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Supraclavicular nerve block

M R Blichfeldt-Eckhardt, C B Laursen, H Berg, J H Holm, L N Hansen, H Ørding, C Andersen, P B Licht, P Toft
Moderate to severe ipsilateral shoulder pain is a common complaint following thoracic surgery. In this prospective, parallel-group study at Odense University Hospital, 76 patients (aged > 18 years) scheduled for lobectomy or pneumonectomy were randomised 1:1 using a computer-generated list to receive an ultrasound-guided supraclavicular phrenic nerve block with 10 ml ropivacaine or 10 ml saline (placebo) immediately following surgery. A nerve catheter was subsequently inserted and treatment continued for 3 days...
September 16, 2016: Anaesthesia
José R Soberón, Joseph W Crookshank, Bobby D Nossaman, Clint E Elliott, Leslie E Sisco-Wise, Scott F Duncan
PURPOSE: Limited data exist regarding the role of perineural blockade of the distal median, ulnar, and radial nerves as a primary anesthetic in patients undergoing hand surgery. We conducted a prospective and randomized pilot study to compare these techniques to brachial plexus blocks as a primary anesthetic in this patient population. METHODS: Sixty patients scheduled for hand surgery were randomized to receive either an ultrasound-guided supraclavicular, infraclavicular, or axillary nerve block (brachial plexus blocks) or ultrasound-guided median, ulnar, and radial nerve blocks performed at the level of the mid to proximal forearm (forearm blocks)...
October 2016: Journal of Hand Surgery
V Ahuja, D Thapa, S Gombar, D Dhiman
BACKGROUND: Unintentional intraneural injection under ultrasound guidance (USG) with fine caliber needles and lower success rate with large caliber Tuohy needles in supraclavicular brachial plexus block (SCB) have been reported. MATERIALS AND METHODS: We undertook study to standardize the use of 20-gauge short versus blunt bevel needle for SCB. After approval of Institutional Ethics Committee and written informed consent, patients were randomized using computer-generated random number table to either of the two groups; blunt bevel needle group (n = 30): SCB under USG using 20-gauge Tuohy needle or short bevel needle group (n = 30): SCB under USG using 20-gauge short bevel needle...
July 2016: Saudi Journal of Anaesthesia
M Stephen Melton, Jeffrey N Browndyke, Todd B Harshbarger, David J Madden, Karen C Nielsen, Stephen M Klein
BACKGROUND: Limited information exists on the effects of temporary functional deafferentation (TFD) on brain activity after peripheral nerve block (PNB) in healthy humans. Increasingly, resting-state functional connectivity (RSFC) is being used to study brain activity and organization. The purpose of this study was to test the hypothesis that TFD through PNB will influence changes in RSFC plasticity in central sensorimotor functional brain networks in healthy human participants. METHODS: The authors achieved TFD using a supraclavicular PNB model with 10 healthy human participants undergoing functional connectivity magnetic resonance imaging before PNB, during active PNB, and during PNB recovery...
August 2016: Anesthesiology
Metha Brattwall, Pether Jildenstål, Margareta Warrén Stomberg, Jan G Jakobsson
Upper extremity blocks are useful as both sole anaesthesia and/or a supplement to general anaesthesia and they further provide effective postoperative analgesia, reducing the need for opioid analgesics. There is without doubt a renewed interest among anaesthesiologists in the interscalene, supraclavicular, infraclavicular, and axillary plexus blocks with the increasing use of ultrasound guidance. The ultrasound-guided technique visualising the needle tip and solution injected reduces the risk of side effects, accidental intravascular injection, and possibly also trauma to surrounding tissues...
2016: F1000Research
O E Etta, S G Akpan, C S Eyo, C U Inyang
BACKGROUND: Brachial plexus block (BPB) has many benefits over general anaesthesia in upper limb procedures. However, its utilization in Nigeria is not as high as expected. AIM: To evaluate BPB in upper limb surgeries, its utilization, outcome and complication profile. MATERIALS AND METHODS: Approval for the study was obtained from the institution's research ethical committee. This was a retrospective study of all patients who underwent upper limb surgeries from May 2011 to December 2014...
January 2015: Journal of the West African College of Surgeons
Anatoli Stav, Leonid Reytman, Michael-Yohay Stav, Isaak Portnoy, Alexander Kantarovsky, Offer Galili, Shmuel Luboshitz, Roger Sevi, Ahud Sternberg
OBJECTIVE: We hypothesized that ultrasound (US)-guided technique of the supra- and infraclavicular and axillary approaches of brachial plexus block (BPB) will produce a high quality of surgical anesthesia for operations below the shoulder independently of the approach and body mass index (BMI). Intercostobrachial and medial brachial cutaneous nerves will be blocked separately because they are not a part of the brachial plexus. METHODS: This is a prospective randomized observer-blinded study...
2016: Rambam Maimonides Medical Journal
T Wiesmann, C Feldmann, H H Müller, L Nentwig, A Beermann, B F El-Zayat, M Zoremba, H Wulf, T Steinfeldt
BACKGROUND: Hemidiaphragmatic palsy is a common consequence of the interscalene brachial plexus block. It occurs less commonly with the supraclavicular approach. Register data suggest that the analgesic quality of a supraclavicular blockade is sufficient for arthroscopic shoulder surgery, although data on the post-operative analgesic effect are lacking. METHODS: After approval by the ethics committee, patients having arthroscopic shoulder surgery under general anaesthesia were randomized to receive a continuous interscalene or supraclavicular blockade...
September 2016: Acta Anaesthesiologica Scandinavica
Naveen Yadav, Arshad Ayub, Rakesh Garg, Samridhi Nanda, Babita Gupta, Chhavi Sawhney
BACKGROUND AND AIMS: There is wide variation in depth of brachial plexus in patient population at supraclavicular region. We plan to find the depth of the corner pocket and correlate it with age, weight, height and body mass index (BMI). MATERIAL AND METHODS: After approval from Ethics Committee, right-sided supraclavicular region of volunteers was scanned. Once an optimal image, which included subclavian artery, pleura, first rib and nerve bundles, was obtained, the corner pocket was kept in the middle of the screen and the image was frozen...
January 2016: Journal of Anaesthesiology, Clinical Pharmacology
Joseph M Neal
UNLABELLED: In 2010, the American Society of Regional Anesthesia and Pain Medicine's evidence-based medicine assessment of ultrasound (US)-guided regional anesthesia (UGRA) analyzed the effect of this nerve localization technology on patient safety. That analysis focused on 4 important regional anesthesia complications: peripheral nerve injury, local anesthetic systemic toxicity (LAST), hemidiaphragmatic paresis (HDP), and pneumothorax. In the intervening 5 years, further research has allowed us to refine our original conclusions...
March 2016: Regional Anesthesia and Pain Medicine
Guo-Ying Liu, Zhen-Qiang Chen, Hai-Yan Jia, Zhi-Gang Dai, Xue-Jun Zhang
OBJECTIVE: Brachial plexus perineural blocks provide specific analgesia for upper limb surgery. We present our experience with ultrasound-guided supraclavicular brachial plexus perineural blocks for distal upper limb surgery. Although single-injection ultrasound-guided supraclavicular blocks have been reported, little is known about the advantages using this approach compared with nerve stimulator guided. METHODS: There were 60 patients who underwent upper limb surgery for orthopedic trauma and received a supraclavicular brachial plexus anesthesia...
2015: International Journal of Clinical and Experimental Medicine
Qingqing Pei, Yanqing Yang, Qin Liu, Zhiyou Peng, Zhiying Feng
BACKGROUND: Sex differences, which may be an important variable for determining anesthetic requirements, have not been well investigated in the aspect of local anesthetic. This investigation aimed to compare the minimum local analgesic concentration (MLAC) of ropivacaine for ultrasound-guided supraclavicular brachial plexus block (US-SCB) between men and women. MATERIAL AND METHODS: Patients aged 18-45 years undergoing elective forearm, wrist, or hand surgeries under US-SCB were divided into 2 groups according to sex...
2015: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
Ke-Vin Chang, Chen-Yu Hung, Tyng-Guey Wang, Rong-Sen Yang, Wei-Zen Sun, Chih-Peng Lin
The classic suprascapular nerve block has limitations, such as postural requirements and lack of direct nerve visualization. This series investigated the analgesic effect of ultrasound-guided supraclavicular suprascapular nerve blocks in patients with malignancy-associated shoulder pain. Ablative radiofrequency lesioning of the suprascapular nerve in 6 patients provided substantial pain relief. The mean distance from the suprascapular nerve to the brachial plexus was 8.05 mm, and the mean angle of needle entry was 20...
November 2015: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
Taeha Ryu, Byung Tae Kil, Jong Hae Kim
Although supraclavicular brachial plexus block (SCBPB) was repopularized by the introduction of ultrasound, its usefulness in shoulder surgery has not been widely reported. The objective of this study was to compare motor and sensory blockades, the incidence of side effects, and intraoperative opioid analgesic requirements between SCBPB and interscalene brachial plexus block (ISBPB) in patients undergoing arthroscopic shoulder surgery. Patients were randomly assigned to 1 of 2 groups (ISBPB group: n = 47; SCBPB group: n = 46)...
October 2015: Medicine (Baltimore)
Vanlapa Arnuntasupakul, Prangmalee Leurcharusmee, Daniel Chora De La Garza, Sonia Ah-Kye, Roderick J Finlayson, De Q H Tran
PURPOSE: This randomized trial aimed to validate a new method for brachial plexus blockade, i.e., targeted intracluster injection supraclavicular block (TII SCB), by comparing it with ultrasound-guided axillary block (AXB). We hypothesized that TII SCB would result in a shorter total anesthesia-related time. METHODS: Forty patients undergoing upper limb surgery were randomized to ultrasound-guided TII SCB (n = 20) or AXB (n = 20). In the TII SCB group, we deposited 16 mL of lidocaine 1...
December 2015: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
Richard M Braun, Kalpit N Shah, Mark Rechnic, Sandra Doehr, Nancy Woods
PURPOSE: To measure changes in upper limb work and power capacity before and after anterior scalene muscle block (ASMB) to suggest thoracic outlet syndrome caused by costoclavicular space compression. METHODS: We evaluated 34 patients disabled by symptoms suggesting thoracic outlet syndrome. An ASMB was performed via a supraclavicular injection. The sternocleidomastoid muscle was injected as a control. We captured data obtained from work simulator measurements before and after ASMB...
November 2015: Journal of Hand Surgery
Thrivikrama Padur Tantry, Pramal Shetty, Rithesh Shetty, Sunil P Shenoy
Regional anesthesia is favored in patients who undergo emergency extremity (limb) surgery, and specifically so in the absence of fasting status. In the absence of ultrasonic guidance, the nerve stimulator still remains a valuable tool in performing a brachial block, but its use is difficult in an emergency surgical patient and greater cautious approach is essential. We identified the supraclavicular plexus by the nerve stimulation-motor response technique as follows. Anterior chest muscles contractions, diaphragmatic contraction, deltoid contractions, and posterior shoulder girdle muscle contractions when identified were taken as "negative response" with decreasing stimulating current...
May 2015: Anesthesia, Essays and Researches
Shivinder Singh, Rakhee Goyal, Kishan Kumar Upadhyay, Navdeep Sethi, Ram Murti Sharma, Anoop Sharma
BACKGROUND AND AIMS: This study was carried out to evaluate the difference in efficacy, safety, and complications of performing brachial plexus nerve blocks by using a nerve locator when compared to ultrasound (US) guidance. MATERIAL AND METHODS: A total of 102 patients undergoing upper limb surgery under supraclavicular brachial plexus blocks were randomly divided into two groups, one with US and the other with nerve stimulator (NS). In Group US, "Titan" Portable US Machine, Sonosite, Inc...
July 2015: Journal of Anaesthesiology, Clinical Pharmacology
Kalyani Nilesh Patil, Noopur Dasmit Singh
BACKGROUND AND AIMS: Ropivacaine is a new amide, long acting, pure S-enantiomer, local anesthetic, with differential blocking effect. The addition of clonidine to local anesthetic improves the quality of peripheral nerve blocks. This study was conducted to evaluate the effect of clonidine on characteristics of ropivacaine-induced supraclavicular brachial plexus block. MATERIAL AND METHODS: A total of 60 adult patients were randomly recruited to two groups of 30 each: Group I: 30 ml 0...
July 2015: Journal of Anaesthesiology, Clinical Pharmacology
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