Bloqueio Pleural
Pleural Block
Karl Otto Geier
Resumo
Justificativa e Objetivos - Em 1986 o bloqueio pleural foi considerado uma importante aquisição da especialidade e, atualmente, vem sendo empregado com maior freqüência. O objetivo desta revisão é enfocar aspectos anatômicos, técnicos e clínicos importantes para a realização do bloqueio pleural. Conteúdo - São abordados aspectos históricos, anatômicos e técnicos do bloqueio pleural, assim como a farmacodinâmica, a farmacinética, as indicações, contra-indicações e complicações. Dentre as indicações são ressaltados o emprego do bloqueio pleural para cirurgia e analgesia pós-operatória como também no tratamento da dor aguda e crônica. Conclusões - O bloqueio pleural, cujo acesso é feito pelo espaço pleural, pode ser realizado tanto percutaneamente como em tórax aberto ao término de cirurgias torácicas. Pode ser utilizado para cirurgia sobre a parede torácica, assim como para analgesia pós-operatória. Apresenta vantagem de ser realizado com uma única punção, provocando bloqueio de vários nervos intercostais com baixa incidência de complicações.
Palavras-chave
Abstract
Background and Objectives - In 1986, pleural block was considered an important breakthrough for anesthesia and is being more frequently used. The aim of this review was to address important anatomic, technical and clinical pleural block aspects. Contents - Pleural block historical, anatomic and technical aspects, as well as pharmacodynamics and pharmacokinetics, indications, contraindications and complications were addressed. Among indications, one may stress the use of pleural block for surgery and postoperative analgesia and for the treatment of acute and chronic pain. Conclusions - Pleural block, accessed by the pleural space, may be performed both percutaneoulsy and in open chest, by the end of thoracic surgeries. It may be used for chest wall surgeries as well as for postoperative analgesia. It has the advantage of a single puncture blocking several intercostal nerves, with low incidence of complications.
Keywords
Referências
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