Infraclavicular nerve block

The results of the pinprick and cold tests performed on the arm, forearm, and wrist-wrist areas of patients scheduled for upper extremity procedures are subjective and dependent on patient's compliance. The purpose of this study was to determine whether the perfusion index (PI) could be used as an objective indicator to demonstrate block efficacy. Fifty patients between the ages of 18 and 65 years who were scheduled for upper extremity procedures and had an American Society of Anesthesiologists risk assessment class of I-II were included in this study...

Bupivacaine hydrochloride 0.5% (5 mg/mL) is commonly utilized for analgesia in brachial plexus blocks. We suggest that ultrasound-guided 0.25% (2.5 mg/mL) bupivacaine can be utilized for effective postoperative analgesia to reduce the effective dose. A total of 126 patients underwent ultrasound-guided brachial plexus blocks with 0.25% bupivacaine. The mean duration of analgesia was 21.95 (σ = 3.93) hours with no complications. Patients that received an infraclavicular block (22.56 σ = 4.02) had a significant increase in analgesia compared to supraclavicular blocks (21...

OBJECTIVE: Diabetic neuropathy is one of the most common complications of diabetes mellitus. Recovery from peripheral nerve blocks in diabetic patients with neuropathy may be delayed because of axonal degeneration and segmental demyelination. The aim of this study is to compare the infraclavicular brachial plexus block durations in patients with and without diabetes mellitus type 2. METHODS: This prospective observational study included 60 patients who were aged 40-80 years, with American Society of Anesthesiologists I-IV physical status and scheduled for elbow, forearm, and/or hand surgery under infraclavicular brachial plexus blocks...

BACKGROUND: Shoulder dislocations are a common presenting injury to the emergency department (ED), with anterior dislocations comprising the majority of these cases. Some patients may tolerate gentle manipulation and reduction, but many require analgesia of some type. Oral or parenteral pain medication is often used alone or in combination with procedural sedation if gentle manipulation fails to achieve reduction. Recently, this treatment algorithm has grown to include regional anesthesia as a mode of analgesia for reduction of shoulder dislocations in the form of brachial plexus blocks...

Continuous nerve block of unilateral paravertebral canal is one of the most reliable and the most commonly performed techniques to control intra- and postoperative pain. It is the technique of injecting local anaesthetic alongside the thoracic vertebra close to where the spinal nerves emerge from the intervertebral foramen. This produces unilateral, segmental, somatic, and sympathetic nerve blockade, which is effective for anaesthesia and in treating acute and chronic pain of unilateral origin from the chest and abdomen...

BACKGROUND: This randomized trial compared perineural dexamethasone with combined perineural dexamethasone-dexmedetomidine for ultrasound-guided infraclavicular block. We hypothesized that the combination of perineural adjuvants would result in a longer motor block. METHODS: Fifty patients undergoing upper limb surgery with ultrasound-guided infraclavicular block (using 35 mL of lidocaine 1%-bupivacaine 0.25% with epinephrine 5 µg/mL) were randomly allocated to receive perineural dexamethasone (2 mg) or combined perineural dexamethasone (2 mg)-dexmedetomidine (50 µg)...

BACKGROUND: The development of ultrasonography technology and its widespread application have increased peripheral nerve block applications, especially in limb surgeries, since it reduces complication rates and increases success rates in peripheral nerve block applications. However, even experienced physicians need to direct a large number of needles and injections for adequate local anesthetic spread, which can cause accidental vascular puncture and local anesthetic systemic toxicity...

Background The management of pain in patients undergoing open reduction and internal fixation (ORIF) of distal radius fractures (DRFs) remains an area of debate for anesthesiologists due to a variety of block options and no definitive superior technique among these modalities. In this retrospective case series, we compare the efficacy of supraclavicular versus infraclavicular regional nerve blocks for surgical patients undergoing distal radial ORIF operations to determine if one approach was superior. Methodology This retrospective case series included patients undergoing ORIF of a DRF at a tertiary academic medical center between April 28, 2016, and August 23, 2021...

Anesthesiologists avoid multiple upper extremity peripheral nerve block applications due to complications such as increased phrenic nerve palsy and local anesthetic systemic toxicity risk. With the introduction of ultrasound into clinical life and the increase in the number of experienced anesthesiologists, such complications are less common. We also discussed three cases that we think may contribute to the literature on this subject. Our first case was scheduled for operation due to a trigger finger in his left hand and carpal tunnel syndrome in his right hand...

Regional anesthesia is an integral component of successful orthopedic surgery. Neuraxial anesthesia is commonly used for surgical anesthesia while peripheral nerve blocks are often used for postoperative analgesia. Patient evaluation for regional anesthesia should include neurological, pulmonary, cardiovascular, and hematological assessments. Neuraxial blocks include spinal, epidural, and combined spinal epidural. Upper extremity peripheral nerve blocks include interscalene, supraclavicular, infraclavicular, and axillary...

Peripheral nerve blocks (PNB) have become standard of care for enhanced recovery pathways after surgery. For brachial plexus delivery of anesthesia, both supraclavicular (SC) and infraclavicular (IC) approaches have been shown to require less supplemental anesthesia, are performed more rapidly, have quicker onset time, and have lower rates of complications than other approaches (axillary, interscalene, etc.). Ultrasound-guidance is commonly utilized to improve outcomes, limit the need for deep sedation or general anesthesia, and reduce procedural complications...

OBJECTIVE: Ultrasound-guided infraclavicular nerve block (IB) has become a well-established method in several outpatient procedures; however, its use in emergency departments (EDs) remains limited. The aim of this study was to compare procedural sedation and anlagesia (PSA) and IB in the pain management for patients who underwent forearm fracture reduction in the ED. METHODS: This prospective randomized study included 60 patients aged 18 to 65 years, who visited the ED with forearm fractures...

Regional anesthesia practices are important because they have the advantages, for example, the patient's awareness is open, spontaneous breathing continues, airway reflexes are preserved, analgesia continues in the post-operative period, and the patient has early mobilization. Local anesthetic at high doses and volumes are used in brachial plexus blocks with nerve stimulator. However, due to the development in ultrasound (US) technology and the increase in image quality, reduced dose of limited anesthesia, and because of its advantages such as vascular and reduced risk of pleural puncture, it has become increasingly widespread...

Regional blocks are being increasingly utilized for anesthesia for various orthopedic procedures. Several studies have shown that regional anesthesia has fewer side effects and improved postoperative pain relief compared to general anesthesia, but regional blocks are not without risks. We present case reports of 2 patients who experienced posterior shoulder instability, one of whom had a posterior shoulder dislocation, immediately in the postanesthesia care unit after undergoing hand surgery with regional anesthesia...

BACKGROUND: This cadaveric study investigated the innervations of the clavicle and clavicular joints (ie, sternoclavicular and acromioclavicular joints). METHODS: Twenty cadavers (40 clavicles) were dissected. A skin incision was made to permit exposure of the posterior cervical triangle and infraclavicular fossa. The platysma, sternocleidomastoid, and trapezius muscles were cleaned in order to identify the supraclavicular nerves. Subsequently, the suprascapular and subclavian nerves were localized after removal of the prevertebral layer of the deep cervical fascia...

BACKGROUND Continuous peripheral nerve blocks can be administered as continuous infusion, patient-controlled boluses, automated boluses, or a combination of these modalities. MATERIAL AND METHODS Ten patients undergoing either ankle (5) or distal radius (5) open reduction and internal fixation received single-injection ropivacaine sciatic nerve block or infraclavicular brachial plexus block and catheter. Infusion pumps were set to begin administering additional ropivacaine 6 h following the initial block as automated boluses supplemented with patient-controlled boluses...

Peripheral Arterial Obstructive Disease (PAOD) may course with severe ischemic pain. In low-income health systems, patients may wait for vascular surgery. Continuous peripheral nerve block may be an effective alternative, with fewer side effects, in this scenario. A female patient with acute arterial obstruction of upper limb evolving with severe ischemic pain. She was submitted to a continuous infraclavicular brachial plexus block, which led to a satisfying pain control until the amputation surgery. The early postoperative period evolved with good pain management...

We aimed to assess the accuracy of an artificial intelligence (AI)-based real-time anatomy identification software specifically developed to ease image interpretation intended for ultrasound-guided peripheral nerve block (UGPNB). Forty healthy participants (20 women, 20 men) were enrolled to perform interscalene, supraclavicular, infraclavicular, and transversus abdominis plane (TAP) blocks under ultrasound guidance using AI software by anesthesiology trainees. During block practice by a trainee, once the software indicates 100% scan success of each block associated anatomic landmarks, both raw and labeled ultrasound images were saved, assessed, and validated using a 5-point scale by expert validators...

Infraclavicular block provides adequate anesthesia to the arm, forearm, and antecubital region. There are many different approaches to infraclavicular brachial plexus block. Corocoid approach which is mostly preferred is not appropriate in some cases that needle orientation disappear. In this case report, we performed a newly defined retroclavicular approach to infraclavicular brachial plexus block and discussed in the light of information in literature. The patient who has 79 year old man, 29.36 body mass index, American Society of Anesthesiologists 3 with chronic renal failure was admitted to the operation room with complaint of aneurysmatic arteriovenous fistula in the left antecubital area...

Introduction In this study, our objective was to compare the lateral sagittal infraclavicular block (LS-ICB) with the costoclavicular infraclavicular block (CC-ICB) for ultrasound (US)-guided infraclavicular brachial plexus block in terms of block dynamics as well as patient and surgeon satisfaction levels. Methods A total of 100 patients, falling under the American Society of Anaesthesiologists (ASA) I-III categories, who were aged 18-65 years and scheduled for elective forearm and hand surgery were enrolled in the study...