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Chapter-22 Nerves and Vessels

BOOK TITLE: A Practical Guide to Surgical Instruments, X-rays and Operative Interventions

Author
1. Agrawal Ajay Kumar
2. Agrawal Neelabh
3. Agrawal Sneha
ISBN
9789352703678
DOI
10.5005/jp/books/14245_23
Edition
1/e
Publishing Year
2018
Pages
5
Author Affiliations
1. Lucknow, Uttar Pradesh, India, Provincial Medical Services, Lucknow, Uttar Pradesh, India
2. KGMU, Lucknow, Uttar Pradesh, India, Department of Trauma Surgery, KGMU, Lucknow, Uttar Pradesh, India
3. Saraswati Dental College, Lucknow, Uttar Pradesh, India
Chapter keywords
Lumbar sympathectomy, Buerger’s disease, Raynaud’s disease, hematoma, Central venous line, Trendelenburg operation, subclavian approach, internal jugular approach.

Abstract

Lumbar sympathectomy has been indicated in vascular diseases involving small and large vessels of lower limb such as Buerger’s disease, Hyperhydrosis and Raynaud’s disease. It can be performed under general as well as spinal anaesthesia. Various complications related to this procedure include breach of peritoneum, retroperitoneal hematoma and incomplete sympathectomy. Trendelenburg operation is carried out where there is varicosity of long saphenous vein. It is contraindicated in cases of pregnancy and deep vein thrombosis. It can cause hematoma formation and pain. Central venous line procedure has been indicated in a number of procedures. This can be achieved either by subclavian or internal jugular approach. Both these approaches are required in cases where PCWP or CVP needs to be obtained, for prolonged parenteral nutrition and for rapid I.V.trasnfusion. Venesection is a procedure that is performed for providing i.v. infusion through a peripheral nerve by exposing it. It is performed under local anaesthesia. Most common sites are long saphenous vein near median malleolus, cephalic vein in delto-pectoral groove and medial cubital vein in the cubital fossa.

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