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Ulnar nerve block

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https://www.readbyqxmd.com/read/28089807/ultrasonography-detects-ulnar-nerve-dislocation-despite-normal-electrophysiology-and-magnetic-resonance-imaging
#1
Jared M Pisapia, Zarina S Ali, Eric D Hudgins, Viviane Khoury, Gregory G Heuer, Eric L Zager
BACKGROUND: Dislocation of the ulnar nerve (UN) occurs in a subset of patients with ulnar neuropathy. Electrodiagnostic and magnetic resonance imaging (MRI) studies are performed to support the clinical diagnosis. We report the case of a patient with ulnar neuropathy with normal electrodiagnostic and MRI studies but with ultrasound (US) showing UN dislocation, which prompted successful treatment by UN submuscular transposition. CASE DESCRIPTION: A healthy 15 year-old female softball player presented with right medial elbow pain and paresthesias of the fourth and fifth digits...
January 12, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28049434/why-does-a-cooled-object-feel-heavier-psychophysical-investigations-into-the-weber-s-phenomenon
#2
James S Dunn, David A Mahns, Saad S Nagi
BACKGROUND: It has long been known that a concomitantly cooled stimulus is perceived as heavier than the same object at a neutral temperature-termed Weber's Phenomenon (WP). In the current study, we re-examined this phenomenon using well-controlled force and temperature stimuli to explore the complex interplay between thermal and tactile systems, and the peripheral substrates contributing to these interactions. A feedback-controlled apparatus was constructed using a mechanical stimulator attached to a 5- × 5-mm thermode...
January 3, 2017: BMC Neuroscience
https://www.readbyqxmd.com/read/27999501/axillary-block-induced-chemical-sympathectomy-in-the-setting-of-digital-ischemia
#3
José R Soberón, T Michael Truxillo, Christin C Gethers, Taylor A Smith, William E Davis
BACKGROUND: Digital ischemia is associated with several rheumatologic disorders and is often difficult to treat. Symptoms and sequelae can include pain, disability, need for amputation, and poor quality of life. METHODS: Patients diagnosed with digital ischemia were referred for an ultrasound-guided axillary nerve block using liposomal bupivacaine (Exparel, Pacira Pharmaceuticals). The primary outcome measure was radial and ulnar artery diameter preprocedure and postprocedure...
2016: Ochsner Journal
https://www.readbyqxmd.com/read/27999499/perineural-liposomal-bupivacaine-for-postoperative-pain-control-in-patients-undergoing-upper-extremity-orthopedic-surgery-a-prospective-and-randomized-pilot-study
#4
José R Soberón, William Ericson-Neilsen, Leslie E Sisco-Wise, Mariella Gastañaduy, David E Beck
BACKGROUND: Upper extremity surgery is commonly performed in the ambulatory setting and is associated with moderate to severe postoperative pain. METHODS: Patients scheduled for upper extremity orthopedic surgery with a peripheral nerve block were randomized to receive either an ultrasound-guided single-injection supraclavicular block or ultrasound-guided median, ulnar, and radial nerve blocks (forearm blocks) performed at the level of the mid to proximal forearm with liposomal bupivacaine (Exparel) combined with a short-acting supraclavicular block...
2016: Ochsner Journal
https://www.readbyqxmd.com/read/27904260/sonographic-identification-of-peripheral-nerves-in-the-forearm
#5
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
#6
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/27827526/the-efficacy-of-pediatric-ultrasound-guided-brachial-plexus-block-anesthesia-and-determination-of-optimal-anesthetic-drug-dosage
#7
Chuanguo Xu, Bing Wang, Aijun Yang, Zhiquan Xie, Chunxue Liu, Xiuwei Lang, Guanglei Wang
BACKGROUND: The objective of the present study was to investigate the effect of pediatric ultrasound guided brachial plexus block anesthesia and to determine the optimal anesthetic drug dosage. METHODS: Ninety-seven children who required elective upper limb surgery were randomly divided into three groups: Group A with 32 cases, Group B with 35 cases and Group C with 30 cases. All three groups of patients underwent ultrasound guided brachial plexus block anesthesia...
November 9, 2016: Minerva Pediatrica
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
#8
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
#9
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/27784125/investigation-of-anodal-stimulation-and-its-implications-for-f-wave-examinations
#10
Takamichi Kanbayashi, Takaharu Yamauchi, Yosuke Miyaji, Masahiro Sonoo
INTRODUCTION: Recent studies have shown that stimulation occurs at the anode of stimulating electrodes instead of anodal block. This phenomenon may be a pitfall in F-wave examinations. METHODS: Subjects included 10 healthy volunteers. Their ulnar nerve was stimulated at the wrist with the cathode placed distally. Antidromic impulses were evaluated using mixed nerve action potential (MNAP) at the elbow. RESULTS: Anodal stimulation occurred for both sensory and motor fibers at 22 mm proximal to the anode, on average, which may theoretically shorten the F-wave latency by about 0...
October 26, 2016: Muscle & Nerve
https://www.readbyqxmd.com/read/27749354/continuous-peripheral-nerve-blocks-an-update-of-the-published-evidence-and-comparison-with-novel-alternative-analgesic-modalities
#11
Brian M Ilfeld
A continuous peripheral nerve block (CPNB) consists of a percutaneously inserted catheter with its tip adjacent to a target nerve/plexus through which local anesthetic may be administered, providing a prolonged block that may be titrated to the desired effect. In the decades after its first report in 1946, a plethora of data relating to CPNB was published, much of which was examined in a 2011 Anesthesia & Analgesia article. The current update is an evidence-based review of the CPNB literature published in the interim...
January 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27681481/occupation-based-intervention-versus-rote-exercise-in-modified-constraint-induced-movement-therapy-for-patients-with-median-and-ulnar-nerve-injuries-a-randomized-controlled-trial
#12
Hamid Reza Rostami, Malahat Akbarfahimi, Afsoon Hassani Mehraban, Ali Reza Akbarinia, Susan Samani
OBJECTIVE: To investigate effect of practice type during modified constraint-induced movement therapy on hand function in patients with chronic median and ulnar nerve injuries. DESIGN: A prospective, single-blinded, randomized controlled clinical trial. SETTING: Participants' private home. SUBJECTS: A convenience sample of 36 outpatient participants allocated randomly to three equal groups. INTERVENTIONS: Intervention groups underwent 3-hour intensive training of affected hand each day, 3-day a week, 4-week in association with immobilisation of healthy hand: occupation-based group practiced meaningful occupations while rote exercise-based group performed rote exercises during constraint-induced movement therapy...
September 28, 2016: Clinical Rehabilitation
https://www.readbyqxmd.com/read/27616824/carpal-tunnel-injections-a-novel-approach-based-on-wrist-width
#13
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/27559280/impact-of-shoulder-internal-rotation-on-ulnar-nerve-excursion-and-strain-in-embalmed-cadavers-a-pilot-study
#14
Mark Gugliotti, Bennett Futterman, Thomas Ahrens, David Block, Lauren Brown, Micheal Dagro, James Falesto, Aliza Lyon
DESIGN: Laboratory study, repeated-measures design. OBJECTIVE: To determine if the substitution of shoulder internal rotation for external rotation during the upper limb neurodynamic test (ULNT3) evokes a comparable ulnar nerve excursion and strain in embalmed cadavers. Shoulder external rotation is a primary movement component of the ULNT3. It has been suggested that shoulder internal rotation may provide a similar load to the nervous system. There are no data to either support or negate this claim...
May 2016: Journal of Manual & Manipulative Therapy
https://www.readbyqxmd.com/read/27555126/recovery-of-laryngeal-nerve-function-with-sugammadex-after-rocuronium-induced-profound-neuromuscular-block
#15
Vittorio Pavoni, Lara Gianesello, Cristiana Martinelli, Andrew Horton, Alessandra Nella, Gabriele Gori, Martina Simonelli, Giuseppe De Scisciolo
STUDY OBJECTIVE: The aim of this study was to evaluate the efficacy of sugammadex in reversing profound rocuronium-induced neuromuscular block at the laryngeal adductor muscles using motor-evoked potentials (mMEPs). DESIGN: A prospective observational study. SETTING: University surgical center. PATIENTS: Twenty patients with American Society of Anesthesiologists physical class I-II status who underwent propofol-remifentanil anesthesia for the surgery of the thyroid gland...
September 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27552333/can-neurologic-examination-predict-pathophysiology-of-ulnar-neuropathy-at-the-elbow
#16
Gregor Omejec, Tomaž Žgur, Simon Podnar
OBJECTIVE: To explore the utility of neurologic examination to predict the pathophysiology of ulnar nerve lesions in patients with ulnar neuropathies at the elbow (UNE). METHODS: We prospectively recruited consecutive patients with suspected UNE. Four blinded investigators took a history and performed neurologic, electrodiagnostic (EDx) and ultrasonographic (US) examinations. In patients with axonal UNE, conduction block and conduction slowing, the pathophysiologies of UNE and neurologic examination findings were compared...
October 2016: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
https://www.readbyqxmd.com/read/27549387/the-neuromuscular-effects-of-rocuronium-under-sevoflurane-remifentanil-or-propofol-remifentanil-anesthesia-a-randomized-clinical-comparative-study-in-an-asian-population
#17
Sangseok Lee, Young Jin Ro, Won Uk Koh, Tomoki Nishiyama, Hong-Seuk Yang
BACKGROUND: We conducted a prospective, randomized, multicenter study to evaluate the differences in the blocking effect of different doses of rocuronium between sevoflurane- or propofol-remifentanil anesthesia in an Asian population. METHODS: A total of 368 ASA I-II patients was enrolled. Anesthesia was induced with 2.0 mg/kg propofol and 0.1 μg/kg/min remifentanil (TIVA) or 5.0 vol.% sevoflurane with 0.1 μg/kg/min remifentanil (SEVO). Tracheal intubation was facilitated at 180 s after the administration of rocuronium at 0...
August 22, 2016: BMC Anesthesiology
https://www.readbyqxmd.com/read/27545305/pharmacokinetics-and-pharmacodynamics-of-rocuronium-in-young-adult-and-elderly-patients-undergoing-elective-surgery
#18
Renan M Varrique, Gabriela R Lauretti, Julia A Matsumoto, Vera L Lanchote, Natalia V de Moraes
OBJECTIVE: To evaluate the impact of advanced age on rocuronium kinetic disposition in ASA I-III patients undergoing elective surgeries. METHODS: Young adult (20-50 years, n = 15) and elderly patients (65-85 years, n = 14) submitted to surgery under general anaesthesia were investigated. All patients were induced with individual intravenous doses of midazolam, rocuronium, fentanyl and propofol. Rocuronium-induced neuromuscular block was monitored by train of four stimulations of the adductor muscle of the thumb on the ulnar nerve...
November 2016: Journal of Pharmacy and Pharmacology
https://www.readbyqxmd.com/read/27524943/qualitative-neuromuscular-monitoring-how-to-optimize-the-use-of-a-peripheral-nerve-stimulator-to-reduce-the-risk-of-residual-neuromuscular-blockade
#19
REVIEW
Stephan R Thilen, Sanjay M Bhananker
This review provides recommendations for anesthesia providers who may not yet have quantitative monitoring and sugammadex available and thus are providing care within the limitations of a conventional peripheral nerve stimulator (PNS) and neostigmine. In order to achieve best results, the provider needs to understand the limitations of the PNS. The PNS should be applied properly and early. All overdosing of neuromuscular blocking drugs should be avoided and the intraoperative neuromuscular blockade should be maintained only as deep as necessary...
2016: Current Anesthesiology Reports
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
#20
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
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