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Pectoralis blocks for insertion of an implantable cardioverter defibrillator in two patients with Duchenne muscular dystrophy

Patients with Duchenne muscular dystrophy (DMD) often have systemic manifestations with comorbid involvement of the cardiac and respiratory systems that increase the risk of anesthetic and perioperative morbidity. These patients frequently develop progressive myocardial involvement with cardiomyopat...

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Autores principales: Froyshteter, Alexander B., Bhalla, Tarun, Tobias, Joseph D., Cambier, Gregory S., Mckee, Christopher T.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5875227/
https://www.ncbi.nlm.nih.gov/pubmed/29628849
http://dx.doi.org/10.4103/sja.SJA_624_17
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author Froyshteter, Alexander B.
Bhalla, Tarun
Tobias, Joseph D.
Cambier, Gregory S.
Mckee, Christopher T.
author_facet Froyshteter, Alexander B.
Bhalla, Tarun
Tobias, Joseph D.
Cambier, Gregory S.
Mckee, Christopher T.
author_sort Froyshteter, Alexander B.
collection PubMed
description Patients with Duchenne muscular dystrophy (DMD) often have systemic manifestations with comorbid involvement of the cardiac and respiratory systems that increase the risk of anesthetic and perioperative morbidity. These patients frequently develop progressive myocardial involvement with cardiomyopathy, depressed cardiac function, and arrhythmias. The latter may necessitate the placement of an automatic implantable cardioverter defibrillator (AICD) insertion. As a means of avoiding the need for general anesthesia and its inherent potential of morbidity, regional anesthesia may be used in specific cases. We present two cases of successful AICD insertion in patients with DMD using unilateral pectoralis and intercostal nerve blocks supplemented with intravenous sedation. Relevant anatomy for this regional anesthetic technique is reviewed and benefits of this anesthetic technique compared to general anesthesia are discussed.
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spelling pubmed-58752272018-04-07 Pectoralis blocks for insertion of an implantable cardioverter defibrillator in two patients with Duchenne muscular dystrophy Froyshteter, Alexander B. Bhalla, Tarun Tobias, Joseph D. Cambier, Gregory S. Mckee, Christopher T. Saudi J Anaesth Case Report Patients with Duchenne muscular dystrophy (DMD) often have systemic manifestations with comorbid involvement of the cardiac and respiratory systems that increase the risk of anesthetic and perioperative morbidity. These patients frequently develop progressive myocardial involvement with cardiomyopathy, depressed cardiac function, and arrhythmias. The latter may necessitate the placement of an automatic implantable cardioverter defibrillator (AICD) insertion. As a means of avoiding the need for general anesthesia and its inherent potential of morbidity, regional anesthesia may be used in specific cases. We present two cases of successful AICD insertion in patients with DMD using unilateral pectoralis and intercostal nerve blocks supplemented with intravenous sedation. Relevant anatomy for this regional anesthetic technique is reviewed and benefits of this anesthetic technique compared to general anesthesia are discussed. Medknow Publications & Media Pvt Ltd 2018 /pmc/articles/PMC5875227/ /pubmed/29628849 http://dx.doi.org/10.4103/sja.SJA_624_17 Text en Copyright: © 2018 Saudi Journal of Anaesthesia http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.
spellingShingle Case Report
Froyshteter, Alexander B.
Bhalla, Tarun
Tobias, Joseph D.
Cambier, Gregory S.
Mckee, Christopher T.
Pectoralis blocks for insertion of an implantable cardioverter defibrillator in two patients with Duchenne muscular dystrophy
title Pectoralis blocks for insertion of an implantable cardioverter defibrillator in two patients with Duchenne muscular dystrophy
title_full Pectoralis blocks for insertion of an implantable cardioverter defibrillator in two patients with Duchenne muscular dystrophy
title_fullStr Pectoralis blocks for insertion of an implantable cardioverter defibrillator in two patients with Duchenne muscular dystrophy
title_full_unstemmed Pectoralis blocks for insertion of an implantable cardioverter defibrillator in two patients with Duchenne muscular dystrophy
title_short Pectoralis blocks for insertion of an implantable cardioverter defibrillator in two patients with Duchenne muscular dystrophy
title_sort pectoralis blocks for insertion of an implantable cardioverter defibrillator in two patients with duchenne muscular dystrophy
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5875227/
https://www.ncbi.nlm.nih.gov/pubmed/29628849
http://dx.doi.org/10.4103/sja.SJA_624_17
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