Bilateral guided cervical block for Zenker diverticulum excision in a patient with ankylosing spondylitis
Patients with severe ankylosing spondylitis (AS) have difficulties in tracheal intubation. An 87-year-old man with severe AS was scheduled for Zenker diverticulum (ZD) excision. It was decided to proceed with combined bilateral cervical plexus blockade using a nerve stimulator. The surgery lasted ab...
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| Veröffentlicht in: | Journal of anesthesia 2009, Vol.23 (1), p.143-146 |
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| container_title | Journal of anesthesia |
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| creator | Naja, Zoher M. Al-Tannir, Mohamad A. Zeidan, Ahed Oweidat, Mustafa El-Rajab, Mariam Ziade, Fouad M. Baraka, Anis S. |
| description | Patients with severe ankylosing spondylitis (AS) have difficulties in tracheal intubation. An 87-year-old man with severe AS was scheduled for Zenker diverticulum (ZD) excision. It was decided to proceed with combined bilateral cervical plexus blockade using a nerve stimulator. The surgery lasted about 3 h, with stable hemodynamics, ECG, and oxygen saturation. The use of a nerve stimulator-guided cervical block minimizes the risk of severe respiratory and/or airway compromise secondary to phrenic nerve or recurrent laryngeal nerve palsy, because it can elicit diaphragmatic muscle response, which helps to avoid the administration of local anesthetic directly to the area of the phrenic nerve, and guides correct needle placement. In conclusion, the nerve stimulatorguided bilateral cervical block in our ZD patient with AS was shown to be a safe and successful alternative anesthetic option. |
| doi_str_mv | 10.1007/s00540-008-0699-y |
| format | Article |
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An 87-year-old man with severe AS was scheduled for Zenker diverticulum (ZD) excision. It was decided to proceed with combined bilateral cervical plexus blockade using a nerve stimulator. The surgery lasted about 3 h, with stable hemodynamics, ECG, and oxygen saturation. The use of a nerve stimulator-guided cervical block minimizes the risk of severe respiratory and/or airway compromise secondary to phrenic nerve or recurrent laryngeal nerve palsy, because it can elicit diaphragmatic muscle response, which helps to avoid the administration of local anesthetic directly to the area of the phrenic nerve, and guides correct needle placement. In conclusion, the nerve stimulatorguided bilateral cervical block in our ZD patient with AS was shown to be a safe and successful alternative anesthetic option.</description><identifier>ISSN: 0913-8668</identifier><identifier>EISSN: 1438-8359</identifier><identifier>DOI: 10.1007/s00540-008-0699-y</identifier><identifier>PMID: 19234842</identifier><language>eng</language><publisher>Japan: Springer Japan</publisher><subject>Aged, 80 and over ; Anesthesia, Spinal ; Anesthesiology ; Anesthetics, Local ; Clinical Report ; Critical Care Medicine ; Electric Stimulation ; Electrocardiography ; Emergency Medicine ; Hemodynamics - physiology ; Humans ; Intensive ; Male ; Medicine ; Medicine & Public Health ; Monitoring, Intraoperative ; Nerve Block ; Oxygen - blood ; Pain Medicine ; Radiography ; Spondylitis, Ankylosing - complications ; Zenker Diverticulum - complications ; Zenker Diverticulum - diagnostic imaging ; Zenker Diverticulum - surgery</subject><ispartof>Journal of anesthesia, 2009, Vol.23 (1), p.143-146</ispartof><rights>Japanese Society of Anesthesiologists 2009</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c348t-12905f0073c697e094c3b34454982986c2a336110e8a09279526194e761487d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00540-008-0699-y$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00540-008-0699-y$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19234842$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Naja, Zoher M.</creatorcontrib><creatorcontrib>Al-Tannir, Mohamad A.</creatorcontrib><creatorcontrib>Zeidan, Ahed</creatorcontrib><creatorcontrib>Oweidat, Mustafa</creatorcontrib><creatorcontrib>El-Rajab, Mariam</creatorcontrib><creatorcontrib>Ziade, Fouad M.</creatorcontrib><creatorcontrib>Baraka, Anis S.</creatorcontrib><title>Bilateral guided cervical block for Zenker diverticulum excision in a patient with ankylosing spondylitis</title><title>Journal of anesthesia</title><addtitle>J Anesth</addtitle><addtitle>J Anesth</addtitle><description>Patients with severe ankylosing spondylitis (AS) have difficulties in tracheal intubation. An 87-year-old man with severe AS was scheduled for Zenker diverticulum (ZD) excision. It was decided to proceed with combined bilateral cervical plexus blockade using a nerve stimulator. The surgery lasted about 3 h, with stable hemodynamics, ECG, and oxygen saturation. The use of a nerve stimulator-guided cervical block minimizes the risk of severe respiratory and/or airway compromise secondary to phrenic nerve or recurrent laryngeal nerve palsy, because it can elicit diaphragmatic muscle response, which helps to avoid the administration of local anesthetic directly to the area of the phrenic nerve, and guides correct needle placement. In conclusion, the nerve stimulatorguided bilateral cervical block in our ZD patient with AS was shown to be a safe and successful alternative anesthetic option.</description><subject>Aged, 80 and over</subject><subject>Anesthesia, Spinal</subject><subject>Anesthesiology</subject><subject>Anesthetics, Local</subject><subject>Clinical Report</subject><subject>Critical Care Medicine</subject><subject>Electric Stimulation</subject><subject>Electrocardiography</subject><subject>Emergency Medicine</subject><subject>Hemodynamics - physiology</subject><subject>Humans</subject><subject>Intensive</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Monitoring, Intraoperative</subject><subject>Nerve Block</subject><subject>Oxygen - blood</subject><subject>Pain Medicine</subject><subject>Radiography</subject><subject>Spondylitis, Ankylosing - complications</subject><subject>Zenker Diverticulum - complications</subject><subject>Zenker Diverticulum - diagnostic imaging</subject><subject>Zenker Diverticulum - surgery</subject><issn>0913-8668</issn><issn>1438-8359</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kE1PGzEQhq2KqqRpfwAX5FtPW8Yfu2sfAfVLQuLCqRfL8U6CE8cO9i6w_75GidQbJ2vkZ17N-xByweA7A-ivCkAroQFQDXRaN_MHsmBSqEaJVp-RBWgmGtV16px8LmULAB1j4hM5Z5oLqSRfEH_jgx0x20A3kx9woA7zs3d1XoXkdnSdMv2LcYeZDv4Z8-jdFKY9xVfni0-R-kgtPdjRYxzpix8fqY27OaTi44aWQ4rDHPzoyxfycW1Dwa-nd0kefv54uP3d3N3_-nN7fde4etLYMK6hXdd2wnW6R9DSiZWQspVaca06x60QtQagsqB5r1veMS2x75hU_SCW5Nsx9pDT04RlNHtfHIZgI6apmF4IzaGilWRH0uVUSsa1OWS_t3k2DMybX3P0a6pf8-bXzHXn8pQ-rfY4_N84Ca0APwKlfsUNZrNNU4618Dup_wCrRoYy</recordid><startdate>2009</startdate><enddate>2009</enddate><creator>Naja, Zoher M.</creator><creator>Al-Tannir, Mohamad A.</creator><creator>Zeidan, Ahed</creator><creator>Oweidat, Mustafa</creator><creator>El-Rajab, Mariam</creator><creator>Ziade, Fouad M.</creator><creator>Baraka, Anis S.</creator><general>Springer Japan</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>2009</creationdate><title>Bilateral guided cervical block for Zenker diverticulum excision in a patient with ankylosing spondylitis</title><author>Naja, Zoher M. ; Al-Tannir, Mohamad A. ; Zeidan, Ahed ; Oweidat, Mustafa ; El-Rajab, Mariam ; Ziade, Fouad M. ; Baraka, Anis S.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c348t-12905f0073c697e094c3b34454982986c2a336110e8a09279526194e761487d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2009</creationdate><topic>Aged, 80 and over</topic><topic>Anesthesia, Spinal</topic><topic>Anesthesiology</topic><topic>Anesthetics, Local</topic><topic>Clinical Report</topic><topic>Critical Care Medicine</topic><topic>Electric Stimulation</topic><topic>Electrocardiography</topic><topic>Emergency Medicine</topic><topic>Hemodynamics - physiology</topic><topic>Humans</topic><topic>Intensive</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Monitoring, Intraoperative</topic><topic>Nerve Block</topic><topic>Oxygen - blood</topic><topic>Pain Medicine</topic><topic>Radiography</topic><topic>Spondylitis, Ankylosing - complications</topic><topic>Zenker Diverticulum - complications</topic><topic>Zenker Diverticulum - diagnostic imaging</topic><topic>Zenker Diverticulum - surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Naja, Zoher M.</creatorcontrib><creatorcontrib>Al-Tannir, Mohamad A.</creatorcontrib><creatorcontrib>Zeidan, Ahed</creatorcontrib><creatorcontrib>Oweidat, Mustafa</creatorcontrib><creatorcontrib>El-Rajab, Mariam</creatorcontrib><creatorcontrib>Ziade, Fouad M.</creatorcontrib><creatorcontrib>Baraka, Anis S.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of anesthesia</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Naja, Zoher M.</au><au>Al-Tannir, Mohamad A.</au><au>Zeidan, Ahed</au><au>Oweidat, Mustafa</au><au>El-Rajab, Mariam</au><au>Ziade, Fouad M.</au><au>Baraka, Anis S.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Bilateral guided cervical block for Zenker diverticulum excision in a patient with ankylosing spondylitis</atitle><jtitle>Journal of anesthesia</jtitle><stitle>J Anesth</stitle><addtitle>J Anesth</addtitle><date>2009</date><risdate>2009</risdate><volume>23</volume><issue>1</issue><spage>143</spage><epage>146</epage><pages>143-146</pages><issn>0913-8668</issn><eissn>1438-8359</eissn><abstract>Patients with severe ankylosing spondylitis (AS) have difficulties in tracheal intubation. An 87-year-old man with severe AS was scheduled for Zenker diverticulum (ZD) excision. It was decided to proceed with combined bilateral cervical plexus blockade using a nerve stimulator. The surgery lasted about 3 h, with stable hemodynamics, ECG, and oxygen saturation. The use of a nerve stimulator-guided cervical block minimizes the risk of severe respiratory and/or airway compromise secondary to phrenic nerve or recurrent laryngeal nerve palsy, because it can elicit diaphragmatic muscle response, which helps to avoid the administration of local anesthetic directly to the area of the phrenic nerve, and guides correct needle placement. In conclusion, the nerve stimulatorguided bilateral cervical block in our ZD patient with AS was shown to be a safe and successful alternative anesthetic option.</abstract><cop>Japan</cop><pub>Springer Japan</pub><pmid>19234842</pmid><doi>10.1007/s00540-008-0699-y</doi><tpages>4</tpages></addata></record> |
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| subjects | Aged, 80 and over Anesthesia, Spinal Anesthesiology Anesthetics, Local Clinical Report Critical Care Medicine Electric Stimulation Electrocardiography Emergency Medicine Hemodynamics - physiology Humans Intensive Male Medicine Medicine & Public Health Monitoring, Intraoperative Nerve Block Oxygen - blood Pain Medicine Radiography Spondylitis, Ankylosing - complications Zenker Diverticulum - complications Zenker Diverticulum - diagnostic imaging Zenker Diverticulum - surgery |
| title | Bilateral guided cervical block for Zenker diverticulum excision in a patient with ankylosing spondylitis |
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