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Brachial plexus

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https://www.readbyqxmd.com/read/29678427/the-psychological-impact-of-adult-traumatic-brachial-plexus-injury
#1
Zoe A Landers, Rishabh Jethanandani, Steve K Lee, Carol A Mancuso, Mavis Seehaus, Scott W Wolfe
PURPOSE: There is a high incidence of posttraumatic stress disorder (PTSD), depression, suicide risk, and psychological distress after orthopedic trauma and hand and upper-extremity injury. Although patients with traumatic adult brachial plexus injury are particularly vulnerable to psychologic distress, minimal clinical data exist about this cohort of patients. In this study, we sought to discover the prevalence of depression, PTSD, suicidal ideation, and substance abuse. METHODS: Between February, 2013 and July, 2014, during scheduled preoperative and/or postoperative appointments, the social worker at a metropolitan brachial plexus center conducted psychosocial assessments and questionnaire assessments of 21 patients evaluating for PTSD, depression, and substance use using 3 validated scales: PTSD Checklist-Specific, Patient Health Questionnaire-8, and National Institute on Drug Abuse Quick Screen...
April 17, 2018: Journal of Hand Surgery
https://www.readbyqxmd.com/read/29672872/neuromuscular-ultrasound-of-the-brachial-plexus-a-standardized-approach
#2
REVIEW
Vanessa Baute, Jeffrey A Strakowski, Jon W Reynolds, Kristopher R Karvelas, Paul Ehlers, Kevin J Brenzy, Zhongyu J Li, Michael S Cartwright
Reliable assessment of brachial plexus disorders can be challenging due to the complexity of the anatomy and variation of potential pathology. Electrodiagnostic testing can be both uncomfortable for the patient and inconclusive. Ultrasound can serve as a complement to clinical assessment, electrodiagnostic testing, and other imaging modalities. This paper describes a systematic approach for performing neuromuscular ultrasound for suspected pathology in the brachial plexus. The literature regarding techniques for brachial plexus ultrasound was reviewed...
April 19, 2018: Muscle & Nerve
https://www.readbyqxmd.com/read/29672828/characteristics-of-children-less-than-2-years-of-age-undergoing-anaesthesia-in-denmark-2005-2015-a-national-observational-study
#3
C Strøm, A Afshari, L H Lundstrøm, N Lohse
There are few data available that describe the current anaesthetic management of children. We have analysed anaesthetic practice and peri-operative complications for children in Denmark aged less than two years. We conducted a population-based observational cohort study using the Danish Anaesthesia Database to identify children who received anaesthesia in hospital from 1 January 2005 until 31 December 2015. Data were combined with that from the Danish National Patient Registry and the Danish Civil Registration System...
April 19, 2018: Anaesthesia
https://www.readbyqxmd.com/read/29668608/optimal-dose-of-perineural-dexmedetomidine-for-interscalene-brachial-plexus-block-to-control-postoperative-pain-in-patients-undergoing-arthroscopic-shoulder-surgery-a-prospective-double-blind-randomized-controlled-study
#4
Hong Soo Jung, Kwon Hui Seo, Jae Hyuk Kang, Jin-Young Jeong, Yong-Shin Kim, Na-Re Han
BACKGROUND: Adjuvant perineural dexmedetomidine can be used to prolong the analgesic effect of interscalene brachial plexus block (ISB). We investigated the optimal dose of dexmedetomidine in ISB for postoperative analgesia in patients undergoing arthroscopic shoulder surgery. METHODS: One hundred patients scheduled for elective shoulder arthroscopic surgery were enrolled in this randomized, double-blind study. Ultrasound-guided ISB was performed before general anesthesia using 22 mL of ropivacaine 0...
April 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29666885/referred-cramping-phantom-hand-pain-elicited-in-the-face-and-eliminated-by-peripheral-nerve-block
#5
Caroline Dietrich, Sandra Nehrdich, Annette Zimmer, Alexander Ritter, Gunther O Hofmann, Wolfgang H R Miltner, Thomas Weiss
Phantom limb pain is a restricting condition for a substantial number of amputees with quite different characteristics of pain. Here, we report on a forearm amputee with constant phantom pain in the hand, in whom we could regularly elicit the rare phenomenon of referred cramping phantom pain by touching the face. To clarify the underlying mechanisms, we followed the cramp during the course of an axillary blockade of the brachial plexus. During the blockade, both phantom pain and the referred cramp were abolished, while a referred sensation of "being touched at the phantom" persisted...
April 17, 2018: Experimental Brain Research. Experimentelle Hirnforschung. Expérimentation Cérébrale
https://www.readbyqxmd.com/read/29657936/cellular-therapy-for-chronic-traumatic-brachial-plexus-injury
#6
Alok Sharma, Hemangi Sane, Nandini Gokulchandran, Prerna Badhe, Suhasini Pai, Pooja Kulkarni, Jayanti Yadav, Sanket Inamdar
Cellular therapy is being actively pursued as a therapeutic modality in many of the neurological diseases. A variety of stem cells from diverse sources have been studied in detail and have been shown to exhibit angiogenetic and immunomodulatory properties in addition to other neuroprotective effects. Published clinical data have shown bone marrow mononuclear cell (BMMNC) injection in neurological disorders is safe and possesses regenerative potential. We illustrate a case of 27-year-old male with traumatic brachial plexus injury, administered with autologous BMMNCs intrathecally and intramuscularly, followed by multidisciplinary rehabilitation...
2018: Advanced Biomedical Research
https://www.readbyqxmd.com/read/29656387/a-nationwide-analysis-of-30-day-adverse-events-unplanned-readmission-and-length-of-hospital-stay-after-peripheral-nerve-surgery-in-extremities-and-the-brachial-plexus
#7
Enrico Martin, Ivo S Muskens, Joeky T Senders, David J Cote, Timothy R Smith, Marike L D Broekman
BACKGROUND: Little is known on adverse events and their timing after peripheral nerve surgery in extremities. The aim of this study is to identify predictors and typical timing of complications, unplanned readmission, and length of hospital stay for patients undergoing peripheral nerve surgery in the extremities. METHODS: Data were extracted from the National Surgical Quality Improvement Program (NSQIP) registry from 2005 to 2015. Adult patients undergoing peripheral nerve surgery in the extremities were included...
April 15, 2018: Microsurgery
https://www.readbyqxmd.com/read/29652235/harvey-cushing-s-management-of-neurogenic-thoracic-outlet-syndrome
#8
Courtney Pendleton, Allan J Belzberg, Robert J Spinner, Alfredo Quinones-Hinojosa
Harvey Cushing is widely regarded as one of the forefathers of neurosurgery, and is primarily associated with his work on intracranial pathology. However, he had a clinical and academic interest in peripheral nerve surgery. Through the courtesy of the Alan Mason Chesney Medical Archives, the surgical records of the Johns Hopkins Hospital from 1896 to 1912 were reviewed. The records of a single patient undergoing brachial plexus exploration and cervical rib resection were selected for detailed review. The operative report and accompanying illustrations demonstrate Cushing's interest in adding approaches to the pathology of the brachial plexus to his operative armamentarium...
April 13, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29650376/trapezius-muscle-transfer-for-restoration-of-elbow-extension-in-a-traumatic-brachial-plexus-injury
#9
Hamza M Alrabai, Martin G Gesheff, Ahmed I Hammouda, Janet D Conway
Voluntary elbow extension is essential for optimal upper limb positioning required for daily living activities, particularly above-shoulder maneuvers. The authors present a case of traumatic brachial plexus injury in which paralysis of the musculature selectively supplied by the posterior cord was based on magnetic resonance imaging and nerve conduction studies. An attempt at a radial nerve graft at another center was not effective. Ipsilateral hand function improved after multiple local tendon transfers were performed...
April 9, 2018: Journal of Hand Surgery
https://www.readbyqxmd.com/read/29630034/effective-dose-of-intravenous-dexmedetomidine-to-prolong-the-analgesic-duration-of-interscalene-brachial-plexus-block-a-single-center-prospective-double-blind-randomized-controlled-trial
#10
RyungA Kang, Ji Seon Jeong, Jae Chul Yoo, Ju Hyun Lee, Soo Joo Choi, Mi Sook Gwak, Tae Soo Hahm, Jin Huh, Justin Sangwook Ko
BACKGROUND AND OBJECTIVES: Intravenous (IV) dexmedetomidine (DEX) is reported to prolong the analgesic duration after single-shot interscalene brachial plexus block (ISBPB). However, the effective analgesic dose of IV DEX remains undetermined. Therefore, we aimed to elucidate the clinically relevant dose of IV DEX to prolong the analgesic duration of ISBPB. METHODS: Seventy-two patients scheduled for arthroscopic shoulder surgery received ISBPB with 15 mL of 0.5% ropivacaine with 1:200,000 epinephrine and were randomly assigned to 1 of 4 groups (n = 18, each): (1) IV normal saline (control), (2) IV DEX 0...
April 6, 2018: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29630033/a-randomized-comparison-between-interscalene-and-small-volume-supraclavicular-blocks-for-arthroscopic-shoulder-surgery
#11
Julián Aliste, Daniela Bravo, Diego Fernández, Sebastián Layera, Roderick J Finlayson, De Q Tran
BACKGROUND AND OBJECTIVES: This randomized trial compared ultrasound (US)-guided interscalene block (ISB) and small-volume supraclavicular block (SCB) for arthroscopic shoulder surgery. We hypothesized that SCB would provide equivalent analgesia to ISB 30 minutes after surgery without the risk of hemidiaphragmatic paralysis (HDP). METHODS: All patients received an US-guided intermediate cervical plexus block. In the ISB group, US-guided ISB was performed with 20 mL of levobupivacaine 0...
April 6, 2018: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29628588/effect-of-dexamethasone-on-characteristics-of-supraclavicular-nerve-block-with-bupivacaine-and-ropivacaine-a-prospective-double-blind-randomized-control-trial
#12
Deeksha Bindal, Neeraj Narang, Rekha Mahindra, Himanshu Gupta, Jyotsna Kubre, Anudeep Saxena
Background: Dexamethasone as an adjuvant to bupivacaine and ropivacaine for supraclavicular brachial plexus (SCBP) block prolongs motor and sensory blockade. However, comparison of effect of dexamethasone (8 mg) when added to these two local anesthetics has not been well studied. This study was conducted to compare analgesic efficacy of dexamethasone as adjuvant to bupivacaine and ropivacaine in SCBP block. Subjects and Methods: Nerve stimulator-guided SCBP block was given to 120 patients, randomly assigned to one of four groups: ( n = 30 in each group) Group B, BD, R, and RD received 30 ml (0...
January 2018: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29628577/comparison-of-dexamethasone-and-buprenorphine-as-adjuvant-in-ultrasound-guided-brachial-plexus-blocks-a-randomized-controlled-trial
#13
Prasanna Vadhanan, Narendren Ganesh, M I Hussain Ahmed
Introduction: Effective postoperative analgesia is imperative for orthopedic surgeries to enhance recovery and facilitate early ambulation. Various additives have been used as adjuvants with local anesthetics in peripheral nerve blocks to provide postoperative analgesia. The aim of this study is to compare the duration of postoperative analgesia with buprenorphine and dexamethasone when administered as an adjuvant during ultrasound-guided brachial plexus blocks. Methodology: Sixty adult patients undergoing various upper arm surgeries were recruited for the study after acquiring ethics committee clearance...
January 2018: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29628569/supraclavicular-brachial-plexus-block-comparison-of-varying-doses-of-nalbuphine-combined-with-levobupivacaine-a-prospective-double-blind-randomized-trial
#14
Sunil Chiruvella, Suresh Kumar Konkyana, Srinivasa Rao Nallam, Gokul Sateesh
Background and Aims: The ideal dose of nalbuphine for brachial plexus block (BPB) is a matter of debate. This study was carried out to evaluate 5 mg or 10 mg of nalbuphine added to 0.375% levobupivacaine, with regard to the duration of analgesia. Our study also sought to assess the onset and duration of sensorimotor blockade, hemodynamic effects, sedation, and adverse effects. Materials and Methods: One hundred adult patients undergoing upper-limb surgeries under supraclavicular BPB were randomly allocated into two groups...
January 2018: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29628564/comparison-of-magnesium-sulfate-and-dexmedetomidine-as-an-adjuvant-to-0-5-ropivacaine-in-infraclavicular-brachial-plexus-block
#15
Mohamed M Abu Elyazed, Mona M Mogahed
Background: Magnesium sulfate and dexmedetomidine were used as adjuvants to local anesthesia to improve the quality of regional anesthesia. Aims: The aim of this study is to evaluate and compare the effects of magnesium sulfate and dexmedetomidine when added to ropivacaine on the quality of infraclavicular brachial plexus block (BPB). Settings and Design: This was a prospective randomized double-blinded controlled study. Patients and Methods: A total of 105 adult patients undergoing surgery in hands, wrist, and forearm using infraclavicular BPB were randomly assigned into three groups...
January 2018: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29628554/comparison-of-ultrasound-with-peripheral-nerve-stimulator-guided-technique-for-supraclavicular-block-in-upper-limb-surgeries-a-randomized-controlled-trial
#16
Vinu Mervick Alfred, Gnanasekaran Srinivasan, Mamie Zachariah
Background: The supraclavicular approach is considered to be the easiest and most effective approach to block the brachial plexus for upper limb surgeries. The classical approach using the anatomical landmark technique was associated with higher failure rates and complications. Ultrasonography (USG) guidance and peripheral nerve stimulator (PNS) have improved the success rates and safety margin. Aims: The aim of the present study is to compare USG with PNS in supraclavicular brachial plexus block for upper limb surgeries with respect to the onset of motor and sensory blockade, total duration of blockade, procedure time, and complications...
January 2018: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29627308/function-in-unaffected-arms-of-children-with-obstetric-brachial-plexus-palsy
#17
Dilek Aktaş, Beyhan Eren, Özge Keniş-Coşkun, Evrim Karadag-Saygi
OBJECTIVE: The objective is to compare the fine and gross motor function of unaffected arms of children with obstetric brachial plexus palsy (OBBP) with typically developing children's dominant upper extremities. METHODS: Fifty-three patients with OBBP and fifty-one typically developing children between the age of 4 and 13 were included in the study. For gross motor function evaluation in the upper extremity box-block test (BBT), for fine motor skill nine-hole peg (9HP) test was used...
March 26, 2018: European Journal of Paediatric Neurology: EJPN
https://www.readbyqxmd.com/read/29623932/evaluation-of-nerve-transfer-options-for-treating-total-brachial-plexus-avulsion-injury-a-retrospective-study-of-73-participants
#18
Kai-Ming Gao, Jing-Jing Hu, Jie Lao, Xin Zhao
Despite recent great progress in diagnosis and microsurgical repair, the prognosis in total brachial plexus-avulsion injury remains unfavorable. Insufficient number of donors and unreasonable use of donor nerves might be key factors. To identify an optimal treatment strategy for this condition, we conducted a retrospective review. Seventy-three patients with total brachial plexus avulsion injury were followed up for an average of 7.3 years. Our analysis demonstrated no significant difference in elbow-flexion recovery between phrenic nerve-transfer (25 cases), phrenic nerve-graft (19 cases), intercostal nerve (17 cases), or contralateral C7 -transfer (12 cases) groups...
March 2018: Neural Regeneration Research
https://www.readbyqxmd.com/read/29623411/timing-of-rehabilitation-in-children-with-obstetric-upper-trunk-brachial-plexus-palsy
#19
Volkan Yilmaz, Ebru Umay, Nihal Tezel, Ibrahim Gundogdu
OBJECTIVES: The initiation timing of rehabilitation in children with obstetric brachial plexus palsy is controversial. The aim of the present study is to evaluate the effectiveness of rehabilitation timing to the functional outcomes of patients with obstetric upper trunk brachial plexus palsy. MATERIAL AND METHODS: Twenty-nine patients, who did not previously received any rehabilitation programme but attended our outpatient clinic, were included for the study. The electrophysiological findings, obstetric characteristics, and demographic features of the patients were recorded...
April 5, 2018: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/29619123/short-term-clinical-results-of-manipulation-under-ultrasound-guided-brachial-plexus-block-in-patients-with-idiopathic-frozen-shoulder-and-diabetic-secondary-frozen-shoulder
#20
Akira Ando, Junichiro Hamada, Yoshihiro Hagiwara, Takuya Sekiguchi, Masashi Koide, Eiji Itoi
Purpose: This study examined the effectiveness of manipulation under ultrasound-guided brachial plexus block in patients with recalcitrant idiopathic frozen shoulder and diabetic secondary frozen shoulder (diabetic frozen shoulder). Methods: Forty-four idiopathic frozen shoulders and 10 diabetic frozen shoulders with failed conservative treatment for at least 3 months were included in this study. The manipulation was performed under ultrasound-guided brachial plexus block and visual analogue scale, range of motion, and Constant scores were measured before manipulation and at the last follow-up examination...
2018: Open Orthopaedics Journal
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