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Radial nerve block

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
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
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
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
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
Emanuel N van den Broeke, Cédric Lenoir, André Mouraux
Secondary hyperalgesia refers to the increase in sensitivity to mechanical nociceptive stimuli delivered outside the area of tissue injury. Previous studies suggested that secondary hyperalgesia is mediated by a specific class of myelinated nociceptors: slowly-adapting A-fibre mechano- and heat-sensitive (AMH) Type I nociceptors. Here, we tested this hypothesis by examining, whether long-lasting heat stimuli, which are known to activate AMH-type I nociceptors, elicit enhanced responses when delivered to the area of secondary hyperalgesia induced by high frequency electrical stimulation of the skin (HFS)...
July 5, 2016: Journal of Physiology
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
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
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
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
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
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
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
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
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
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
Faramarz Mosaffa, Babak Gharaei, Mohammad Qoreishi, Sajjad Razavi, Farhad Safari, Mohammad Fathi, Gholamreza Mohseni, Hedayatollah Elyasi, Fahimeh Hosseini
BACKGROUND: Although local anesthesia is a suitable method for upper limb surgeries, there is debate regarding the effects of appropriate dosing. OBJECTIVES: In the current study, we investigated the effects of the concentration and volume of a local anesthetic on the beginning and quality of anesthesia during upper limb orthopedic surgeries. PATIENTS AND METHODS: This double-blinded, randomized, clinical trial was conducted on 60 patients aged between 18 and 85 years candidated for upper limb orthopedic operations...
August 2015: Anesthesiology and Pain Medicine
Taeha Ryu, Byung Tae Kil, Jong Hae Kim
Although supraclavicular brachial plexus block (SCBPB) was repopularized by the introduction of ultrasound, its usefulness in shoulder surgery has not been widely reported. The objective of this study was to compare motor and sensory blockades, the incidence of side effects, and intraoperative opioid analgesic requirements between SCBPB and interscalene brachial plexus block (ISBPB) in patients undergoing arthroscopic shoulder surgery. Patients were randomly assigned to 1 of 2 groups (ISBPB group: n = 47; SCBPB group: n = 46)...
October 2015: Medicine (Baltimore)
Shivinder Singh, Rakhee Goyal, Kishan Kumar Upadhyay, Navdeep Sethi, Ram Murti Sharma, Anoop Sharma
BACKGROUND AND AIMS: This study was carried out to evaluate the difference in efficacy, safety, and complications of performing brachial plexus nerve blocks by using a nerve locator when compared to ultrasound (US) guidance. MATERIAL AND METHODS: A total of 102 patients undergoing upper limb surgery under supraclavicular brachial plexus blocks were randomly divided into two groups, one with US and the other with nerve stimulator (NS). In Group US, "Titan" Portable US Machine, Sonosite, Inc...
July 2015: Journal of Anaesthesiology, Clinical Pharmacology
M Elhosseini Tageldin, Mamun Alrashid, Al-Achraf Khoriati, Srinivas Gadikoppula, Henry Dushan Atkinson
BACKGROUND: We present a pilot series of patients with distal forearm fractures manipulated following a proximal periosteal nerve block with local anaesthesia. This is a novel technique which can be utilised in adults and children and is described herein. METHODS: With a median of 40 years (range 10-81 years), 42 patients (16 children) with distal radial and ulnar fractures were included. Of these patients, 40 underwent periosteal blocks in the emergency room or fracture clinic; 2 were already inpatients...
2015: Journal of Orthopaedic Surgery and Research
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