Taller de Anestesia Regional en Niños

Bajo el patrocinio del Capítulo de Anestesia Pediátrica de la Sociedad Venezolana de Anestesilogía, coordinado en conjunto con el Postgrado de Anestesiología del Hospital Central de Maracay, el 18 y 19 de este mes recibimos en nuestra ciudad la visita los anestesiólogos: Belén de José María, del Hospital Sant Joan de Dèu, de Barcelona España; y de Luc Tielens, del Hospital Sint Radboud Ziekenhuis, Nijmegen Holanda, y Mirén Viteri,
del Hospital J.M. de los Rios de Caracas. Donde en conjunto los residentes del postgrado de Anestesiología del Hospital Central de Maracay con los anestesiólogos del Hospital Militar y otros anestesiólogos invitados, se hizo un taller de anestesia regional en niños y un taller de reanimación neonatal. Nueva e interesante información científica aportaron a nuestra comunidad los distinguidos visitantes, lo cual resultará en una mejor atención a nuestros pacientes pediátricos, así como la apertura de nuevos campos en la investigación clínica. Los invitados demostraron todo su desprendimiento, humildad y sabiduría al hacer excelentes demostraciones y servir de voluntarios para las mismas. Quedamos altamente agradecidos con Maria y Luc, sin dejar por fuera a Mirén por haber estado con nosotros en esta nuestra humilde casa La Ciudad de Maracay, Estado Aragua, Venezuela.
Comentarios:
Miguel A. Silva B. MD,
Médico Anestesiólogo,
Coordinador del Postgrado de Anestesilogía del Hospital Central de Maracay.
* Todas las imagenes de los tres ultimos Post. son de la demostración de tan distinguidos colegas.

Belén de José María, una docente versatil.

Management of tracheal agenesis.
Paediatr Anaesth.2000;10(4):441-4.
De Jose Maria B, Drudis R, Monclus E, Silva A, Santander S, Cusi V.

Department of Paediatric Anaesthesia Universitat de Barcelona, Barcelona, Spain.
Complete tracheal agenesis is a very rare congenital anomaly that is only compatible with life in some cases with associated tracheo-oesophageal or broncho-oesophageal fistula. In most cases, concomitant congenital anomalies of the heart, digestive tract or genitourinary tract are present. It should be suspected in any neonate with a history of hydramnios, absent crying, respiratory distress and difficulty in intubation. The possibility for surgical correction or palliation rests on the extent of atresia present. We present a case of complete tracheal agenesis without tracheo nor broncho-oesophageal fistula (type II by Floyd's classification) - the diagnosis of which was prenatally suspected - and discuss the important features of the airway management of this
condition.

Luc Tielens en Maracay, Hospital Militar.

Ultrasound-guided interscalene brachial plexus block in a child with femur fibula ulna syndrome.

Paediatr Anaesth.2006 Mar;16(3):330-2
Jan van Geffen G, Tielens L., Gielen M.

Medical Centre, Institute for Anesthesiology, Radboud University Nijmegen, Nijmegen, The Netherlands. g.vangeffen@anes.umcn.nl
Ultrasound-guided interscalene brachial plexus block is described in a 7-year-old child with femur fibula ulna syndrome. It is suggested that ultrasound is a useful tool in situations where nerve stimulation for nerve localization cannot be used.

Belén de José María, MD y Luc Tielens, MD

Vertical infraclavicular brachial plexus block in children: a preliminary study.

Paediatr Anaesth. 2004 Nov;14(11):931-5
de Jose Maria B, Tielens LK.

Department of Anesthesiology, Hospital Sant Joan de Deu, University Hospital UB, Barcelona, Spain. bdejosemaria@hsjdbcn.org
BACKGROUND: Brachial plexus blockade is a well-established technique in upper limb surgery. Among the infraclavicular approaches, the vertical infraclavicular brachial plexus (VIP) block is easy to perform and has a large spectrum of nerve blockade. The aim of this preliminary study was to determine the ease, effectiveness, safety, and duration of the VIP block in pediatric trauma surgery. METHODS: Fifty-five patients (ASA physical status I and II, age range 5-17 years old) scheduled for upper limb trauma surgery received a VIP block under light general anesthesia, using 0.5 ml x kg(-1) of ropivacaine 0.5%. The number of attempts and time to perform the block, the occurrence of a surgical response, the visual analogue score (VAS) scores, the incidence of complications and the duration of the block were evaluated. RESULTS: The brachial plexus was found easily at the first or second attempt in 85% (47 of 55) of the cases, in 15% (eight of 55) of the cases it was localized after three to four attempts. The mean time to perform the block was 3.35 +/- 3.37 min. Ninety-eight percentage (54 of 55) of the blockades were effective for surgery and in just one case was ineffective. The VAS scores at the end of the procedure in 100% (55 of 55) of the cases were <3.>