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Brachial plexus catheter

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https://www.readbyqxmd.com/read/28604465/brachial-plexus-injury-associated-with-subclavian-vein-cannulation-a-case-report
#1
Ezgi Gozubuyuk, Mehmet I Buget, Turgut Akgul, Demet Altun, Suleyman Kuçukay
We documented brachial plexus injury by electromyography and magnetic resonance imaging secondary to needle sticks for central line insertion. This type of complication is rare in the literature, as few case reports exist. Brachial plexus injury can happen because of anatomic variations. Nevertheless, multiple attempts or introducer needle rotations should be avoided during subclavian vein catheterization. Pain that emerges in the ipsilateral arm after subclavian catheter placement should be taken into serious consideration...
June 8, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28542052/continuous-interscalene-block-for-postoperative-analgesia-and-shoulder-immobilization-after-pectoralis-major-tendon-reinsertion-a-case-report
#2
John J Finneran, Brian M Ilfeld, Jacklynn F Sztain
We present the case of a 38-year-old man undergoing surgical repair of his pectoralis major tendon. An interscalene catheter was placed between the middle and lower trunks of the brachial plexus. Postoperatively, ropivacaine 0.2% was infused through postoperative day. The patient had excellent pain control requiring minimal opioid analgesics. A catheter between the middle and lower trunks of the brachial plexus provided excellent postoperative analgesia after pectoralis major tendon reinsertion. Additionally, the block likely protected the surgical repair during emergence from anesthesia and in the early postoperative period by providing a motor block of the pectoralis major muscle...
May 23, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28403412/reduced-hemidiaphragmatic-paresis-with-extrafascial-compared-with-conventional-intrafascial-tip-placement-for-continuous-interscalene-brachial-plexus-block-a-randomized-controlled-double-blind-trial
#3
E Albrecht, I Bathory, N Fournier, A Jacot-Guillarmod, A Farron, R Brull
Background.: The incidence of hemidiaphragmatic paresis with continuous interscalene brachial plexus block (CISB) can approach 100%. We tested the hypothesis that extrafascial placement of the catheter tip reduces the rate of hemidiaphragmatic paresis compared with intrafascial tip placement for CISB while providing effective analgesia. Methods.: Seventy patients undergoing elective major shoulder surgery under general anaesthesia were randomized to receive an ultrasound-guided CISB plexus block for analgesia with the catheter tip placed either within (intrafascial group) or immediately outside (extrafascial group) the brachial plexus sheath midway between the levels of C5 and C6...
April 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28403100/delayed-bilateral-vocal-cord-paresis-after-a-continuous-interscalene-brachial-plexus-block-and-endotracheal-intubation-a-lesson-why-we-should-use-low-concentrated-local-anesthetics-for-continuous-blocks
#4
Hee-Sun Park, Ha-Jung Kim, Young-Jin Ro, Hong-Seuk Yang, Won-Uk Koh
RATIONALE: Recurrent laryngeal nerve block is an uncommon complication that can occur after an interscalene brachial plexus block (ISB), which may lead to vocal cord palsy or paresis. However, if the recurrent laryngeal nerve is blocked in patients with a preexisting contralateral vocal cord palsy following neck surgery, this may lead to devastating acute respiratory failure. Thus, ISB is contraindicated in patients with contralateral vocal cord lesion. To the best of our knowledge, there are no reports of bilateral vocal cord paresis, which occurred after a continuous ISB and endotracheal intubation in a patient with no history of vocal cord injury or surgery of the neck...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28348896/effect-of-arm-positioning-on-entrapment-of-infraclavicular-nerve-block-catheter
#5
Eric Kamenetsky, Rahul Reddy, Mark C Kendall, Antoun Nader, Jessica J Weeks
Continuous brachial plexus nerve block catheters are commonly inserted for postoperative analgesia after upper extremity surgery. Modifications of the insertion technique have been described to improve the safety of placing an infraclavicular brachial plexus catheter. Rarely, these catheters may become damaged or entrapped, complicating their removal. We describe a case of infraclavicular brachial plexus catheter entrapment related to differences in arm positioning during catheter placement and removal. Written authorization to obtain, use, and disclose information and images was obtained from the patient...
2017: Case Reports in Anesthesiology
https://www.readbyqxmd.com/read/28277420/regional-to-the-rescue-axillary-brachial-plexus-nerve-block-facilitates-removal-of-entrapped-transradial-catheter-placed-for-cardiac-catheterization
#6
Brian M Fitzgerald, Lee A Babbel, Ferdinand K Bacomo, Sandeep T Dhanjal
OBJECTIVE: Our objective was to describe the first reported use of an axillary brachial plexus block to treat the entrapment of a transradial artery catheter due to vasospasm. CASE REPORT: A 42-year-old man undergoing transradial arterial cardiac catheterization suffered arterial vasospasm causing the catheter to become entrapped and refractory to conservative (warm compresses) and standard pharmacologic interventions (intracatheter verapamil, intravenous infusions of nitroglycerin and nicardipine, and subcutaneous lidocaine and topical nitroglycerin)...
March 8, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28277258/continuous-versus-single-shot-brachial-plexus-block-and-their-relationship-to-discharge-barriers-and-length-of-stay
#7
COMPARATIVE STUDY
Matthew Thompson, Robert Simonds, Bryce Clinger, Kristen Kobulnicky, Adam P Sima, Laura Lahaye, N Douglas Boardman
BACKGROUND: Brachial plexus block has been associated with improved pain control and decreased length of stay in patients undergoing upper extremity arthroplasty. Continuous delivery is associated with a shorter length of stay; however, comparisons to single-shot delivery in this setting are scarce. As the paradigm shifts to outpatient arthroplasty in the era of bundled payments, there exists a strong impetus to identify the most effective mode of analgesia associated with the least risk to patients...
April 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28272290/a-double-blind-randomized-comparison-of-continuous-interscalene-supraclavicular-and-suprascapular-blocks-for-total-shoulder-arthroplasty
#8
David B Auyong, Stanley C Yuan, Daniel S Choi, Joshuel A Pahang, April E Slee, Neil A Hanson
BACKGROUND AND OBJECTIVES: Continuous brachial plexus blocks at the interscalene level are associated with known diaphragm dysfunction from phrenic nerve paresis. More distal blocks along the brachial plexus may provide postsurgical analgesia while potentially having less effect on diaphragm function. Continuous interscalene, continuous supraclavicular, and continuous suprascapular nerve blocks were evaluated for respiratory function and analgesia after total shoulder arthroplasty. METHODS: After ethics board approval, subjects presenting for total shoulder arthroplasty were planned for randomization in a 1:1:1 ratio of a continuous interscalene, supraclavicular, or suprascapular block...
May 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28259372/-gas-tamponade-following-intraoperative-pneumothorax-on-a-single-lung-a-case-study
#9
S D El Jaouhari, O Mamane Nassirou, M Meziane, M Bensghir, C Haimeur
Intraoperative pneumothorax is a rare complication with a high risk of cardiorespiratory arrest by gas tamponade especially on a single lung. We report the case of a female patient aged 53 years who benefited from a left pneumonectomy on pulmonary tuberculosis sequelae. The patient presented early postoperative anemia with a left hemothorax requiring an emergency thoracotomy. In perioperative, the patient had a gas tamponade following a pneumothorax of the remaining lung, and the fate has been avoided by an exsufflation...
April 2017: Revue de Pneumologie Clinique
https://www.readbyqxmd.com/read/27631270/a-prospective-randomized-and-controlled-study-of-interscalene-brachial-plexus-block-for-arthroscopic-shoulder-surgery-a-comparison-of-c5-and-conventional-approach-a-consort-compliant-article
#10
RANDOMIZED CONTROLLED TRIAL
Hyun-Jung Shin, Hyo-Seok Na, Ah-Young Oh, Jung-Won Hwang, Byung-Gun Kim, Hee-Pyoung Park, Young-Tae Jeon, Seong-Won Min, Jung-Hee Ryu
BACKGROUND: The shoulder area is mainly innervated with the C5 and C6 nerve roots, and interscalene brachial plexus block (ISB) is widely used for postoperative analgesia after shoulder surgery. However, it is associated with adverse effects, such as numbness and weakness in the blocked arm due to an unwanted block of the lower brachial plexus (C7-T1). We hypothesized that the C5 approach during ISB would provide postoperative analgesia while minimizing adverse events after arthroscopic shoulder surgery...
September 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27464944/a-novel-approach-to-brachial-plexus-catheter-management-a-brachial-plexus-test-dose-for-phrenic-nerve-paralysis-and-patient-controlled-demand-only-dosing-for-a-patient-with-extreme-obesity
#11
Adam W Meier, Shin-E Lin, Neil A Hanson, David B Auyong
A 53-year-old woman with extreme obesity (body mass index = 82 kg/m) presented for an open reduction and internal fixation of the proximal humerus. This report describes the novel management of her continuous brachial plexus catheter in the setting of her comorbidities. Phrenic nerve paralysis from brachial plexus blocks can cause clinically significant dyspnea in obese patients. Brachial plexus catheters can be used effectively for these patients with some modification to routine management. We detail our use of a short-acting chloroprocaine test dose for phrenic paralysis and demand-only dosing to provide effective analgesia while avoiding respiratory complications associated with these blocks...
September 15, 2016: A & A Case Reports
https://www.readbyqxmd.com/read/27258178/continuous-suprascapular-nerve-block-with-a-perineural-catheter-for-reverse-shoulder-arthroplasty-rescue-analgesia-in-a-patient-with-severe-chronic-obstructive-pulmonary-disease
#12
Matthew Careskey, Ramana Naidu
Reverse open shoulder arthroplasty requires a comprehensive analgesic plan involving regional anesthesia. The commonly performed interscalene brachial plexus blockade confers a high likelihood of diaphragmatic paralysis via phrenic nerve palsy, making this option riskier in patients with limited pulmonary reserve. Continuous blockade of the suprascapular nerve, a more distal branch of the C5 and C6 nerve roots, may be a viable alternative. We report a successful case of the use of a suprascapular nerve block with continuous programmed intermittent bolus perineural analgesia in a patient with severe chronic obstructive pulmonary disease who underwent reverse open shoulder arthroplasty...
July 15, 2016: A & A Case Reports
https://www.readbyqxmd.com/read/27107906/postoperative-analgesia-in-a-prolonged-continuous-interscalene-block-versus-single-shot-block-in-outpatient-arthroscopic-rotator-cuff-repair-a-prospective-randomized-study
#13
Tariq Malik, Daniel Mass, Stephan Cohn
PURPOSE: To compare the analgesic efficacy of 3-day continuous interscalene brachial plexus block versus a single-shot block for arthroscopic rotator cuff repair. METHODS: Eighty-five patients scheduled for arthroscopic rotator cuff repair were randomly assigned to either the single-shot group (SSG) or continuous interscalene brachial block group (CG). Patients in the SSG received 2.5 mg/kg of 0.5% bupivacaine up to 25 mL; the CG received the same dose as a loading dose via catheter followed by an infusion of 0...
August 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/27098548/phrenic-palsy-and-analgesic-quality-of-continuous-supraclavicular-vs-interscalene-plexus-blocks-after-shoulder-surgery
#14
RANDOMIZED CONTROLLED TRIAL
T Wiesmann, C Feldmann, H H Müller, L Nentwig, A Beermann, B F El-Zayat, M Zoremba, H Wulf, T Steinfeldt
BACKGROUND: Hemidiaphragmatic palsy is a common consequence of the interscalene brachial plexus block. It occurs less commonly with the supraclavicular approach. Register data suggest that the analgesic quality of a supraclavicular blockade is sufficient for arthroscopic shoulder surgery, although data on the post-operative analgesic effect are lacking. METHODS: After approval by the ethics committee, patients having arthroscopic shoulder surgery under general anaesthesia were randomized to receive a continuous interscalene or supraclavicular blockade...
September 2016: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/26992617/infraclavicular-first-rib-resection-for-the-treatment-of-acute-venous-thoracic-outlet-syndrome
#15
Jeffrey J Siracuse, Paul C Johnston, Douglas W Jones, Heather L Gill, Peter H Connolly, Andrew J Meltzer, Darren B Schneider
OBJECTIVE: Venous thoracic outlet syndrome (VTOS) is most commonly treated by transaxillary, supraclavicular, or paraclavicular approaches, based on surgeon preference. However, we have adopted an infraclavicular approach to VTOS as the surgical pathology is in the anterior costoclavicular space. We hypothesize that this approach, combined with catheter-directed thrombolysis (CDT) with venoplasty as needed, provides safe and effective treatment of patients with an acute presentation of VTOS...
October 2015: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/26849172/an-analysis-of-1505-consecutive-patients-receiving-continuous-interscalene-analgesia-at-home-a-multicentre-prospective-safety-study
#16
MULTICENTER STUDY
M J Fredrickson, P Leightley, A Wong, M Chaddock, A Abeysekera, C Frampton
Continuous interscalene brachial plexus block has been shown to be the most effective analgesic technique following shoulder surgery; however, its use is uncommon due to logistical and safety concerns related to ambulatory administration. We prospectively studied 1505 consecutive patients undergoing shoulder surgery who received continuous interscalene analgesia at home. Catheter removal was by the patient between postoperative days two and five. There were no major complications although 27% of patients reported mild dyspnoea, 13% hoarseness and 7% dysphagia...
April 2016: Anaesthesia
https://www.readbyqxmd.com/read/26650425/regional-versus-general-anesthesia-and-the-incidence-of-unplanned-health-care-resource-utilization-for-postoperative-pain-after-wrist-fracture-surgery-results-from-a-retrospective-quality-improvement-project
#17
COMPARATIVE STUDY
Sarah Sunderland, Cynthia H Yarnold, Stephen J Head, Jill A Osborn, Andrew Purssell, John K Peel, Stephan K W Schwarz
BACKGROUND AND OBJECTIVES: The establishment at our center of a dedicated regional anesthesia service in 2008-2009 has resulted in a marked increase in single-shot brachial plexus blocks (sBPBs) for ambulatory wrist fracture surgery. Despite the documented benefits of regional over general anesthesia (GA), there has been a perceived increase among sBPB patients in postoperative return rates for pain at our institution. We conducted a retrospective quality improvement project to examine this...
January 2016: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/26584952/the-relationship-of-the-musculocutaneous-nerve-to-the-brachial-plexus-evaluated-by-mri
#18
Trygve Kjelstrup, Axel R Sauter, Per K Hol
Axillary plexus blocks (AXB) are widely used for upper limb operations. It is recommend that AXB should be performed using a multiple injection technique. Information about the course and position of the musculocutaneous nerve (MCN) is of relevance for AXB performance. The objective of this study was to examine the position of the MCN and its relationship to the axillary sheath using MRI. 54 patients underwent an AXB with 40 ml of local anaesthetic before MRI examination. The course of the MCN and the position where it left the axillary sheath and perforated the coracobrachial muscle (MCN exit point), in relation to the axillary artery and the block needle insertion point in the axillary fold, were recorded...
February 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/26495085/ultrasound-guided-continuous-axillary-brachial-plexus-block-using-a-nerve-stimulating-catheter-epistim%C3%A2-catheter
#19
Sang Sik Choi, Mi Kyoung Lee, Jung Eun Kim, Se Hee Kim, Gwi Eun Yeo
Brachial plexus block (BPB) under ultrasound guidance has come to be widely used. However, nerve injury has been reported following ultrasound-guided BPB. We hypothesized that BPB under ultrasound guidance in conjunction with real-time electrical nerve stimulation would help us prevent nerve injury and do more successful procedure. Here, we report the successful induction and maintenance of ultrasound-guided BPB and the achievement of good peri- and postoperative pain control using a conductive catheter, the EpiStim®...
October 2015: Korean Journal of Pain
https://www.readbyqxmd.com/read/26487153/influence-of-arm-position-on-catheter-placement-during-real-time-ultrasound-guided-right-infraclavicular-proximal-axillary-venous-catheterization
#20
RANDOMIZED CONTROLLED TRIAL
J H Ahn, I S Kim, K M Shin, S S Kang, S J Hong, J H Park, H J Kim, S H Lee, D Y Kim, J H Jung
BACKGROUND: Real-time ultrasound-guided infraclavicular proximal axillary venous catheterization is used in many clinical situations and provides the advantages of catheter stabilization, a reduced risk of catheter-related infection, and comfort for the patient without limitation of movement. However, unintended catheter tip dislocation and accidental arterial puncture occur occasionally. This study was designed to investigate the influence of arm position on catheter placement and complications...
March 2016: British Journal of Anaesthesia
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