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Supraclavicular brachial plexus block

Faramarz Mosaffa, Seyed Amir Mohajerani, Reza Aminnejad, Ali Solhpour, Shideh Dabir, Gholam Reza Mohseni
BACKGROUND: Preemptive analgesia is the blocking of pain perception afferent pathways before noxious painful stimuli. Clonidine is an alpha agonist drug that is partially selective for α-2 adrenoreceptors. Clonidine is used as anti-anxiety medication and an, analgesic, and it prolongs the duration of the block in the brachial plexus block. OBJECTIVES: To compare the effect of preemptive clonidine with midazolam on intraoperative sedation, duration of block, and postoperative pain scores...
June 2016: Anesthesiology and Pain Medicine
Arvinder Pal Singh, Malika Mahindra, Ruchi Gupta, Sukhminder Jit Singh Bajwa
AIMS AND OBJECTIVES: Supplementation of dexmedetomidine produces a dose-dependent sedation, anxiolysis and analgesia without respiratory depression. This study was conducted to evaluate the possible effect of dexmedetomidine as an adjuvant to levobupivacaine for supraclavicular brachial plexus block in upper limb surgery. SETTINGS AND DESIGN: Tertiary care institute, Department of Anaesthesiology and Intensive Care, a placebo-controlled study. MATERIALS AND METHODS: After obtaining Ethical Committee approval, a randomized, double-blind, placebo-controlled study was conducted on sixty American Society of Anesthesiologists physical status I and II patients in the age group of 18-60 years, divided randomly into two groups, Group I received 30 ml of 0...
September 2016: Anesthesia, Essays and Researches
Archana Tripathi, Khushboo Sharma, Mukesh Somvanshi, Rajib Lochan Samal
BACKGROUND AND AIMS: Various additives are mixed with local anesthetic agents to increase the quality of block in regional anesthesia. We compared clonidine and dexmedetomidine as an adjunct to bupivacaine in supraclavicular brachial plexus block with respect to the onset and duration of sensory and motor block and duration of analgesia. MATERIAL AND METHODS: Sixty American Society of Anesthesiologists Grades I and II patients scheduled for various orthopedic surgeries of the upper limb under supraclavicular brachial plexus block were divided into two equal groups in a randomized, double-blind manner...
July 2016: Journal of Anaesthesiology, Clinical Pharmacology
José R Soberón, Joseph W Crookshank, Bobby D Nossaman, Clint E Elliott, Leslie E Sisco-Wise, Scott F Duncan
PURPOSE: Limited data exist regarding the role of perineural blockade of the distal median, ulnar, and radial nerves as a primary anesthetic in patients undergoing hand surgery. We conducted a prospective and randomized pilot study to compare these techniques to brachial plexus blocks as a primary anesthetic in this patient population. METHODS: Sixty patients scheduled for hand surgery were randomized to receive either an ultrasound-guided supraclavicular, infraclavicular, or axillary nerve block (brachial plexus blocks) or ultrasound-guided median, ulnar, and radial nerve blocks performed at the level of the mid to proximal forearm (forearm blocks)...
October 2016: Journal of Hand Surgery
Ritu Baloda, Jatinder Paul Singh Bhupal, Parmod Kumar, Gurjit Singh Gandhi
INTRODUCTION: Brachial plexus block is an excellent method for attaining optimal operating conditions by producing complete muscular relaxation, maintaining stable intraoperative haemodynamics and the associated sympathetic block. In addition, they provide extended postoperative analgesia with minimal side effects. Different adjuvants have been described in literature to hasten the onset and prolong the duration of block. The present study was conducted to study the effect of adding dexamethasone to levobupivacaine in supraclavicular brachial plexus block...
June 2016: Journal of Clinical and Diagnostic Research: JCDR
V Ahuja, D Thapa, S Gombar, D Dhiman
BACKGROUND: Unintentional intraneural injection under ultrasound guidance (USG) with fine caliber needles and lower success rate with large caliber Tuohy needles in supraclavicular brachial plexus block (SCB) have been reported. MATERIALS AND METHODS: We undertook study to standardize the use of 20-gauge short versus blunt bevel needle for SCB. After approval of Institutional Ethics Committee and written informed consent, patients were randomized using computer-generated random number table to either of the two groups; blunt bevel needle group (n = 30): SCB under USG using 20-gauge Tuohy needle or short bevel needle group (n = 30): SCB under USG using 20-gauge short bevel needle...
July 2016: Saudi Journal of Anaesthesia
Hong Jin Lim, Mohd Shahnaz Hasan, Karuthan Chinna
BACKGROUND AND OBJECTIVES: A high sodium concentration is known to antagonize local anesthetics when infiltrated around neural tissue. Thus, we hypothesized that the onset time for sensory and motor blockade, in supraclavicular brachial plexus block using ropivacaine diluted with dextrose would be shorter than with saline. METHODS: Patients scheduled for upper limb surgery were randomized to receive ultrasound guided supraclavicular brachial plexus block with 0...
July 2016: Brazilian Journal of Anesthesiology
Tuhin Mistry, Vandana Mangal, Gaurav Sharma, Aachu Agrawal
BACKGROUND AND AIMS: Supraclavicular approach to the brachial plexus may be associated with complications such as pneumothorax, inadvertent vascular puncture, inter-scalene block and neurovascular injuries. The present study was conceived to find out the variation in depth of brachial plexus to suggest the minimum length of needle required to effectively perform the block, thus preventing possible complications. METHODS: After approval from our Institutional Ethical Committee, informed and written consent was obtained from each of the ninety American Society of Anesthesiologists Physical Status I and II patients recruited, of either sex in the age group of 20-50 years...
June 2016: Indian Journal of Anaesthesia
Arun Kumar Alarasan, Jitendre Agrawal, Bhanu Choudhary, Amrita Melhotra, Satyendre Uike, Arghya Mukherji
BACKGROUND AND AIMS: With the use of ultrasound, a minimal effective volume of 20 ml has been described for supraclavicular brachial plexus block. However achieving a long duration of analgesia with this minimal volume remains a challenge. We aimed to determine the effect of dexamethasone on onset and duration of analgesia in low volume supraclavicular brachial plexus block. MATERIAL AND METHODS: Sixty patients were randomly divided into two groups of 30 each. Group C received saline (2 ml) + 20 ml of 0...
April 2016: Journal of Anaesthesiology, Clinical Pharmacology
Hong Jin Lim, Mohd Shahnaz Hasan, Karuthan Chinna
BACKGROUND AND OBJECTIVES: A high sodium concentration is known to antagonize local anesthetics when infiltrated around neural tissue. Thus, we hypothesized that the onset time for sensory and motor blockade, in supraclavicular brachial plexus block using ropivacaine diluted with dextrose would be shorter than with saline. METHODS: Patients scheduled for upper limb surgery were randomized to receive ultrasound guided supraclavicular brachial plexus block with 0...
July 2016: Revista Brasileira de Anestesiologia
Jeffrey Hull, Jean Heath, Wendy Bishop
Ultrasound-guided supraclavicular brachial plexus block using 1% and 2% lidocaine in 21 procedures is reported. Average procedure time was 5.1 minutes (± 1.2 min; range, 2-8 min). Average time of onset and duration were 4.8 minutes (± 3.7 min; range, 0-10 min) and 77.9 minutes (± 26.7 min; range, 44-133 min), respectively, for sensory block and 8.4 minutes (± 5.7 min; range, 3-23 min) and 99 minutes (± 40.5 min; range, 45-171 min), respectively, for motor block. The pain scale assessment averaged 0.4 (± 1...
May 2016: Journal of Vascular and Interventional Radiology: JVIR
Anatoli Stav, Leonid Reytman, Michael-Yohay Stav, Isaak Portnoy, Alexander Kantarovsky, Offer Galili, Shmuel Luboshitz, Roger Sevi, Ahud Sternberg
OBJECTIVE: We hypothesized that ultrasound (US)-guided technique of the supra- and infraclavicular and axillary approaches of brachial plexus block (BPB) will produce a high quality of surgical anesthesia for operations below the shoulder independently of the approach and body mass index (BMI). Intercostobrachial and medial brachial cutaneous nerves will be blocked separately because they are not a part of the brachial plexus. METHODS: This is a prospective randomized observer-blinded study...
2016: Rambam Maimonides Medical Journal
T Wiesmann, C Feldmann, H H Müller, L Nentwig, A Beermann, B F El-Zayat, M Zoremba, H Wulf, T Steinfeldt
BACKGROUND: Hemidiaphragmatic palsy is a common consequence of the interscalene brachial plexus block. It occurs less commonly with the supraclavicular approach. Register data suggest that the analgesic quality of a supraclavicular blockade is sufficient for arthroscopic shoulder surgery, although data on the post-operative analgesic effect are lacking. METHODS: After approval by the ethics committee, patients having arthroscopic shoulder surgery under general anaesthesia were randomized to receive a continuous interscalene or supraclavicular blockade...
September 2016: Acta Anaesthesiologica Scandinavica
Naveen Yadav, Arshad Ayub, Rakesh Garg, Samridhi Nanda, Babita Gupta, Chhavi Sawhney
BACKGROUND AND AIMS: There is wide variation in depth of brachial plexus in patient population at supraclavicular region. We plan to find the depth of the corner pocket and correlate it with age, weight, height and body mass index (BMI). MATERIAL AND METHODS: After approval from Ethics Committee, right-sided supraclavicular region of volunteers was scanned. Once an optimal image, which included subclavian artery, pleura, first rib and nerve bundles, was obtained, the corner pocket was kept in the middle of the screen and the image was frozen...
January 2016: Journal of Anaesthesiology, Clinical Pharmacology
W U Koh, H J Kim, H S Park, W J Choi, H S Yang, Y J Ro
Continuous interscalene block is an approved modality for postoperative pain control, but it may cause hemidiaphragmatic paresis. In this study we aimed to determine whether continuous supraclavicular block would provide postoperative analgesia comparable to that of continuous interscalene block and reduce the incidence of hemidiaphragmatic paresis. Patients scheduled for open rotator cuff repair were randomly allocated to receive continuous interscalene (n = 38) or supraclavicular block (n = 37). Both participants and assessing clinicians were blinded to the group allocation...
June 2016: Anaesthesia
G Fang, L Wan, W Mei, H H Yu, A L Luo
The aim of this study was to determine the minimum effective concentration of ropivacaine for ultrasound-guided supraclavicular brachial plexus block. Fifty-one patients undergoing arm surgery received double-injection ultrasound-guided supraclavicular block using ropivacaine 40 ml. The concentration of ropivacaine administered to each patient started at 0.225% and then depended on the response of the previous one, based on a biased coin design up-and-down sequential method. In case of failure, the ropivacaine concentration was increased by 0...
June 2016: Anaesthesia
Surekha Patil, Debasis Debata, Chaula Doshi, Varsha Vyas, Sapna Sinha
BACKGROUND AND AIMS: Supraclavicular brachial plexus block is ideal for upper limb surgical procedures. Buprenorphine, an agonist antagonist opioid has been used as an adjunct to prolong analgesia. We aimed to evaluate the quality and duration of postoperative analgesia by addition of buprenorphine to local anesthetic solution. MATERIAL AND METHODS: A prospective, randomized, double-blind control study was conducted on 50 healthy patients of ASA Grade I/II of age group 20-70 years scheduled for orthopedic and reconstructive surgery of upper limb under supraclavicular brachial plexus block...
October 2015: Journal of Anaesthesiology, Clinical Pharmacology
Mi Geum Lee, Kyung Cheon Lee, Hong Soon Kim, Seol Ju Park, Young Je Suh, Hyeon Ju Shin
There are many different approaches to ultrasound-guided supraclavicular brachial plexus block (US-SCBPB), and each has a different success rate and complications. The most commonly performed US-SCBPB is the corner pocket approach in which the needle is advanced very close to the subclavian artery and pleura. Therefore, it may be associated with a risk of subclavian artery puncture or pneumothorax. We advanced the needle into the central part of the neural cluster after penetrating the sheath of the brachial plexus in US-SCBPB...
December 2015: Korean Journal of Anesthesiology
Guo-Ying Liu, Zhen-Qiang Chen, Hai-Yan Jia, Zhi-Gang Dai, Xue-Jun Zhang
OBJECTIVE: Brachial plexus perineural blocks provide specific analgesia for upper limb surgery. We present our experience with ultrasound-guided supraclavicular brachial plexus perineural blocks for distal upper limb surgery. Although single-injection ultrasound-guided supraclavicular blocks have been reported, little is known about the advantages using this approach compared with nerve stimulator guided. METHODS: There were 60 patients who underwent upper limb surgery for orthopedic trauma and received a supraclavicular brachial plexus anesthesia...
2015: International Journal of Clinical and Experimental Medicine
Qingqing Pei, Yanqing Yang, Qin Liu, Zhiyou Peng, Zhiying Feng
BACKGROUND: Sex differences, which may be an important variable for determining anesthetic requirements, have not been well investigated in the aspect of local anesthetic. This investigation aimed to compare the minimum local analgesic concentration (MLAC) of ropivacaine for ultrasound-guided supraclavicular brachial plexus block (US-SCB) between men and women. MATERIAL AND METHODS: Patients aged 18-45 years undergoing elective forearm, wrist, or hand surgeries under US-SCB were divided into 2 groups according to sex...
2015: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
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