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Brachial plexus

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https://www.readbyqxmd.com/read/28723837/minimum-effective-volume-of-lidocaine-for-ultrasound-guided-costoclavicular-block
#1
Thitipan Sotthisopha, Maria Francisca Elgueta, Artid Samerchua, Prangmalee Leurcharusmee, Worakamol Tiyaprasertkul, Aida Gordon, Roderick J Finlayson, De Q Tran
BACKGROUND AND OBJECTIVES: This dose-finding study aimed to determine the minimum effective volume in 90% of patients (MEV90) of lidocaine 1.5% with epinephrine 5 μg/mL for ultrasound-guided costoclavicular block. METHODS: Using an in-plane technique and a lateral-to-medial direction, the block needle was positioned in the middle of the 3 cords of the brachial plexus in the costoclavicular space. The entire volume of lidocaine was deposited in this location. Dose assignment was carried out using a biased-coin-design up-and-down sequential method, where the total volume of local anesthetic administered to each patient depended on the response of the previous one...
July 19, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28723713/somatotopic-fascicular-lesions-of-the-brachial-plexus-demonstrated-by-high-resolution-magnetic-resonance-neurography
#2
Tim Hilgenfeld, Johann Jende, Daniel Schwarz, Philipp Bäumer, Jennifer Kollmer, Sabine Heiland, Martin Bendszus, Mirko Pham
OBJECTIVES: The aim of this study was to evaluate whether high-resolution brachial plexus (BP) magnetic resonance neurography (MRN) is capable of (1) distinguishing patients with compressive neuropathy or noncompressive plexopathy from age- and sex-matched controls, (2) discriminating between patients with compressive neuropathy and noncompressive plexopathy, and (3) detecting spatial lesion patterns suggesting somatotopic organization of the BP. MATERIALS AND METHODS: Thirty-six patients (50...
July 18, 2017: Investigative Radiology
https://www.readbyqxmd.com/read/28721690/pre-or-postoperative-interscalene-block-and-or-general-anesthesia-for-arthroscopic-shoulder-surgery-a-retrospective-observational-study
#3
Laura Bosco, Cheng Zhou, John A C Murdoch, Ryan Bicknell, Wilma M Hopman, Rachel Phelan, Vidur Shyam
PURPOSE: Arthroscopic shoulder surgery can be performed with an interscalene brachial plexus block (ISBPB) alone, ISBPB combined with general anesthesia (GA), or GA alone. Postoperative pain is typically managed with opioids; however, both GA and opioids have adverse effects which can delay discharge. This retrospective study compares the efficacy of four methods of anesthesia management for arthroscopic shoulder surgery. METHODS: Charts of all patients who underwent shoulder surgery by a single surgeon from 2012-2015 were categorized by analgesic regimen: GA only (n = 177), single-shot ISBPB only (n = 124), or pre- vs postoperative ISBPB combined with GA (ISBPB + GA [n = 72] vs GA + ISBPB [n = 52], respectively)...
July 18, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28719549/long-term-follow-up-of-neonatal-brachial-plexopathy-psychological-and-physical-function-in-adolescents-and-young-adults
#4
Lesley Butler, Janith Mills, Heather M Richard, Russell Riddle, Marybeth Ezaki, Scott Oishi
PURPOSE: The prevalence of neonatal brachial plexus palsy (NBPP) has been increasing since the early 1980s. No known studies have examined long-term psychological health and quality of life (QOL) in young adults. The purpose of this study was to investigate the psychosocial and intellectual aspects of NBPP during adolescence into young adulthood. METHODS: A total of 31 patients were enrolled in the adolescent group (16 to 18 y) and 25 in the young adult group (23 to 28 y)...
July 17, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28719548/forearm-pronation-osteotomy-for-supination-contracture-secondary-to-obstetrical-brachial-plexus-palsy-a-retrospective-cohort-study
#5
Aharon Z Gladstein, Brant Sachleben, Emily S Ho, Alison Anthony, Howard M Clarke, Sevan Hopyan
BACKGROUND: Obstetrical brachial plexus palsy can lead to fixed forearm supination contracture. Fixed supination may lead to functional deficits as the affected hand cannot be positioned optimally for activities on a desk such as writing and typing, or for using tools including utensils, which require a neutral or pronated forearm. Forearm pronation osteotomy has been used to address this problem, although the functional benefit over nonoperative management has not been clearly defined...
July 17, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28717892/a-population-based-study-of-injuries-to-the-brachial-plexus-and-to-the-peripheral-nerves-of-the-shoulder-girdle-and-upper-limb-in-the-italian-region-friuli-venezia-giulia
#6
Francesca Valent, Roberto Eleopra, Paolo Manganotti, Paolo Passadore
The aim of this study was to estimate the incidence, identify the causes, and explore treatments of the injuries to the brachial plexus and peripheral nerves of the shoulder girdle and upper limb in the 1,220,000-inhabitant Italian region Friuli Venezia Giulia.We linked at the individual patient level various administrative databases using an anonymous stochastic key: list of residents, hospital discharge, emergency department, and outpatient care prescriptions database. We abstracted hospital discharge records with at least one discharge diagnosis code ICD-9-CM 953...
July 17, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28716694/-isolated-long-thoracic-nerve-palsy-more-than-meets-the-eye
#7
Andrés A Maldonado, Scott L Zuckerman, B Matthew Howe, Michelle L Mauermann, Robert J Spinner
INTRODUCTION: Two main hypotheses have been proposed for the pathophysiology of long thoracic nerve (LTN) palsy: nerve compression and nerve inflammation. We hypothesized that critical reinterpretation of electrodiagnostic (EDX) studies and MRIs of patients with a diagnosis of non-traumatic isolated LTN palsy could provide insight into the pathophysiology and, potentially, the treatment. MATERIAL AND METHODS: A retrospective review was performed of all patients with a diagnosis of non-traumatic isolated LTN palsy and an EDX and brachial plexus or shoulder MRI studies performed at our institution...
June 27, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28712103/randomised-controlled-trial-of-analgesic-effectiveness-of-three-different-techniques-of-single-shot-interscalene-brachial-plexus-block-using-20-ml-of-0-5-ropivacaine-for-shoulder-arthroscopy
#8
Michał Jan Stasiowski, Michał Kolny, Marek Zuber, Radosław Marciniak, Ewa Chabierska, Przemysław Jałowiecki, Aleksandra Pluta, Bartłomiej Możdżyński
Background Shoulder arthroscopic procedures impose a challenge to anaesthesiologists in terms of postoperative analgesia. Proper pain management after arthroscopic procedures improves patient satisfaction and facilitates early rehabilitation. METHODS: We performed a randomized, prospective clinical study to assess the influence of anthropometric parameters and IBPB technique on the quality of postoperative analgesia. A total of 106 randomly selected patients of ASA I-III status scheduled for elective shoulder arthroscopy ...
July 16, 2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/28711374/the-components-of-shoulder-and-elbow-movements-as-goals-of-primary-reconstructive-operation-in-obstetric-brachial-plexus-lesions
#9
Jerzy Luszawski, Wiesław Marcol, Marek Mandera
Most of the cases of obstetric brachial plexus lesions (OBPL) show satisfactory improvement with conservative management, but in about 25% some surgical treatment is indicated. The present paper analyzes the effects of primary reconstructive surgeries in aspect of achieving delineated intraoperatively goals. Children operated before the age of 18 months with follow-up period longer than 1 year were selected. Therapeutic goals established during the operation were identified by analysis of initial clinical status and operative protocols...
June 30, 2017: Neurologia i Neurochirurgia Polska
https://www.readbyqxmd.com/read/28709767/obstetrical-brachial-plexus-palsy
#10
Patricia O'Berry, Mackenzie Brown, Leslie Phillips, Sarah Helen Evans
Obstetrical brachial plexus palsy is a disorder of the peripheral nervous system and occurs in as many as 0.4% of infants born. It is associated with shoulder dystocia, use of mechanical extraction, and macrosomia; it occurs more frequently in infants born by vaginal delivery. The unilateral injury to the brachial plexus complex occurs during the delivery phase as lateral traction is applied to the head to permit shoulder clearance. The infant typically presents in the delivery room with decreased active movements of the affected arm and asymmetrical primitive reflex responses...
July 11, 2017: Current Problems in Pediatric and Adolescent Health Care
https://www.readbyqxmd.com/read/28706376/axillary-artery-injury-and-brachial-plexus-palsy-as-a-complication-of-proximal-humerus-fractures
#11
G Bucci, G Lucar-López, J Sanchez-Gonzalez, F Malagelada, J Palencia Lopez, K A Guevara-Noriega
No abstract text is available yet for this article.
September 2017: Journal of Orthopaedics
https://www.readbyqxmd.com/read/28702389/correlation-between-the-elbow-flexion-and-the-hand-and-wrist-flexion-after-neurotization-of-the-fascicles-of-the-ulnar-nerve-to-the-motor-branch-to-the-biceps
#12
Ricardo Boso Escudero, Marcelo Rosa de Rezende, Erick Yoshio Wataya, Fernando Vicente de Pontes, Álvaro Baik Cho, Marina Justi Pisani
OBJECTIVE: Gain in elbow flexion in patients with brachial plexus injury is extremely important. The transfer of a fascicle from the ulnar nerve to the motor branch of the musculocutaneous nerve (Oberlin surgery) is a treatment option. However, in some patients, gain in elbow flexion is associated with wrist and finger flexion. This study aimed to assess the frequency of this association and the functional behavior of the limb. METHODS: Case-control study of 18 patients who underwent the Oberlin surgery...
May 2017: Revista Brasileira de Ortopedia
https://www.readbyqxmd.com/read/28696151/paravertebral-brachial-plexus-blockade-in-cats-a-cadaver-study
#13
Marina C Evangelista, Beatriz P Monteiro, Graeme M Doodnaught, Pascale Benoist, Paulo V Steagall
Objectives The aims of this study were to describe the paravertebral brachial plexus (PBP) blockade in cats, and compare the spread of bupivacaine-methylene blue solution (BMS) using two volumes of injection into the PBP. Methods Six cadavers (4.4 ± 1.8 kg) randomly received 0.15 ml/kg (LOW) or 0.2 ml/kg (HIGH) per injection of BMS into the PBP. The first injection was made ventral to the transverse process of the sixth cervical vertebra (nerves C6 and C7) at the emergence of nerve roots. A second injection was performed at the edge of the cranial border of the scapula and directed ventrally towards the first rib (C8 and T1)...
July 1, 2017: Journal of Feline Medicine and Surgery
https://www.readbyqxmd.com/read/28694575/early-thoracoscopic-plication-of-diaphragm-in-a-newborn-with-brachial-plexus-palsy-and-concurrent-phrenic-nerve-palsy
#14
Saurabh Shyam Garge, Gouri Rao Passi, Devendra Ghanekar
Phrenic nerve palsy is a rare cause of respiratory distress in a newborn. When conservative measures fail to achieve adequate ventilation, then early surgical plication has been found to be associated with good outcome. We report a case of neonate with phrenic nerve palsy in whom an early thoracoscopic diaphragmatic plication was done.
July 2017: Journal of Indian Association of Pediatric Surgeons
https://www.readbyqxmd.com/read/28688963/continuous-interscalene-brachial-plexus-blockade-is-associated-with-reduced-length-of-stay-after-shoulder-arthroplasty
#15
Peter N Chalmers, Dane Salazar, Mitchell E Fingerman, Jay D Keener, Aaron Chamberlain
BACKGROUND: Catheter-delivered continuous interscaleneanesthesia has demonstrated improved pain control in randomized clinical trials.The purpose of this study is to determine whether the introduction of continuous catheteranesthesia was associated with a change in length of stay (LOS), readmission, rates of discharge home without home health or nursing services, or opioid administration. We hypothesized that the introduction of continuous catheter anesthesia would be associated with a decrease in LOS, readmission, non-home discharge, and opioid administration...
July 5, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28688932/neurologic-complications-of-shoulder-joint-replacement
#16
Craig M Ball
BACKGROUND: Little attention has been given to neurologic complications after shoulder joint replacement (SJR). Previously thought to occur infrequently, it is likely that many are not clinically recognized, and they can result in postoperative morbidity and impair the patient's recovery. The purpose of this study was to document the prevalence of nerve complications after SJR, to identify the nerves involved, and to define patient outcomes. METHODS: This was a retrospective review of 211 SJRs in 202 patients during a 5-year period were included, with 89 male and 122 female patients at an average age of 70 years...
July 5, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28681763/contralateral-brachial-plexus-injury-following-retromastoid-suboccipital-craniotomy-a-report-and-review-of-literature
#17
Raghav Singla, Ravi Sharma, Shashwat Mishra, Hemanshu Prabhakar
No abstract text is available yet for this article.
July 2017: Neurology India
https://www.readbyqxmd.com/read/28677632/ultrasonographic-diagnosis-of-thoracic-outlet-syndrome-secondary-to-brachial-plexus-piercing-variation
#18
Vanessa Leonhard, Gregory Caldwell, Mei Goh, Sean Reeder, Heather F Smith
Structural variations of the thoracic outlet create a unique risk for neurogenic thoracic outlet syndrome (nTOS) that is difficult to diagnose clinically. Common anatomical variations in brachial plexus (BP) branching were recently discovered in which portions of the proximal plexus pierce the anterior scalene. This results in possible impingement of BP nerves within the muscle belly and, therefore, predisposition for nTOS. We hypothesized that some cases of disputed nTOS result from these BP branching variants...
July 4, 2017: Diagnostics
https://www.readbyqxmd.com/read/28676895/analysis-of-normal-and-dysplastic-glenohumeral-morphology-at-magnetic-resonance-imaging-in-children-with-neonatal-brachial-plexus-palsy
#19
Fabian van de Bunt, Michael L Pearl, Eric K Lee, Lauren Peng, Paul Didomenico
BACKGROUND: Glenoid version and percentage of the humeral head anterior to the scapular line are commonly used 2-D measures to assess deformity of the glenohumeral joint of children with neonatal brachial plexus palsy. OBJECTIVE: To assess whether glenoid version and percentage of the humeral head anterior to the scapular line would be altered by standardizing the measurements to the orientation of the scapula. MATERIALS AND METHODS: Twenty-one bilateral magnetic resonance imaging (MRI) scans were evaluated by four reviewers...
July 4, 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/28674717/obstetric-brachial-plexus-injury-knowledge-among-health-care-providers-in-saudi-arabia
#20
Rakan S Al-Essa, Rakan M Al-Khilaiwi, Ali A Al-Qahtani, Abdullah M Al-Thunayan, Mohammad M Al-Qattan
To assess the basic knowledge on obstetric brachial plexus injury among obstetricians, pediatricians, and physio-/occupational therapists in major hospitals in Riyadh.  We aimed to identify if inadequate knowledge is the reason behind delayed referrals to the Hand Clinic. Methods: This is a cross-sectional questionnaire-based study  conducted at 5 major hospitals in Riyadh, Saudi Arabia between June 2015 and August 2015.  A questionnaire of 6 questions (multiple choice closed-ended questions) was given to obstetricians, pediatricians, and  physio-/occupational therapists' in these selected hospitals...
July 2017: Saudi Medical Journal
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