Importance of sympathectomy induced by continuous brachial plexus block for digital replantation in a patient with liver cirrhosis: Case report

Publication date: Available online 5 May 2015 Source:Colombian Journal of Anesthesiology Author(s): Rosana Guerrero-Domínguez , Daniel López-Herrera-Rodríguez , Guiomar Fernández-Castelllano , Fernando Federero , Ignacio Jiménez Hand microsurgeries are procedures performed by reconstructive surgeons and require a complex and highly individualized approach. The management of anesthesia in patients with cirrhosis may be challenging. Liver dysfunction may condition the extended use of anesthetic agents as a result of a disrupted metabolism and clearance. This case describes the anesthetic management of a patient with cirrhosis, using a combined anesthetic technique with continuous axillary block of the brachial plexus to prevent postoperative pain and maintain extended vasodilatation. The continuous brachial plexus block under local anesthesia has shown improved tissue perfusion following limb replantation surgery. This technique is particularly helpful to prevent vasospasm in the reconstructed tissue during the postoperative period. In patients with cirrhosis, this technique provides adequate postoperative pain control.
Source: Colombian Journal of Anesthesiology - Category: Anesthesiology Source Type: research