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https://www.readbyqxmd.com/read/28898151/postoperative-analgesia-for-shoulder-surgery
#1
Neel Desai
Both arthroscopic and open surgery of the shoulder are associated with significant postoperative pain. Use of opioids can result in adverse systemic effects, so a multi-modal analgesic approach and complementary analgesic techniques should be considered to minimize the postoperative opioid requirement. Single shot interscalene block provides effective pain control of early and limited duration which can be extended with a catheter. Continuous interscalene block should be considered for more invasive shoulder procedures...
September 2, 2017: British Journal of Hospital Medicine
https://www.readbyqxmd.com/read/28890559/comparison-of-the-post-operative-analgesic-effect-of-paravertebral-block-pectoral-nerve-block-and-local-infiltration-in-patients-undergoing-modified-radical-mastectomy-a-randomised-double-blind-trial
#2
Kartik Syal, Ankita Chandel
BACKGROUND AND AIMS: Paravertebral block, pectoral nerve (Pecs) block and wound infiltration are three modalities for post-operative analgesia following breast surgery. This study compares the analgesic efficacy of these techniques for post-operative analgesia. METHODS: Sixty-five patients with American Society of Anesthesiologists' physical status 1 or 2 undergoing modified radical mastectomy with axillary dissection were recruited for the study. All patients received 21 mL 0...
August 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28871408/evaluation-of-the-relationship-between-the-topographical-anatomy-in-the-axillary-region-of-the-brachial-plexus-and-the-body-mass-index
#3
Omur Ozturk, Aysu Hayriye Tezcan, Ali Bilge, Hakan Ateş, Hatice Yagmurdur, Mesut Erbas
To investigate the topographic anatomy of the median, musculocutaneous, radial and ulnar nerves with respect to the axillary artery and to seek whether these configurations are associated with baseline descriptive data including age, gender, and body-mass index. This cross-sectional trial was carried out on 199 patients (85 women, 114 men; average age: 46.78 ± 15.45 years) in the department of anaesthesiology and reanimation of a tertiary care center. Topographic anatomy of the median, musculocutaneous, radial and ulnar nerves was assessed with ultrasonography...
September 4, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28867151/-axillary-local-anesthetic-spread-after-the-thoracic-interfacial-ultrasound-block-a-cadaveric-and-radiological-evaluation
#4
Patricia Alfaro de la Torre, Jerry Wayne Jones, Servando López Álvarez, Paula Diéguez Garcia, Francisco Javier Garcia de Miguel, Eva Maria Monzon Rubio, Federico Carol Boeris, Monir Kabiri Sacramento, Osmany Duany, Mario Fajardo Pérez, Borja de la Quintana Gordon
BACKGROUND: Oral opioid analgesics have been used for management of peri- and postoperative analgesia in patients undergoing axillary dissection. The axillary region is a difficult zone to block and does not have a specific regional anesthesia technique published that offers its adequate blockade. METHODS: After institutional review board approval, anatomic and radiological studies were conducted to determine the deposition and spread of methylene blue and local anesthetic injected respectively into the axilla via the thoracic inter-fascial plane...
August 31, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28861374/oncoplastic-round-block-technique-has-comparable-operative-parameters-as-standard-wide-local-excision-a-matched-case-control-study
#5
Geok-Hoon Lim, John Carson Allen, Ruey Pyng Ng
BACKGROUND: Although oncoplastic breast surgery is used to resect larger tumors with lower re-excision rates compared to standard wide local excision (sWLE), criticisms of oncoplastic surgery include a longer-albeit, well concealed-scar, longer operating time and hospital stay, and increased risk of complications. Round block technique has been reported to be very suitable for patients with relatively smaller breasts and minimal ptosis. We aim to determine if round block technique will result in operative parameters comparable with sWLE...
August 2017: Gland Surgery
https://www.readbyqxmd.com/read/28861202/comparison-of-arthroscopically-guided-suprascapular-nerve-block-and-blinded-axillary-nerve-block-vs-blinded-suprascapular-nerve-block-in-arthroscopic-rotator-cuff-repair-a-randomized-controlled-trial
#6
Sang Hun Ko, Sung Do Cho, Chae Chil Lee, Jang Kyu Choi, Han Wook Kim, Seon Jae Park, Mun Hee Bae, Jae Ryong Cha
BACKGROUND: The purpose of this study was to compare the results of arthroscopically guided suprascapular nerve block (SSNB) and blinded axillary nerve block with those of blinded SSNB in terms of postoperative pain and satisfaction within the first 48 hours after arthroscopic rotator cuff repair. METHODS: Forty patients who underwent arthroscopic rotator cuff repair for medium-sized full thickness rotator cuff tears were included in this study. Among them, 20 patients were randomly assigned to group 1 and preemptively underwent blinded SSNB and axillary nerve block of 10 mL 0...
September 2017: Clinics in Orthopedic Surgery
https://www.readbyqxmd.com/read/28831314/surgery-averted-using-a-novel-minimally-invasive-approach-to-treat-very-severe-radial-artery-spasm
#7
Anthony A Cochet, Daniel A Bellin
A 42-year-old male admitted with a non-ST elevation myocardial infarction was referred for invasive angiographic assessment. Based on preprocedural assessment, the right radial artery approach was selected. Despite possessing none of the consensus risk factors for radial artery spasm, in addition to receiving standard arterial spasm prophylaxis and conscious sedation, the patient suffered very severe radial artery spasm with initial catheter placement, resulting in entrapment of a 5 Fr pigtail catheter within the left ventricle...
2017: Case Reports in Cardiology
https://www.readbyqxmd.com/read/28779963/partial-breast-radiotherapy-after-breast-conservation-surgery-for-patients-with-early-breast-cancer-uk-import-low-trial-5-year-results-from-a-multicentre-randomised-controlled-phase-3-non-inferiority-trial
#8
Charlotte E Coles, Clare L Griffin, Anna M Kirby, Jenny Titley, Rajiv K Agrawal, Abdulla Alhasso, Indrani S Bhattacharya, Adrian M Brunt, Laura Ciurlionis, Charlie Chan, Ellen M Donovan, Marie A Emson, Adrian N Harnett, Joanne S Haviland, Penelope Hopwood, Monica L Jefford, Ronald Kaggwa, Elinor J Sawyer, Isabel Syndikus, Yat M Tsang, Duncan A Wheatley, Maggie Wilcox, John R Yarnold, Judith M Bliss
BACKGROUND: Local cancer relapse risk after breast conservation surgery followed by radiotherapy has fallen sharply in many countries, and is influenced by patient age and clinicopathological factors. We hypothesise that partial-breast radiotherapy restricted to the vicinity of the original tumour in women at lower than average risk of local relapse will improve the balance of beneficial versus adverse effects compared with whole-breast radiotherapy. METHODS: IMPORT LOW is a multicentre, randomised, controlled, phase 3, non-inferiority trial done in 30 radiotherapy centres in the UK...
September 9, 2017: Lancet
https://www.readbyqxmd.com/read/28767480/combined-selective-nerve-blockade-and-local-infiltration-analgesia-in-a-total-shoulder-arthroplasty-patient-with-chronic-pain-and-severe-restrictive-lung-disease-a-case-report
#9
Jason K Panchamia, David A Olsen, Joaquin Sanchez-Sotelo, Adam W Amundson
Interscalene brachial plexus block is considered the most complete postoperative analgesia after total shoulder arthroplasty. Interscalene brachial plexus block-induced ipsilateral hemidiaphragmatic paralysis may not be tolerated in patients with preexisting pulmonary disease. Selective distal nerve blocks avoid the risk of phrenic nerve block; however, they may provide incomplete analgesia to the glenohumeral joint. We report a case of combined selective suprascapular and axillary nerve blockade in combination with local infiltration analgesia in a patient with severe lung disease undergoing total shoulder arthroplasty...
August 1, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28752007/importance-of-the-upper-extremity-position-for-a-safe-and-effective-axillary-block-a-comparative-study
#10
Ömür Öztürk, Aysu Hayriye Tezcan, Ali Bilge, Esref Erdem, Hatice Yağmurdur, Burhan Dost
OBJECTIVE: Our aim was to determine the ideal position of upper extremities during ultrasonography guidance for axillary block. The position that provides the shortest distance between the median and musculocutaneous nerves was assumed to be the most appropriate position for axillary block. METHODS: In this cross-sectional study, 120 (45 female and 75 male) patients were placed in a position with a shoulder at 90° / elbow 90° (position 1) and a shoulder 90° / elbow 0° (position 2)...
June 2017: Turkish Journal of Anaesthesiology and Reanimation
https://www.readbyqxmd.com/read/28741649/the-effect-of-metrics-based-feedback-on-acquisition-of-sonographic-skills-relevant-to-performance-of-ultrasound-guided-axillary-brachial-plexus-block
#11
O M A Ahmed, T Niessen, B D O'Donnell, A G Gallagher, D S Breslin, A DunnGalvin, G D Shorten
The objective of this study was to examine the effect of metrics-based vs. non-metrics-based feedback on novices learning predefined competencies for acquisition and interpretation of sonographic images relevant to performance of ultrasound-guided axillary brachial plexus block. Twelve anaesthetic trainees were randomly assigned to either metrics-based-feedback or non-metrics-based feedback groups. After a common learning phase, all participants attempted to perform a predefined task that involved scanning the left axilla of a single volunteer...
September 2017: Anaesthesia
https://www.readbyqxmd.com/read/28670361/the-effect-of-high-sox3-expression-on-lymphangiogenesis-and-lymph-node-metastasis-in-esophageal-squamous-cell-carcinoma
#12
Yi-Feng Zheng, Kun Li, Qing-Yong Cai, Lie Yang, Qun-You Tan, Wei Guo, Ru-Wen Wang
OBJECTIVE: This study aimed to investigate the effect of Sox3 expression on biological behaviors of esophageal squamous cell carcinoma (ESCC) and explore its possible mechanism. METHODS: ESCC cell lines that highly expressed Sox3 were selected and transfected with lentivirus carrying sox3 siRNA to establish ESCC cell lines which expressed Sox3 of different levels. Using in vitro experiments including cell invasion, cell scratch, cell proliferation and tube formation of lymphatic endothelial cells, as well as an in vivo experiment of axillary lymph node metastasis in a nude mouse model of a xenotransplanted tumor, the effect of Sox3 expression variation on lymphangiogenesis and lymph node metastasis in ESCC cells was investigated...
2017: American Journal of Translational Research
https://www.readbyqxmd.com/read/28654558/the-efficacy-of-ultrasound-guided-type-ii-pectoral-nerve-blocks-in-perioperative-pain-management-for-immediate-reconstruction-after-modified-radical-mastectomy-a-prospective-randomized-study
#13
Kaiyuan Wang, Xiaobei Zhang, Tingting Zhang, Hui Yue, Shan Sun, Hongwei Zhao, Peng Zhou
OBJECTIVES: The pectoral nerves (Pecs) II block is a technique that places local anesthetic between the thoracic muscles to block the axillary and breast regions. This study aimed to compare the quality of perioperative analgesia and side effects of the Pecs II block under general anesthesia versus general anesthesia alone in immediate unilateral breast reconstruction with an implant and latissimus dorsi (LD) flap after modified radical mastectomy. METHODS: Sixty-four patients scheduled for immediate breast reconstruction after modified radical mastectomy were randomly allocated into the Pecs II block under general anesthesia group (Group P, n=32) or the general anesthesia alone group (Group G, n=32)...
June 16, 2017: Clinical Journal of Pain
https://www.readbyqxmd.com/read/28651779/-randomized-prospective-study-of-three-different-techniques-for-ultrasound-guided-axillary-brachial-plexus-block
#14
Leonardo Henirque Cunha Ferraro, Alexandre Takeda, Paulo César Castello Branco de Sousa, Fernanda Moreira Gomes Mehlmann, Jorge Kiyoshi Mitsunaga Junior, Luiz Fernando Dos Reis Falcão
INTRODUCTION: Randomized prospective study comparing two perivascular techniques with the perineural technique for ultrasound-guided axillary brachial plexus block (US-ABPB). The primary objective was to verify if these perivascular techniques are noninferior to the perineural technique. METHOD: 240 patients were randomized to receive the techniques: below the artery (BA), around the artery (AA) or perineural (PN). The anesthetic volume used was 40mL of 0.375% bupivacaine...
June 23, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28625445/prospective-double-blind-randomized-placebo-controlled-clinical-trial-of-the-pectoral-nerves-pecs-block-type-ii
#15
Barbara Versyck, Geert-Jan van Geffen, Patrick Van Houwe
STUDY OBJECTIVE: The aim of this clinical trial was to test the hypothesis whether adding the pectoral nerves (Pecs) block type II to the anesthetic procedure reduces opioid consumption during and after breast surgery. DESIGN: A prospective randomized double blind placebo-controlled study. SETTING: A secondary hospital. PATIENTS: 140 breast cancer stage 1-3 patients undergoing mastectomy or tumorectomy with sentinel node or axillary node dissection...
August 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28621182/-non-intubated-uniportal-video-assisted-thoracic-surgery-vats-lobectomy-as-a-new-procedure-in-our-department
#16
József Furák, Zsolt Szabó, Theodor Horváth, Tibor Géczi, Balázs Pécsy, Tibor Németh, Aurél Ottlakán, Zsolt Molnár, György Lázár
AIM: Due to the emerging experience in VATS (video assisted thoracic surgery) lobectomies, in some centers the so called "non-intubated" VATS lobectomies (NITS - non-intubated thoracic surgery) gained increased authority, during which endotracheal intubation and muscle relaxation of the patient is not carried out, thus surgery is being performed with the patient breathing spontaneously. The recent study deals with our initial experience gained during uniportal NITS VATS lobectomies. PATIENTS AND METHOD: Between 24...
June 2017: Magyar Sebészet
https://www.readbyqxmd.com/read/28586719/a-heparin-conjugate-lhbisd4-inhibits-lymphangiogenesis-and-attenuates-lymph-node-metastasis-by-blocking-vegf-c-signaling-pathway
#17
Jeong Uk Choi, Seung Woo Chung, Taslim A Al-Hilal, Farzana Alam, Jooho Park, Foyez Mahmud, Jee-Heon Jeong, Sang Yoon Kim, Youngro Byun
Clinical studies have found that the incidence of cancer metastasis through the lymphatic vessels are 3-5 times higher than that through the blood vessels. These findings suggest the potency of anti-lymphangiogenic therapy in reducing the incidence of cancer metastasis. Previously, we reported LHbisD4, which is the conjugate of low molecular weight heparin (LMWH) and four bis-deoxycholates as a potent anti-angiogenic drug with less toxicity and orally active property. Here, we show that LHbisD4 could also suppress the formation of new lymphatic vessels and attenuate the incidence of metastasis by blocking VEGF-C signaling pathway...
September 2017: Biomaterials
https://www.readbyqxmd.com/read/28584346/analgesic-efficacy-of-ultrasound-guided-paravertebral-block-versus-serratus-plane-block-for-modified-radical-mastectomy-a-randomised-controlled-trial
#18
Kapil Gupta, Kadapa Srikanth, Kiran Kumar Girdhar, Vincent Chan
BACKGROUND AND AIMS: Modified radical mastectomy (MRM) may be associated with severe post-operative pain, leading to chronic pain syndrome. We compared the post-operative analgesic profile of two ultrasound-guided nerve blocks: Paravertebral block (PVB) and serratus plane block (SPB). METHODS: This double-blind, randomised study was conducted on fifty adult females, scheduled for MRM with axillary dissection. After inducing general anaesthesia with intravenous midazolam 1 mg, fentanyl 1...
May 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28580881/blocking-the-cycle-cyclin-dependent-kinase-4-6-inhibitors-in-metastatic-hormone-receptor-positive-breast-cancer
#19
REVIEW
Seth A Wander, Erica L Mayer, Harold J Burstein
The Oncology Grand Rounds series is designed to place original reports published in the Journal into clinical context. A case presentation is followed by a description of diagnostic and management challenges, a review of the relevant literature, and a summary of the authors' suggested management approaches. The goal of this series is to help readers better understand how to apply the results of key studies, including those published in Journal of Clinical Oncology, to patients seen in their own clinical practice...
September 1, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28571239/efficacy-of-dexmedetomidine-in-two-different-doses-as-an-adjuvant-to-lignocaine-in-patients-scheduled-for-surgeries-under-axillary-block
#20
Aman Thakur, Jai Singh, Sudarshan Kumar, Shelly Rana, Priyanka Sood, Versha Verma
INTRODUCTION: The effect of adding dexmedetomidine (α2-adrenoceptor agonist) to local anaesthetics in brachial plexus blocks has been evaluated, however there has been no consensus regarding the ideal dose of dexmedetomidine. Without ultrasound axillary block has been considered as the safest approach for brachial block. AIM: To evaluate the efficacy of two doses of dexmedetomidine (0.5 μg/kg and 1 μg/kg) as an adjuvant to lignocaine in patients undergoing forearm surgeries under axillary brachial plexus block...
April 2017: Journal of Clinical and Diagnostic Research: JCDR
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