RESUMEN

BACKGROUND: Regional anaesthesia can be an attractive alternative anaesthetic approach in clavicle surgery, but it requires the peripheral block of multiple cervical and brachial nerves that transmit nociceptive information. Deep cervical plexus blocks, as paravertebral nerve block, can lead to severe side effects, such as unilateral diaphragmatic paralysis. CASE REPORT: A 66-year-old male patient, American Society of Anesthesiologists physical status III, was scheduled for open reduction and internal fixation of the right clavicle with plates and screws after a high-energy trauma. Pre-anaesthetic evaluation revealed right hemopneumothorax and bilateral rib fractures. We decided to perform regional anaesthesia (superficial cervical plexus block and clavipectoral fascial plane block), combined with dexmedetomidine perfusion to avoid invasive mechanical ventilation and prevent additional pulmonary complications. The surgical procedure was successfully completed without any further anaesthesia requirements. The patient remained comfortable during the postoperative period. CONCLUSION: Regional anaesthesia for clavicle surgeries has the advantage of promoting non-opioid free anaesthesia. Effective pain control enhances patient satisfaction and reduces the length of stay in hospital. In our case report, a combined superficial cervical plexus block and clavipectoral fascial plane block was a safe and effective regional anaesthetic approach.

RESUMEN

Desenvolver atividades ocupacionais com pacientes oncológicos, em ambiente hospitalar, implica na exposição dos trabalhadores às situações de risco intrínsecas ao processo de trabalho. O estudo objetivou identificar a percepção dos trabalhadores de uma equipe que atua em um Centro de Alta Complexidade em Oncologia, acerca dos riscos ocupacionais, bem como as formas de prevenção adotadas. Estudo qualitativo e descritivo, com participação de quinze profissionais. A coleta de dados foi feita por meio de entrevista e analisados à luz da análise de conteúdo. Como resultado teve-se duas categorias: "Riscos ocupacionais no ambiente de trabalho na ótica dos trabalhadores" e "Medidas utilizadas para minimizar a exposição aos riscos ocupacionais". Os riscos apontados foram inerentes ao processo de trabalho, dentre eles destacaram-se os químicos, representados pelas drogas antineoplásicas, e, os físicos, referidos pelas radiações ionizantes. Os profissionais conheciam e identificavam as medidas de proteção, assim como a importância de utilizá-las. Concluiu-se que ações de intervenção educativas direcionadas como educação à saúde são necessárias para a minimização da exposição do trabalhador para que atue com maior segurança e tenha sua saúde preservada

By developing occupational activities to cancer patients, in hospital environment, implies exposing workers to intrinsic risk situations to the work process. This study aimed to identify the perceptions of workers in a team who acts in a High Complexity Center in Oncology about occupational risks, as well as ways to prevent them. It's qualitative descriptive, with the participation of fifteen professionals. Data were collected through interviews and analyzed in the view of content analysis. As a result, there were two categories: occupational hazards in the workplace from the perspective of workers and measures used to minimize exposure to occupational risks. The risks mentioned were inherent to the work process, among them the chemical hazards - which were represented by anticancer drugs, and physical ones such as ionizing radiation. The professionals knew and identified the measures of protection, as well as the importance of using them. It was concluded that directed actions of educational intervention as health education are needed to minimize worker exposure for acting more safely and have their health preserved.