Aplikasi klinis Continous Interscalene Block

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The brachial plexus block was started by Ansbro in 1946. In 1999, Boezaart published a new technique, namely continuous interscalene block. Most of these methods have problems with inaccurate catheter placement or catheter dislocation. Continuous Interscalene Block (CISB) is a proximal brachial plexus block in the neck that can be performed through an anterior or posterior approach. The anterior approach is also called True Continuous Interscalene Block and the posterior approach is known as the Continuous Cerval Paravertebral Block. CISB is indicated after a major shoulder surgery, lateral clavicula, acromiocalvicular joint and proximal humerus and can also be used to treat chronic upper limb pain. Continuous Interscalene Block (CISB) complications are similar to single ISB injections, although the incidence of diaphragmatic paralysis due to the frenic nerve block has been reported to be significantly reduced. , 2-0.75%. The concentration used depends on the patient's factors, the purpose of the block (analgesia or anesthesia), and the absence of a catheter. If there is a catheter, the initial bolus dose can be reduced and additional local anesthesia can be injected through a catheter. Continuous infusion of rovipacaine 0.2% 4-10 ml / hour can be used for postoperative analgesia. The use of a continuous infusion of bupivacaine 0.125% with a speed of 0.125 ml / kg per hour can also efficiently treat pain. Compared to continuous techniques, the PCRA technique (Patient control regional analgesia) with a low basal infusion of 5 ml / hour of bupivacaine coupled with a small bolus of 2.5 ml / 30 minutes PCA can provide efficient pain control, but local anesthetic consumption is reduced by 37% and effect the side is low.

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