MICROSURGICAL FREE MUSCLE TRANSFER IN A COMBINATION OF REGIONAL AND SPINAL ANESTHESIA. CLINICAL CASE
Volkmann's ischemic contracture is the result of acute circulatory disturbance in the limb with the development of peripheral nerve ischemia and the formation of neurogenic contracture. Correction of such contractures includes various techniques: tenolysis, neurolysis, transfer and lengthening of muscles and tendons. The most difficult reconstruction method is microsurgical autotransplantation of the free muscle, such as the small muscle of the thigh, with its neurotization. Due to the duration of the operation (more than 4 hours) and the need for simultaneous work in two remote anatomical regions (donor zone - lower limb, recipient zone - upper limb), such interventions in adult patients are performed under conditions of general anesthesia (GA) with endotracheal intubation. However, some patients, in view of the severity of the previous injury, have high risks or even contraindications for endotracheal anesthesia. The article presents the experience of treating a patient using combined regional anesthesia: blockade of the left brachial plexus in the interstitial space in combination with spinal anesthesia, against the background of intravenous sedation, without turning off consciousness.
Keywords
Volkmann's contracture,
regional anesthesia,
spinal anesthesia,
free muscle flapAuthors
| Baytinger A.V. | Institute of Microsurgery | drbaitinger@gmail.com |
| Sheykina T.V. | Institute of Microsurgery | |
Всего: 2
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