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Radial nerve block

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https://www.readbyqxmd.com/read/27904260/sonographic-identification-of-peripheral-nerves-in-the-forearm
#1
Saundra A Jackson, Charlotte Derr, Anthony De Lucia, Marvin Harris, Zuheily Closser, Branko Miladinovic, Rahul Mhaskar, Theresa Jorgensen, Lori Green
BACKGROUND: With the growing utilization of ultrasonography in emergency medicine combined with the concern over adequate pain management in the emergency department (ED), ultrasound guidance for peripheral nerve blockade in ED is an area of increasing interest. The medical literature has multiple reports supporting the use of ultrasound guidance in peripheral nerve blocks. However, to perform a peripheral nerve block, one must first be able to reliably identify the specific nerve before the procedure...
October 2016: Journal of Emergencies, Trauma, and Shock
https://www.readbyqxmd.com/read/27828793/comparison-of-supraclavicular-and-infraclavicular-brachial-plexus-block-a-systemic-review-of-randomized-controlled-trials
#2
Sun-Kyung Park, Su-Young Lee, Won Ho Kim, Han-Seul Park, Young-Jin Lim, Jae-Hyon Bahk
BACKGROUND: Supraclavicular (SC) and infraclavicular (IC) brachial plexus block (BPB) are commonly used for upper extremity surgery. Recent clinical studies have compared the effect of SC- and IC-BPB, but there have been controversies over spread of sensory blockade in each of the 4 peripheral nerve branches of brachial plexus. METHODS: This study included a systemic review, using the Medline and EMBASE database from their inceptions through March 2016. Randomized controlled trials (RCTs) comparing SC- and IC-BPB were included...
November 8, 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27798452/double-injection-technique-assisted-by-a-nerve-stimulator-for-ultrasound-guided-supraclavicular-brachial-plexus-block-results-in-better-distal-sensory-motor-block-a-randomised-controlled-trial
#3
Quehua Luo, Weifeng Yao, HaiHua Shu, Ming Zhong
BACKGROUND: To evaluate the efficacy of a nerve stimulator when used with ultrasound-guided double injection in supraclavicular brachial plexus block. OBJECTIVES: We hypothesised that targeting the inferior trunk of the plexus guided by a nerve stimulator would obtain a higher success rate of ulnar nerve blockade than the traditional double-injection technique. DESIGN: A blinded randomised controlled study. SETTING: Conducted at the University Hospital from October 2015 to January 2016...
October 27, 2016: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/27788289/brachial-plexus-in-the-pampas-fox-lycalopex-gymnocercus-a-descriptive-and-comparative-analysis
#4
Paulo de Souza Junior, Natan da Cruz de Carvalho, Karine de Mattos, Marcelo Abidu Figueiredo, André Luiz Quagliatto Santos
Twenty thoracic limbs of ten Lycalopex gymnocercus were dissected to describe origin and distribution of the nerves forming brachial plexuses. The brachial plexus resulted from the connections between the ventral branches of the last three cervical nerves (C6, C7 and C8) and first thoracic nerve (T1). These branches connected the suprascapular, subscapular, axillary, musculocutaneous, radial, median and ulnar nerves to the intrinsic musculature and connected the brachiocephalic, thoracodorsal, lateral thoracic, long thoracic, cranial pectoral and caudal pectoral nerves to the extrinsic musculature...
October 27, 2016: Anatomical Record: Advances in Integrative Anatomy and Evolutionary Biology
https://www.readbyqxmd.com/read/27616824/carpal-tunnel-injections-a-novel-approach-based-on-wrist-width
#5
Travis J Menge, Elizabeth B Rinker, Kang-Hsien Fan, John J Block, Donald H Lee
INTRODUCTION: Carpal tunnel steroid injections (CTIs) have the potential risk of damaging underlying critical structures, including the median nerve (MN), radial artery (RA), and ulnar neurovascular bundle (UB). The purpose of this study was to analyze the safety of a volar radial (VR) and volar ulnar (VU) CTI, using standardized anatomical "safe zones." MATERIALS AND METHODS: This study was performed on 87 cadaveric arms using a percentage of the total wrist width as a guide for placement of a VR (30 and 33% of total wrist width) and VU (60 and 66% of total wrist width) injection...
April 2016: Journal of Hand and Microsurgery
https://www.readbyqxmd.com/read/27524691/distal-peripheral-nerve-blocks-in-the-forearm-as%C3%A2-an-alternative-to-proximal-brachial-plexus-blockade-in-patients-undergoing-hand-surgery-a-prospective-and-randomized-pilot-study
#6
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
https://www.readbyqxmd.com/read/27507152/variations-in-brachial-plexus-with-respect-to-concomitant-accompanying-aberrant-arm-arteries
#7
Horst Claassen, Oliver Schmitt, Andreas Wree, Marko Schulze
INTRODUCTION: Variations in the brachial plexus are the rule rather than the exception. This fact is of special interest for the anesthetist when planning axillary block of brachial plexus. MATERIAL AND METHODS: 167 cadaver arms were evaluated for variations in brachial plexus, with focus on the cords of the plexus, the loop of the median nerve, and the course of the median, musculocutaneous, ulnar, axillary and radial nerves. In addition, concomitant arterial variations were recorded...
August 6, 2016: Annals of Anatomy, Anatomischer Anzeiger: Official Organ of the Anatomische Gesellschaft
https://www.readbyqxmd.com/read/27501616/onset-time-of-2-lidocaine-and-0-5-bupivacaine-mixture-versus-0-5-bupivacaine-alone-using-ultrasound-and-double-nerve-stimulation-for-infraclavicular-brachial-plexus-anesthesia-in-esrd-patients-undergoing-arteriovenous-fistula-creation
#8
RANDOMIZED CONTROLLED TRIAL
Orawan Pongraweewan, Nipa Inchua, Chanatthee Kitsiripant, Benchawan Kongmuang, Wannapa Tiwirach
OBJECTIVE: To reduce the onset of 0.5% bupivacaine by adding 2% lidocaine with 0.5% bupivacaine for ultrasound-guided and double stimulation technique at musculocutaneous and radial nerve for infraclavicular brachial plexus block. DESIGN: Prospective randomized double-blinded, controlled trial study. MATERIAL AND METHOD: 90 patients undergoing creation of arteriovenous fistula under ultrasound-guided infraclavicular brachial plexus block were randomized into 2 groups...
May 2016: Journal of the Medical Association of Thailand, Chotmaihet Thangphaet
https://www.readbyqxmd.com/read/27380869/efficacy-of-ultrasound-guided-axillary-brachial-plexus-block-for-analgesia-during-percutaneous-transluminal-angioplasty-for-dialysis-access
#9
Emiko Chiba, Kohei Hamamoto, Michio Nagashima, Katsuhiko Matsuura, Tomohisa Okochi, Keisuke Tanno, Osamu Tanaka
PURPOSE: To evaluate the efficacy and safety of ultrasound (US)-guided axillary brachial plexus block (ABPB) for analgesia during percutaneous transluminal angioplasty (PTA) for dialysis access. SUBJECTS AND METHODS: Twenty-one patients who underwent PTA for stenotic dialysis access shunts and who had previous experience of PTA without sedation, analgesia, and anesthesia were included. The access type in all patients was native arteriovenous fistulae in the forearm...
October 2016: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/27377467/secondary-hyperalgesia-is-mediated-by-heat-insensitive-a-fibre-nociceptors
#10
Emanuel N van den Broeke, Cédric Lenoir, André Mouraux
KEY POINTS: It is believed that secondary hyperalgesia (the increased sensitivity to mechanical nociceptive stimuli that develops after cutaneous tissue injury in the surrounding uninjured skin) is mediated by a subclass of nociceptors: the slowly adapting A-fibre mechano-heat nociceptors (AMH-type I). Here we tested this hypothesis. By using intense long-lasting heat stimuli, which are known to activate these slowly adapting AMH-type I nociceptors, we show that the perceived intensity elicited by these stimuli is not increased in the area of secondary hyperalgesia...
November 15, 2016: Journal of Physiology
https://www.readbyqxmd.com/read/27353456/general-anaesthesia-vs-conscious-sedation-for-transfemoral-aortic-valve-implantation-a-single-uk-centre-before-and-after-study
#11
L F Miles, K R Joshi, E H Ogilvie, C G Densem, A A Klein, M O'Sullivan, G Martinez, C D Sudarshan, Y Abu-Omar, J F Irons
Reported data suggest that 99% of transfemoral, transcatheter aortic valve implantations in the UK are performed under general anaesthesia. This before-and-after study is the first UK comparison of conscious sedation vs. general anaesthesia for this procedure. Patients who underwent general anaesthesia received tracheal intubation, positive pressure ventilation, radial arterial and central venous access and urinary catheterisation. Anaesthesia was maintained with propofol or sevoflurane. Patients who received conscious sedation had a fascia iliaca and ilioinguinal nerve block and low-dose remifentanil infusion, without invasive monitoring or urinary catheterisation...
August 2016: Anaesthesia
https://www.readbyqxmd.com/read/27263529/cold-evoked-potentials-ready-for-clinical-use
#12
P Hüllemann, A Nerdal, A Binder, S Helfert, M Reimer, R Baron
BACKGROUND: Cold-evoked potentials (CEPs) are known to assess the integrity of A-delta fibres and the spinothalamic tract. Nevertheless, the clinical value was not investigated previously. The aim of this study was to measure CEPs in 16 healthy subjects from the face, hand and foot sole and to investigate whether CEPs reliably detect A-delta fibre abnormalities. METHODS: Swift cold stimuli were applied to the skin with a commercially available thermode, which cooled down from 30 to 25 °C in approximately 0...
June 5, 2016: European Journal of Pain: EJP
https://www.readbyqxmd.com/read/27220118/complications-of-distal-radius-fractures-treated-by-volar-locking-plate-fixation
#13
Hiroshi Satake, Naomi Hanaka, Ryusuke Honma, Tadayoshi Watanabe, Shigeru Inoue, Yumiko Kanauchi, Yoshihiro Kato, Taku Nakajima, Daisuke Sato, Jun Eto, Masahiro Maruyama, Yasushi Naganuma, Junya Sasaki, Shuji Toyono, Mikio Harada, Daisuke Ishigaki, Masatoshi Takahara, Michiaki Takagi
The current study investigated the incidence of complications after surgery for distal radial fractures. This multicenter retrospective study was conducted at 11 institutions. A total of 824 patients who had distal radius fractures that were treated surgically between January 2010 and August 2012 were identified. The study patients were older than 18 years and were observed for at least 12 weeks after surgery for distal radius fractures with a volar locking plate. Sex, age, fracture type according to AO classification, implants, wrist range of motion, grip strength, fracture consolidation rate, and complications were studied...
September 1, 2016: Orthopedics
https://www.readbyqxmd.com/read/27185666/compartment-syndrome-in-a-patient-treated-with-perineural-liposomal-bupivacaine-exparel
#14
José Raul Soberón, Leslie E Sisco-Wise, Ross M Dunbar
Acute compartment syndrome is a condition that may result in sensorimotor deficits and loss of function of the affected limb as a result of ischemic injury. It is considered a surgical emergency and prompt diagnosis and treatment results in more favorable outcomes. The use of regional anesthesia is controversial in patients at risk for compartment syndrome due to concern of its potential to mask symptoms of the condition. A 44-year-old African American male presented to surgery for open reduction and internal fixation of a comminuted distal radius fracture...
June 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27159548/ultrasound-guided-continuous-superficial-radial-nerve-block-for-complex-regional-pain-syndrome
#15
Daryl S Henshaw, Sarah L Kittner, Jonathan D Jaffe
Although there are many potentially effective therapeutic options for complex regional pain syndrome (CRPS), no definitive treatment exists. Therefore, patients often exhaust both medical and surgical treatment options attempting to find relief for their symptoms. As pain control and restoration of physical movement are primary treatment goals, strategies that include regional anesthesia techniques are commonly employed, but potentially underutilized, treatment modalities. The authors present a patient with refractory CRPS that had significant improvement in both pain control and the ability to tolerate intensive physical therapy following the placement of a superficial radial nerve catheter and an infusion of local anesthetic for 6 days as part of a multimodal analgesic regimen...
June 2016: Journal of Pain & Palliative Care Pharmacotherapy
https://www.readbyqxmd.com/read/27008302/combined-spinal-cord-stimulation-and-peripheral-nerve-stimulation-for-brachial-plexopathy-a-case-report
#16
Ji Hye Choi, Shu Chung Choi, Dong Kyu Kim, Choon Ho Sung, Jin Young Chon, Sung Jin Hong, Ji Young Lee, Ho Sik Moon
Brachial plexopathy usually results from an iatrogenic brachial plexus injury and can sometimes cause severe chronic pain and disability. There are a number of possible treatments for this condition, including medication, physical therapy, nerve blocks, and neuromodulation, but they are not always successful. Recently, combined spinal cord stimulation (SCS) and peripheral nerve stimulation (PNS) have been tried for various chronic pain diseases because of their different mechanisms of action.Here, we describe the case of a 54-year-old man who was diagnosed with brachial plexopathy 8 years ago...
March 2016: Pain Physician
https://www.readbyqxmd.com/read/26931789/ultrasound-guided-nerve-blocks-in-emergency-medicine-practice
#17
Richard Amini, Jeffrey Z Kartchner, Arun Nagdev, Srikar Adhikari
OBJECTIVES: The purpose of this study was to investigate the current practice of ultrasound (US)-guided regional anesthesia at academic emergency departments, including education, protocols, policies, and quality assessment. METHODS: We conducted a cross-sectional study. A questionnaire on US-guided nerve blocks was electronically sent to all emergency US directors and emergency US fellowship directors. RESULTS: A total of 121 of 171 academic institutions with an emergency medicine residency program participated in this study, representing a 71% response rate...
April 2016: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/26896944/pulsed-radiofrequency-on-radial-nerve-under-ultrasound-guidance-for-treatment-of-intractable-lateral-epicondylitis
#18
Dae Seok Oh, Tae Hyung Kang, Hyae Jin Kim
Lateral epicondylitis is a painful and functionally limiting disorder. Although lateral elbow pain is generally self-limiting, in a minority of people symptoms persist for a long time. When various conservative treatments fail, surgical approach is recommended. Surgical denervation of several nerves that innervate the lateral humeral epicondyle could be considered in patients with refractory pain because it denervates the region of pain. Pulsed radiofrequency is a minimally invasive procedure that improves chronic pain when applied to various neural tissues without causing any significant destruction and painful complication...
June 2016: Journal of Anesthesia
https://www.readbyqxmd.com/read/26764488/assessment-of-median-nerve-mobility-by-ultrasound-dynamic-imaging-for-diagnosing-carpal-tunnel-syndrome
#19
Tai-Tzung Kuo, Ming-Ru Lee, Yin-Yin Liao, Jiann-Perng Chen, Yen-Wei Hsu, Chih-Kuang Yeh
Carpal tunnel syndrome (CTS) is the most common peripheral neuropathy and is characterized by median nerve entrapment at the wrist and the resulting median nerve dysfunction. CTS is diagnosed clinically as the gold standard and confirmed with nerve conduction studies (NCS). Complementing NCS, ultrasound imaging could provide additional anatomical information on pathological and motion changes of the median nerve. The purpose of this study was to estimate the transverse sliding patterns of the median nerve during finger movements by analyzing ultrasound dynamic images to distinguish between normal subjects and CTS patients...
2016: PloS One
https://www.readbyqxmd.com/read/26644614/comparison-between-perivascular-and-perineural-ultrasound-guided-axillary-brachial-plexus-block-using-levobupivacaine-a-prospective-randomised-clinical-study
#20
Uday Ambi, Pvv Bhanupriya, Shivanand Y Hulkund, D S Prakashappa
BACKGROUND AND AIMS: Ultrasound (US)-guided regional blocks are becoming increasingly popular as its use increases success rate, shortens block onset time and reduces complications. Currently, there exist two methods to perform US-guided axillary brachial plexus block (US-ABPB), the perivascular (PV) and the perineural (PN) techniques. We compared the two techniques to study the block characteristics and other variables using levobupivacaine. METHODS: In this prospective, randomised trial, 60 patients were randomly allocated to receive a PV (n = 30) or PN (n = 30) US-ABPB...
October 2015: Indian Journal of Anaesthesia
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