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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
#1
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...
November 21, 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
#2
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...
November 8, 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27790416/accessory-upper-subscapular-nerve-the-neurotisation-tool
#3
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
#4
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
#5
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...
October 5, 2016: Der Anaesthesist
https://www.readbyqxmd.com/read/27707619/single-center-results-of-a-series-of-prosthetic-axillary-axillary-arteriovenous-access-grafts-for-hemodialysis
#6
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...
October 1, 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
#7
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
#8
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
#9
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
#10
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
#11
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/27494369/high-negative-pressure-subcutaneous-suction-drain-for-managing-debilitating-subcutaneous-emphysema-secondary-to-tube-thoracostomy-for-an-iatrogenic-post-computed-tomography-guided-transthoracic-needle-biopsy-pneumothorax-case-report-and-review-of-literature
#12
Zeeshan Ahmed, Pinakin Patel, Suresh Singh, Raj Govind Sharma, Pankaj Somani, Abdul Rauf Gouri, Shiv Singh
INTRODUCTION: Subcutaneous emphysema is a common complication of tube thoracostomy. Though self-limiting, it should be treated when it causes palpebral closure, dyspnea, dysphagia or undue disfigurement resulting in anxiety and distress to the patient. PRESENTATION OF CASE: A 72year old man who was a known case of COPD on bronchodilators developed a large pneumothorax and respiratory distress after a CT guided transthoracic lung biopsy done for a lung opacity (approx...
2016: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/27396474/a-prospective-randomised-trial-comparing-insertion-success-rate-and-incidence-of-catheterisation-related-complications-for-subclavian-venous-catheterisation-using-a-thin-walled-introducer-needle-or-a-catheter-over-needle-technique
#13
E Kim, B G Kim, Y J Lim, Y T Jeon, J W Hwang, H C Kim, Y H Choi, H P Park
In clinical practice, both a thin-walled introducer needle and catheter-over-needle technique can be used to allow insertion of a guidewire during central venous catheterisation using the Seldinger technique. We compared the incidence of catheterisation-related complications (arterial puncture, haemothorax, pneumothorax, haematoma and catheter tip malposition) and insertion success rate for these two techniques in patients requiring right-sided subclavian central venous catheterisation. A total of 414 patients requiring infraclavicular subclavian venous catheterisation were randomly allocated to either a thin-walled introducer needle (needle group, n = 208) or catheter-over-needle technique (catheter group, n = 206)...
September 2016: Anaesthesia
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/27354622/nodal-ratio-as-a-prognostic-factor-in-patients-with-four-or-more-positive-axillary-nodes-treated-with-breast-conserving-therapy-and-regional-nodal-irradiation
#15
Giuseppe Iatì, Antonio Pontoriero, Stefania Mondello, Anna Santacaterina, Angelo Platania, Pasquale Frosina, Marilena Mattace Raso, Dario Aiello, Antonio Arcudi, Gabriella Arena, Giacomo Marino, Micol Mazzei, Carmen Rifatto, Edoarda Risoleti, Raffaele Runco, Giuseppe Sansotta, Pietro Delia, Alessandro Sindoni, Stefano Pergolizzi
AIM: This study aimed to investigate the prognostic value of the axillary lymph node ratio (i.e. positive axillary nodes to nodes removed) in patients with breast cancer treated with conservative surgery and regional radiotherapy. PATIENTS AND METHODS: We retrieved the records of 195 patients with breast cancer with pathological stage pT1-2 pN2-3, treated from January 2005 to December 2013 at our Radiation Oncology Centers; their clinical data were retrospectively evaluated...
July 2016: Anticancer Research
https://www.readbyqxmd.com/read/27294044/endoscopic-and-robotic-parathyroidectomy-in-patients-with-primary-hyperparathyroidism
#16
REVIEW
Laurent Brunaud, Zhen Li, Klaas Van Den Heede, Thomas Cuny, Sam Van Slycke
Primary hyperparathyroidism (PHPT) is one of the most common endocrine disorders for which parathyroidectomy is the most effective therapy. Until late 1970s, the standard approach to parathyroidectomy was a four-gland exploration using a large skin incision. However, 80 to 85 percent of cases of PHPT are caused by a single adenoma. As such, the concept of performing a bilateral exploration in order to visualize all four glands has been argued to be excessive since in the majority of cases, there is only one abnormal gland...
June 2016: Gland Surgery
https://www.readbyqxmd.com/read/27239291/upper-extremity-nerve-block-how-can-benefit-duration-and-safety-be-improved-an-update
#17
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/27172108/-significance-of-secondary-mucosal-primaries-in-patients-with-a-cervical-cup-syndrome
#18
A M Franzen, A Lieder, A Buchali
BACKGROUND: We discuss the significance of an occult primary in the prognosis of cervical carcinoma with unknown primary (CUP) after completion of diagnostic and treatment. PATIENTS/METHODS: A series of 36 patients diagnosed between 2001 and 2009 underwent staging including panendoscopy, mapping and tonsillectomy, ultrasound and CT/MRI of the neck, thorax and abdomen. The patients recieved neck surgery followed by adjuvant radio-(chemo-)therapy of cervical fields as well as limited mucosal irradiation (IMRT, GHD 50 Gy)...
July 2016: Laryngo- Rhino- Otologie
https://www.readbyqxmd.com/read/27126378/pedicled-adipofascial-infraclavicular-flap-elevation-technique-and-its-use-for-maintaining-neck-contour-and-vessel-coverage-after-radical-and-modified-radical-neck-dissection
#19
John Yoo, Tsu-Hui Hubert Low, Samantha Tam, Allison Partridge, S Danielle MacNeil, Anthony C Nichols, Kevin Fung
BACKGROUND: The pedicled adipofascial infraclavicular flap (ICF) is based on the anterior perforator of the supraclavicular artery and supplies the fasciocutaneous tissue of the upper chest. This flap may be used to address neck contour defects and vessel coverage after radical and modified radical neck dissections (MRNDs). METHODS: We described the pedicled adipofascial ICF elevation technique and its use immediately after neck dissections in order to maintain soft tissue volume and vessel coverage...
October 2016: Head & Neck
https://www.readbyqxmd.com/read/27101216/comparison-of-the-supraclavicular-infraclavicular-and-axillary-approaches-for-ultrasound-guided-brachial-plexus-block-for-surgical-anesthesia
#20
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...
2016: Rambam Maimonides Medical Journal
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