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Infraclavicular nerve catheter

Sushil F Sancheti, Vishal Uppal, Robert Sandeski, M Kwesi Kwofie, Jennifer J Szerb
BACKGROUND AND OBJECTIVES: Retroclavicular block is designed to overcome the negative aspects of the commonly utilized ultrasound-guided parasagittal approach to the infraclavicular block. However, this approach necessitates the needle traversing an area posterior to the clavicle inaccessible to ultrasound wave conduction. This study sought to document the structures vulnerable to needle injury during a retroclavicular block. METHODS: A Tuohy needle was inserted using a retroclavicular approach to the infraclavicular block in 3 lightly embalmed cadavers followed by a catheter insertion 4 cm beyond the needle tip...
June 19, 2018: Regional Anesthesia and Pain Medicine
Michaela B Quast, Hans P Sviggum, Andrew C Hanson, David E Stoike, David P Martin, Adam D Niesen
STUDY OBJECTIVES: Continuous brachial plexus catheters are often used to decrease pain following elbow surgery. This investigation aimed to assess the rate of early failure of infraclavicular (IC) and axillary (AX) nerve catheters following elbow surgery. DESIGN: Retrospective study. SETTING: Postoperative recovery unit and inpatient hospital floor. PATIENTS: 328 patients who received IC or AX nerve catheters and underwent elbow surgery were identified by retrospective query of our institution's database...
February 3, 2018: Journal of Clinical Anesthesia
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
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
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
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
T Kyle Harrison, T Edward Kim, Steven K Howard, Natasha Funck, Michael J Wagner, Tessa L Walters, Catherine Curtin, James Chang, Toni Ganaway, Edward R Mariano
OBJECTIVES: Using a through-the-needle local anesthetic bolus technique, ultrasound-guided infraclavicular perineural catheters have been shown to provide greater analgesia compared to supraclavicular catheters. A through-the-catheter bolus technique, which arguably "tests" the anesthetic efficacy of the catheter before initiating an infusion, has been validated for infraclavicular catheters but not supraclavicular catheters. This study investigated the through-the-catheter bolus technique for supraclavicular catheters and tested the hypothesis that infraclavicular catheters provide faster onset of brachial plexus anesthesia...
February 2015: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
Adam O Spencer, Ban C H Tsui
No abstract text is available yet for this article.
July 2014: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
Zahab S Ahsan, Brendan Carvalho, Jeffrey Yao
PURPOSE: To explore the incidence of failure of continuous peripheral nerve blockade (CPNB) after upper extremity operations. METHODS: Patient data regarding postoperative CPNB were retrospectively obtained from our institution's regional anesthesia database. Documented information on the first postoperative day included pain assessment ratings (numerical verbal pain scale, patient-reported breakthrough pain upon perceived return of sensation, appearance of the catheter site, complications, time of return of sensation, day of return of sensation, residual blockade, patient satisfaction with the block, and whether patient would receive the block again)...
February 2014: Journal of Hand Surgery
Brian M Ilfeld, Tobias Moeller-Bertram, Steven R Hanling, Kyle Tokarz, Edward R Mariano, Vanessa J Loland, Sarah J Madison, Eliza J Ferguson, Anya C Morgan, Mark S Wallace
BACKGROUND: There is currently no reliable treatment for phantom limb pain (PLP). Chronic PLP and associated cortical abnormalities may be maintained from abnormal peripheral input, raising the possibility that a continuous peripheral nerve block (CPNB) of extended duration may permanently reorganize cortical pain mapping, thus providing lasting relief. METHODS: Three men with below-the-knee (2) or -elbow (1) amputations and intractable PLP received femoral/sciatic or infraclavicular perineural catheter(s), respectively...
June 2013: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
José A Aguirre, Daniela Gresch, Annemarie Popovici, Jost Bernhard, Alain Borgeat
No abstract text is available yet for this article.
May 2013: Anesthesiology
Zbigniew J Koscielniak-Nielsen, Jörgen B Dahl
PURPOSE OF REVIEW: Is ultrasound guidance changing the practice of upper extremity regional anesthesia? This review will aim to describe the findings published in the literature during the previous 18 months. RECENT FINDINGS: In some approaches to brachial plexus blockade, local anesthetic volumes may be reduced without deterioration of analgesic effect. However, even 10 ml of local injected into the interscalene space may result in diaphragmatic paresis. High-resolution ultrasonography has revealed anatomical variations of C5, C6 and C7 nerve roots in almost half of the patients examined, without negative block effectiveness...
April 2012: Current Opinion in Anaesthesiology
Benjamin G Bruce, Andrew Green, Theodore A Blaine, Lee V Wesner
Regional anesthesia of the upper extremity has several clinical applications and is reported to have several advantages over general anesthesia for orthopaedic surgery. These advantages, such as improved postoperative pain, decreased postoperative opioid administration, and reduced recovery time, have led to widespread acceptance of a variety of regional nerve blocks. Interscalene block is the most commonly used block for shoulder surgery. Other brachial plexus nerve blocks used for orthopaedic surgery of the upper extremity are supraclavicular, infraclavicular, and axillary...
January 2012: Journal of the American Academy of Orthopaedic Surgeons
Gokul Toshniwal, Rani Sunder, Ronald Thomas, G P Dureja
UNLABELLED: Interventional pain management techniques play an important role in the multidisciplinary approach to management of complex regional pain syndrome (CRPS). In this preliminary study we compared the efficacy of continuous stellate ganglion (CSG) block with that of continuous infraclavicular brachial plexus (CIBP) block in management of CRPS type I of upper extremity. METHODS: Thirty-three patients with CRPS type I of upper extremity were randomly assigned to either CSG or CIBP group...
January 2012: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
Thomas M Halaszynski
PURPOSE OF REVIEW: Ultrasound-guidance is gaining tremendous popularity. There is growing evidence of value with emphasis on clinical relevance, but can ultrasound-guidance scientifically warrant changing the practice of upper extremity regional? The literature is searched to describe findings where ultrasound may reduce complication rates, reduce block performance times, and improve block efficacy and quality. RECENT FINDINGS: Ultrasound examination identified variations in anatomical positioning of C5-C7 roots in approximately half of all patients despite no deleterious effects on block efficacy...
October 2011: Current Opinion in Anaesthesiology
Mariantina Fragou, Andreas Gravvanis, Vasilios Dimitriou, Apostolos Papalois, Gregorios Kouraklis, Andreas Karabinis, Theodosios Saranteas, John Poularas, John Papanikolaou, Periklis Davlouros, Nicos Labropoulos, Dimitrios Karakitsos
OBJECTIVE: Subclavian vein catheterization may cause various complications. We compared the real-time ultrasound-guided subclavian vein cannulation vs. the landmark method in critical care patients. DESIGN: Prospective randomized study. SETTING: Medical intensive care unit of a tertiary medical center. PATIENTS: Four hundred sixty-three mechanically ventilated patients enrolled in a randomized controlled ISRCTN-registered trial (ISRCTN-61258470)...
July 2011: Critical Care Medicine
Edward R Mariano, NavParkash S Sandhu, Vanessa J Loland, Michael L Bishop, Sarah J Madison, Reid A Abrams, Matthew J Meunier, Eliza J Ferguson, Brian M Ilfeld
BACKGROUND: Although the efficacy of single-injection supraclavicular nerve blocks is well established, no controlled study of continuous supraclavicular blocks is available, and their relative risks and benefits remain unknown. In contrast, the analgesia provided by continuous infraclavicular nerve blocks has been validated in randomized controlled trials. We therefore compared supraclavicular with infraclavicular perineural local anesthetic infusion following distal upper-extremity surgery...
January 2011: Regional Anesthesia and Pain Medicine
Steven R Clendenen, Christopher B Robards, Nathan J Clendenen, James E Freidenstein, Roy A Greengrass
Background. There are a variety of techniques for targeting placement of an infraclavicular blockade; these include eliciting paresthesias, nerve stimulation, and 2-dimensional (2D) ultrasound (US) guidance. Current 2D US allows direct visualization of a "flat" image of the advancing needle and neurovascular structures but without the ability to extensively analyze multidimensional data and allow for real-time manipulation. Three-dimensional (3D) ultrasonography has gained popularity and usefulness in many clinical specialties such as obstetrics and cardiology...
2010: Anesthesiology Research and Practice
Astrid M Morin, Peter Kranke, Hinnerk Wulf, Rudolf Stienstra, Leopold H J Eberhart
BACKGROUND AND OBJECTIVES: Stimulating catheters provide feedback regarding the location of the catheter tip in relation to the target nerve or plexus. There is debate concerning whether stimulating catheters may reduce the failure rate of postoperative analgesia or whether they may enhance functional recovery by providing superior and more reliable postoperative analgesia. METHODS: Studies comparing the effect of stimulating versus nonstimulating catheters for postoperative analgesia were systematically and independently searched by 2 authors...
March 2010: Regional Anesthesia and Pain Medicine
Edward R Mariano, Vanessa J Loland, Richard H Bellars, NavParkash S Sandhu, Michael L Bishop, Reid A Abrams, Matthew J Meunier, Rosalita C Maldonado, Eliza J Ferguson, Brian M Ilfeld
OBJECTIVE: Electrical stimulation (ES)- and ultrasound-guided placement techniques have been described for infraclavicular brachial plexus perineural catheters but to our knowledge have never been previously compared in a randomized fashion, leaving the optimal method undetermined. We tested the hypothesis that infraclavicular catheters placed via ultrasound guidance alone require less time for placement and produce equivalent results compared with catheters placed solely via ES. METHODS: Preoperatively, patients receiving an infraclavicular perineural catheter for distal upper extremity surgery were randomly assigned to either ES with a stimulating catheter or ultrasound guidance with a nonstimulating catheter...
September 2009: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
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