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Cervical plexus block

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
Ali Ahiskalioglu, Ahmet Murat Yayik, Elif Oral Ahiskalioglu, Aysenur Dostbil, Omer Doymus, Erdem Karadeniz, Muhammet Ali Ari, Furkan Sengoz, Haci Ahmet Alici, Erkan Cem Celik
PURPOSES: The postoperative analgesic effect of tizanidine has not yet been evaluated sufficiently. The role of bilateral superficial cervical plexus block (BSCPB) for postoperative analgesia after thyroidectomy remains questionable. We aimed to evaluate the analgesic effect of combined use of BSCPB and a single-dose oral tizanidine in patients undergoing elective thyroid surgery. METHODS: Sixty patients undergoing thyroidectomy were randomized into 3 groups. The control group (Group C, n = 20) received BSCPB with 0...
February 21, 2018: Journal of Anesthesia
D Mayhew, N Sahgal, R Khirwadkar, J M Hunter, A Banerjee
BACKGROUND: Thyroid surgery is moderately painful, but is increasingly being considered as a day-case procedure. Bilateral superficial cervical plexus block (BSCPB) provides an adjuvant technique to facilitate this approach, but there is great evidential heterogeneity in randomised controlled trials (RCTs) about its use. METHODS: A systematic search, critical appraisal, and analysis of RCTs was performed. Trials investigating preoperative or postoperative BSCPB compared with control in patients undergoing thyroid surgery via neck incision were included...
February 2018: British Journal of Anaesthesia
Paolo Monticelli, Ella Fitzgerald, Jaime Viscasillas
OBJECTIVE: To describe a novel in-plane ultrasound (US)-guided approach to the sixth (C6), seventh (C7), eighth (C8) cervical and to the first thoracic (T1) spinal nerves. STUDY DESIGN: Prospective, descriptive, experimental anatomic study. ANIMALS: A total of seven canine Beagle cadavers. METHODS: Phase 1: One cadaver was used to define bony landmarks for the C6-T1 spinal nerves using computed tomography (CT) and magnetic resonance imaging...
September 15, 2017: Veterinary Anaesthesia and Analgesia
Nilgun Kavrut Ozturk, Ali Sait Kavakli, Kadir Sagdic, Kerem Inanoglu, Raif Umot Ayoglu
OBJECTIVES: Although the cervical plexus block generally provides adequate analgesia for carotid endarterectomy, pain caused by metal retractors on the inferior surface of the mandible is not prevented by the cervical block. Different pain relief methods can be performed for patients who experience discomfort in these areas. In this study, the authors evaluated the effect of mandibular block in addition to cervical plexus block on pain scores in carotid endarterectomy. DESIGN: A prospective, randomized, controlled trial...
June 20, 2017: Journal of Cardiothoracic and Vascular Anesthesia
Hong Zeng, Zhengqian Li, Xiaoqing Zhang, Ning Wang, Yang Tian, Jun Wang
RATIONALE: Primary hyperparathyroidism (PHPT) during pregnancy is rare. Nevertheless, hypercalcemia secondary to gestational PHPT may be masked by physiological changes in calcium homeostasis during pregnancy. Gestational PHPT constitutes a serious danger to mother and fetus. Surgery is the only curative treatment when conservative treatment could not control the condition. Due to the lack of guidelines concerning PHPT during pregnancy, the optimal anesthetic management of PHPT during pregnancy needs to be individualized...
December 2017: Medicine (Baltimore)
Alicia Skelding, Alexander Valverde, Melissa Sinclair, Jeffrey Thomason, Noel Moens
OBJECTIVES: To describe the ventral spinal nerve rami contribution to the formation of the brachial plexus (BP), and to compare ease of performing and nerve staining between three blind techniques for BP blockade in dogs. STUDY DESIGN: Prospective, randomized, blind study. ANIMALS: A total of 18 dog cadavers weighing 28.2 ± 9.7 kg (mean ± standard deviation). METHODS: Dogs were randomly assigned to two of three BP treatments: traditional approach (TA), perpendicular approach (PA), and axillary approach (AA)...
December 12, 2017: Veterinary Anaesthesia and Analgesia
Andrzej Krol, Arber Vala, Leonidas Phylactides, Matthew Szarko, Miguel A Reina, Jose de Andrés
BACKGROUND: The aim of the study was to investigate the difference between intraneural and perineural injection pressures in human cadavers. Targeted nerves included the cervical roots, the supraclavicular and infraclavicular brachial plexus, the sciatic-subgluteal nerve and the common peroneal and tibial nerves. METHODS: Ten readings were obtained for each nerve location. 1mL of 0.9% NaCl was injected over ten seconds - deliberately slower than in clinical practice to eliminate the risk of aberrant readings relating to the speed of injection...
January 16, 2018: Minerva Anestesiologica
Deepak Thapa, Vanita Ahuja, Deepanshu Dhiman
No abstract text is available yet for this article.
December 2017: Indian Journal of Anaesthesia
Ayhan Kaydu, Ebru Tarıkçı Kılıç, Erhan Gökçek, Mehmet Salim Akdemir
Regional anesthesia in the form of combined cervical plexus block is gaining popularity as a technique of choice for cervical spine surgeries, especially for urgent ones. An important advantage is that it allows continuous monitoring of patient's neurological status. The success of the block often depends on accurate placement of the local anesthetic. Landmarks for the block are therefore of great importance. In this case, we aimed to present a 74-year-old man with C4-5 odontoid fracture. We planned to perform a unilateral combined cervical plexus block for anterior cervical instrumentation and fusion (ACIF) operation because of his associated high-risk comorbid disorders...
October 2017: Anesthesia, Essays and Researches
Stanley K H Lam, Kenneth Dean Reeves, An-Lin Cheng
Deep nerve hydrodissection uses fluid injection under pressure to purposely separate nerves from areas of suspected fascial compression, which are increasingly viewed as potential perpetuating factors in recalcitrant neuropathic pain/complex regional pain. The usage of 5% dextrose water (D5W) as a primary injectate for hydrodissection, with or without low dose anesthetic, could limit anesthetic-related toxicity. An analgesic effect of 5% dextrose water (D5W) upon perineural injection in patients with chronic neuropathic pain has recently been described...
2017: BioMed Research International
Ronald Seidel
Blockades of the cervical plexus are established anesthesia procedures, not only in the context of operative carotid revascularizations. Recent investigations define inner sonoanatomic landmarks as well as the importance of brain nerves for innervation in the neck region. The present practice-oriented article discusses current study results, alternative techniques (ultrasound- versus landmark-guided) and fields of application (carotid desobliteration, surgery of the shoulder, ear and infraclavicular region)...
November 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
Ya Hu, Ming Cui, Zhengyi Sun, Zhe Su, Xiang Gao, Quan Liao, Yupei Zhao
Background: Primary hyperparathyroidism (pHPT) in pregnancy is a rare event, but it poses a significant risk to mothers and fetuses. The optimal treatment strategy remains controversial. Methods: We present a consecutive series of twelve pregnant women with pHPT. Results: Twelve women were diagnosed with pHPT during pregnancy or in the postpartum period. Four of them presented no symptoms or mild symptoms. Four patients experienced serious complications, including hypercalcaemic crisis, acute pancreatitis, and eclampsia...
2017: International Journal of Endocrinology
Xu Li, Min-Na Li, Xu-Lei Cui, Shu-Ai Tang, Ya Hu, Quan Liao, Yu-Guang Huang
Objective To explore the efficacy and safety of ultrasound-guided cervical root block (CRB) in patients undergoing minimally invasive parathyroidectomy (MIP).Methods We enrolled 35 patients with hyperparathyroidism undergoing MIP in Peking Union Medical College Hospital.C4-7 nerve roots were identified in ultrasound imaging by the shape of the transverse process.A 50 mm insulated needle was gently introduced by an in-plane approach toward the posterior edge of the nerve root located at the inside of the posterior tubercle...
October 30, 2017: Zhongguo Yi Xue Ke Xue Yuan Xue Bao. Acta Academiae Medicinae Sinicae
Hyung Tae Kim, Sae Young Kim, Gyung Jo Byun, Byung Chul Shin, Jin Young Lee, Eun Joo Choi, Jong Bum Choi, Ji Hee Hong, Seung Won Choi, Yeon Dong Kim
Background: Recently, the use of ultrasound (US) techniques in regional anesthesia and pain medicine has increased significantly. However, the current extent of training in the use of US-guided pain management procedures in Korea remains unknown. The purpose of the present study was to assess the current state of US training provided during Korean Pain Society (KPS) pain fellowship programs through the comparative analysis between training hospitals. Methods: We conducted an anonymous survey of 51 pain physicians who had completed KPS fellowships in 2017...
October 2017: Korean Journal of Pain
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
D Musso, S Flohr-Madsen, K Meknas, T Wilsgaard, L M Ytrebø, Ø Klaastad
BACKGROUND: Interscalene brachial plexus block is currently the gold standard for intra- and post-operative pain management for patients undergoing arthroscopic shoulder surgery. However, it is associated with block related complications, of which effect on the phrenic nerve have been of most interest. Side effects caused by general anesthesia, when this is required, are also a concern. We hypothesized that the combination of superficial cervical plexus block, suprascapular nerve block, and infraclavicular brachial plexus block would provide a good alternative to interscalene block and general anesthesia...
October 2017: Acta Anaesthesiologica Scandinavica
Tjokorda Gde Agung Senapathi, I Made Gede Widnyana, I Gusti Ngurah Mahaalit Aribawa, Made Wiryana, I Ketut Sinardja, I Ketut Wibawa Nada, Aa Gde Putra Semara Jaya, I Gede Koko Swadharma Putra
PURPOSE: Thyroidectomy causes postoperative pain and patient discomfort. Bilateral superficial cervical plexus block is a regional anesthesia technique that can provide analgesia during and after surgery. This study aims to compare the effectiveness of ultrasound (US)-guided versus landmark (LM) technique for bilateral superficial cervical plexus block in thyroidectomy. PATIENTS AND METHODS: Thirty-six patients undergoing thyroidectomy were divided into two groups randomly (n=18); either US-guided (US group) or LM technique (LM group) for bilateral superficial cervical plexus block...
2017: Journal of Pain Research
B R Shrestha, P Sharma
In routine practice, regional anaesthesia is less commonly used for clavicular fracture compared to general anaesthesia. We report two cases of clavicle fracture for which operative treatment was done under combined superficial cervical plexus and interscalene brachial plexus block. In both the cases combination of ropivacaine and dexmeditomidine was used for block. Both the patients exhibited comfort and there was no additional analgesic demand in both the cases. Thus combination of interscalene and superficial cervical plexus block can prove to be useful in patients with clavicle fracture where administration of general anaesthesia and its adverse effects could be avoided...
April 2017: JNMA; Journal of the Nepal Medical Association
Xijian Ke, Ji Li, Yong Liu, Xi Wu, Wei Mei
BACKGROUND: Anesthesia management for patients with severe ankylosing spondylitis scheduled for total hip arthroplasty is challenging due to a potential difficult airway and difficult neuraxial block. We report 4 cases with ankylosing spondylitis successfully managed with a combination of lumbar plexus, sacral plexus and T12 paravertebral block. CASE PRESENTATION: Four patients were scheduled for total hip arthroplasty. All of them were diagnosed as severe ankylosing spondylitis with rigidity and immobilization of cervical and lumbar spine and hip joints...
June 26, 2017: BMC Anesthesiology
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