Revision of loop colostomy under regional anaesthesia and sedation.
- Author:
Oriana NG
1
;
Sze Ying THONG
1
;
Claramae Shulyn CHIA
2
;
Melissa Ching Ching TEO
2
Author Information
- Publication Type:Case Reports
- Keywords: abdominal wall surgery; colostomy; ilioinguinal-iliohypogastric; rectus sheath and transversus abdominis plane blocks; ultrasonography-guided regional anaesthesia
- MeSH: Abdominal Wall; surgery; Aged; Anesthesia, Conduction; methods; Anesthesia, General; adverse effects; Colostomy; adverse effects; methods; Conscious Sedation; methods; Dexmedetomidine; administration & dosage; Fentanyl; administration & dosage; Hemodynamics; Humans; Ketamine; administration & dosage; Laparoscopy; Male; Nerve Block; methods; Pain, Postoperative; Postoperative Period; Propofol; administration & dosage; Pulmonary Embolism; complications; Reoperation; methods; Tachycardia, Supraventricular; complications; Ultrasonography, Interventional
- From:Singapore medical journal 2015;56(5):e89-91
- CountrySingapore
- Language:English
- Abstract: Patients presenting for emergency abdominal procedures often have medical issues that cause both general anaesthesia and central neuraxial blockade to pose significant risks. Regional anaesthetic techniques are often used adjunctively for abdominal procedures under general anaesthesia, but there is limited published data on procedures done under peripheral nerve or plexus blocks. We herein report the case of a patient with recent pulmonary embolism and supraventricular tachycardia who required colostomy refashioning. Ultrasonography-guided regional anaesthesia was administered using a combination of ilioinguinal-iliohypogastric, rectus sheath and transversus abdominis plane blocks. This was supplemented with propofol and dexmedetomidine sedation as well as intermittent fentanyl and ketamine boluses to cover for visceral stimulation. We discuss the anatomical rationale for the choice of blocks and compare the anaesthetic conduct with similar cases that were previously reported.
