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https://www.readbyqxmd.com/read/28207458/response-to-influence-of-mechanical-mentilation-on-the-incidence-of-pneumothorax-during-infraclavicular-subclavian-vein-catheterization-a-prospective-randomized-noninferiority-trial
#1
Etrusca Brogi, Giampaolo Martinelli, Francesco Forfori
No abstract text is available yet for this article.
March 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28205117/a-randomized-comparison-between-costoclavicular-and-paracoracoid-ultrasound-guided-infraclavicular-block-for-upper-limb-surgery
#2
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
#3
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
#4
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/28129767/helical-tomotherapy-for-locally-advanced-or-recurrent-breast-cancer
#5
M N Duma, C Heinrich, C Schönknecht, B Chizzali, M Mayinger, M Devecka, S Kampfer, S E Combs
PURPOSE: We report our experience of using helical tomotherapy (HT) to treat large and irregular shaped loco-regional advanced breast cancer target volumes embracing various organs at risk. PATIENTS AND METHODS: We retrospectively analyzed 26 patients treated for very large, irregular shaped breast cancers. Patients were treated either with the intent to achieve local control in a primary setting (n = 14) or in a reirradiation setting (n = 12). The recurrence group was heavily pretreated with systemic therapy...
January 28, 2017: Radiation Oncology
https://www.readbyqxmd.com/read/28126454/ultrasound-guided-retroclavicular-approach-infraclavicular-brachial-plexus-block-for-upper-extremity-emergency-procedures
#6
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
#7
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
#8
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
#9
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
#10
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/27869288/infraclavicular-access-to-the-axillary-vein-new-possibilities-for-the-catheterization-of-the-central-veins-in-the-intensive-care-unit
#11
Ryszard Gawda, Tomasz Czarnik, Lidia Łysenko
Central vein cannulation is one of the most commonly performed procedures in intensive care. Traditionally, the jugular and subclavian vein are recommended as the first choice option. Nevertheless, these attempts are not always obtainable for critically ill patients. For this reason, the axillary vein seems to be a rational alternative approach. In this narrative review, we evaluate the usefulness of the infraclavicular access to the axillary vein. The existing evidence suggests that infraclavicular approach to the axillary vein is a reliable method of central vein catheterization, especially when performed with ultrasound guidance...
2016: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/27828793/comparison-of-supraclavicular-and-infraclavicular-brachial-plexus-block-a-systemic-review-of-randomized-controlled-trials
#12
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
#13
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/27742773/novel-experience-of-laser-assisted-inside-out-central-venous-access-in-a-patient-with-bilateral-subclavian-vein-occlusion-requiring-pacemaker-implantation
#14
Thandar Aye, Thanh Trung Phan, Douglas Findlay Muir, Nicholas John Linker, Richard Hartley, Andrew John Turley
AIM: This new laser facilitated 'inside-out' technique was used for transvenous pacemaker insertion in a pacemaker-dependent patient with bilateral subclavian occlusion and a failed epicardial system who is not suitable for a transfemoral approach. METHOD AND RESULTS: Procedure was undertaken under general anaesthesia with venous access obtained from right femoral vein and left axillary vein. 7F multipurpose catheter was used to enter proximal edge of the occluded segment of subclavian vein via femoral approach, which then supported stiff angioplasty wires and microcatheters to tunnel into the body of occlusion...
October 14, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/27709274/-injuries-to-blood-vessels-near-the-heart-caused-by-central-venous-catheters
#15
J Abram, J Klocker, N Innerhofer-Pompernigg, M Mittermayr, M C Freund, N Gravenstein, V Wenzel
Injuries to blood vessels near the heart can quickly become life-threatening and include arterial injuries during central venous puncture, which can lead to hemorrhagic shock. We report 6 patients in whom injury to the subclavian artery and vein led to life-threatening complications. Central venous catheters are associated with a multitude of risks, such as venous thrombosis, air embolism, systemic or local infections, paresthesia, hemothorax, pneumothorax, and cervical hematoma, which are not always immediately discernible...
November 2016: Der Anaesthesist
https://www.readbyqxmd.com/read/27707619/single-center-results-of-a-series-of-prosthetic-axillary-axillary-arteriovenous-access-grafts-for-hemodialysis
#16
Oliver Gale-Grant, Eric S Chemla
OBJECTIVE: Prosthetic infraclavicular axillary-axillary arteriovenous access grafts are one of a number of complex dialysis access options in patients when all of the usual upper limb possibilities have been exhausted. We present a follow-up of 35 patients who received this access graft during a 9-year period. METHODS: Patients were identified from our own operation records. Follow-up data were gathered from their locally held electronic medical records. Primary and secondary patency were calculated using the Kaplan-Meier estimate...
December 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27639006/diagnosis-and-treatment-of-effort-induced-thrombosis-of-the-axillary-subclavian-vein-due-to-venous-thoracic-outlet-syndrome
#17
REVIEW
Chandu Vemuri, Payam Salehi, Jaime Benarroch-Gampel, Lauren N McLaughlin, Robert W Thompson
Venous thoracic outlet syndrome (VTOS) is uncommon but most frequently occurs in young, active, healthy patients. This condition typically presents as subclavian vein (SCV) effort thrombosis, also known as Paget-Schroetter syndrome. The pathophysiology underlying VTOS is chronic repetitive compression injury of the SCV in the costoclavicular space, resulting in progressive venous scarring, focal stenosis, and eventual thrombosis. Clinical evaluation includes a history and physical examination followed by catheter-based venography, for definitive confirmation of the diagnosis and initial treatment with pharmacomechanical thrombolysis...
October 2016: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/27547909/ultrasound-guided-retroclavicular-block-aka-posterior-approach-infraclavicular-block-anatomical-variation-of-the-clavicle-limits-block-feasibility
#18
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/27537756/influence-of-mechanical-ventilation-on-the-incidence-of-pneumothorax-during-infraclavicular-subclavian-vein-catheterization-a-prospective-randomized-noninferiority-trial
#19
Eugene Kim, Hyun Joo Kim, Deok Man Hong, Hee-Pyoung Park, Jae-Hyon Bahk
BACKGROUND: It remains unclear whether we have to interrupt mechanical ventilation during infraclavicular subclavian venous catheterization. In practice, the clinicians' choice about lung deflation depends on their own discretion. The purpose of this study was to assess the influence of mechanical ventilation on the incidence of pneumothorax during infraclavicular subclavian venous catheterization. METHODS: A total of 332 patients, who needed subclavian venous catheterization, were randomly assigned to 1 of the 2 groups: catheterizations were performed with the patients' lungs under mechanical ventilation (ventilation group, n = 165) or without mechanical ventilation (deflation group, n = 167)...
September 2016: Anesthesia and Analgesia
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
#20
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
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