Regional anaesthesia in the obese patient: Lost landmarks and evolving ultrasound guidance

被引：27

作者：

Brodsky, Jay B. ^{[1
]}

Mariano, Edward R. ^{[2
]}

机构：

[1] Stanford Univ, Med Ctr, Sch Med, Dept Anesthesia, 300 Pasteur Dr, Stanford, CA 94305 USA

[2] Stanford Univ, Sch Med, Dept Anesthesia, Vet Affairs Palo Alto Hlth Care Syst, Palo Alto, CA 94304 USA

来源：

BEST PRACTICE & RESEARCH-CLINICAL ANAESTHESIOLOGY | 2011年 / 25卷 / 01期

关键词：

regional anaesthesia; obesity; neuraxial block; peripheral nerve block; ultrasound-guided regional anaesthesia;

D O I：

10.1016/j.bpa.2010.12.005

中图分类号：

R614 [麻醉学];

学科分类号：

100217 ;

摘要：

Obesity is associated with a number of anaesthetic-related risks. Regional anaesthesia offers many potential advantages for the obese surgical patient. Advantages include a reduction in systemic opioid requirements and their associated side effects, and possible avoidance of general anaesthesia in select circumstances, with a lower rate of complications. Historically, performing regional anaesthesia procedures in the obese has presented challenges due to difficulty in identifying surface landmarks and availability of appropriate equipment. Ultrasound guidance may aid the regional anaesthesia practitioner with direct visualisation of underlying anatomic structures and real-time needle direction. Further research is needed to determine optimal regional anaesthesia techniques, local anaesthetic dosage and perioperative outcomes in obese patients. (C) 2010 Elsevier Ltd. All rights reserved.

引用

页码：61 / 72

页数：12

共 61 条

[1]

Amer Soc Anesthesiologists, 2006, ANESTHESIOLOGY, V104, P1081

[2] Ultrasound using the transverse approach to the lumbar spine provides reliable landmarks for labor epidurals [J].

Arzola, Cristian ;

Davies, Sharon ;

Rofaeel, Ayman ;

Carvalho, Jose C. A. .

ANESTHESIA AND ANALGESIA, 2007, 104 (05) :1188-1192

[3] Ultrasound Imaging of the Lumbar Spine in the Transverse Plane: The Correlation Between Estimated and Actual Depth to the Epidural Space in Obese Parturients [J].

Balki, Mrinalini ;

Lee, Yung ;

Halpern, Stephen ;

Carvalho, Jose C. A. .

ANESTHESIA AND ANALGESIA, 2009, 108 (06) :1876-1881

[4]

BRODSKY JB, 1984, WESTERN J MED, V140, P750

[5]

Brull R, 2009, CAN J ANAESTH, V56, P812, DOI 10.1007/s12630-009-9170-2

[6]

Carvalho Jose Carlos Almeida, 2008, Anesthesiol Clin, V26, P145, DOI 10.1016/j.anclin.2007.11.007

[7] Effects of ultrasound guidance on the minimum effective anaesthetic volume required to block the femoral nerve [J].

Casati, A. ;

Baciarello, M. ;

Di Cianni, S. ;

Danelli, G. ;

De Marco, G. ;

Leone, S. ;

Rossi, M. ;

Fanelli, G. .

BRITISH JOURNAL OF ANAESTHESIA, 2007, 98 (06) :823-827

[8] Anesthesia in the obese patient: Pharmacokinetic considerations [J].

Casati, A ;

Putzu, M .

JOURNAL OF CLINICAL ANESTHESIA, 2005, 17 (02) :134-145

[9] Ultrasound guidance improves success rate of axillary brachial plexus block [J].

Chan, Vincent W. S. ;

Perlas, Anahi ;

McCartney, Colin J. L. ;

Brull, Richard ;

Xu, Daquan ;

Abbas, Sherif .

CANADIAN JOURNAL OF ANAESTHESIA-JOURNAL CANADIEN D ANESTHESIE, 2007, 54 (03) :176-182

[10] A randomized trial of bupivicaine pain pumps to eliminate the need for patient controlled analgesia pumps in primary laparoscopic Roux-en-Y gastric bypass [J].

Cottam, Daniel R. ;

Fisher, Barry ;

Atkinson, James ;

Link, Daniel ;

Volk, Peter ;

Friesen, Clifford ;

Link, Daniel ;

Grace, Brian ;

Trovar, Robin .

OBESITY SURGERY, 2007, 17 (05) :595-600

← 1 2 3 4 5 6 7 →