У нас вы можете посмотреть бесплатно Ultrasound Pectoralis (PECS) Block 1 and 2 for Breast Surgery или скачать в максимальном доступном качестве, видео которое было загружено на ютуб. Для загрузки выберите вариант из формы ниже:
Если кнопки скачивания не
загрузились
НАЖМИТЕ ЗДЕСЬ или обновите страницу
Если возникают проблемы со скачиванием видео, пожалуйста напишите в поддержку по адресу внизу
страницы.
Спасибо за использование сервиса ClipSaver.ru
www.mpsurgery.com This is a video example of the pectoralis 1 and 2 blocks in breast surgery. PECTS blocks can be used to reduce pain, post operative nausea and vomiting, as well as decreased narcotic use. The block can improve pain following mastectomy, breast augmentation, mastopexy or breast lift, or lumpectomy. The Pecs I block involves a hydrodissection of the plane between the pectoral muscles with local anesthetic to block the lateral and medial pectoral nerves. The main landmarks to identify the point of injection under US guidance are the pectoralis major and pectoralis minor muscles and the pectoral branch of the thoracoacromial artery. The block is performed with the patient supine, either with the arm next to the chest or abducted 90 degrees. With standard American Society of Anesthesiology (ASA) monitoring and supplemental oxygen, the operator locates the coracoid process on US in the paramedian sagittal plane. The transducer is rotated slightly to allow an in-plane needle trajectory from the proximal and medial side toward the lateral side (ie, the caudal border of the transducer is moved laterally, while the proximal border remains unchanged) (Figure 7). This rotation helps image the pectoral branch of the thoracoacromial artery. The proper fascial plane is confirmed by hydrodissection to open the space between the pectoralis muscles. The suggested volume is 0.2 mL/kg of a longacting local anesthetic (Figure 8); however, the reader should be informed that dose-ranging studies have not been conducted at the time of publication, and, therefore, there are no evidencebased recommendations currently available. Pecs II Block:- The goal of the Pecs II block is to infiltrate two fascial compartments by dividing the dose of local anesthetic between the pectoral nerves (the pectoral fascia and clavipectoral fascia) and under the pectoralis minor muscle (between the clavipectoral fascia and the superficial border of the serratus muscle). The local anesthetic should cover two important compartments of the fascias involved: The pectoral compartment with the pectoral nerves and the intercostal branches for the axilla and chest. The block is performed with the patient supine, either with the arm abducted 90 degrees or by his or her side. The first injection is similar to Pecs I, whereas the second is made at the anterior axillary line at the level of the fourth rib. The depth is usually 1–3 cm for the first injection and 3–6 cm for the second injection. With the transducer at the midclavicular level and angled inferolaterally, the axillary artery and vein and the second rib can be identified (Figure 9).