[Block of the cervical plexus for the unipolar exclusion of a gastroplasty after bronchial fistula].
A 46 year old man was operated on for an oesophageal carcinoma. Total oesophagectomy and gastroplasty were carried out. Postoperatively, a fistula developed between the gastroplasty and the right main bronchus. This led to respiratory impairment, with pulmonary infection, pleural effusion and hypoxia; the patient could not remain supine. A cervical oesophagostomy was decided on; to carry it out, a cervical plexus block was preferred to a cervical epidural anaesthesia because of the lesser respiratory and haemodynamic effects of the former technique. The procedure was well supported by the patient, and no significant hypoxia was detected by continuous pulse oximetry. Artificial ventilation of this patient was therefore successfully avoided.
Sardin
B
B
Département d'Anesthésie-Réanimation, CHU Dupuytrene, Limoges.
Pèze
P
P
Devalois
B
B
Desport
J C
JC
Ferré-Boulanger
F
F
D001983:Bronchial Fistula / Q000601:surgery*; D002572:Cervical Plexus; D004938:Esophageal Neoplasms / Q000601:surgery; D004946:Esophagostomy; D005747:Gastric Fistula / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009407:Nerve Block / Q000379:methods*; D011183:Postoperative Complications / Q000601:surgery*; D012086:Reoperation; D013270:Stomach / Q000601:surgery*
Bloc du plexus cervical pour exclusion unipolaire d'une gastroplastie après fistule bronchique.