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Chest wall block

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https://www.readbyqxmd.com/read/30095696/pectoral-block-failure-may-be-due-to-incomplete-coverage-of-anatomical-targets-a-dissection-study
#1
Lena F Carstensen, Morten Jenstrup, Jørgen Lund, Jørgen Tranum-Jensen
BACKGROUND AND OBJECTIVES: The popularization of ultrasound-guided nerve blocks in cosmetic and reconstructive breast surgery calls for better anatomical understanding of chest wall innervation. When inserting subpectoral implants, pain from pocket dissection, stretching of muscle, and release of costal attachments may be relieved by blocking the pectoral nerves in the interpectoral (IP) space.We describe the variable anatomy of the pectoral nerves in the IP space in order to define the area to be covered for sufficient blockade, based on cadaver dissections...
August 8, 2018: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/30094117/syncopal-episodes-of-arrhythmogenic-right-ventricular-cardiomyopathy-in-a-patient-with-pre-existing-seizure-disorder
#2
James R Kimber, Syed Rafay Ali Sabzwari, Hiwot Ayele
Arrhythmogenic right ventricular cardiomyopathy (ARVC), is a heritable condition that is an important, and under-recognized cause of sudden cardiac death. Microscopically, it is represented by fibrofatty replacement of myocardium involving the right ventricular inflow area, apex, and infundibulum. Common clinical manifestations of ARVC include palpitations, syncope, chest pain, dyspnea, and sudden cardiac death. This is a case of a 25-year-old male with a history of thalassemia, and tonic-clonic seizure status post head trauma with cystic encephalomalacia in left parietal lobe who described recurrent syncope...
June 7, 2018: Curēus
https://www.readbyqxmd.com/read/30063656/serratus-plane-block-a-cadaveric-study-to-evaluate-optimal-injectate-spread
#3
Abhijit Biswas, Valera Castanov, Zhi Li, Anahi Perlas, Richelle Kruisselbrink, Anne Agur, Vincent Chan
BACKGROUND AND OBJECTIVES: Although serratus plane block reportedly provides satisfactory analgesia for breast and thoracic surgeries, the optimal technique for consistent success has not been studied. The goal of this anatomical study was to evaluate the impact of volume, level, and site of injection on the extent of injectate spread that can influence anesthetic coverage. METHODS: Ultrasound-guided dye injection and subsequent dissection were performed in 39 cadaveric hemithoraces...
July 30, 2018: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29961280/-application-of-chest-ct-scan-in-gestational-trophoblastic-neoplasia-with-lung-metastasis
#4
Y Cheng, F H Ma, X R Wang, X N Le, G F Zhang, X Lu
Objective: To explore the role of CT scan for the diagnosis of lung metastasis in stage Ⅲ gestational trophoblastic neoplasia (GTN) . Methods: To figure out the role of CT scan for lung metastasis in GTN initial diagnosis, treatment and follow-up, 93 GTN patients with lung metastasis from January, 2015 to December, 2016 were retrospectively analyzed in Obstetrics and Gynecology Hospital of Fudan University. Results: (1) Among 93 GTN patients with lung metastasis, 70 patients with the International Federation of Gynecology and Obstetrics (FIGO) score ≤6 were defined as low risk GTN and 23 patients score score ≥7 were defined as high risk GTN...
June 25, 2018: Zhonghua Fu Chan Ke za Zhi
https://www.readbyqxmd.com/read/29912448/nuclear-stress-testing-referrals-time-for-a-novel-radiation-sparing-approach
#5
Steven C Romero, Joshua P Dettmer
Background: A Science Advisory from the American Heart Association implores clinicians to always consider equivalent tests which do not use ionizing radiation. Intersocietal guidelines describe only two scenarios where a nuclear stress test is the only option for non-invasive evaluation: left bundle branch block (LBBB) and ventricular-paced rhythm; otherwise, treadmill EKG and stress echocardiography are feasible. This study sought to measure our compliance with appropriate use criteria,6 and then to apply our own Novel Radiation Sparing Approach (NRSA) to measure what percentage could have been evaluated without radiation...
April 18, 2018: Military Medicine
https://www.readbyqxmd.com/read/29904455/high-grade-atrioventricular-block-in-von-recklinghausen-disease-a-rare-phenomenon
#6
Glenmore Lasam, Marcelina Lasam
A case of a 73-year-old woman with a history of von Recklinghausen disease (neurofibromatosis type 1) who presented initially with a gradual onset of shortness of breath and lightheadedness with no associated fever, chills, angina, palpitations, cough, weight loss, night sweats, nausea, vomiting, or constipation. She was found to be severely bradycardic and in third degree atrioventricular block by her primary care physician. She was admitted in the hospital because of intermittent bouts of lightheadedness and progression of the shortness of breath...
June 2018: Cardiology Research
https://www.readbyqxmd.com/read/29738329/transthoracic-arteriovenous-graft-repair-with-the-pectoralis-pecs-ii-nerve-block-for-primary-intraoperative-anesthesia-and-postoperative-analgesia-a-case-report
#7
Gabriel Farkas, Garret Weber, Jonathon Miller, Jeff Xu
The PECS II nerve block is a relatively new regional anesthetic technique that targets the medial and lateral pectoral nerves, as well as the lateral cutaneous branches of the intercostal nerves. It has been described for surgical cases involving the breast, as an adjunct or alternative to neuraxial or paravertebral techniques. This case report describes the first successful use of the PECS II nerve block placed using ultrasound guidance as the primary anesthetic and postoperative analgesic in a non-breast-related chest wall surgery...
May 7, 2018: A&A practice
https://www.readbyqxmd.com/read/29714650/real-time-view-of-anesthetic-solution-spread-during-an-ultrasound-guided-thoracic-paravertebral-block
#8
Domenico P Santonastaso, Annabella de Chiara, Marco Rispoli, Giovanni Musetti, Vanni Agnoletti
BACKGROUND: Thoracic paravertebral block is a technique for perioperative analgesia in patients undergoing thoracic, chest wall, or breast surgery, or for pain management with rib fractures, which can be performed with or without ultrasound guidance. The ultrasound guidance technique can be used to identify the thoracic paravertebral space, guide needle placement, monitor the spread of local anesthetic (LA) solution, and reduce complications such as pleural puncture and pneumothorax. The possibility of assessing anesthetic spread in real time using ultrasound guidance during paravertebral block offers numerous advantages, including the immediate and accurate identification of the extent of nervous block, with a consequent reduction of LA dose...
March 1, 2018: Tumori
https://www.readbyqxmd.com/read/29552514/hybrid-treatment-of-t3-chest-wall-lung-cancer-lobectomy
#9
Massimo Osvaldo Jaus, Annarita Forcione, Alessandro Gonfiotti, Francesco Carleo, Alessia Raffaella De Massimi, Luigi Carbone, Marco Di Martino, Giuseppe Cardillo
Nowadays the treatment of patients with non-small cell lung cancer (NSCLC) that invades the chest wall is still questioned. The classic approach is a lobectomy that requires chest wall resection through thoracotomy, but thanks to the progress in the field of thoracoscopic surgery, this procedure can be performed by video-assisted thoracoscopic surgery (VATS). Major advances have been made in recent years both in the surgical technique associated with thoracoscopy and in the instrumentation available today. This has allowed the use of thoracoscopic technique even in advanced disease...
2018: Journal of visualized surgery
https://www.readbyqxmd.com/read/29469550/chest-wall-blocks-and-minimally-invasive-image-guide-procedures-the-meeting-point-between-radiology-and-anesthesiology-that-could-improve-safety-and-patient-outcomes-in-nora
#10
Pierfrancesco Fusco, Stefano Di Carlo, Marco Vespasiano, Paolo Scimia, Emiliano Petrucci, Luigi Panella, Franco Marinangeli
No abstract text is available yet for this article.
August 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29457120/spread-of-injectate-in-ultrasound-guided-serratus-plane-block-a-cadaveric-study
#11
Tatsuya Kunigo, Takeshi Murouchi, Shuji Yamamoto, Michiaki Yamakage
Background: Serratus plane block is a thoracic truncal block that has been proposed as alternatives for analgesia such as epidural anesthesia and paravertebral block for the anterolateral chest wall. Previously, we performed the clinical study about optimal volume of the local anesthetic in serratus plane block. The primary aim of this study was to assess the pattern of distribution of dye into the serratus plane of cadavers after ultrasound-guided serratus plane injection. Findings: Ultrasound-guided serratus plane injection was performed at the level of the fourth rib on the mid-axillary line in nine adult Thiel-embalmed cadavers...
2018: JA clinical reports
https://www.readbyqxmd.com/read/29325364/-the-efficacy-and-safety-of-coil-embolization-of-septal-branch-in-the-treatment-of-patients-with-obstructive-hypertrophic-cardiomyopathy
#12
H Liu, Q Wu, H W Tan, J Pang
Objective: To observe the clinical efficacy and safety of coil embolization of septal branch in the treatment of obstructive hypertrophic cardiomyopathy (HOCM). Methods: Eighteen patients with HOCM hospitalized in our department from September 2014 to October 2016 were enrolled in this study. There were 12 males and 6 females in this cohort and the age of patients ranged from 22 to 64 years old. Left ventricular outflow tract gradient (LVOTG) was derived from echocardiographic apical five-chamber view at pre-operation and at 48 hours and 6 months post operation...
December 24, 2017: Zhonghua Xin Xue Guan Bing za Zhi
https://www.readbyqxmd.com/read/29321434/tricuspid-and-mitral-valve-regurgitation-with-bi-fascicular-block-following-a-horse-kick
#13
Tomoki Kokubun, Masayoshi Oikawa, Yasuhiro Ichijo, Yoshiyuki Matsumoto, Tetsuro Yokokawa, Kazuhiko Nakazato, Yoshiyuki Sato, Shinya Takase, Hiroharu Shinjo, Hitoshi Yokoyama, Hitoshi Suzuki, Shu-Ichi Saitoh, Yasuchika Takeishi
A 40-year-old man was transferred to our hospital following an isolated horse kick injury to the anterior chest wall. The case showed bi-fascicular block, severe tricuspid valve regurgitation due to ruptured chordae tendineae of the anterior leaflet, moderate mitral valve regurgitation due to prolapse of mitral anterior leaflet, and hypokinetic motion of the inferior septal wall. Both tricuspid and mitral insufficiency were completely repaired by a surgical operation. Fortunately, these injuries were not fatal in this case, but the comprehensive assessment of cardiac damage and careful observation are important for managing patients with cardiac injury...
June 1, 2018: Internal Medicine
https://www.readbyqxmd.com/read/29275956/lyme-carditis-early-occurrence-and-prolonged-recovery
#14
Jianwei Fu Md, Luna Bhatta
Lyme carditis is an uncommon manifestation of early disseminated Lyme disease. This case illustrates a 66-year-old male with complaints of fatigue, myalgias, and fever after a tick bite 3days earlier. A large erythema migrans was found on the chest wall. Initial electrocardiogram showed sinus rhythm with second degree 2:1 atrioventricular (AV) block, which progressed to intermittent complete AV block rapidly. He was treated with intravenous ceftriaxone. Over the course of 2-weeks of antibiotic therapy, the intermittent high-grade AV block improved slowly and progressively...
May 2018: Journal of Electrocardiology
https://www.readbyqxmd.com/read/29102405/erector-spinae-plane-block-for-radical-mastectomy-a-new-indication
#15
M Veiga, D Costa, I Brazão
The erector spinae plane block is a technique recently described by Forero et al. in September 2016. It has applications in the control of chronic pain with neuropathic component of the chest wall, and for pain control in thoracoscopic surgery. In this article, we describe the use of this technique as part of a multimodal analgesic approach in a 40-year-old woman, who underwent radical mastectomy due to breast cancer. By performing this block before anesthetic induction, we have achieved an opioid sparing effect, avoiding a possible immunomodulatory effect, although not yet proven in humans...
February 2018: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/29016551/pectoral-fascial-pecs-i-and-ii-blocks-as-rescue-analgesia-in-a-patient-undergoing-minimally-invasive-cardiac-surgery
#16
Suraj Yalamuri, Rebecca Y Klinger, W Michael Bullock, Donald D Glower, Brandi A Bottiger, Jeffrey C Gadsden
INTRODUCTION: Patients undergoing minimally invasive cardiac surgery have the potential for significant pain from the thoracotomy site. We report the successful use of pectoral nerve block types I and II (Pecs I and II) as rescue analgesia in a patient undergoing minimally invasive mitral valve repair. CASE REPORT: In this case, a 78-year-old man, with no history of chronic pain, underwent mitral valve repair via right anterior thoracotomy for severe mitral regurgitation...
November 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28894365/photothermal-ablation-of-inflammatory-breast-cancer-tumor-emboli-using-plasmonic-gold-nanostars
#17
Bridget M Crawford, Ronnie L Shammas, Andrew M Fales, David A Brown, Scott T Hollenbeck, Tuan Vo-Dinh, Gayathri R Devi
Inflammatory breast cancer (IBC) is rare, but it is the most aggressive subtype of breast cancer. IBC has a unique presentation of diffuse tumor cell clusters called tumor emboli in the dermis of the chest wall that block lymph vessels causing a painful, erythematous, and edematous breast. Lack of effective therapeutic treatments has caused mortality rates of this cancer to reach 20%-30% in case of women with stage III-IV disease. Plasmonic nanoparticles, via photothermal ablation, are emerging as lead candidates in next-generation cancer treatment for site-specific cell death...
2017: International Journal of Nanomedicine
https://www.readbyqxmd.com/read/28891826/injection-volume-and-anesthetic-effect-in-serratus-plane-block
#18
Tatsuya Kunigo, Takeshi Murouchi, Shuji Yamamoto, Michiaki Yamakage
BACKGROUND AND OBJECTIVES: Serratus plane block is performed for analgesia of the anterior chest wall. However, there has been no study concerning the appropriate volume for this block. This prospective randomized controlled study assesses the dermatomal spread and analgesic effects of serratus plane block. METHODS: Ultrasound-guided serratus plane block was performed for breast cancer surgery. The patients were randomly assigned to receive 20 or 40 mL of 0.375% ropivacaine...
November 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28489642/pupillary-reflex-for-evaluation-of-thoracic-paravertebral-block-a-prospective-observational-feasibility-study
#19
Baptiste Duceau, Mélanie Baubillier, Gaëlle Bouroche, Aline Albi-Feldzer, Christian Jayr
BACKGROUND: Although thoracic paravertebral block (TPVB) is recommended in major breast surgery, there is no gold standard to assess the success of TPVB. Pupillary dilation reflex (PDR) is the variation of the pupillary diameter after a noxious stimulus. The objective was to evaluate the feasibility of recording the PDR to assess analgesia in an anesthetized thoracic dermatome after TPVB. METHODS: This prospective, observational, single-center study included 32 patients requiring breast surgery under general anesthesia and TPVB...
October 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28419049/an-anatomical-basis-for-naming-plane-blocks-of-the-anteromedial-chest-wall
#20
LETTER
Ki Jinn Chin
No abstract text is available yet for this article.
May 2017: Regional Anesthesia and Pain Medicine
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