Importance of preoperative guided ultrasound in patients with femoral fracture: case report

Objective: The aim of this report is to represent the role of the use of bedside ultrasound by the anesthesiologist, offering an individualized approach to the specific condition of the patient, without unnecessary postponement of femur fracture surgical repair in the elderly. Case report: Female pa...

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Main Authors: Marcos Guilherme Cunha Cruvinel, Fabiano Soares Carneiro, Roberto Cardoso Bessa Junior
Format: Article
Language:English
Published: Elsevier 2019-03-01
Series:Brazilian Journal of Anesthesiology
Online Access:http://www.sciencedirect.com/science/article/pii/S0104001418301441
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spelling doaj-15e0505062f94c0c8570b21023c660152020-11-25T00:47:42ZengElsevierBrazilian Journal of Anesthesiology0104-00142019-03-01692204207Importance of preoperative guided ultrasound in patients with femoral fracture: case reportMarcos Guilherme Cunha Cruvinel0Fabiano Soares Carneiro1Roberto Cardoso Bessa Junior2Corresponding author.; Hospital Lifecenter, Departamento de Anestesiologia, Belo Horizonte, MG, BrazilHospital Lifecenter, Departamento de Anestesiologia, Belo Horizonte, MG, BrazilHospital Lifecenter, Departamento de Anestesiologia, Belo Horizonte, MG, BrazilObjective: The aim of this report is to represent the role of the use of bedside ultrasound by the anesthesiologist, offering an individualized approach to the specific condition of the patient, without unnecessary postponement of femur fracture surgical repair in the elderly. Case report: Female patient, 86 years old, hypertensive, victim of trochanteric fracture of the femur, taken to the operating room after being released by cardiology service. A bedside ultrasound exam allowed the identification of aortic stenosis, left ventricular hypertrophy, carotid stenosis, and signs of hypovolemia. From these findings, it was decided to use an ultrasound-guided block of the nerves femoral and lateral cutaneous of the thigh as an anesthetic technique. Conclusions: The use of ultrasound guidance by the anesthesiologist can provide relevant information for individualizing the anesthetic technique, without postponing the surgical intervention, which usually occurs when the patient is referred for complete examination by the specialist. Resumo: Objetivo: Exemplificar o papel do emprego da ultrassonografia à beira do leito pelo anestesiologista e oferecer uma abordagem individualizada para a condição específica do paciente, sem que haja postergação desnecessária de correções cirúrgicas de fraturas de fêmur em idosos. Relato do caso: Paciente feminina, 86 anos, hipertensa, vítima de fratura trocantérica de fêmur, levada ao bloco cirúrgico após liberação cardiológica. O exame ultrassonográfico à beira do leito possibilitou a identificação de estenose aórtica, hipertrofia ventricular esquerda, estenose de carótida e indícios de hipovolemia. A partir desses achados, decidiu-se pelo bloqueio nos nervos femoral e cutâneo lateral da coxa guiado pela ultrassonografia como técnica anestésica. Conclusão: O uso da ultrassonografia direcionada à beira do leito pelo anestesiologista pode fornecer informações relevantes para a individualização da técnica anestésica, sem que haja postergação da intervenção cirúrgica, a qual comumente ocorre quando o paciente é referenciado para exame completo pelo especialista. Keywords: Perioperative medicine, Anesthesia, Femur fracture, Ultrasonography, Echocardiography, Palavras-chave: Medicina perioperatória, Anestesia, Fratura de fêmur, Ultrasonografia, Ecocardiografiahttp://www.sciencedirect.com/science/article/pii/S0104001418301441
collection DOAJ
language English
format Article
sources DOAJ
author Marcos Guilherme Cunha Cruvinel
Fabiano Soares Carneiro
Roberto Cardoso Bessa Junior
spellingShingle Marcos Guilherme Cunha Cruvinel
Fabiano Soares Carneiro
Roberto Cardoso Bessa Junior
Importance of preoperative guided ultrasound in patients with femoral fracture: case report
Brazilian Journal of Anesthesiology
author_facet Marcos Guilherme Cunha Cruvinel
Fabiano Soares Carneiro
Roberto Cardoso Bessa Junior
author_sort Marcos Guilherme Cunha Cruvinel
title Importance of preoperative guided ultrasound in patients with femoral fracture: case report
title_short Importance of preoperative guided ultrasound in patients with femoral fracture: case report
title_full Importance of preoperative guided ultrasound in patients with femoral fracture: case report
title_fullStr Importance of preoperative guided ultrasound in patients with femoral fracture: case report
title_full_unstemmed Importance of preoperative guided ultrasound in patients with femoral fracture: case report
title_sort importance of preoperative guided ultrasound in patients with femoral fracture: case report
publisher Elsevier
series Brazilian Journal of Anesthesiology
issn 0104-0014
publishDate 2019-03-01
description Objective: The aim of this report is to represent the role of the use of bedside ultrasound by the anesthesiologist, offering an individualized approach to the specific condition of the patient, without unnecessary postponement of femur fracture surgical repair in the elderly. Case report: Female patient, 86 years old, hypertensive, victim of trochanteric fracture of the femur, taken to the operating room after being released by cardiology service. A bedside ultrasound exam allowed the identification of aortic stenosis, left ventricular hypertrophy, carotid stenosis, and signs of hypovolemia. From these findings, it was decided to use an ultrasound-guided block of the nerves femoral and lateral cutaneous of the thigh as an anesthetic technique. Conclusions: The use of ultrasound guidance by the anesthesiologist can provide relevant information for individualizing the anesthetic technique, without postponing the surgical intervention, which usually occurs when the patient is referred for complete examination by the specialist. Resumo: Objetivo: Exemplificar o papel do emprego da ultrassonografia à beira do leito pelo anestesiologista e oferecer uma abordagem individualizada para a condição específica do paciente, sem que haja postergação desnecessária de correções cirúrgicas de fraturas de fêmur em idosos. Relato do caso: Paciente feminina, 86 anos, hipertensa, vítima de fratura trocantérica de fêmur, levada ao bloco cirúrgico após liberação cardiológica. O exame ultrassonográfico à beira do leito possibilitou a identificação de estenose aórtica, hipertrofia ventricular esquerda, estenose de carótida e indícios de hipovolemia. A partir desses achados, decidiu-se pelo bloqueio nos nervos femoral e cutâneo lateral da coxa guiado pela ultrassonografia como técnica anestésica. Conclusão: O uso da ultrassonografia direcionada à beira do leito pelo anestesiologista pode fornecer informações relevantes para a individualização da técnica anestésica, sem que haja postergação da intervenção cirúrgica, a qual comumente ocorre quando o paciente é referenciado para exame completo pelo especialista. Keywords: Perioperative medicine, Anesthesia, Femur fracture, Ultrasonography, Echocardiography, Palavras-chave: Medicina perioperatória, Anestesia, Fratura de fêmur, Ultrasonografia, Ecocardiografia
url http://www.sciencedirect.com/science/article/pii/S0104001418301441
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