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#36072 Brachial plexus block as an analgesic and therapeutic strategy in Buerger’s disease
  1. Jorge Carteiro1 and
  2. André Aguiar2
  1. 1Anestesiologia, Centro Hospitalar Lisboa Norte, Lisboa, Portugal
  2. 2Anestesiologia, Centro Hospitalar Universitário do Algarve – Hospital de Faro, Faro, Portugal


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Background and Aims Buerger’s disease is a non-arteriosclerotic segmental inflammatory occlusive vasculitis of small vessels, typically affecting the extremities. The main goal of treatment is to improve blood flow to the affected tissues, which can be achieved by reducing the activity of the sympathetic nervous system. One effective method for achieving this is through the use of brachial plexus block, which blocks sympathetic fibers and promotes vasodilatation.

Methods 36-year-old man, complaining of pain and trophic lesions in the extremities of the first and second fingers of the right hand with 1 month of evolution. Upon admission he reports pain 10/10 on the numerical rating scale, which has prevented him from sleeping for the last few days. We performed a brachial plexus block, supraclavicular approach and started patient controlled regional analgesia with Ropivacaine 0.2% 15ml every 4hours, 10ml bolus with 1hour lockout. He also started Alprostadil and Enoxaparin.

Results Patient always reported intensity less than 2/10 and he mentioned that since we performed theblock he was able to sleep again. Seven days after the treatment initiation, the signs attributed to poor perfusion in fingers regressed significantly and on the 14th day, no signs of poor perfusion were observed.

Conclusions We concluded that the brachial plexus block ensured the return of the patient‘s quality of life by greatly reducing the intensity of the pain and providing him with the possibility of being able to sleep. Furthermore, we believe that the contribution of the brachial plexus block was decisive for the success of the treatment.

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