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Kalliopi Pitarokoili, Moritz Kronlage, Philip Bäumer, Daniel Schwarz, Ralf Gold, Martin Bendszus, Min-Suk Yoon
Background: We present a clinical, electrophysiological, sonographical and magnetic resonance neurography (MRN) study examining the complementary role of two neuroimaging methods of the peripheral nervous system for patients with chronic inflammatory demyelinating polyneuropathy (CIDP). Furthermore, we explore the significance of cross-sectional area (CSA) increase through correlations with MRN markers of nerve integrity. Methods: A total of 108 nerve segments on the median, ulnar, radial, tibial and fibular nerve, as well as the lumbar and cervical plexus of 18 CIDP patients were examined with high-resonance nerve ultrasound (HRUS) and MRN additionally to the nerve conduction studies...
2018: Therapeutic Advances in Neurological Disorders
Andrew T Koogler, Michael Kushelev
A 76-year-old male presented for reverse total shoulder arthroplasty (TSA) in the beach chair position. A preoperative interscalene nerve catheter was placed under direct ultrasound-guidance utilizing a posterior in-plane approach. On POD 2, the catheter was removed. Three weeks postoperatively, the patient reported worsening dyspnea with a subsequent chest X-ray demonstrating an elevated right hemidiaphragm. Pulmonary function testing revealed worsening deficit from presurgical values consistent with phrenic nerve palsy...
2018: Case Reports in Anesthesiology
Philippe Marty, Fabrice Ferré, Bertrand Basset, Constance Marquis, Benoit Bataille, Martine Chaubard, Mehdi Merouani, Olivier Rontes, Alain Delbos
PURPOSE: Ambulatory process in arthroscopic shoulder surgery has boomed over past decades. Some anesthetic techniques such as interscalene block (ISB) and its surrogates are associated with diaphragmatic paralysis and might compromise outpatient procedure. HYPOTHESIS: This study aims to assess consequences of diaphragmatic paralysis in obese patients. METHODS: This prospective observational study screened patients with body mass index (BMI) ≥ 30 kg/m2 undergoing acromioplasty or supraspinatus tendon repair...
March 6, 2018: Journal of Anesthesia
Ahmet Aslan, Ahmet Aktan, Mine Aslan, Yıldız Gülseren, Adnan Kabaalioğlu
OBJECTIVES: To determine the sonoelastographic findings for the normal brachial plexus via shear wave elastography (SWE) and strain elastography (SE) and the reliability of the measurements. METHODS: Thirty-nine healthy adult volunteers were included in the study. The brachial plexus was evaluated with SWE and SE at the interscalene region by 2 observers separately, and the observers were unaware of each other's outcomes. The elastic modulus (kilopascals), shear wave velocity (SWV, meters per second), and strain ratio were obtained...
February 26, 2018: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
Sung-Min Rhee, Nam Yun Chung, Hyeon Jang Jeong, Joo Han Oh
BACKGROUND: Subacromial pain pumps are used for analgesia after arthroscopic rotator cuff surgery. However, there is controversy about myotoxic or tendinotoxic effects of local anesthetics. HYPOTHESIS: Ropivacaine administered via a subacromial pain pump would have no adverse effect on rotator cuff tendon healing, fatty degeneration, strength, or functional outcomes after arthroscopic repair. STUDY DESIGN: Cohort study; Level of evidence, 3...
February 1, 2018: American Journal of Sports Medicine
Cun-Jin Wang, Ya-Li Ge, Ju Gao, Feng-Yun Long, Zhi-Hua Mi, Tian-Feng Huang, Xiang-Zhi Fang, Xiao-Ping Chen, Yu-Si Hua, Yang Zhang
Ultrasound-guided interscalene brachial plexus blockade (IBPB) has a relatively high success rate in shoulder surgery; however, whether multiple injections are superior to a single injection (SI) is currently unknown. In the present study, ultrasound-guided SI and triple-injection (TI) IBPBs were compared in a prospective randomized trial. A total of 111 patients undergoing arthroscopic shoulder surgery and presenting with an American Society of Anesthesiologists physical status grading of I-II were randomly allocated to receive IBPB with 15 ml of 1% ropivacaine as a SI or TI...
March 2018: Experimental and Therapeutic Medicine
Jai Singh, Versha Verma, Aman Thakur, Priyanka Sood
No abstract text is available yet for this article.
January 2018: Saudi Journal of Anaesthesia
Santhanam Suresh, Claude Ecoffey, Adrian Bosenberg, Per-Anne Lonnqvist, Gildasio S de Oliveira, Oscar de Leon Casasola, José de Andrés, Giorgio Ivani
BACKGROUND AND OBJECTIVES: Dosage of local anesthetics (LAs) used for regional anesthesia in children is not well determined. In order to evaluate and come to a consensus regarding some of these controversial topics, The European Society of Regional Anaesthesia and Pain Therapy (ESRA) and the American Society of Regional Anesthesia and Pain Medicine (ASRA) developed a Joint Committee Practice Advisory on Local Anesthetics and Adjuvants Dosage in Pediatric Regional Anesthesia. METHODS: Representatives from both ASRA and ESRA composed the joint committee practice advisory...
January 9, 2018: Regional Anesthesia and Pain Medicine
Mathew Nelson, Alexandra Reens, Lara Reda, David Lee
BACKGROUND: Interscalene brachial plexus blocks have been a routinely performed method of anesthesia for shoulder surgery that decreases the need for general anesthesia, length of stay, and recovery time. We describe a case of bupivacaine toxicity after an interscalene block. CASE REPORT: The patient was a 66-year-old man who presented to our Emergency Department by emergency medical services from an ambulatory surgery center where he had undergone rotator cuff surgery, with bradycardia and hypotension...
December 30, 2017: Journal of Emergency Medicine
Sally A Corey, Santosh Varkey, Douglas R Phillips, Gregory L Gay
CASE: A 57-year-old woman with no noteworthy medical or surgical history underwent an interscalene block with bupivacaine in preparation for an arthroscopic rotator cuff repair. Following administration of the bupivacaine, the patient sustained a ventricular fibrillation arrest. After successful cardiopulmonary resuscitation, she was diagnosed with Brugada syndrome. An implantable cardioverter-defibrillator was placed, and the rotator cuff repair was performed 1 month later. CONCLUSION: Brugada syndrome is an abnormality of the cardiac conduction system that leads to cardiac arrhythmias...
October 2017: JBJS Case Connector
Cheng Zhou, Stephen Choi, Richard Brull, Faraj W Abdallah
No abstract text is available yet for this article.
January 2018: Regional Anesthesia and Pain Medicine
M Boissard, V Crenn, T Noailles, S Campard, F Lespagnol
INTRODUCTION: Shoulder arthroscopy is particularly suited to outpatient surgery, thanks to advances in anesthetic and analgesic techniques. The main goal of this study was to compare postoperative recovery after shoulder arthroscopy between outpatient and inpatient management. HYPOTHESIS: There is no difference in functional recovery between inpatient and outpatient management. MATERIALS AND METHOD: A single-center, single-operator prospective study was conducted...
February 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
Brandon Michael Henry, Jens Vikse, Beatrice Sanna, Dominik Taterra, Martyna Gomulska, Przemysław A Pękala, R Shane Tubbs, Krzysztof A Tomaszewski
BACKGROUND: Cervical ribs (CR) are supernumerary ribs that arise from the seventh cervical vertebra. In the presence of CR, the boundaries of the interscalene triangle can be further constricted and result in neurovascular compression and thoracic outlet syndrome (TOS). The aim of our study was to provide a comprehensive evidence-based assessment of CR prevalence and their association with TOS as well as surgical approach to excision of CR and surgical patients' characteristics. METHODS: A thorough search of major electronic databases was conducted to identify any relevant studies...
February 2018: World Neurosurgery
Darren Holland, Ryan J J Amadeo, Scott Wolfe, Linda Girling, Faylene Funk, Mark Collister, Emily Czaplinski, Celeste Ferguson, Jeff Leiter, Jason Old, Peter MacDonald, Brenden Dufault, Thomas C Mutter
PURPOSE: Dexamethasone prolongs the duration of interscalene block, but the benefits of higher doses and perineural vs intravenous administration remain unclear. METHODS: This factorial design, double-blinded trial randomized 280 adult patients undergoing ambulatory arthroscopic shoulder surgery at a single centre in a 1:1:1:1 ratio. Patients received ultrasound-guided interscalene block with 30 mL 0.5% bupivacaine and 4 mg or 8 mg dexamethasone by either the perineural or intravenous route...
November 10, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
V M López Escárraga, K Dubos España, R H Castillo Bustos, L Peidró, S Sastre, X Sala-Blanch
INTRODUCTION: Diaphragmatic paralysis is a side-effect associated with interscalene block. Thickness index of the diaphragm muscle (inspiratory thickness/expiratory thickness) obtained by ultrasound has recently been introduced in clinical practice for diagnosis of diaphragm muscle atrophy. Our objective was to evaluate this index for the diagnosis of acute phrenic paresis associated with interscalene block. PATIENTS AND METHODS: We designed an observational study in 22 patients scheduled for shoulder arthroscopy...
November 7, 2017: Revista Española de Anestesiología y Reanimación
Betul Basaran, Aysun Ankay Yilbas, Zeki Gultekin
BACKGROUND: Interscalene block (ISB) is commonly associated with Horner's syndrome due to spread of local anesthetic to the cervical sympathetic chain. Postganglionic neurons that originate from superior cervical ganglia form the sympathetic innervation of eye. Decrease in sympathetic tone may change intraocular pressure (IOP) and ocular perfusion pressure (OPP). The aim of the study was to investigate whether ISB affects IOP and/or OPP. METHODS: Thirty patients scheduled for ambulatory shoulder surgery under regional anesthesia with a single-shot ISB (15 mL 0...
October 23, 2017: BMC Anesthesiology
T Volk, C Kubulus
Regional anesthesia has undergone many changes over the years and the increasing use of ultrasound has certainly played an important role in this. Apart from individual case reports in the literature of very different blocking options, some new procedures seem to have become established and can be broadly applied. Among these are blockades, by which ultrasound-guided injection of local anesthetics is carried out in fascial or muscular layers rather than around target nerves (e.g. cervical plexus blocks and truncal blocks)...
December 2017: Der Anaesthesist
Zhi Yuen Beh, Huae Min Tham, Yean Chin Lim, Noelle Louise Lim
No abstract text is available yet for this article.
October 2017: Korean Journal of Anesthesiology
Ahmet Kemalettin Koltka, Mehmet Büget, Emre Sertaç Bingül, Ali Erşen, Süleyman Küçükay, Ata Can Atalar, Mert Şentürk
OBJECTIVES: In arthroscopic rotator cuff surgery for postoperative analgesia opioids, nonsteroid analgesics, and local anesthetics can be used. This study aimed to compare the effectiveness, additional analgesic requirements, patients satisfaction, and complications of single-shot interscalene and supraclavicular blocks. METHODS: After obtaining the ethics committee's approval and informed consent, 50 ASA I-II patients were randomized to either the interscalene (GISB) or supraclavicular (GSCB) group...
July 2017: Aǧrı: Ağrı (Algoloji) Derneği'nin Yayın Organıdır, the Journal of the Turkish Society of Algology
J Oxlund, A H Clausen, S Venø, M D Nielsen, M Pall, T Strøm, P Toft
BACKGROUND: Ultrasound-guided interscalene nerve block with ropivacaine as local anesthetic agent given as boluses or continuous infusion is the preferred pain management after major shoulder surgery. The use of automated intermittent boluses has been shown to be superior to continuous infusion in sciatic and epidural nerve block. HYPOTHESIS: Automated intermittent boluses reduce pain after major shoulder surgery. METHODS: Seventy patients aged 18-75 years, scheduled for major shoulder surgery under general anesthesia with interscalene nerve block were included in this randomized controlled trial...
January 2018: Acta Anaesthesiologica Scandinavica
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