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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
#1
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
#2
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 (TA), around the artery (TR) 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
#3
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
#4
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
#5
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
#6
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
#7
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...
June 3, 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
#8
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
https://www.readbyqxmd.com/read/28564653/skin-perfusion-changes-within-12-h-after-axillary-plexus-block
#9
Andrea Wenger, Amro Amr, Hans-Eberhard Schaller, Jens Rothenberger
BACKGROUND/PURPOSE: An improvement of the blood flow would be beneficial in microvascular upper-extremity reconstruction and in digit replantation. In the present work, skin perfusion changes and their duration due to axillary plexus block were quantified. METHODS: The peripheral blood flow of the upper extremities in 20 patients undergoing trapeziectomy under axillary plexus block was analyzed. RESULTS: Laser Doppler spectrophotometry was used to measure perfusion factors over a 12-h period, with the contralateral hand acting as the control...
June 1, 2017: European Surgical Research. Europäische Chirurgische Forschung. Recherches Chirurgicales Européennes
https://www.readbyqxmd.com/read/28556465/biphasic-axillary-synovial-sarcoma-diagnosed-by-preoperative-fine-needle-aspiration-cytology
#10
Cristina Díaz Del Arco, Mª Jesús Fernández Aceñero
Synovial sarcoma (SS) is a soft-tissue sarcoma which usually occurs in lower extremities. Less than 20 cases of SS located in shoulder or axillary region have been reported, and these studies describe histopathological features. We report a case of axillary SS diagnosed by fine-needle aspiration cytology, immunocytochemistry, and molecular techniques performed on cytology smears. A 48-year-old woman presented with a palpable and well-defined axillary mass which measured 4 cm. On-site smears showed high cellularity with spindle cells, and a mesenchymal tumor was suspected...
May 28, 2017: Diagnostic Cytopathology
https://www.readbyqxmd.com/read/28550902/quantification-of-the-vasodilatory-effect-of-axillary-plexus-block-a-prospective-controlled-study
#11
Andrea Wenger, Jens Rothenberger, Lara-Elena Hakim-Meibodi, Thomas Notheisen, Hans-Eberhard Schaller
BACKGROUND: Axillary plexus block is a common method for regional anesthesia, especially in hand and wrist surgery. Local anesthetics (e.g., mepivacaine) are injected around the peripheral nerves in the axilla. A vasodilatory effect due to sympathicolysis has been described, but not quantified. MATERIALS AND METHODS: In a prospective controlled study between October 2012 and July 2013, we analyzed 20 patients with saddle joint arthritis undergoing trapeziectomy under axillary plexus block...
May 15, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28509780/hypnosis-and-axillary-compartment-block-for-breast-cancer-surgery-a-case-report
#12
Régis Fuzier, Sylviane Achelous, Geneviève Salvignol, Eva Jouve
Hypnosis has been proven to be a powerful tool in the management of anxiety and pain. It allows for an increase of pain threshold, which can reach the level of surgical analgesia. Recently injection of local anesthetics around the serratus muscle has been presented as an alternative to paravertebral block for cancer breast surgery. We report the successful use of hypnosis in combination with an axillary compartment block for lumpectomy and axillary lymph node dissection.
May 12, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28497932/individual-duration-of-axillary-brachial-plexus-block-is-unpredictable-a-prospective-double-centred-observational-study
#13
Wouter Droog, D-Yin Lin, José S Huisman, Fleur A Franssen, G Peter van Aggelen, J Henk Coert, Eilish M Galvin
BACKGROUND: The duration of effect for axillary plexus block using ropivacaine is highly variable. The available literature does not offer any plausible means of predicting time of block offset for individual patients, making it difficult to give accurate information and plan postoperative analgesics. This study was designed to identify factors influencing axillary plexus block offset time. METHODS: A total of 92 patients participated in this prospective double centred observational study...
May 12, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28439445/ultrasound-guided-continuous-interpectoral-block-for-patient-undergoing-mastectomy-and-axillary-clearance
#14
Mario Fajardo-Pérez, Ece Yamak Altınpulluk, Javier García-Miguel, Borja Quintana-Gordon
Using a single dose of local anaesthetics has some disadvantages and provides limited analgesia depending on the pharmacokinetic characteristics of the local anaesthetic used. Nevertheless, the use of continuous perineural infusions allows sustained pain control. Ultrasound-guided interpectoral block followed by the placement of catheters in patients undergoing mastectomies with or without lymph node axillary dissections can result in sufficient pain control. We present a case of a 58-year-old woman undergoing mastectomy and axillary clearance who received ultrasound-guided continuous interpectoral block for postoperative analgesia...
April 2017: Turkish Journal of Anaesthesiology and Reanimation
https://www.readbyqxmd.com/read/28435344/development-of-performance-and-error-metrics-for-ultrasound-guided-axillary-brachial-plexus-block
#15
Osman M Ahmed, Brian D O'Donnell, Anthony G Gallagher, George D Shorten
PURPOSE: Change in the landscape of medical education coupled with a paradigm shift toward outcome-based training mandates the trainee to demonstrate specific predefined performance benchmarks in order to progress through training. A valid and reliable assessment tool is a prerequisite for this process. The objective of this study was to characterize ultrasound-guided axillary brachial plexus block to develop performance and error metrics and to verify face and content validity using a modified Delphi method...
2017: Advances in Medical Education and Practice
https://www.readbyqxmd.com/read/28420906/comparison-of-ultrasound-and-ultrasound-plus-nerve-stimulator-guidance-axillary-plexus-block
#16
Gokhan Demirelli, Semih Baskan, Isil Karabeyoglu, Ismail Aytac, Dilsen Hatice Ornek, Alper Erdogmus, Mustafa Baydar
OBJECTIVE: To evaluate the characteristics of axillary plexus blockade applied using ultrasound only and using ultrasound together with nerve stimulator in patients undergoing planned forearm, wrist or hand surgery. METHODS: This randomised, prospective, double-blinded, single-centre study was conducted at Ankara Numune Training and Research Hospital, Ankara, Turkey, from November 2014 to August 2015, and comprised patients undergoing forearm, wrist or hand surgery...
April 2017: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/28405261/blocking-of-the-lymphatic-vessel-in-lymphedema
#17
Hisako Hara, Makoto Mihara
Objective: In this case report, we present a case wherein we observed a blocking of lymphatic vessels in indocyanine green lymphography and found a shrunken lymphatic vessel intraoperatively. Methods: We performed indocyanine green lymphography and lymphaticovenous anastomosis on a 77-year-old woman. She had previously undergone right mastectomy and axillary lymph node dissection accompanied by radiotherapy and chemotherapy for right breast cancer. She noticed swelling in the right upper limb 22 years after the surgery and consulted our hospital...
2017: Eplasty
https://www.readbyqxmd.com/read/28349586/transfemoral-access-when-superior-venous-approach-is-not-feasible-equals-overall-success-of-permanent-pacemaker-implantation-ten-year-series
#18
Juan J García Guerrero, Joaquín Fernández de la Concha Castañeda, Manuel Doblado Calatrava, Ángel Redondo Méndez, Manuel Lázaro Medrano, Antonio Merchán Herrera
BACKGROUND: When permanent pacemaker implantation is not possible or advisable via superior venous access (i.e., axillary or subclavian veins), safe and feasible surgical alternatives are required. The femoral approach is relatively unknown and seldom studied. This single-center study analyzed 10-year outcomes of a femoral implantation approach. METHODS: Data about the implantation procedure (indication, approach, lead and pacemaker models, complications), patient characteristics (age, sex, medications, comorbidities), and follow-up were analyzed for all permanent pacemaker implantations using the femoral approach between June 2001 and June 2011...
March 28, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28344948/the-effect-of-combining-axillary-brachial-plexus-block-with-interscalene-or-supraclavicular-block-for-upper-limb-surgeries-using-neurostimulation-technique
#19
H O Idehen, C A Imarengiaye
BACKGROUND: The different approaches to the brachial plexus have clinical implications and all these approaches have clinical limitations. Combining different approaches helps to reduce these limitations. Can a combination of two different methods of brachial plexus block give a better anaesthetic outcome? AIM: To compare the effect of combining axillary plexus block with interscalene as opposed to axillary plexus block with supraclavicular blocks. DESIGN OF STUDY: Prospective observational study...
April 2016: Journal of the West African College of Surgeons
https://www.readbyqxmd.com/read/28341760/intratumoral-heterogeneity-in-breast-cancer-a-comparison-of-primary-and-metastatic-breast-cancers
#20
Yu-Jie Shi, Julia Y S Tsang, Yun-Bi Ni, Gary M Tse
Intratumoral heterogeneity presents challenges in the management of cancer. To gain deeper insight in intratumoral heterogeneity at different levels and tumor sites for common biomarkers in breast cancers, this report examines seven cases of invasive breast cancer with multiple axillary nodal metastases and/or recurrences for immunohistochemical expression of estrogen receptors, progesterone receptors, human epidermal growth receptor 2, and Ki67 on all tissue blocks in both primary and metastatic tumors. The Oncologist 2017;22:487-490...
April 2017: Oncologist
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