The Lung Point Early Identification of Pneumothorax on Point of Care Ultrasound

Source: Anesthesiology - Category: Anesthesiology Source Type: research

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We report a case of a 41-year-old male with anticipated difficult airway undergoing a repair of a bilateral radial fracture under bilateral sequential brachial plexus block. Anesthesiologists are reluctant to perform bilateral blocks because of the fear of complications like diaphragmatic paralysis, local anesthetic (LA) toxicity, and pneumothorax. We advise that with the correct application of LA pharmacokinetics, careful patient selection and usage of ultrasound, bilateral blocks can be done safely. We used chloroprocaine as an LA in one of the blocks to reduce the dose required for the more toxic LAs. chloroprocaine's f...
Source: Local and Regional Anesthesia - Category: Anesthesiology Tags: Local Reg Anesth Source Type: research
In recent years, thoracic paravertebral block (TPVB) has become one of the most widespread techniques for perioperative analgesia in patients undergoing thoracic surgery. The reason for such reevaulation of the TPVB is ultrasound guidance, which identifies the thoracic paravertebral space (TPVS), guides needle placement, and monitors the spread of local anesthesia solutions.1 Moreover, the ultrasound-guided (USG) approach reduces complications such as pleural puncture and pneumothorax.2 There are many different techniques of performing USG TPVB, but the “indispensable prerequisite” is to establish an optimal ax...
Source: Journal of Cardiothoracic and Vascular Anesthesia - Category: Anesthesiology Authors: Tags: Letter to the Editor Source Type: research
​Seventy-five percent of trauma injuries involve some kind of thoracic insult, a quarter of which need a procedural intervention like a chest tube. (Surg Clin North Am 2007;87[1]:95; http://bit.ly/2HaoX90.) Long-term illness, lung disease, and post-operative complications may cause pleural effusions or a pneumothorax, so treating these conditions quickly can significantly decrease patient morbidity and mortality. Other indications for chest tube placement include:Trauma: Pneumothorax, hemopneumothorax, or tension pneumothoraxLong-term illness: Pleural effusion (cancer, pneumonia)Infection: Empyema, purulent pleuriti...
Source: The Procedural Pause - Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
Abstract Lung ultrasound is an underrated tool in preclinical emergency situations, intensive care units, ORs and emergency rooms. For certain clinical questions, there is a drastically higher sensitivity in comparison to chest X-ray examinations (sensitivity in pneumothorax diagnostics 86 vs. 28%, specificity 97 vs. 100%. A standardized examination improves the quality of the ultrasound examination and thus the diagnostic value. The article provides basic information on pulmonary ultrasound and aims to highlight the superiority of ultrasound over x-ray procedures for anesthesia, intensive care and emergency medic...
Source: Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS - Category: Intensive Care Authors: Tags: Anasthesiol Intensivmed Notfallmed Schmerzther Source Type: research
Conclusions: TBLC guided by radial EBUS mini-probe is novel, efficient, feasible and safe method for histological diagnosis of ILDs.
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Interventional Pulmonology Source Type: research
Pleural disease is an increasingly common presentation and local anaesthetic thoracoscopy (LAT) is becoming widely available throughout the UK. When there is little or no pleural fluid present at the time of LAT the use of a Boutin needle can decrease the number of patients requiring video assisted thorascopic surgery. All patients who underwent LAT, between October 2013-July 2017, at Royal Hampshire County Hospital were reviewed. All cases where a Boutin needle was used were identified. Each patient had a thoracic ultrasound (TUS) in the lateral decubitus position prior to the start of the LAT, lidocaine was used to anaes...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Interventional Pulmonology Source Type: research
We read with interest the recent paper discussing an ultrasound guided oblique intercostal approach for paravertebral catheters placement in 2 neonates scheduled for tracheoesophageal fistula repair [1]. While we applaud the author's choice of using for paravertebral catheters (PVBCs) in such small neonates, we question the technique used; an ultrasound image was not presented, and the figure and block details do not seem to be in concordance with the approach used. The depth of paravertebral space with intercostal approach is only few millimiters, making this approach extremely challenging, with a high risk of pneumothora...
Source: Journal of Clinical Anesthesia - Category: Anesthesiology Authors: Tags: Correspondence Source Type: research
Purpose of review Ultrasound guidance has become the accepted standard of practice for peripheral regional anesthesia. Despite evidence supporting the efficacy of ultrasound-guided regional anesthesia, its impact on patient safety has been less clear. Recent findings Evidence has been consistent that ultrasound guidance reduces the incidence of vascular injury, local anesthetic systemic toxicity, pneumothorax and phrenic nerve block. Within the limited global scope of the epidemiology and etiologic complexity of perioperative (including block-related) peripheral nerve injury, there has not been consistent evidence tha...
Source: Current Opinion in Anaesthesiology - Category: Anesthesiology Tags: REGIONAL ANESTHESIA: Edited by Nabil M. Elkassabany Source Type: research
Low risk of pneumothorax, catheter misplacement after ultrasound - guided procedure
Source: Pulmonary Medicine News - Doctors Lounge - Category: Respiratory Medicine Tags: Pulmonology, Radiology, Surgery, Anesthesiology & amp; Pain, Critical Care, Journal, Source Type: news
Proficiency in echocardiography and lung ultrasound has become essential for anesthesiologists and critical care physicians. Nonetheless, comprehensive echocardiography measurements often are time-consuming and technically challenging, and conventional 2-dimensional images do not permit evaluation of specific conditions (eg, systolic anterior motion of the mitral valve, pneumothorax), which have important clinical implications in the perioperative setting. M-mode (motion-based) ultrasonographic imaging, however, provides the most reliable temporal resolution in ultrasonography.
Source: Journal of Cardiothoracic and Vascular Anesthesia - Category: Anesthesiology Authors: Tags: Expert Review Source Type: research
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