tailieunhanh - Báo cáo y học: "Low-concentration, continuous brachial plexus block in the management of Purple Glove Syndrome: a case report"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Low-concentration, continuous brachial plexus block in the management of Purple Glove Syndrome: a case report. | Singh et al. Journal of Medical Case Reports 2010 4 48 http content 4 1 48 jA CASE REPORTS CASE REPORT Open Access Low-concentration continuous brachial plexus block in the management of Purple Glove Syndrome a case report Georgene Singh 1 VergheseTCherian1 and Binu PThomas2 Abstract Introduction Purple Glove Syndrome is a devastating complication of intravenous phenytoin administration. Adequate analgesia and preservation of limb movement for physiotherapy are the two essential components of management. Case presentation A 26-year-old Tamil woman from India developed Purple Glove Syndrome after intravenous administration of phenytoin. She was managed conservatively by limb elevation physiotherapy and oral antibiotics. A 20G intravenous cannula was inserted into the sheath of her brachial plexus and a continuous infusion of bupivacaine at a low concentration with fentanyl 2 gg ml at a rate of 1 to 2 ml hr was given. She had adequate analgesia with preserved motor function which helped in physiotherapy and functional recovery of the hand in a month. Conclusion A continuous blockade of the brachial plexus with a low concentration of bupivacaine and fentanyl helps to alleviate the vasospasm and the pain while preserving the motor function for the patient to perform active movements of the finger and hand. Introduction Intravenous administration of phenytoin can result in soft tissue injury at the site of injection leading to oedema and purplish-black discolouration of the hand. This is known as the Purple Glove Syndrome PGS . The management of PGS is mainly conservative which includes limb elevation and physiotherapy. Use of low concentration of local anaesthetic for brachial plexus block has the added advantage of preserving motor function to facilitate physiotherapy in addition to providing adequate analgesia and relief of vasospasm. Case presentation A 26-year-old Tamil woman from India presented with an alleged .