Cinthia Stefania Wiedman DuarteLuis Guillermo Ibarra Ibarra National Rehabilitation Institute, Mexico
Title: EFFECTIVENESS OF BRACHIAL PLEXUS BLOCK WITH COSTOCLAVICULAR APPROACH AND FACTORS THAT MODIFY SONOANATOMY IN PEDIATRIC PATIENTS
Pediatric brachial plexus block has become a good alternative for upper extremity surgical procedures, especially since the advent of ultrasonography. The mainaim of the study was to evaluate the effectiveness of the blockade with the costoclavicular approach in the pediatric population, and compare the sonoanatomy of the costoclavicular window with the coracoid one, and determinate if the position of the arm has an impact on the ultrasound image. A total of 8 patients with upper limb fractures were evaluated. Of the 8 patients, 5 were male (62.5%), 3 female (37.5%) with a mean age of 8.8 years. Ultrasonographic screening was performed comparing the sonoanatomy of the costoclavicular and coracoid approaches, better observing the brachial plexus cords and vascular structures with the costoclavicular approach. With the arm abducted 90 and 110 °, a better visualization of the neurovascular structures and an improvement in the quality of the block was obtained. The ropivacaine dose was 1.5mg / kg between 0.3-0.5%, with an average motor block time of 6.7 hours, and an average sensory block of 11.25 hours. There were not complications.