RESUMEN
This is a case report of a 55-year-old woman who was treated with a hemicorporectomy consequent to an invasive undifferentiated sacral chordoma. We describe the clinical course and rehabilitation process in an amputee outpatient clinic and report outcome measures such as the modified Functional Reach Test, the Amputee Mobility Predictor, the Functional Independence Measure, and the Short-Form Health Survey after 9 months of rehabilitation.
Asunto(s)
Amputación Quirúrgica/rehabilitación , Amputados/rehabilitación , Condroma/cirugía , Modalidades de Fisioterapia , Sacro/cirugía , Neoplasias de la Columna Vertebral/cirugía , Condroma/diagnóstico , Condroma/rehabilitación , Femenino , Humanos , Imagen por Resonancia Magnética , Persona de Mediana Edad , Neoplasias de la Columna Vertebral/diagnóstico , Neoplasias de la Columna Vertebral/rehabilitaciónRESUMEN
OBJECTIVE: To evaluate the effect of bupivacaine on muscle force and histology. We hypothesize that bupivacaine will worsen the muscle's physiological activity. SETTING: Controlled laboratory experiment. METHODS: Bupivacaine (0.5 mL, 0.5%) was injected into the mid belly and distal portions of the right gastrocnemius in 32 Wistar male rats (the left gastrocnemius was used as a control). After 5, 14, 21, and 28 days, in groups of 4, muscle force was evaluated and the animals were euthanized by an overdose of anesthetic for histologic evaluation. One-way analysis of variance was used to analyze data from force and weight measurements. Only the values of P < .05 were considered to be statistically significant. RESULTS: Bupivacaine causes a process of degeneration-regeneration of the muscle fibers and it also causes a reduction in muscle force, which is significant at 2 and 3 weeks and does not normalize at 4 weeks. The muscle injury is obvious after 5 days, and the degenerative process is predominant at 2 and 3 weeks. We found an increase in muscle mass in the acute phase and a decrease in muscle force. CONCLUSION: Although our results do not allow a direct clinical application, we believe that caution should be warranted when intramuscular bupivacaine is used.