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Superior trunk block

Joe Iwanaga, R Shane Tubbs
The superior alveolar nerves course lateral to the maxillary sinus and the greater palatine nerve travels through the hard palate. This difficult three-dimensional anatomy has led some dentists and oral surgeons to a critical misunderstanding in developing the anterior and middle superior alveolar (AMSA) nerve block and the palatal approach anterior superior alveolar (P-ASA) nerve block. In this review, the anatomy of the posterior, middle and anterior superior alveolar nerves, greater palatine nerve, and nasopalatine nerve are revisited in order to clarify the anatomy of these blocks so that the perpetuated anatomical misunderstanding is rectified...
January 28, 2018: Curēus
Alessandro Gronchi, Stefano Ferrari, Vittorio Quagliuolo, Javier Martin Broto, Antonio Lopez Pousa, Giovanni Grignani, Umberto Basso, Jean-Yves Blay, Oscar Tendero, Robert Diaz Beveridge, Virginia Ferraresi, Iwona Lugowska, Domenico Franco Merlo, Valeria Fontana, Emanuela Marchesi, Davide Maria Donati, Elena Palassini, Emanuela Palmerini, Rita De Sanctis, Carlo Morosi, Silvia Stacchiotti, Silvia Bagué, Jean Michelle Coindre, Angelo Paolo Dei Tos, Piero Picci, Paolo Bruzzi, Paolo Giovanni Casali
BACKGROUND: Previous trials from our group suggested an overall survival benefit with five cycles of adjuvant full-dose epirubicin plus ifosfamide in localised high-risk soft-tissue sarcoma of the extremities or trunk wall, and no difference in overall survival benefit between three cycles versus five cycles of the same neoadjuvant regimen. We aimed to show the superiority of the neoadjuvant administration of histotype-tailored regimen to standard chemotherapy. METHODS: For this international, open-label, randomised, controlled, phase 3, multicentre trial, patients were enrolled from 32 hospitals in Italy, Spain, France, and Poland...
June 2017: Lancet Oncology
Takahiro Tamura, Shoichi Mori, Atsushi Mori, Masahiko Ando, Shuichi Yokota, Yasuyuki Shibata, Kimitoshi Nishiwaki
PURPOSE: We conducted a comparative study to evaluate analgesic efficacy between paravertebral block via the surgical field (PVB-sf), in which the catheter was inserted into the ventral side of the sympathetic trunk in the paravertebral space by a thoracic surgeon under thoracoscopic visualization, and epidural block (Epi) using ropivacaine for post-thoracotomy pain relief. METHODS: Lung cancer patients scheduled for lobectomy via thoracotomy were randomly allocated to receive either PVB-sf or Epi (n = 36 per group)...
April 2017: Journal of Anesthesia
Senem Akpınar, Halil İbrahim Açar, Ayhan Cömert, Bülent Şam, Alaittin Elhan
OBJECTIVE: The present study was performed on cadavers to evaluate the efficacy of the different supraclavicular block techniques (Vongvises, Dalens, plumb-bob and inter-SCM) by investigating the location of the needle tip on the brachial plexus and to determine the most suitable block techniques according to the site of the surgery. METHODS: The study was performed on one embalmed and nine fresh cadavers. After the dissection, the skin of the cadavers was restored in its original position...
August 2016: Turkish Journal of Anaesthesiology and Reanimation
Joseph Munyiri Nderitu, Fawzia Butt, Hassan Saidi
Comprehensive understanding of the variations in the branches of the infraorbital nerve (ION) is vital to the prevention of iatrogenic nerve injury and successful ION blockade during orbitozygomatic facial procedures. Only a few studies exist on the variant anatomy of the branching patterns of this nerve. This article provides a detailed description of the variations of the nasal and superior labial branches of the ION. This study was performed on 84 IONs by dissecting 42 formalin-fixed cadavers from the Laboratory of Topographic Anatomy, Department of Human Anatomy, University of Nairobi...
November 2016: Craniomaxillofacial Trauma & Reconstruction
Michael B Pohl, Karen D Kendall, Chirag Patel, J Preston Wiley, Carolyn Emery, Reed Ferber
CONTEXT: Researchers have postulated that reduced hip-abductor muscle strength may have a role in the progression of knee osteoarthritis by increasing the external knee-adduction moment. However, the relationship between hip-abductor strength and frontal-plane biomechanics remains unclear. OBJECTIVE: To experimentally reduce hip-abduction strength and observe the subsequent changes in frontal-plane biomechanics. DESIGN: Descriptive laboratory study...
April 2015: Journal of Athletic Training
David Burckett-St Laurent, Vincent Chan, Ki Jinn Chin
PURPOSE: The conventional ultrasound-guided interscalene block targets the C5 and C6 nerve roots at approximately the level of the cricoid cartilage where they lie in the groove between the anterior and middle scalene muscles. This technique, although effective at providing regional anesthesia of the shoulder, is associated with risks of phrenic nerve palsy, injury to the dorsal scapular and long thoracic nerves, and long-term postoperative neurologic symptoms. In this case report, we describe the ultrasound-guided superior trunk block...
December 2014: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
C Rothe, C Steen-Hansen, J Lund, M T Jenstrup, K H W Lange
BACKGROUND: The standard approach for the suprascapular nerve block is deep in the supraspinous fossa. However, with this approach, the suprascapular nerve is difficult to visualize by ultrasound. The aim of this study was to describe a new method to visualize and selectively block the suprascapular nerve in a more superficial and proximal location. METHODS: Twelve healthy volunteers were included. We located the brachial plexus in transverse section with ultrasound, and by longitudinal slide, we identified the departure of the suprascapular nerve from the superior trunk...
November 2014: Acta Anaesthesiologica Scandinavica
K E Y Claes, K K J Cathenis, Ph K E W Ballaux
We present a case of visceral ischemia due to an anatomic versus balloon length mismatch. An 80-year-old women underwent elective coronary artery bypass graft surgery. The direct post-operative period was complicated by low cardiac output, not responding to inotropic or vasopressor drugs. An intra-aortic balloon pump (IABP) was inserted during an explorative rethoracotomy. The first 3 days, an improvement of the hemodynamic function was seen. During this period, hepatic dysfunction, renal failure with need for hemodialysis and rising values of serum lactate were seen...
May 2014: Acta Chirurgica Belgica
M Patzkowski, J Scheiner
We report a novel circumstance of brachial plexus anesthesia in a parturient. A 25-year-old woman at 34 weeks of gestation presented with a pathologic proximal right humerus fracture from an intramedullary mass. She was scheduled for tumor biopsy which was performed using a two-site ultrasound-guided brachial plexus block to maximize odds of complete anesthesia while minimizing the risk of phrenic nerve paresis. After a supraclavicular block with 0.5% ropivacaine 20 mL, we translated our ultrasound probe cephalad, inferior to the root of C7 where the divisions of the superior trunk could be seen in a tightly compact arrangement...
May 2014: International Journal of Obstetric Anesthesia
Ali H Adam, Ammar M A Mohammed, Abbas Grebballa, Sahar Rizig
The brachial plexus is a complicated plexus supplying the upper limb. The brachial plexus is of great practical importance to the surgeon. It is encountered during operations upon the root of the neck, and hence it is in danger. Variations in the formation of the brachial plexus are common; and knowledge of the variation of the brachial plexus may be useful for surgeons, for improved guidance during supraclavicular block procedures, and for surgical approaches for brachial plexus. Here we report a case in which the superior trunk of the brachial plexus was found to be absent on the right side during a study on the cadaver-neck specimens in the Department of Anatomy...
July 2011: International Journal of Applied and Basic Medical Research
Özlem Kirazlı, Necati Tatarlı, Davut Ceylan, Hüsniye Hacıoğlu, Seda Uygun, Aşkın Şeker, Evren Keleş, Safiye Çavdar
During routine anatomical dissection of the upper extremity of a 64-year-old cadaver for educational purposes, we observed variations in the brachial plexus on each side. On the right an anomaly of cord formation was present and on the left there was a communication between the musculocutaneous nerve (MCN) and median nerve (MN). On the right side the brachial plexus showed two trunks, superior (C5 and C6) and inferior (C7, C8, and T1); the middle trunk was absent. The superior trunk bifurcated into anterior and posterior divisions, the anterior division continued as the lateral cord forming the MCN...
December 2013: Journal of Neurological Surgery. Part A, Central European Neurosurgery
Sninya Manaka
We use two oriental medical techniques in headache management. One is topological microstimulation, and the other is acupuncture point BL10 (Tianzhu) block. 1. Topological microstimulation The topological microstimulation apparatus delivers programmed fluctuating electrical signals to electrodes placed on the distal portion of the limbs, where meridians are concentrated. Topological microstimulation adjusts "qi-blood-fluid" circulating through meridians. "Qi-blood-fluid" is a virtual concept of oriental medicine that means 3 elements (qi, blood, and colorless body fluid)...
2012: Rinshō Shinkeigaku, Clinical Neurology
Sonoko Matsumoto, Kanna Nakamura, Masataka Ifuku, Shuji Komatsu, Yoshihito Morita, Mina Imai, Hiromasa Mitsuhata
BACKGROUND: Lumbar spine disease in the elderly people is complicated by a variety of pathophysiology in the spine and the cause of the pain is unclear. Diagnosis of pain may be difficult in patients with pain in the thigh and groin area. Sacroiliac joint is supporting the trunk and movable joint. We examined the effect of the sacroiliac joint block for intractable low back pain. METHODS: Retrospectively we examined the duration of disease in patients with hip and leg pain visiting the hospital for eight months, and we questioned the site of pain awareness...
September 2012: Masui. the Japanese Journal of Anesthesiology
Tarun Bhalla, Amod Sawardekar, Elisabeth Dewhirst, Narasimhan Jagannathan, Joseph D Tobias
Regional anesthetic techniques for perioperative analgesia in children are being increasingly utilized with the reported advantages of providing superior analgesia, decreasing opioid consumption, and reducing opioid-related adverse effects. The following article reviews the available literature regarding core and trunk blocks in infants and children; specifically, transversus abdominis plane, ilioinguinal/iliohypogastric nerve, rectus sheath, lumbar plexus, and paravertebral and intercostal nerve blockade. The common indications and potential complications and adverse effects for each block are presented...
February 2013: Journal of Anesthesia
Karen D Kendall, Chirag Patel, J Preston Wiley, Michael B Pohl, Carolyn A Emery, Reed Ferber
OBJECTIVE: To investigate the validity of the Trendelenburg test (TT) using an ultrasound-guided nerve block (UNB) of the superior gluteal nerve and determine whether the reduction in hip abductor muscle (HABD) strength would result in the theorized mechanical compensatory strategies measured during the TT. DESIGN: Quasi-experimental. SETTING: Hospital. PARTICIPANTS: Convenience sample of 9 healthy men. Only participants with no current or previous injury to the lumbar spine, pelvis, or lower extremities, and no previous surgeries were included...
January 2013: Clinical Journal of Sport Medicine: Official Journal of the Canadian Academy of Sport Medicine
Avinash Kambadakone, Ashraf Thabet, Debra A Gervais, Peter R Mueller, Ronald S Arellano
The celiac plexus is the largest visceral plexus and is located deep in the retroperitoneum, over the anterolateral surface of the aorta and around the origin of the celiac trunk. It serves as a relay center for nociceptive impulses that originate from the upper abdominal viscera, from the stomach to the proximal transverse colon. Celiac plexus neurolysis, with agents such as ethanol, is an effective means of diminishing pain that arises from these structures. Percutaneous imaging-guided celiac plexus neurolysis has been established as an invaluable therapeutic option in the management of intractable abdominal pain in patients with upper abdominal malignancy...
October 2011: Radiographics: a Review Publication of the Radiological Society of North America, Inc
Philippe Gautier, Catherine Vandepitte, Caroline Ramquet, Mieke DeCoopman, Daquan Xu, Admir Hadzic
BACKGROUND: The use of ultrasound to monitor needle placement and spread of local anesthetics (LA) has allowed reductions in the volume of LA required to anesthetize peripheral nerves. In the current study we investigated the minimal volume necessary to accomplish surgical anesthesia with interscalene brachial plexus block. METHODS: Twenty ASA physical status I-III patients, ages 18 to 75 years and scheduled for shoulder surgery under interscalene brachial plexus block, were enrolled...
October 2011: Anesthesia and Analgesia
H Eliasson, M Wahren-Herlenius, S-E Sonesson
OBJECTIVE: Fetal bradyarrhythmias have various underlying mechanisms. As blocked atrial bigeminy (BB) generally resolves spontaneously, but incomplete atrioventricular block (AVB) might respond to steroid treatment, correct diagnosis is of major importance. Our objectives were to assess the underlying mechanisms in fetal bradyarrhythmia and the accuracy of Doppler techniques in differentiating between them. METHODS: Seventy-eight patients referred to our tertiary center between 1990 and 2007 for evaluation of fetal bradycardia were analyzed retrospectively...
February 2011: Ultrasound in Obstetrics & Gynecology
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