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https://www.readbyqxmd.com/read/28344948/the-effect-of-combining-axillary-brachial-plexus-block-with-interscalene-or-supraclavicular-block-for-upper-limb-surgeries-using-neurostimulation-technique
#1
H O Idehen, C A Imarengiaye
BACKGROUND: The different approaches to the brachial plexus have clinical implications and all these approaches have clinical limitations. Combining different approaches helps to reduce these limitations. Can a combination of two different methods of brachial plexus block give a better anaesthetic outcome? AIM: To compare the effect of combining axillary plexus block with interscalene as opposed to axillary plexus block with supraclavicular blocks. DESIGN OF STUDY: Prospective observational study...
April 2016: Journal of the West African College of Surgeons
https://www.readbyqxmd.com/read/28343681/ultrasound-evaluation-of-diaphragm-function-and-its-application-in-critical-patients-mechanical-ventilation-and-brachial-plexus-block
#2
F de B de la Quintana Gordon, B Nacarino Alcorta, M Fajardo Pérez
Before diaphragm ultrasonography, assessment of diaphragm function was very difficult due to the complex nature of its exploration. The use of this new technique has shed light on diagnostic problems and treatment with an improvement in final outcomes for critically ill patients, in whom the incidence of diaphragm weakness or dysfunction has been underestimated. Better knowledge of diaphragm function enables us earlier diagnosis by quantification of diaphragm contractile activity or evaluation of functional status after delivery of plexus block anaesthesia, facilitating therapeutic decisions...
March 23, 2017: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/28339446/pulsed-radiofrequency-ablation-of-pudendal-nerve-for-treatment-of-a-case-of-refractory-pelvic-pain
#3
Vadim Petrov-Kondratov, Avneesh Chhabra, Stephanie Jones
Pudendal neuralgia (PN) is a result of pudendal nerve entrapment or injury, also called "Alcock syndrome." Pain that develops is often chronic, and at times debilitating. If conservative measures fail, invasive treatment modalities can be considered. The goal of this case report is to add to a small body of literature that a pulsed radiofrequency (PRF) ablation can be effectively used to treat PN and to show that high resolution MR neurography imaging can be used to detect pudendal neuropathy. CASE PRESENTATION: We present a case of a 51-year-old woman with 5 years of worsening right groin and vulva pain...
March 2017: Pain Physician
https://www.readbyqxmd.com/read/28328862/postoperative-analgesia-comparing-levobupivacaine-and-ropivacaine-for-brachial-plexus-block-a-randomized-prospective-trial
#4
Kunitaro Watanabe, Joho Tokumine, Alan Kawarai Lefor, Kumi Moriyama, Hideaki Sakamoto, Tetsuo Inoue, Tomoko Yorozu
BACKGROUND: On a pharmacologic basis, levobupivacaine is expected to last longer than ropivacaine. However, most reports of these anesthetics for brachial plexus block do not suggest a difference in analgesic effect. The aim of this study is to compare the postoperative analgesic effects of levobupivacaine and ropivacaine when used for treating ultrasound-guided brachial plexus block. METHODS: A total of 62 patients undergoing orthopedic surgery procedures were prospectively enrolled and randomized to receive levobupivacaine (group L, N = 31) or ropivacaine (group R, N = 31)...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28326321/ultrasound-guided-versus-fluoroscopy-guided-deep-cervical-plexus-block-for-the-treatment-of-cervicogenic-headache
#5
Qing Wan, Haiyun Yang, Xiao Li, Caina Lin, Songjian Ke, Shaoling Wu, Chao Ma
Objective. The aim of this study was to compare the efficacy of ultrasound-guided deep cervical plexus block with fluoroscopy-guided deep cervical plexus block for patients with cervicogenic headache (CeH). Methods. A total of 56 patients with CeH were recruited and randomly assigned to either the ultrasound-guided (US) or the fluoroscopy-guided (FL) injection group. A mixture of 2-4 mL 1% lidocaine and 7 mg betamethasone was injected along C2 and/or C3 transverse process. The measurement of pain was evaluated by patients' ratings of a 10-point numerical pain scale (NPS) before and 2 wks, 12 wks, and 24 wks after treatments...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28315922/superior-perioperative-analgesia-with-combined-femoral-obturator-sciatic-nerve-block-in-comparison-with-posterior-lumbar-plexus-and-sciatic-nerve-block-for-acl-reconstructive-surgery
#6
Metaxia Bareka, Michael Hantes, Eleni Arnaoutoglou, George Vretzakis
PURPOSE: The purpose of this randomized controlled study is to compare and evaluate the intraoperative and post-operative outcome of PLPS nerve block and that of femoral, obturator and sciatic (FOS) nerve block as a method of anaesthesia, in performing ACL reconstruction. METHODS: Patients referred for elective arthroscopic ACL reconstruction using hamstring autograft were divided in two groups. The first group received combined femoral-obturator-sciatic nerve block (FOS Group) under dual guidance, whereas the second group received posterior lumbar plexus block under neurostimulation and sciatic nerve block (PLPS Group) under dual guidance...
March 18, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28306578/selective-low-volume-nerve-block-for-the-open-surgical-fixation-of-a-midshaft-clavicle-fracture-in-a-conscious-high-risk-patient-a-case-report
#7
Carlos I Salvadores de Arzuaga, José M Naya Sieiro, Oscar Salmeron Zafra, Miguel A González Posada, Esther Marquez Martínez
We report a case of successful intraoperative management using only low-volume regional anesthesia for the open surgical fixation of a traumatic clavicle fracture in a conscious 69-year-old man with severe chronic obstructive pulmonary disease. To avoid general anesthesia, we provided low-volume C5 and C6 nerve root blocks along with a superficial cervical plexus block using only 9 mL of anesthetic solution to avoid the often encountered complications of higher volume injections. Throughout the procedure, the patient remained comfortable and cooperative with stable hemodynamics and respiration...
March 16, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28298785/the-effect-of-intravenous-dexmedetomidine-compared-to-propofol-on-patients-hemodynamics-as-a-sedative-in-brachial-plexus-block-a-comparative-study
#8
Amarjeet Kumar, Chandni Sinha, Ajeet Kumar, Poonam Kumari
BACKGROUND: The quest for an ideal sedative during regional anesthesia is on. Although propofol has been accepted as a sedative intraoperatively, it can be associated with troublesome hemodynamic changes. Dexmedetomidine is a new alpha 2 agonist used widely for sedation. AIMS: In this study, we tried to compare equivalent doses of dexmedetomidine infusion with propofol with emphasis on their effect on the hemodynamics. SETTINGS AND DESIGN: Prospective, single-blinded randomized controlled trial...
January 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28298773/comparison-of-nerve-stimulation-guided-axillary-brachial-plexus-block-single-injection-versus-four-injections-a-prospective-randomized-double-blind-study
#9
Santoshi V Badiger, Sameer N Desai
BACKGROUND: A variety of techniques have been described for the axillary block using nerve stimulator, either with single injection, two, three, or four separate injections. Identification of all the four nerves is more difficult and time-consuming than other methods. AIMS: Aim of the present study is to compare success rate, onset, and duration of sensory and motor anesthesia of axillary block using nerve stimulator, either with single injection after identification of any one of the four nerves or four separate injections following identification of each of nerve...
January 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28298772/effect-of-dexmedetomidine-as-an-adjuvant-to-0-75-ropivacaine-in-interscalene-brachial-plexus-block-using-nerve-stimulator-a-prospective-randomized-double-blind-study
#10
H D Rashmi, H K Komala
BACKGROUND: Ropivacaine, a newer local anesthetic (LA), has been increasingly used nowadays in different concentrations for peripheral nerve blocks. It has lesser cardiac toxicity and higher safety margin when compared to bupivacaine. Dexmedetomidine, a novel α2 agonist, is widely used as adjuvant to LA in peripheral nerve blocks to decrease the time of onset and increase the duration of the block. In this study, we evaluated the effect of dexmedetomidine as an adjuvant with 0.75% ropivacaine for interscalene brachial plexus block using nerve stimulator...
January 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28298769/effect-of-addition-of-fentanyl-to-xylocaine-hydrochloride-in-brachial-plexus-block-by-supraclavicular-approach
#11
Venkata Raghavendra Paluvadi, Venkata Sesha Sai Krishna Manne
AIM: This study was designed to quantitatively compare the effects of 1.5% xylocaine with 1.5% xylocaine and fentanyl (1 μg/kg) mixture for supraclavicular brachial plexus block. MATERIALS AND METHODS: Sixty patients between the age group of 20-60 and scheduled for upper limb surgery were divided into two groups (xylocaine group and xylocaine plus fentanyl group). After performing supraclavicular brachial plexus block, an assessment was made for onset of analgesia, duration and degree of analgesia, block intensity, and for any other side effects...
January 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28298754/perineural-nalbuphine-in-ambulatory-upper-limb-surgery-a-comparison-of-effects-of-levobupivacaine-with-and-without-nalbuphine-as-adjuvant-in-supraclavicular-brachial-plexus-block-a-prospective-double-blinded-randomized-controlled-study
#12
Anjan Das, Sandip RoyBasunia, Anindya Mukherjee, Hirak Biswas, Rajasree Biswas, Tapobrata Mitra, Surajit Chattopadhyay, Subrata Kumar Mandal
BACKGROUND AND AIMS: Various opioid additives have been trialed to prolong brachial plexus block. We evaluated the effect of adding nalbuphine hydrochloride to levobupivacaine for supraclavicular brachial plexus blockade. The primary end-points were the onset and duration of sensory and motor blocks and duration of analgesia. MATERIALS AND METHODS: Seventy-eight patients (aged 25-45 years) posted for ambulatory forearm and hand surgery under supraclavicular brachial plexus block were divided into two equal groups (Groups LN and LC) in a randomized, double-blind fashion...
January 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28297053/general-regional-or-local-anesthesia-for-successful-radial-cephalic-arteriovenous-fistula
#13
David Shemesh, Yefim Raikhinstein, Ilya Goldin, Oded Olsha
Autogenous fistulas and in particular radiocephalic fistulas are recommended as the first vascular access for hemodialysis. Unfortunately, the rates of early failure and non-maturation are very high. For more than a decade, brachial plexus block has been proposed as the anesthesia of choice for fistula creation due to its beneficial sympathectomy-like effect, causing vasodilation and attenuation of spasm. Until recently, there was not a single randomized clinical study supporting this proposition. Because performing regional anesthesia is time-consuming and requires expertise, many surgeons prefer local or general anesthesia for vascular access surgery...
March 6, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28288050/pain-management-modalities-after-total-knee-arthroplasty-a-network-meta-analysis-of-170-randomized-controlled-trials
#14
Abdullah Sulieman Terkawi, Dimitris Mavridis, Daniel I Sessler, Megan S Nunemaker, Khaled S Doais, Rayan Sulieman Terkawi, Yazzed Sulieman Terkawi, Maria Petropoulou, Edward C Nemergut
BACKGROUND: Optimal analgesia for total knee arthroplasty remains challenging. Many modalities have been used, including peripheral nerve block, periarticular infiltration, and epidural analgesia. However, the relative efficacy of various modalities remains unknown. The authors aimed to quantify and rank order the efficacy of available analgesic modalities for various clinically important outcomes. METHODS: The authors searched multiple databases, each from inception until July 15, 2016...
March 13, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28280382/retention-of-finger-blood-flow-against-postural-change-as-an-indicator-of-successful-sympathetic-block-in-the-upper-limb
#15
Toshihiko Nakatani, Tatsuya Hashimoto, Ichiro Sutou, Yoji Saito
BACKGROUND: Sympathetic block in the upper limb has diagnostic, therapeutic and prognostic utility for disorders in the upper extremity that are associated with sympathetic disturbances. Increased skin temperature and decreased sweating are used to identify the adequacy of sympathetic block in the upper limb after stellate ganglion block (SGB). Baroreflexes elicited by postural change induce a reduction in peripheral blood flow by causing sympathetic vasoconstriction. We hypothesized that sympathetic block in the upper limb reduces the decrease in finger blood flow caused by baroreflexes stimulated by postural change from the supine to long sitting position...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28277420/regional-to-the-rescue-axillary-brachial-plexus-nerve-block-facilitates-removal-of-entrapped-transradial-catheter-placed-for-cardiac-catheterization
#16
Brian M Fitzgerald, Lee A Babbel, Ferdinand K Bacomo, Sandeep T Dhanjal
OBJECTIVE: Our objective was to describe the first reported use of an axillary brachial plexus block to treat the entrapment of a transradial artery catheter due to vasospasm. CASE REPORT: A 42-year-old man undergoing transradial arterial cardiac catheterization suffered arterial vasospasm causing the catheter to become entrapped and refractory to conservative (warm compresses) and standard pharmacologic interventions (intracatheter verapamil, intravenous infusions of nitroglycerin and nicardipine, and subcutaneous lidocaine and topical nitroglycerin)...
March 8, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28277419/complications-after-continuous-posterior-lumbar-plexus-blockade-for-total-hip-arthroplasty-a-retrospective-cohort-study
#17
Catherine W Njathi, Rebecca L Johnson, Ruple S Laughlin, Darrell R Schroeder, Adam K Jacob, Sandra L Kopp
BACKGROUND AND OBJECTIVES: While benefits of regional anesthesia in total hip arthroplasty (THA) are well documented, data describing the incidence of complications related to the use of posterior lumbar plexus blockade for THA remain limited. Our primary aim was to evaluate the incidence of infectious, bleeding, and neurological complications related specifically to the use of continuous posterior lumbar plexus block for elective THA. METHODS: We reviewed the electronic medical records of all adult patients who underwent elective THA with continuous posterior lumbar plexus blockade between December 1, 2004, and April 30, 2015, using the Mayo Clinic Total Joint Registry...
March 8, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28277325/the-pathway-of-injectate-spread-with-the-transmuscular-quadratus-lumborum-block-a-cadaver-study
#18
Mette Dam, Bernhard Moriggl, Christian K Hansen, Romed Hoermann, Thomas F Bendtsen, Jens Børglum
BACKGROUND: The spread of injectate resulting from a transmuscular quadratus lumborum (TQL) block and a transverse oblique paramedian (TOP) TQL block has never been examined. The aim of this cadaveric study was to investigate by which pathway the injectate spreads cephalad into the thoracic paravertebral space and which nerves were dyed by the injectate cephalad and caudad to the diaphragm when performing a TQL and a TOP TQL block. We also aimed to investigate whether the thoracic and lumbar sympathetic trunks as well as the lumbar plexus were covered by the injectate...
March 8, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28277258/continuous-versus-single-shot-brachial-plexus-block-and-their-relationship-to-discharge-barriers-and-length-of-stay
#19
Matthew Thompson, Robert Simonds, Bryce Clinger, Kristen Kobulnicky, Adam P Sima, Laura Lahaye, N Douglas Boardman
BACKGROUND: Brachial plexus block has been associated with improved pain control and decreased length of stay in patients undergoing upper extremity arthroplasty. Continuous delivery is associated with a shorter length of stay; however, comparisons to single-shot delivery in this setting are scarce. As the paradigm shifts to outpatient arthroplasty in the era of bundled payments, there exists a strong impetus to identify the most effective mode of analgesia associated with the least risk to patients...
October 26, 2016: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28272290/a-double-blind-randomized-comparison-of-continuous-interscalene-supraclavicular-and-suprascapular-blocks-for-total-shoulder-arthroplasty
#20
David B Auyong, Stanley C Yuan, Daniel S Choi, Joshuel A Pahang, April E Slee, Neil A Hanson
BACKGROUND AND OBJECTIVES: Continuous brachial plexus blocks at the interscalene level are associated with known diaphragm dysfunction from phrenic nerve paresis. More distal blocks along the brachial plexus may provide postsurgical analgesia while potentially having less effect on diaphragm function. Continuous interscalene, continuous supraclavicular, and continuous suprascapular nerve blocks were evaluated for respiratory function and analgesia after total shoulder arthroplasty. METHODS: After ethics board approval, subjects presenting for total shoulder arthroplasty were planned for randomization in a 1:1:1 ratio of a continuous interscalene, supraclavicular, or suprascapular block...
March 8, 2017: Regional Anesthesia and Pain Medicine
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