PDF(Pubmed)
Abstract：
Patients requiring complex upper arm arteriovenous fistulas or grafts may not be suitable candidates for a single regional anesthesia technique and monitored anesthesia care because the necessary thoracic (T2) dermatomal area of the medial, upper arm remains spared by any solitary brachial plexus (C5-T1) technique. An infiltrative intercostobrachial nerve block can often be used in conjunction with a brachial plexus block; however, coverage may still be incomplete. This case report describes the use of a high thoracic paravertebral block in conjunction with a brachial plexus block to achieve adequate anesthetic coverage for an upper arm arteriovenous fistula creation procedure extending into the axilla. The result of this technique showed adequate coverage of the upper arm and demonstrates that paravertebral blocks are a reasonable adjunct for proximal upper arm arteriovenous fistula procedures.
摘要：
需要复杂的上臂动静脉瘘或移植物的患者可能不是单一区域麻醉技术和监测麻醉护理的合适人选，因为需要内侧的胸部（T2）皮肤区，上臂保留任何孤立臂丛神经（C5-T1）技术。浸润性肋间臂神经阻滞通常可与臂丛神经阻滞联合使用；然而，报道可能仍然不完整。此病例报告描述了将高胸椎旁阻滞与臂丛神经阻滞结合使用，以实现对延伸到腋窝的上臂动静脉瘘创建程序的足够麻醉覆盖。该技术的结果表明上臂有足够的覆盖范围，并证明椎旁阻滞是上臂近端动静脉瘘手术的合理辅助手段。
