caa a22 4500 445373385 CHVBK 20180317142954.0 cr unu---uuuuu 170323e20111201xx s 000 0 eng 10.1007/s00540-011-1238-9 doi (NATIONALLICENCE)springer-10.1007/s00540-011-1238-9 Ultrasound-guided bilateral brachial plexus blockade with propofol-ketamine sedation [Elektronische Daten] [Kazuya Toju, Takahiro Hakozaki, Masahiko Akatsu, Tsuyoshi Isosu, Masahiro Murakawa] We report the use of ultrasound-guided bilateral brachial plexus block in a patient with bilateral radius fractures. An axillary block was performed on the patient's right and a supraclavicular block on her left using an in-plane (long-axis) needle insertion technique. Into each side was injected 20 ml 0.5% ropivacaine, giving a total volume (dose) of 40ml (200mg). Provisions were made for rescue analgesia or unplanned conversion to general anesthesia during the operation, but these were not needed; furthermore, no perioperative complications were observed. General anesthesia has traditionally been used for simultaneous surgery involving the bilateral upper extremities because of concerns relating to local anesthetic toxicity, phrenic nerve blockade, and pneumothorax. The ultrasound-guided technique facilitates a reduction in the minimal effective volume of local anesthetic and can prevent potentially critical complications. Moreover, the technique can be performed within the recommended safe dose limits of the anesthetic, rendering it an important option for bilateral upper extremity surgery. Japanese Society of Anesthesiologists, 2011 Ultrasound nationallicence Brachial plexus block nationallicence Monitored anesthesia care nationallicence Toju Kazuya Department of Anesthesiology, Fukushima Prefectural Minami-Aizu Hospital, Kazashimo 14-1, Tajima, Minami-Aizu, Fukushima, Japan aut Hakozaki Takahiro Department of Anesthesiology, Fukushima Medical University School of Medicine, Hikarigaoka 1, 960-1295, Fukushima, Fukushima, Japan aut Akatsu Masahiko Department of Anesthesiology, Fukushima Medical University School of Medicine, Hikarigaoka 1, 960-1295, Fukushima, Fukushima, Japan aut Isosu Tsuyoshi Department of Anesthesiology, Fukushima Medical University School of Medicine, Hikarigaoka 1, 960-1295, Fukushima, Fukushima, Japan aut Murakawa Masahiro Department of Anesthesiology, Fukushima Medical University School of Medicine, Hikarigaoka 1, 960-1295, Fukushima, Fukushima, Japan aut Journal of Anesthesia Springer Japan 25/6(2011-12-01), 927-929 0913-8668 25:6<927 2011 25 540 https://doi.org/10.1007/s00540-011-1238-9 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00540-011-1238-9 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Toju Kazuya Department of Anesthesiology, Fukushima Prefectural Minami-Aizu Hospital, Kazashimo 14-1, Tajima, Minami-Aizu, Fukushima, Japan aut NATIONALLICENCE 700 1- Hakozaki Takahiro Department of Anesthesiology, Fukushima Medical University School of Medicine, Hikarigaoka 1, 960-1295, Fukushima, Fukushima, Japan aut NATIONALLICENCE 700 1- Akatsu Masahiko Department of Anesthesiology, Fukushima Medical University School of Medicine, Hikarigaoka 1, 960-1295, Fukushima, Fukushima, Japan aut NATIONALLICENCE 700 1- Isosu Tsuyoshi Department of Anesthesiology, Fukushima Medical University School of Medicine, Hikarigaoka 1, 960-1295, Fukushima, Fukushima, Japan aut NATIONALLICENCE 700 1- Murakawa Masahiro Department of Anesthesiology, Fukushima Medical University School of Medicine, Hikarigaoka 1, 960-1295, Fukushima, Fukushima, Japan aut NATIONALLICENCE 773 0- Journal of Anesthesia Springer Japan 25/6(2011-12-01), 927-929 0913-8668 25:6<927 2011 25 540 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer