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Intravenous regional anesthesia or the Bier block technique is used to anesthetize a specific limb or extremity. It uses exsanguinated or blood-drained vessels to transport local anesthetics or LAs to the peripheral nerve trunks. Lidocaine without vasoconstrictors like epinephrine is most commonly used for this technique. Other drugs used are prilocaine, ropivacaine, and chloroprocaine. Bupivacaine is not recommended for this technique due to its high cardiac toxicity.
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Chemistry is the study of matter and the changes it undergoes. Matter is anything that has mass and occupies space. Matter is all around us; the air, water, soil, mountains, even our bodies are all examples of matter. Matter is divided into three states — solid, liquid, and gas — that are commonly found on earth. The fourth state of matter, plasma, occurs naturally in the interiors of stars. 
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The upper limb consists of the arm, forearm, wrist, and hand bones. The humerus is the single bone of the upper arm region. Proximally, it has a large, spherical, smooth head that articulates with the glenoid cavity of the scapula to form the glenohumeral or shoulder joint. The margin of the head is the anatomical neck, a residual epiphyseal plate. Laterally it extends to form bony projections called the greater tubercle and the lesser tubercle. Next to the tubercles is the surgical neck, a...
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Matter: Pure Substances and Mixtures
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The earliest recorded discussion of the basic structure of matter comes from ancient Greek philosophers. Leucippus and Democritus argued that all matter was composed of small, finite particles that they called atomos, meaning “indivisible.” Later, Aristotle and others came to the conclusion that matter consisted of various combinations of the four “elements” — fire, earth, air, and water — and could be infinitely divided. Interestingly, these philosophers...
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Resultados tras cirugía de húmero proximal: ¿Importa el uso de anestesia regional?

Bill Young1, Amy L Ladd1

  • 1Department of Orthopaedic Surgery, Stanford University, Stanford, CA.

Journal of hand surgery global online
|January 26, 2026
PubMed
Resumen

La anestesia regional para la cirugía de fractura de húmero proximal aumentó las visitas a urgencias y las prescripciones de opioides. Se necesita más investigación para reducir estos eventos adversos en pacientes que reciben anestesia regional.

Palabras clave:
UrgenciasFracturaOpioideHúmero proximalAnestesia regional

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Área de la Ciencia:

  • Cirugía Ortopédica
  • Anestesiología
  • Investigación de Servicios de Salud

Sus antecedentes:

  • La anestesia regional es un método común para el manejo del dolor durante la cirugía de fractura de húmero proximal.
  • La anestesia general es un enfoque alternativo para el manejo del dolor en estos procedimientos.

Objetivo del estudio:

  • Investigar la asociación entre la anestesia regional y los resultados postoperatorios en la cirugía de fractura de húmero proximal.
  • Comparar la utilización de urgencias (ED), las prescripciones de opioides perioperatorios y el uso persistente de opioides entre los grupos de anestesia regional y general.

Principales métodos:

  • Análisis retrospectivo de pacientes sometidos a reducción abierta y fijación interna (ORIF) o artroplastia de hombro por fracturas de húmero proximal.
  • Se utilizó el emparejamiento por puntuación de propensión para comparar pacientes que recibieron anestesia regional frente a anestesia general.
  • Los resultados incluyeron visitas a urgencias dentro de los 7 y 30 días, y prescripciones de opioides perioperatorias y persistentes.

Principales resultados:

  • La anestesia regional se asoció con un aumento significativo de las visitas a urgencias dentro de los 7 y 30 días posteriores a la cirugía tanto para pacientes de ORIF como de artroplastia de hombro.
  • Los pacientes que recibieron anestesia regional también tuvieron mayores prescripciones de opioides perioperatorios en comparación con los que recibieron anestesia general.
  • Se observó una mayor incidencia de prescripciones persistentes de opioides postoperatorios en el grupo de anestesia regional, aunque no se detalla explícitamente en el texto proporcionado.

Conclusiones:

  • La anestesia regional para la cirugía de fractura de húmero proximal se asocia con un aumento de la utilización postoperatoria de urgencias y tasas más altas de prescripción de opioides.
  • Se necesitan intervenciones para mitigar los posibles eventos adversos asociados con la anestesia regional en esta población de pacientes.
  • Se justifica una mayor investigación para reducir las visitas a urgencias y las complicaciones relacionadas con los opioides.