anesthesia, therefore a combined technique was proposed with general anesthesia and a continuous erector spinae plane (ESP) block for anesthesia and analgesia. Surgery occurred successfully and there was no need to supplement or alter the initially planned anesthetic technique. Patient referred pain score ranging from 0-1 in rest and motion postoperative and required no complementary opioid for pain control. Infusion in the ESP catheter was maintained for 48h, after which it was removed and patient discharged without further complications or pain.
Keywords
ESP Block Technique, Thoracotomy, Neurofibromatosis Patient, Anesthesia
To cite this article
Matheus de Castro Abi-Ramia Chimelli, Amanda Caroline Figueiredo Gomes Andrade, Marcelo Grisólia Gonçalo, Clarissa Mayara de Sales Guimarães, Carlos Frederico Panisset Lanhas La Cava, Carlos Darcy Alves Bersot, Continuous ESP Block Technique for an Open Thoracotomy in Neurofibromatosis Patient, Advances in Surgical Sciences. Vol. 7, No. 2, 2019, pp. 35-37. doi: 10.11648/j.ass.20190702.12
Copyright
Copyright © 2019 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Reference
[1]
Hirsch NP, Murphy A, Radcliffe JJ. Neurofibromatosis: clinical presentations and anaesthetic implications. Br J Anaesth. 2001; 86: 555-564.
[2]
Crowe FW, Schull WJ, Neel JV. A Clinical, Pathological, and Genetic Study of Multiple Neurofibromatosis. Springfield, IL: Charles C. Thomas, 1956.
[3]
Fox CJ, Tomaijian S, Kaye AJ, et al. Perioperative management of neurofibromatosis type 1. Ochsner J 2012; 12: 111-121.
[4]
McSwain JR, Doty JW, Wilson SW. Regional anesthesia in patients with pre-existing neurologic disease. Curr Opin Anesthesiol 2014; 27: 538-543.
[5]
Forero M, Adhikary SD, Lopez H. The Erector Spinae Plane Block: A Novel Analgesic Technique in Thoracic Neuropathic Pain. Reg Anesth Pain Med 2016; 41: 621-627.
[6]
Chin KJ, Adhikary S, Sarwani N, et al. The analgesic efficacy of pre-operative bilateral erector spinae plane (ESP) blocks in patients having ventral hernia repair. Anaesthesia 2017; 72: 1-8.
[7]
Chin KJ, Malhas L, Perlas A. The Erector Spinae Plane Block Provides Visceral Abdominal Analgesia in Bariatric Surgery. Reg Anesth Pain Med 2017; 42: 372-376.
[8]
Freise H, Van Aken HK. Risks and Benefits of thoracic epidural anaesthesia. British Journal of Anaesthesia. 2011; 107 (6): 859-868.
[9]
Block BM, Liu SS, Rowlingson AJ, et al. Efficacy of Postoperative Epidural Analgesia: A Metanalysis. JAMA 2003; 290: 2455-2463.
[10]
Williams UU, Zavala AM, Van Meter A, et al. Unanticipated Compression of the Trachea in a 5-month-old Undergoing an MRI for Evaluation of Neurofibromatosis. A&A Case Reports 2017; 8: 1-3.
[11]
Spiegel JE, Hapgood A, Hess PE. Epidural anesthesia in a parturient with neurofibromatosis type 2 undergoing cesarean section. International Journal of Obstetric Anesthesia. 2005; 14: 336-339.
[12]
Esler MD, Durbridge J, Kirby S. Epidural haematoma after dural puncture in a parturient with neurofibromatosis. Br J Anaesth 2001; 87: 932-934.
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