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A complete regional anesthesia technique for cardiac pacemaker insertion.

S M Raza1, A R Vasireddy, K D Candido

  • 1Department of Anesthesiology, West Side Veterans Administration Hospital, University of Illinois College of Medicine.

Journal of Cardiothoracic and Vascular Anesthesia
|February 1, 1991
PubMed
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This study demonstrates that a combination of cervical plexus and intercostal nerve blocks provides effective anesthesia for transvenous cardiac pacemaker insertion. This technique ensures patient comfort and safety, avoiding complications like pneumothorax during the procedure.

Area of Science:

  • Anesthesiology
  • Thoracic Surgery

Background:

  • Transvenous cardiac pacemaker insertion is a common procedure.
  • Effective anesthesia is crucial for patient comfort and procedural success.
  • Previous anesthetic techniques may have limitations or risks.

Purpose of the Study:

  • To evaluate the efficacy and safety of a combined cervical plexus and intercostal nerve block for transvenous cardiac pacemaker insertion.
  • To determine if this anesthetic technique provides adequate surgical anesthesia without supplemental agents.
  • To assess for potential complications such as pneumothorax or diaphragmatic paralysis.

Main Methods:

  • Sixteen adult patients undergoing permanent transvenous cardiac pacemaker insertion were included.
  • Anesthesia was achieved using a combination of cervical plexus block and intercostal nerve blocks (2nd-4th).

Related Experiment Videos

  • A mixture of 1% mepivacaine and 0.2% tetracaine with epinephrine (1:200,000) was utilized.

    • Main Results:

    • Consistent surgical anesthesia was achieved from the C3 to T4 dermatomes.
    • No brachial plexus anesthesia was observed.
    • Anesthesia was adequate for all pacemaker insertion approaches, except abdominal pouch placement, without supplemental analgesia.
    • No instances of diaphragmatic paralysis or pneumothorax were documented via fluoroscopy.
    • No serious complications or side effects were reported.

    Conclusions:

    • Combined cervical plexus and intercostal nerve blocks offer a safe and effective anesthetic option for transvenous cardiac pacemaker implantation.
    • This technique provides reliable anesthesia without significant adverse events.
    • It represents a viable alternative to other anesthetic approaches for this procedure.