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287
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Posters
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Peripheral Nerve Block
287. The use of ultrasound guided regional anaesthesia in a rural developing area in india for plastic and orthopaedic operations U. Oberndofer, M. Weintraud, S. Kettner, P. Marhofer [email protected] Department of Anesthesiology & Intensive Care Medicine, Medical University Vienna, Vienna, Austria Background: A non government aid organisation (“Asha Vihar”) performs orthopaedic and plastic operations on local patients (mainly children) in a developing part in the north of India. Therefore two anaesthetists, well experienced in the technique of ultrasound guided nerve blocks were sent to India to support this organisation. Due to poor ventilation facilities, the aim for the anaesthetic management was to avoid any kind of airway-management. Therefore various operations should be done under ultrasound guided peripheral nerve blocks in combination with mild sedation. Methods: After rectal premedication with Midazolam and Ketamin S (each 1mg/kg) and establishment of a venous access, the ultrasound guided nerve blocks were performed with a SonoSite 180 plus transportable ultrasound equipment. Intraoperatively the patients were sedated with Propofol (continuous infusion or titrated bolus on demand). The patients, most of them children between 0-2 years were breathing spontaneously with oxygen supply via a facial mask. All patients received paracetamol suppositories (30 mg/kg) for postoperative pain therapy. Results: We performed 111 brachial and lumbosacral plexus nerve blocks on 41 patients. The rate of success of the blocks was 100%, which enabled us to perform all operations without any disturbance. None of our patients required any emergency airway management during or after surgery. No additional opioids were required during the operations. Summary: Ultrasound guided regional blocks offers the opportunity to perform safe anaesthesia under difficult circumstances. Furthermore, the results illustrate the potency of ultrasound guided peripheral regional anaesthesia in children in terms of avoidance of general anaesthesia and realization of adequate perioperative pain management.
Posters
•
Peripheral Nerve Block
287. The use of ultrasound guided regional anaesthesia in a rural developing area in india for plastic and orthopaedic operations U. Oberndofer, M. Weintraud, S. Kettner, P. Marhofer [email protected] Department of Anesthesiology & Intensive Care Medicine, Medical University Vienna, Vienna, Austria Background: A non government aid organisation (“Asha Vihar”) performs orthopaedic and plastic operations on local patients (mainly children) in a developing part in the north of India. Therefore two anaesthetists, well experienced in the technique of ultrasound guided nerve blocks were sent to India to support this organisation. Due to poor ventilation facilities, the aim for the anaesthetic management was to avoid any kind of airway-management. Therefore various operations should be done under ultrasound guided peripheral nerve blocks in combination with mild sedation. Methods: After rectal premedication with Midazolam and Ketamin S (each 1mg/kg) and establishment of a venous access, the ultrasound guided nerve blocks were performed with a SonoSite 180 plus transportable ultrasound equipment. Intraoperatively the patients were sedated with Propofol (continuous infusion or titrated bolus on demand). The patients, most of them children between 0-2 years were breathing spontaneously with oxygen supply via a facial mask. All patients received paracetamol suppositories (30 mg/kg) for postoperative pain therapy. Results: We performed 111 brachial and lumbosacral plexus nerve blocks on 41 patients. The rate of success of the blocks was 100%, which enabled us to perform all operations without any disturbance. None of our patients required any emergency airway management during or after surgery. No additional opioids were required during the operations. Summary: Ultrasound guided regional blocks offers the opportunity to perform safe anaesthesia under difficult circumstances. Furthermore, the results illustrate the potency of ultrasound guided peripheral regional anaesthesia in children in terms of avoidance of general anaesthesia and realization of adequate perioperative pain management.