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Infraclavicular block

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https://www.readbyqxmd.com/read/28205117/a-randomized-comparison-between-costoclavicular-and-paracoracoid-ultrasound-guided-infraclavicular-block-for-upper-limb-surgery
#1
Prangmalee Leurcharusmee, Maria Francisca Elgueta, Worakamol Tiyaprasertkul, Thitipan Sotthisopha, Artid Samerchua, Aida Gordon, Julian Aliste, Roderick J Finlayson, De Q H Tran
BACKGROUND: This two-centre randomized trial compared costoclavicular and paracoracoid ultrasound-guided infraclavicular brachial plexus block in patients undergoing upper limb surgery. We hypothesized that both techniques would result in similar onset times and designed the study as an equivalence trial. METHODS: Ninety patients undergoing upper limb surgery at or distal to the elbow were randomly allocated to receive a costoclavicular (n = 45) or paracoracoid (n = 45) ultrasound-guided infraclavicular brachial plexus block...
February 15, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28157792/ultrasound-guided-costoclavicular-brachial-plexus-block-sonoanatomy-technique-and-block-dynamics
#2
Jia Wei Li, Banchobporn Songthamwat, Winnie Samy, Xavier Sala-Blanch, Manoj Kumar Karmakar
BACKGROUND AND OBJECTIVES: This study aimed to describe in detail the relevant sonoanatomy, technique, and block dynamics of an ultrasound-guided costoclavicular brachial plexus block (BPB). METHODS: Thirty patients scheduled for hand or forearm surgery under a BPB underwent transverse ultrasound imaging of the medial infraclavicular fossa to identify the cords of the brachial plexus at the costoclavicular space (CCS). An ultrasound-guided BPB was then performed at the CCS with 20 mL of 0...
March 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28149139/can-we-perform-distal-nerve-block-instead-of-brachial-plexus-nerve-block-under-ultrasound-guidance-for-hand-surgery
#3
Ilker Ince, Mehmet Aksoy, Mine Celik
OBJECTIVE: Distal nerve blocks are used in the event of unsuccessful blocks as rescue techniques. The primary purpose of this study was to determine the sufficiency for anesthesia of distal nerve block without the need for deep sedation or general anesthesia. The secondary purpose was to compare block performance times, block onset times, and patient and surgeon satisfaction. MATERIALS AND METHODS: Patients who underwent hand surgery associated with the innervation area of the radial and median nerves were included in the study...
October 2016: Eurasian Journal of Medicine
https://www.readbyqxmd.com/read/28126454/ultrasound-guided-retroclavicular-approach-infraclavicular-brachial-plexus-block-for-upper-extremity-emergency-procedures
#4
Josh Luftig, Daniel Mantuani, Andrew A Herring, Arun Nagdev
The America Society of Anesthesiology guidelines recommend multimodal analgesia that combines regional anesthetic techniques with pharmacotherapy to improve peri-procedural pain management and reduce opioid related complications. Commonly performed emergency procedures of the upper extremity such as fracture and dislocation reduction, wound debridement, and abscess incision and drainage are ideal candidates for ultrasound-guided (USG) regional anesthesia of the brachial plexus. However, adoption of regional anesthesia by emergency practitioners has been limited by concerns for potential complications and perceived technical difficulty...
January 15, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28111732/awake-hand-surgery-under-ultrasound-guided-infraclavicular-block-is-possible-for-cooperative-children
#5
Hülya Yanal, Yavuz Gürkan, Alparslan Kuş, Onur Balaban, Mine Solak, Kamil Toker
In recent years, brachial plexus anesthesia techniques for upper limb surgery have been used more and more commonly on children; however, the patient is typically under deep sedation or general anesthesia. For eligible, cooperative children, surgery can also be performed using regional blocks while the patient is awake. We present 5 cases in which Ultrasound (US)-guided infraclavicular brachial plexus blocks (ICB) were used on children for hand or forearm surgery. Surgical anesthesia was achieved in all patients and surgery was completed uneventfully using brachial plexus anesthesia, without need for deep sedation...
October 2016: Aǧrı: Ağrı (Algoloji) Derneği'nin Yayın Organıdır, the Journal of the Turkish Society of Algology
https://www.readbyqxmd.com/read/27990435/low-volume-brachial-plexus-block-providing-surgical-anesthesia-for-distal-arm-surgery-comparing-supraclavicular-infraclavicular-and-axillary-approach-a-randomized-observer-blind-trial
#6
RANDOMIZED CONTROLLED TRIAL
Mojgan Vazin, Kenneth Jensen, Danja L Kristensen, Mathias Hjort, Katrine Tanggaard, Manoj K Karmakar, Thomas F Bendtsen, Jens Børglum
Background. Distal arm surgery is widely performed under regional anesthesia with brachial plexus block. The preponderance of evidence for the efficacy relies upon injection of local anesthetic in excess of 30 mL. We aimed to compare three different ultrasound-guided brachial plexus block techniques restricting the total volume to 20 mL. Methods. 120 patients were prospectively randomized to ultrasound-guided brachial plexus block with 20 mL ropivacaine 0.75% at either the supraclavicular, infraclavicular, or axillary level...
2016: BioMed Research International
https://www.readbyqxmd.com/read/27941477/diaphragm-sparing-nerve-blocks-for-shoulder-surgery
#7
De Q H Tran, Maria Francisca Elgueta, Julian Aliste, Roderick J Finlayson
Shoulder surgery can result in significant postoperative pain. Interscalene brachial plexus blocks (ISBs) constitute the current criterion standard for analgesia but may be contraindicated in patients with pulmonary pathology due to the inherent risk of phrenic nerve block and symptomatic hemidiaphragmatic paralysis. Although ultrasound-guided ISB with small volumes (5 mL), dilute local anesthetic (LA) concentrations, and LA injection 4 mm lateral to the brachial plexus have been shown to reduce the risk of phrenic nerve block, no single intervention can decrease its incidence below 20%...
January 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/27938934/medial-approach-of-ultrasound-guided-costoclavicular-plexus-block-and-its-effects-on-regional-perfussion
#8
D Nieuwveld, V Mojica, A E Herrera, J Pomés, A Prats, X Sala-Blanch
INTRODUCTION: Ultrasound-guided infraclavicular block in the costoclavicular space located between the clavicle and the first rib, reaches the secondary trunks when they are clustered together and lateral to the axillary artery. This block is most often performed through a lateral approach, the difficulty being finding the coracoid process an obstacle and guiding the needle towards the vessels and pleura. A medial approach, meaning from inside to outside, will avoid these structures. Traditionally the assessment of a successful block is through motor or sensitive responses but a sympathetic fibre block can also be evaluated measuring the changes in humeral artery blood flow, skin temperature and/or perfusion index...
December 8, 2016: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/27828793/comparison-of-supraclavicular-and-infraclavicular-brachial-plexus-block-a-systemic-review-of-randomized-controlled-trials
#9
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...
February 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27790416/accessory-upper-subscapular-nerve-the-neurotisation-tool
#10
Vishwajit Ravindra Deshmukh, Rabindra Prasad Mandal, Harisha Kusuma, Neerja Rani
During the routine dissection classes for undergraduate students, uncommon variation in relation to the upper subscapular nerve of posterior cord of brachial plexus was observed. Normally upper subscapular nerve takes origin from the posterior cord, but in this case report, it arises in triplet fashion, just above the circumflex scapular artery. All these accessory nerves were supplying upper part of the subscapularis muscle. As per our knowledge, this is a rare variation of brachial plexus. Many variations are encountered in the formation of brachial plexus...
September 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/27547909/ultrasound-guided-retroclavicular-block-aka-posterior-approach-infraclavicular-block-anatomical-variation-of-the-clavicle-limits-block-feasibility
#11
COMMENT
Zhi Yuen Beh, Mohd Shahnaz Hasan, Hou Yee Lai
No abstract text is available yet for this article.
September 2016: Regional Anesthesia and Pain Medicine
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
#12
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/27501616/onset-time-of-2-lidocaine-and-0-5-bupivacaine-mixture-versus-0-5-bupivacaine-alone-using-ultrasound-and-double-nerve-stimulation-for-infraclavicular-brachial-plexus-anesthesia-in-esrd-patients-undergoing-arteriovenous-fistula-creation
#13
RANDOMIZED CONTROLLED TRIAL
Orawan Pongraweewan, Nipa Inchua, Chanatthee Kitsiripant, Benchawan Kongmuang, Wannapa Tiwirach
OBJECTIVE: To reduce the onset of 0.5% bupivacaine by adding 2% lidocaine with 0.5% bupivacaine for ultrasound-guided and double stimulation technique at musculocutaneous and radial nerve for infraclavicular brachial plexus block. DESIGN: Prospective randomized double-blinded, controlled trial study. MATERIAL AND METHOD: 90 patients undergoing creation of arteriovenous fistula under ultrasound-guided infraclavicular brachial plexus block were randomized into 2 groups...
May 2016: Journal of the Medical Association of Thailand, Chotmaihet Thangphaet
https://www.readbyqxmd.com/read/27396247/a-randomised-placebo-controlled-trial-examining-the-effect-on-hand-supination-after-the-addition-of-a-suprascapular-nerve-block-to-infraclavicular-brachial-plexus-blockade
#14
S Flohr-Madsen, L M Ytrebø, K Valen, T Wilsgaard, Ø Klaastad
Some surgeons believe that infraclavicular brachial plexus blocks tends to result in supination of the hand/forearm, which may make surgical access to the dorsum of the hand more difficult. We hypothesised that this supination may be reduced by the addition of a suprascapular nerve block. In a double-blind, randomised, placebo-controlled study, our primary outcome measure was the amount of supination (as assessed by wrist angulation) 30 min after infraclavicular brachial plexus block, with (suprascapular group) or without (control group) a supplementary suprascapular block...
August 2016: Anaesthesia
https://www.readbyqxmd.com/read/27239291/upper-extremity-nerve-block-how-can-benefit-duration-and-safety-be-improved-an-update
#15
REVIEW
Metha Brattwall, Pether Jildenstål, Margareta Warrén Stomberg, Jan G Jakobsson
Upper extremity blocks are useful as both sole anaesthesia and/or a supplement to general anaesthesia and they further provide effective postoperative analgesia, reducing the need for opioid analgesics. There is without doubt a renewed interest among anaesthesiologists in the interscalene, supraclavicular, infraclavicular, and axillary plexus blocks with the increasing use of ultrasound guidance. The ultrasound-guided technique visualising the needle tip and solution injected reduces the risk of side effects, accidental intravascular injection, and possibly also trauma to surrounding tissues...
2016: F1000Research
https://www.readbyqxmd.com/read/27101216/comparison-of-the-supraclavicular-infraclavicular-and-axillary-approaches-for-ultrasound-guided-brachial-plexus-block-for-surgical-anesthesia
#16
Anatoli Stav, Leonid Reytman, Michael-Yohay Stav, Isaak Portnoy, Alexander Kantarovsky, Offer Galili, Shmuel Luboshitz, Roger Sevi, Ahud Sternberg
OBJECTIVE: We hypothesized that ultrasound (US)-guided technique of the supra- and infraclavicular and axillary approaches of brachial plexus block (BPB) will produce a high quality of surgical anesthesia for operations below the shoulder independently of the approach and body mass index (BMI). Intercostobrachial and medial brachial cutaneous nerves will be blocked separately because they are not a part of the brachial plexus. METHODS: This is a prospective randomized observer-blinded study...
April 19, 2016: Rambam Maimonides Medical Journal
https://www.readbyqxmd.com/read/27035461/anatomic-basis-for-brachial-plexus-block-at-the-costoclavicular-space-a-cadaver-anatomic-study
#17
Xavier Sala-Blanch, Miguel Angel Reina, Pawinee Pangthipampai, Manoj Kumar Karmakar
BACKGROUND AND OBJECTIVES: The costoclavicular space (CCS), which is located deep and posterior to the midpoint of the clavicle, may be a better site for infraclavicular brachial plexus block than the traditional lateral paracoracoid site. However, currently, there is paucity of data on the anatomy of the brachial plexus at the CCS. We undertook this cadaver anatomic study to define the anatomy of the cords of the brachial plexus at the CCS and thereby establish the anatomic basis for ultrasound-guided infraclavicular brachial plexus block at this proximal site...
May 2016: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/27015546/a-multicenter-randomized-comparison-between-intravenous-and-perineural-dexamethasone-for-ultrasound-guided-infraclavicular-block
#18
RANDOMIZED CONTROLLED TRIAL
Prangmalee Leurcharusmee, Julian Aliste, Tom C R V Van Zundert, Phatthanaphol Engsusophon, Vanlapa Arnuntasupakul, Worakamol Tiyaprasertkul, Amornrat Tangjitbampenbun, Sonia Ah-Kye, Roderick J Finlayson, De Q H Tran
BACKGROUND AND OBJECTIVES: This multicenter, randomized trial compared intravenous (IV) and perineural (PN) dexamethasone for ultrasound (US)-guided infraclavicular brachial plexus block. Our research hypothesis was both modalities would result in similar durations of motor block. METHODS: One hundred fifty patients undergoing upper limb surgery with US-guided infraclavicular block were randomly allocated to receive IV or PN dexamethasone (5 mg). The local anesthetic agent (35 mL of lidocaine 1%-bupivacaine 0...
May 2016: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/26951450/anesthetic-management-of-the-first-pediatric-bilateral-hand-transplant
#19
Harshad G Gurnaney, John E Fiadjoe, L Scott Levin, Benjamin Chang, Heather Delvalle, Jorge Gálvez, Mohamed A Rehman
PURPOSE: The purpose of this case report is to describe the anesthetic and case management of the first vascularized composite allograft pediatric bilateral hand transplant. CLINICAL DETAILS: Our patient was an eight-year-old male with a medical history of Staphylococcus aureus sepsis at one year of age that resulted in end-stage renal disease as well as bilateral upper and lower extremity amputations. After referral for bilateral hand transplantation, the transplantation team, with expertise in all aspects of perioperative care (surgery, anesthesiology, nephrology, renal transplantation, pediatric intensive care, and therapeutic pharmacy), was consulted to help develop anesthetic and other perioperative protocols for surgery...
June 2016: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/26914135/pregabalin-administered-as-an-anxiolytic-agent-in-ultrasound-guided-infraclavicular-block-a-controlled-double-blind-dose-ranging-trial
#20
RANDOMIZED CONTROLLED TRIAL
M B Cegin, L Soyoral, N Yuzkat, V Baydi, U Goktas
OBJECTIVE: Adjuvant agents, given with local anesthetics or via venous, oral, or rectal routes for peripheral nerve blocking, have been in use for a long time. Literature studies about pregabalin usage in peripheral nerve blocking are limited in number. In this study, we aimed to reveal the blocking quality of pregabalin administered orally in various doses as an anxiolytic agent and its effective dose range. PATIENTS AND METHODS: Eighty patients who underwent upper extremity bone surgery were included in the study...
2016: European Review for Medical and Pharmacological Sciences
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