FIELD: medicine.
SUBSTANCE: patient is fixed in the supine position with the head turned in the direction opposite to the procedure. Ultrasound imaging of the brachial plexus i performed by means of a HF sensor at the level of the cricoid cartilage and a local anesthetic is administered via a neurostimulating needle. At that, sensor scanning is carried along the side surface of the neck from the transverse process C6 level along the long axis with the needle positioned in the sensor plane. The neurostimulating needle is inserted lateral to the ultrasonic probe in its scanning plane. The anesthetic is administered sequentially to the upper, middle and lower trunks of the brachial plexus and C7-C8 spines, as well as into the area of the outer cervical plexus between the anterior scalene and sternocleidomastoid muscle fascia from the same place of injection. An ultrasound scanner with a linear ultrasound probe with a frequency of 10-12 MHz is applied for screening. Thus, anesthesia uses 8.10 ml of 0.5% ropivacaine solution for brachial plexus blockade, and 5.3 ml of 0.2% ropivacaine for outer cervical plexus blockade.
EFFECT: method reduces the dose of anesthetic, reduces the likelihood of complications, reduces procedure time, eliminates the influence of the subjective factor on the operation and makes the manipulation a universal technology.
4 cl, 5 ex, 10 dwg
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Authors
Dates
2017-02-17—Published
2015-08-17—Filed