Ultrasound-guided supraclavicular approach to the subclavian vein in infants and children.

نویسندگان

  • V Kulkarni
  • K P Mulavisala
  • R K Mudunuri
  • J R Byalal
چکیده

citation list is impressive, and I would note that systemic betamethasone has also shown promise. Regarding their concerns about neurotoxicity, I agree that it is an unsettled issue. We made no assertions about the safety or recommendations for the use of perineural dexamethasone. One must not, however, be alarmist: a careful reading of one of their citations, an elegant preclinical model of adjuvant neurotoxicity, reveals that, in the paradigm studied, ropivacaine was much more neurotoxic than dexamethasone. One larger question I would like to pose is, ‘What is the duration of a nerve block?’ Is it the duration of anaesthesia to pinprick? Is it the duration of motor weakness? Or, as I would argue, is it the length of time the patient is comfortable? In a real-world setting, we studied the most easily measured and clinically relevant outcome: how long patients were comfortable enough to not require other analgesics. Yes, systemic administration, if equally effective, would be much preferred. Including systemic administration in our trial would have required a much larger patient sample, as it was already a four-group trial. Consequently, we were forced to leave the question open. It will not, however, remain open for long.

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Ultrasound-Guided Subclavian Vein Cannulation in Neonate via Supraclavicular Approach

Central venous cannulation of infants may be challenging. Ultrasonography is recommended and has been found superior to classic landmark technique in pediatric central venous cannulation. The cannulation of the subclavian vein using supraclavicular approach under real-time ultrasound guidance is a novel technique. It may have advantages over ultrasound-guided jugular vein cannulation in specifi...

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Consecutive, prospective case series of a new method for ultrasound-guided supraclavicular approach to the brachiocephalic vein in children.

BACKGROUND During ultrasound (US)-guided cannulation of the subclavian vein (SCV) via an infraclavicular route, the view of the needle behind the clavicle may be obscured. This study describes the US-guided supraclavicular cannulation of the brachiocephalic vein (BCV). METHODS The 25 mm broadband linear array US probe was placed in the supraclavicular region to obtain a longitudinal view of t...

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Ultrasound-guided catheterization of the left subclavian vein without recognition of persistent left superior vena cava

RATIONALE A persistent left superior vena cava (PLSVC) is rare, but the most common thoracic venous anomaly. We report a case of PLSVC unrecognized during left subclavian vein catheterization using real-time ultrasound-guided supraclavicular approach. PATIENT CONCERNS A 79-year-old man with history of hypertension presented with traumatic subdural hemorrhage, subarachnoid hemorrhage, and epid...

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Supraclavicular Approach to Ultrasound-Guided Brachiocephalic Vein Cannulation in Children and Neonates

The correct choice of intra vascular access in critically ill neonates should be individualized depending on the type and duration of therapy, gestational and chronological age, weight and/or size, diagnosis, clinical status, and venous system patency. Accordingly, there is an ongoing demand for optimization of catheterization. Recently, the use of ultrasound (US)-guided cannulation of the subc...

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Anatomical variations of the clavicle and main vascular structures in two pediatric patients : subclavicular vein cannulation with supraclavicular approach

Introduction Central venous catheterization (CVC) is implemented for volume resuscitation, hemodynamic monitoring, vasopressor administration, frequent blood sampling, parenteral nutritional support and the administration of long-term chemotherapy [1]. Generally, it is attempted using the internal jugular, subclavian or femoral veins. The subclavian vein access has been the recommended approach...

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عنوان ژورنال:
  • British journal of anaesthesia

دوره 108 1  شماره 

صفحات  -

تاریخ انتشار 2012