34 Interpleural Anesthesia Perspective Interpleural anesthesia is a technique developed in an attempt to simplify body wall and visceral anesthesia after upper abdominal or thoracic surgery. Although considerable research has been carried out on the technique, accurate stratification of the risks and benefits of interpleural anesthesia remains elusive, and it is primarily a technique of historical interest. Patient Selection Patients undergoing upper abdominal or flank surgery or those recovering from fractured ribs have been most frequently selected for interpleural anesthesia. The appropriate selection of these patients remains ill defined. Pharmacologic Choice Most commonly, 20 to 30 mL of local anesthetic solution is injected through the interpleural needle or catheter. The most common local anesthetic concentrations used have been 0.25% to 0.5% bupivacaine or 0.2% to 0.5% ropivacaine. Placement Anatomy The pleural space extends from the apex of the lung to the inferior reflection of the pleura at approximately L1. The pleural space also relates to the posterior and anterior mediastinal structures, as illustrated in Figure 34-1. Figure 34-1. Interpleural block: anatomy. Position Only gold members can continue reading. Log In or Register to continue Share this:Click to share on Twitter (Opens in new window)Click to share on Facebook (Opens in new window) Related Related posts: Distal Upper Extremity Block Translaryngeal Block Supraclavicular Block Sciatic Block Superior Hypogastric Plexus Block Celiac Plexus Block Tags: Atlas of Regional Anesthesia May 31, 2016 | Posted by admin in ANESTHESIA | Comments Off on Interpleural Anesthesia Full access? Get Clinical Tree
34 Interpleural Anesthesia Perspective Interpleural anesthesia is a technique developed in an attempt to simplify body wall and visceral anesthesia after upper abdominal or thoracic surgery. Although considerable research has been carried out on the technique, accurate stratification of the risks and benefits of interpleural anesthesia remains elusive, and it is primarily a technique of historical interest. Patient Selection Patients undergoing upper abdominal or flank surgery or those recovering from fractured ribs have been most frequently selected for interpleural anesthesia. The appropriate selection of these patients remains ill defined. Pharmacologic Choice Most commonly, 20 to 30 mL of local anesthetic solution is injected through the interpleural needle or catheter. The most common local anesthetic concentrations used have been 0.25% to 0.5% bupivacaine or 0.2% to 0.5% ropivacaine. Placement Anatomy The pleural space extends from the apex of the lung to the inferior reflection of the pleura at approximately L1. The pleural space also relates to the posterior and anterior mediastinal structures, as illustrated in Figure 34-1. Figure 34-1. Interpleural block: anatomy. Position Only gold members can continue reading. Log In or Register to continue Share this:Click to share on Twitter (Opens in new window)Click to share on Facebook (Opens in new window) Related Related posts: Distal Upper Extremity Block Translaryngeal Block Supraclavicular Block Sciatic Block Superior Hypogastric Plexus Block Celiac Plexus Block Tags: Atlas of Regional Anesthesia May 31, 2016 | Posted by admin in ANESTHESIA | Comments Off on Interpleural Anesthesia Full access? Get Clinical Tree
