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Ulnar 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/27827526/the-efficacy-of-pediatric-ultrasound-guided-brachial-plexus-block-anesthesia-and-determination-of-optimal-anesthetic-drug-dosage
#3
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
#4
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
#5
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
#6
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
#7
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
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
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
#15
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
#16
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
#17
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...
November 2016: Annals of Anatomy, Anatomischer Anzeiger: Official Organ of the Anatomische Gesellschaft
https://www.readbyqxmd.com/read/27446787/anatomic-characteristics-of-pronator-quadratus-muscle-a-cadaver-study
#18
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
https://www.readbyqxmd.com/read/27398787/anconeus-epitrochlearis-muscle-causing-ulnar-neuropathy-at-the-elbow-clinical-and-neurophysiological-differential-diagnosis
#19
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
https://www.readbyqxmd.com/read/27373054/contemporaneous-evaluation-of-intraoperative-ulnar-and-median-nerve-somatosensory-evoked-potentials-for-patient-positioning-a-review-of-four-cases
#20
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
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