Importance of sympathectomy induced by continuous brachial plexus block for digital replantation in a patient with liver cirrhosis: Case report

  • Rosana Guerrero-Domínguez Hospital Universitario Virgen del Rocío, Sevilla, Spain
  • Daniel López-Herrera-Rodríguez Hospital Universitario Virgen del Rocío, Sevilla, Spain
  • Guiomar Fernández-Castelllano Hospital Universitario Virgen del Rocío, Sevilla, Spain
  • Francisco Federero Hospital Universitario Virgen del Rocío, Sevilla, Spain
  • Ignacio Jiménez Hospital Universitario Virgen del Rocío, Sevilla, Spain
Keywords: Liver cirrhosis, Nerve block, Microsurgery, Brachial Plexus, Anesthesia

Abstract

Hand microsurgeries are procedures performed by reconstructive surgeons and require a complex and highly individualized approach. The management of anesthesia in patients with cirrhosis may be challenging. Liver dysfunction may condition the extended use of anesthetic agents as a result of a disrupted metabolism and clearance.

This case describes the anesthetic management of a patient with cirrhosis, using a combined anesthetic technique with continuous axillary block of the brachial plexus to prevent postoperative pain and maintain extended vasodilatation. The continuous brachial plexus block under local anesthesia has shown improved tissue perfusion following limb replantation surgery. This technique is particularly helpful to prevent vasospasm in the reconstructed tissue during the postoperative period. In patients with cirrhosis, this technique provides adequate postoperative pain control.

References

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How to Cite
1.
Guerrero-Domínguez R, López-Herrera-Rodríguez D, Fernández-Castelllano G, Federero F, Jiménez I. Importance of sympathectomy induced by continuous brachial plexus block for digital replantation in a patient with liver cirrhosis: Case report. Colomb. J. Anesthesiol. [Internet]. 2015 Jul. 1 [cited 2024 Jun. 17];43(3):250-3. Available from: https://www.revcolanest.com.co/index.php/rca/article/view/196

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Published
2015-07-01
How to Cite
1.
Guerrero-Domínguez R, López-Herrera-Rodríguez D, Fernández-Castelllano G, Federero F, Jiménez I. Importance of sympathectomy induced by continuous brachial plexus block for digital replantation in a patient with liver cirrhosis: Case report. Colomb. J. Anesthesiol. [Internet]. 2015 Jul. 1 [cited 2024 Jun. 17];43(3):250-3. Available from: https://www.revcolanest.com.co/index.php/rca/article/view/196
Section
Case Report / Case Series

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