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Inicio Revista Española de Anestesiología y Reanimación (English Edition) S-ICD implantation under the serratus plane block and transversus thoracis muscl...
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Vol. 69. Issue 2.
Pages 102-104 (February 2022)
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Vol. 69. Issue 2.
Pages 102-104 (February 2022)
Case report
S-ICD implantation under the serratus plane block and transversus thoracis muscle plane block. A clinical case
Implantación subcutánea de DCI-S mediante bloqueos del plano del músculo serrato y del músculo torácico transverso. Caso clínico
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D. Roriz
Corresponding author
roriz.diana@gmail.com

Corresponding author.
, J. Brandão, R. Graça, S. Caramelo, C. Correia, R. Abrunhosa
Department of Anesthesiology and Pain Therapy, Centro Hospitalar de trás-os-Montes e Alto Douro, EPE, Vila Real, Portugal
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Abstract
Introduction

The development of a subcutaneous implantable cardioverter-defibrillator (S-ICD) combined with the typical patient comorbidities creates new challenges for anaesthesia.

Clinical Case

A young male, ASA II, was proposed for S-ICD placement, after recovery from a sudden CRP episode. We performed regional anaesthesia with a serratus plane block (SPB) and transversus thoracic muscle plane block (TTPB) with administration of Mepivacaine and Ropivacaine. S-ICD placement was achieved under regional anaesthesia. In the perioperative period, the patient remained hemodynamically stable, without any complications or pain.

Discussion

The implantation of the ICD occurs in fragile patients, with high anaesthetic risk. In this case, the association of SPB and TTPB was an effective anaesthetic/analgesic approach, has advantages when compared with other techniques and has potential use in other procedures.

Keywords:
Regional anesthesia
Peripheral nerve block
Chest wall anesthesia
Resumen
Introducción

El desarrollo de un desfibrilador-cardioversor implantable subcutáneo (DCI-S), combinado con las comorbilidades normales del paciente, crea nuevos retos en anestesia.

Caso clínico

Varón joven, ASA II, propuesto para implantación de DCI-S, tras recuperarse de un episodio de parada cardiaca súbita. Realizamos anestesia regional con bloqueo en el plano del músculo serrato (SPB) y bloqueo del plano del músculo torácico transverso (TTPB) con administración de Mepivacaína y Ropivacaína. La implantación de DCI-S se logró bajo anestesia regional. En el periodo perioperatorio el paciente permaneció hemodinámicamente estable, sin complicaciones ni dolor.

Discusión

La implantación de DCI se produce en pacientes frágiles, con alto riesgo anestésico. En este caso, la asociación de SPB y TTPB fue una técnica anestésica/analgésica efectiva, con ventajas en comparación con otras técnicas, y uso potencial en otros procedimientos.

Palabras clave:
Anestesia regional
Bloqueo del nervio periférico
Anestesia de la pared torácica

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