Read by QxMD icon Read

Ulnar nerve block

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...
October 3, 2016: Anesthesia and Analgesia
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
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
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
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
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
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
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...
August 21, 2016: Journal of Pharmacy and Pharmacology
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
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
Phil Woo Choung, Min Young Kim, Hyung Soon Im, Ki Hoon Kim, Im Joo Rhyu, Byung Kyu Park, Dong Hwee Kim
OBJECTIVE: To identify the anatomic characteristics of the pronator quadratus (PQ) muscle and the entry zone (EZ) of the anterior interosseous nerve (AIN) to this muscle by means of cadaver dissection. METHODS: We examined the PQ muscle and AIN in 20 forearms from 10 fresh cadavers. After identifying the PQ muscle and the EZ of the AIN, we measured the distances from the midpoint (MidP) of the PQ muscle and EZ to the vertical line passing the tip of the ulnar styloid process (MidP_X and EZ_X, respectively) and to the medial border of the ulna (MidP_Y and EZ_Y, respectively)...
June 2016: Annals of Rehabilitation Medicine
A Erdem Bagatur, Mehmet Burak Yalcin, Utku Erdem Ozer
Ulnar neuropathy at the elbow is the second most frequent entrapment neuropathy and is considered idiopathic in most patients. However, several anatomic variations, including the anconeus epitrochlearis muscle, have been reported to cause ulnar nerve compression. The anconeus epitrochlearis muscle is a common anatomic variation, with a prevalence of up to 34%, but the clinical diagnosis of ulnar neuropathy of the elbow as a result of this variation is rare, with an unknown prevalence. It is a congenital accessory muscle between the medial humeral epicondyle and the olecranon that covers the posterior aspect of the cubital tunnel and is usually an operative finding, not a preoperative diagnosis...
September 1, 2016: Orthopedics
Justin W Silverstein, T EP, CNCT, Ricky Madhok, Christopher D Frendo, Hargovind DeWal, George R Lee, MS
Somatosensory evoked potentials (SSEPs) are a valuable tool for assessing changes in peripheral nerve pathways caused by patient positioning during spinal surgeries. These changes, when left undiagnosed, may lead to postoperative neurological sequelae. Why an upper extremity SSEP attenuates due to positioning is not necessarily clear and can be multifactorial, affecting the peripheral nerves or elements of the brachial plexus. A conduction block can occur at any point along the course of the nerve secondary to entrapment, compression, and ischemia...
June 2016: Neurodiagnostic Journal
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
Serhan Yildirim, Rahşan Adviye, Hakan Levent Gül, Ülkü Türk Börü
Objective Acute motor axonal neuropathy (AMAN), characterized with decreased compound muscle action potentials (CMAP) and absence of demyelinating findings in electrophysiological studies, is a subtype of Guillain-Barre Syndrome (GBS). A 4 yr-old male patient presented with ascending weakness, dysarthria and dysphagia to İstanbul Dr. Lütfi Kırdar Kartal Training and Research Hospital Neurology outpatient for three days to in 2012. Dysphonia, restricted eye movements, flaccid tetraplegia and areflexia were found in neurological examination...
2016: Iranian Journal of Child Neurology
Aping Sun, Yingshuang Zhang, Xiangyi Liu, Lu Chen, Qingli Sun, Shuo Zhang, Dongsheng Fan
OBJECTIVE: To investigate the clinical characteristics, electrophysiological findings and treatment response of Lewis-Sumner syndrome (LSS). METHODS: Data of nine patients with LSS, who were diagnosed and treated from May 2008 to August 2014 in Department of Neurology, Peking University Third Hospital, were analyzed retrospectively, including clinical features, electrophysiological studies, pathological characteristics, therapy and follow up. RESULTS: The nine cases included seven males and two females, with the average age being 29 years old (18-64 years old)...
March 22, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
S Heschl, B Hallmann, T Zilke, G Gemes, M Schoerghuber, M Auer-Grumbach, F Quehenberger, P Lirk, Q Hogan, M Rigaud
BACKGROUND: Peripheral nerve stimulation is commonly used for nerve localization in regional anaesthesia, but recommended stimulation currents of 0.3-0.5 mA do not reliably produce motor activity in the absence of intraneural needle placement. As this may be particularly true in patients with diabetic neuropathy, we examined the stimulation threshold in patients with and without diabetes. METHODS: Preoperative evaluation included a neurological exam and electroneurography...
April 2016: British Journal of Anaesthesia
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
Stefan Soltesz, Christian Stark, Karl G Noé, Michael Anapolski, Thomas Mencke
PURPOSE: Positioning for surgery can restrict access to the patient's hand, thereby limiting assessment of the response at the adductor pollicis muscle to ulnar nerve stimulation. We evaluated a novel site to assess neuromuscular block by stimulating the accessory nerve and measuring the acceleromyographic response at the trapezius muscle. METHODS: In this prospective non-blinded observational study, we assessed neuromuscular transmission in anesthetized adult female patients undergoing elective laparoscopic gynecological surgery...
June 2016: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
Fetch more papers »
Fetching more papers... Fetching...
Read by QxMD. Sign in or create an account to discover new knowledge that matter to you.
Remove bar
Read by QxMD icon Read

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"