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Lucas Rovira, Jorge Úbeda, José de Andrés
No abstract text is available yet for this article.
October 2018: Regional Anesthesia and Pain Medicine
Sushil F Sancheti, Vishal Uppal, Robert Sandeski, M Kwesi Kwofie, Jennifer J Szerb
BACKGROUND AND OBJECTIVES: Retroclavicular block is designed to overcome the negative aspects of the commonly utilized ultrasound-guided parasagittal approach to the infraclavicular block. However, this approach necessitates the needle traversing an area posterior to the clavicle inaccessible to ultrasound wave conduction. This study sought to document the structures vulnerable to needle injury during a retroclavicular block. METHODS: A Tuohy needle was inserted using a retroclavicular approach to the infraclavicular block in 3 lightly embalmed cadavers followed by a catheter insertion 4 cm beyond the needle tip...
June 19, 2018: Regional Anesthesia and Pain Medicine
Shivani Ahlawat, Filippo Del Grande, Laura M Fayad
OBJECTIVE: To describe MR imaging features of presumed vascular plexi in the periscapular (PSC) and retroclavicular (RC) locations. MATERIALS/METHODS: 443 consecutive MR studies performed as "brachial plexus" protocol (axialT1-W and sagittal STIR) were reviewed for presence, size and characteristics of PSC and RC plexi. RESULTS: Presumed PSC and RC vascular plexi were present in 10%. Both plexi more commonly occurred on the left side...
June 9, 2018: Clinical Imaging
Chandni Sinha, Amarjeet Kumar, Akhilesh Kumar Singh, Umesh Kumar Bhadani
No abstract text is available yet for this article.
October 2017: Saudi Journal of Anaesthesia
P L Langlois, A F Gil-Blanco, D Jessop, Y Sansoucy, F D'Aragon, N Albert, P Echave
BACKGROUND: The coracoid approach is recognized as the simplest approach to perform brachial plexus anaesthesia, but needle visualization needs to be improved. With a different needle entry point, the retroclavicular approach confers a perpendicular angle between the ultrasound and the needle, which theoretically enhances needle visualization. This trial compares these two techniques. The leading hypothesis is that the retroclavicular approach is comparable to the infraclavicular coracoid approach in general aspects, but needle visualization is better with this novel approach...
July 21, 2017: Trials
Nilgun Kavrut Ozturk, Ali Sait Kavakli
PURPOSE: This prospective randomized study compared the coracoid and retroclavicular approaches to ultrasound-guided infraclavicular brachial plexus block (IBPB) in terms of needle tip and shaft visibility and quality of block. We hypothesized that the retroclavicular approach would increase needle tip and shaft visibility and decrease the number of needle passes compared to the coracoid approach. METHODS: A total of 100 adult patients who received IBPB block for upper limb surgery were randomized into two groups: a coracoid approach group (group C) and a retroclavicular approach group (group R)...
August 2017: Journal of Anesthesia
Josh Luftig, Daniel Mantuani, Andrew A Herring, Arun Nagdev
The America Society of Anesthesiology guidelines recommend multimodal analgesia that combines regional anesthetic techniques with pharmacotherapy to improve peri-procedural pain management and reduce opioid related complications. Commonly performed emergency procedures of the upper extremity such as fracture and dislocation reduction, wound debridement, and abscess incision and drainage are ideal candidates for ultrasound-guided (USG) regional anesthesia of the brachial plexus. However, adoption of regional anesthesia by emergency practitioners has been limited by concerns for potential complications and perceived technical difficulty...
May 2017: American Journal of Emergency Medicine
Zhi Yuen Beh, Mohd Shahnaz Hasan, Hou Yee Lai
No abstract text is available yet for this article.
September 2016: Regional Anesthesia and Pain Medicine
Jacques Smit, Raymond Tang, Himat Vaghadia, Andrew Sawka
No abstract text is available yet for this article.
March 2016: Regional Anesthesia and Pain Medicine
Jayme Augusto Bertelli, Marcos Flávio Ghizoni
OBJECTIVE Transfer of the spinal accessory nerve to the suprascapular nerve is a common procedure, performed to reestablish shoulder motion in patients with total brachial plexus palsy. However, the results of this procedure remain largely unknown. METHODS Over an 11-year period (2002-2012), 257 patients with total brachial plexus palsy were operated upon in the authors' department by a single surgeon and had the spinal accessory nerve transferred to the suprascapular nerve. Among these, 110 had adequate follow-up and were included in this study...
June 2016: Journal of Neurosurgery. Spine
Jasmin Charbonneau, Yannick Fréchette, Yanick Sansoucy, Pablo Echave
BACKGROUND AND OBJECTIVES: The aim of this feasibility study was to determine the success rate (sensory and surgical) of the novel retroclavicular block and to thoroughly describe the technique. In addition, needle tip and shaft visibility, needling time, procedural discomfort, motor block success rate, patient satisfaction at 48-hour follow-up, and complications were also recorded. METHODS: Fifty patients scheduled for distal upper limb surgery received an in-plane, single-shot, ultrasound-guided retroclavicular block with 40 mL of mepivacaine 1...
September 2015: Regional Anesthesia and Pain Medicine
Arnoldo Piccardo, Michela Massollo, Roberto Bandelloni, Anselmo Arlandini, Luca Foppiani
A 77-year-old woman underwent thyroidectomy and (131)I remnant ablation for tall-cell differentiated cancer (DTC) of the left lobe. Detectable Tg levels (4.1 μg/L) under TSH suppression, with undetectable serum Tg-antibody levels, prompted neck ultrasonography, which revealed a lymph node in the left laterocervical region and in the right retroclavicular region. (18)F-FDG PET/CT showed uptake by the left lymph node. (18)F-choline PET/CT showed increased uptake by both lymph nodes. Histopathology revealed DTC solid metastasis in the left lymph node and solid and cystic metastasis in the right one...
August 2015: Clinical Nuclear Medicine
Raymond Tse, Willem Pondaag, Martijn Malessy
Surgical exploration and reconstruction of the brachial plexus requires adequate exposure beyond the zone of injury. In the case of extensive lesions, some authors advocate clavicle osteotomy for an extensile approach. Such an osteotomy introduces further morbidity and may impact upon the delicate nerve reconstruction. A new simple but effective method of clavicle elevation is described that provides access to the retroclavicular brachial plexus during exploration for birth brachial plexus palsy.
June 2014: Techniques in Hand & Upper Extremity Surgery
M D Sewell, N Al-Hadithy, A Le Leu, S M Lambert
The sternoclavicular joint (SCJ) is a pivotal articulation in the linked system of the upper limb girdle, providing load-bearing in compression while resisting displacement in tension or distraction at the manubrium sterni. The SCJ and acromioclavicular joint (ACJ) both have a small surface area of contact protected by an intra-articular fibrocartilaginous disc and are supported by strong extrinsic and intrinsic capsular ligaments. The function of load-sharing in the upper limb by bulky periscapular and thoracobrachial muscles is extremely important to the longevity of both joints...
June 2013: Bone & Joint Journal
Antonio García-López, Alejandro Iborra
The standard transclavicular approach allows only limited and narrow exposure if the cervical thoracic region for the resection of tumors of the brachial plexus is involved. We report 2 cases of retroclavicular tumors of the brachial plexus. We performed a complete resection in both cases using the transmanubrial transclavicular approach. This approach consists of retracting an osteomuscular flap that involves the medial portion of the clavicle, part of the sternal manubrium, the sternoclavicular joint, and the sternocleidomastoid muscle...
October 2011: Annals of Plastic Surgery
E G Eising, W Jentzen
UNLABELLED: The enhanced absorption of X-rays in calcified structures is a basic prerequisite for performing conventional bone radiography. On the other hand, nothing has been reported on possible absorption effects of 'calcifications' as frequent findings in thyroid nodules or in the sternal bone / sternoclavicular joints. This may be caused by the general opinion, that the high energy of 99mTc-photons (140 keV) do not make visible absorptions effects very likely. PATIENTS, METHODS: To prove possible absorption effects of calcifications on thyroid scintigraphy experimentally, effects of calcium absorbers were tested on a technetium flood phantom...
2010: Nuklearmedizin. Nuclear Medicine
David Chwei-Chin Chuang
BACKGROUND: Adult brachial plexus reconstruction remains a dilemma to the reconstructive microsurgeon, especially when attempting to reconstruct cases of total root avulsion. A significant improvement in results has been achieved by a better understanding of various methods of reconstruction and prolonged postoperative rehabilitation. METHODS: This study was based on review of the literature and personal experience with 819 patients operated on between 1986 and 2003...
December 2009: Plastic and Reconstructive Surgery
P Bourgeois, D Munck, F Sales
AIMS: To determine the frequency of supradiaphragmatic lymph nodes that receive lymph from the lower limbs and the intraabdominal organs. METHODS: Three hundred and thirty-four bipedal lymphoscintigraphy results of the lower limbs were reviewed. RESULTS: Lymph nodes were visualized in only the supraclavicular/retroclavicular (SRC) area in 113 cases (33.2%, 109 on the left and 4 on the right), in only the mediastinum in 5 cases (1.5%), in the mediastinum and the left SRC area in 18 cases (5...
May 2008: European Journal of Surgical Oncology
S Cipanio, R Oggionio, V Manganio, G Bellandi, L Ercolini, S Michelagnoli
Central venous catheterisation may sometimes be associated with life-threatening complications. Of these, subclavian artery puncture (infraclavicular approach), though seldom, (incidence 1-2%) following accidental arterial cannulation, may lead to arterial occlusion, embolism, pseudoaneurysms, vessel laceration or dissection or fatal hemorrhaging. Such complications may be even more severe in critically ill patients requiring systemic anticoagulation therapy or those with acute coagulation dysfunction. The authors report a case of an accidental cannulation of the subclavian artery with a central catheter and its successful removal using an endovascular cover stent positioned via a percutaneous approach...
April 2007: Minerva Anestesiologica
Kale D Bodily, Robert J Spinner, Alexander Y Shin, Allen T Bishop
The anatomy of the suprascapular nerve is important to surgeons when focal nerve lesions necessitate surgical repair. Recent experience with a patient who had a complete suprascapular nerve lesion in the retroclavicular region (combined with axillary and musculocutaneous nerve lesions) is presented to illustrate that successful direct nerve repair is possible despite resection of a neuroma. Specifically, we found that neurolysis and mobilization of the suprascapular nerve and release of the superior transverse scapular ligament provided the necessary nerve length to achieve direct nerve repair after the neuroma was removed...
November 2005: Clinical Anatomy
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