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Thoracodorsal block

S Goswami, P Kundra, J Bhattacharyya
Background: Pectoral nerve block1 (PEC1) given between pectoralis major and minor, and modified pectoral nerve block2 (mPEC2) performed between pectoralis minor and serratus anterior, can provide continuous analgesia after modified radical mastectomy (MRM) when catheters are placed before skin closure. This study was designed to compare PEC1 and mPEC2 block for providing postoperative pain relief after MRM. Methods: Sixty-two physically fit patients undergoing MRM were assigned into two groups (Group PEC1, n=31 and Group mPEC2, n=31)...
October 1, 2017: British Journal of Anaesthesia
Paulo de Souza Junior, Natan da Cruz de Carvalho, Karine de Mattos, Marcelo Abidu Figueiredo, André Luiz Quagliatto Santos
Twenty thoracic limbs of ten Lycalopex gymnocercus were dissected to describe origin and distribution of the nerves forming brachial plexuses. The brachial plexus resulted from the connections between the ventral branches of the last three cervical nerves (C6, C7, and C8) and first thoracic nerve (T1). These branches connected the suprascapular, subscapular, axillary, musculocutaneous, radial, median and ulnar nerves to the intrinsic musculature and connected the brachiocephalic, thoracodorsal, lateral thoracic, long thoracic, cranial pectoral and caudal pectoral nerves to the extrinsic musculature...
March 2017: Anatomical Record: Advances in Integrative Anatomy and Evolutionary Biology
Rakhi Rastogi, Virendra Budhiraja, Kshitij Bansal
Background. Knowledge of anatomical variations of posterior cord and its branches is important not only for the administration of anaesthetic blocks but also for surgical approaches to the neck, axilla, and upper arm. The present study aimed to record the prevalence of such variations with embryological explanation and clinical implication. Material and Method. 37 formalin-preserved cadavers, that is, 74 upper extremities from the Indian population, constituted the material for the study. Cadavers were dissected during routine anatomy classes for medical undergraduate...
2013: ISRN Anatomy
James A Angus, Ashenafi H Betrie, Christine E Wright
Recent reports have provided evidence for a new concept that in small resistance arteries α1D-adrenoceptor-mediated contraction is intimately linked to pannexin-1 (Px1) hemichannels that open to allow the release of ATP, from the smooth muscle effector cell, that acts back on P2Y purinoceptors to cause contraction. This concept mainly relied on using mefloquine 10-20μM as a putative selective Px1 channel-blocking agent to completely inhibit the contraction to phenylephrine, but not K(+) 40mM. Lower concentrations of mefloquine had no effect...
March 5, 2015: European Journal of Pharmacology
Junjie Li, Zimian Gao, Weiyang Gao, Zhefeng Li
OBJECTIVE: To observe the effects of surgical delay procedure on the survival of perforator flap with three angiosomes in rat, and to explore its possible mechanism. METHODS: The flap model was a perforator flap with three angiosomes which located on the right dorsal side of a rat based on the right deep circumflex iliac vessel. The two connection areas between the three angiosomes were successively named choke zone (CZ) 1 and CZ 2 beginning from the pedicle to the remote area...
August 2014: Zhonghua Shao Shang za Zhi, Zhonghua Shaoshang Zazhi, Chinese Journal of Burns
Junjie Li, Zimian Gao, Weiyang Gao, Zhefeng Li
OBJECTIVE: To observe the effects of surgical delay procedure on the survival of perforator flap with three angiosomes in rat, and to explore its possible mechanism. METHODS: The flap model was a perforator flap with three angiosomes which located on the right dorsal side of a rat based on the right deep circumflex iliac vessel. The two connection areas between the three angiosomes were successively named choke zone (CZ) 1 and CZ 2 beginning from the pedicle to the remote area...
August 2014: Zhonghua Shao Shang za Zhi, Zhonghua Shaoshang Zazhi, Chinese Journal of Burns
M Salih Sevdi, Isil Gunday, Cavidan Arar, Alkin Colak, Nesrin Turan
PURPOSE: We hypothesized that, after axillary block, positioning the patient in a lateral position with the injected side down and simultaneously in a 20° Trendelenburg position will increase the success rate and quality of the block. METHODS: Fifty patients with chronic renal failure (ASA 2-3) scheduled for arteriovenous fistula surgery were included in this study. In all patients, 30-40 ml of 0.25 % levobupivacaine were injected into the axillary sheath. The block was performed as three injections (multiple injection technique) with the arm in 90° abduction and 90° flexion in the supine position...
August 2014: Journal of Anesthesia
Ayda Türköz, Sule T Balcı, Meltem Can Güner, Halim Ulugöl, Can Vuran, Emre Özker, Rıza Türköz
BACKGROUND: Thoracotomy causes severe pain in the postoperative period. Perioperative thoracic paravertebral block reduces pain score and may improve outcome after pediatric cardiac surgery. This prospective study was designed for the efficacy and duration of a single level, single injection ultrasound-guided thoracic paravertebral block (TPVB) for fifteen infants undergoing aortic coarctation repair. METHODS: After approval of the ethical committee and the relatives of the patients, 15 infants who had undergone thoracotomy were enrolled in the study...
November 2013: Paediatric Anaesthesia
Özlem Kirazlı, Necati Tatarlı, Davut Ceylan, Hüsniye Hacıoğlu, Seda Uygun, Aşkın Şeker, Evren Keleş, Safiye Çavdar
During routine anatomical dissection of the upper extremity of a 64-year-old cadaver for educational purposes, we observed variations in the brachial plexus on each side. On the right an anomaly of cord formation was present and on the left there was a communication between the musculocutaneous nerve (MCN) and median nerve (MN). On the right side the brachial plexus showed two trunks, superior (C5 and C6) and inferior (C7, C8, and T1); the middle trunk was absent. The superior trunk bifurcated into anterior and posterior divisions, the anterior division continued as the lateral cord forming the MCN...
December 2013: Journal of Neurological Surgery. Part A, Central European Neurosurgery
Xiang Wang, Zhe Shao, Han-zhong Zhang, Fei Zhu, Hui Shen, Zheng-jun Shang
OBJECTIVE: To explore a method for ectopic prefabrication of mandible with vascular pedicle. METHODS: Cancellous bone blocks harvested from the dog ribs were packaged with mandible-shaped titanium mesh scaffold and implanted into latissimus dorsi of dog with thoracodorsal artery and vein through the scaffold. After 12 weeks, bone formation and vascularization were evaluated by gross inspection, histological examination and immunohistochemistry. RESULTS: Vascularized mandible with thoracodorsal artery and vein were formed and histological staining and immunohistochemisty confirmed new bone formation and vascularization...
September 2012: Zhonghua Kou Qiang Yi Xue za Zhi, Zhonghua Kouqiang Yixue Zazhi, Chinese Journal of Stomatology
Sung Jun Yang, Jin Sup Eom, Taik Jong Lee, Sei Hyun Ahn, Byung Ho Son
BACKGROUND: Nipple-sparing mastectomy (NSM) is gaining popularity due to its superior aesthetic results. When reconstructing the breast with free abdominal tissue transfer, we must readdress the recipient vessel, because NSM can cause difficulty in access to the chest vessel. METHODS: Between June 2006 and March 2011, a total of 92 women underwent NSM with free abdominal tissue transfer. A lateral oblique incision was used for the nipple-sparing mastectomy. For recipient vessels, the internal mammary vessels were chosen if the mastectomy flap did not block access to the vessels...
May 2012: Archives of Plastic Surgery
Renu Baliyan, Vandana Mehta, Jyoti Arora, Ashish K Nayyar, R K Suri, Gaytri Rath
Variant branching pattern of the cords of brachial plexus coupled with erroneous communications has been an area of concern for surgeons opting to explore this region. Anaesthetic blocks and surgical approaches are the highlights of these interventions, where a keen familiarization of the anatomy of this region is mandatory. The present case description reports a unilateral variant branching pattern of the posterior cord coexistent with a neural communication between lateral and medial cords in an adult male cadaver...
2011: Acta Medica (Hradec Králové)
Johnstone M Muthoka, Simeon R Sinkeet, Swaleh H Shahbal, Ludia C Matakwa, Julius A Ogeng'o
BACKGROUND: Variations in the branching of posterior cord are important during surgical approaches to the axilla and upper arm, administration of anesthetic blocks, interpreting effects of nervous compressions and in repair of plexus injuries. The patterns of branching show population differences. Data from the African population is scarce. OBJECTIVE: To describe the branching pattern of the posterior cord in a Kenyan population. MATERIALS AND METHODS: Seventy-five brachial plexuses from 68 formalin fixed cadavers were explored by gross dissection...
2011: Journal of Brachial Plexus and Peripheral Nerve Injury
O Orlowski, V Bullmann, V Vieth, T Filler, N Osada, H Van Aken, T P Weber
The aim of this study was to examine the effect of a 20 degrees Trendelenburg position on the blockade of nerves that exit the brachial plexus proximally in patients undergoing single-injection axillary brachial plexus block. After a pilot study of eight cadavers suggested that a head-down and lateral position would encourage the proximal spread of local anaesthetic, 72 patients undergoing elective surgery were divided into two equal groups: a Supine group and a Modified Position group (lateral position, 20 degrees head-down tilt)...
June 2006: Anaesthesia
I Peradze, T Peradze, G Tsilosani
The purpose of the work was the simplification of technical side of autotransplantation and replantation by pre-preparation of vascular pedicle. 173 patients were observed and treated. Microsurgical autotransplantation of tissues was done in 29 cases, fingers autotransplantation in 44 cases (35 patients), fingers replantation in 66 cases (38 patients), replantation of thick parts of extremities in 34 cases (3 patients). Thoracodorsal flap on the neuro-vascular flap was transplntated in 16 cases, groin flap in 3 cases, deltoid flap -- in 3 cases, scapular flap -- in 1 case, saphenal -- 1 case, gracilis muscle in 3 cases, iliac crest flap in 2 cases, rib segment on vascular pedicle -- in 8 cases...
October 2005: Georgian Medical News
S Kapral, O Jandrasits, C Schabernig, R Likar, B Reddy, N Mayer, C Weinstabl
BACKGROUND: In the last few years infraclavicular plexus block has become a method of increasing interest. However, this block has been associated with high complication incidences and without advantage in the quality of blockade over the axillary approach. We prospectively studied 40 patients (ASA I-III) undergoing surgery of the forearm and hand, and investigated the performance of the lateral infraclavicular plexus block against an axillary paravascular block to evaluate the success rate as well as the extent and quality of blockade...
November 1999: Acta Anaesthesiologica Scandinavica
A S Palmer, S M Spies, A J Miller, R Greene, A Balino
Mobilization of the latissimus dorsi muscle from the chest wall for cardiomyoplasty interrupts part of its blood supply. The time required for adequate collaterals to develop from the thoracodorsal artery is unknown. In four dogs, the latissimus dorsi muscle was mobilized as for cardiomyoplasty and stimulating electrodes were implanted. The muscle was replaced on the chest wall over a sheet of Gore-Tex (W. L. Gore & Associates, Inc. Flagstaff, AZ) membrane to block growth of collateral vessels from the chest wall...
July 1995: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
S Kakinuma, F Sasabe, H Nogaki, K Negoro, M Morimatsu
A 66-year-old Japanese man underwent the resection of the upper lobe of the left lung for primary lung cancer. One year later, his back muscles neighboring the operation scar gradually began to twitch upwards intermittently. The involuntary muscle twitch was accompanied with severe local pain, and intensity of the pain and contraction slowly increased. The abnormal muscle contractions were confined to the left latissimus dorsi muscle on needle EMG. The pain and movement ceased by blocking of either thoracodorsal nerve or brachial plexus, and disappeared finally by resection of the nerve...
October 1994: Rinshō Shinkeigaku, Clinical Neurology
K Wintsch, P Helaly
A flap of loose connective tissue based on the thoracodorsal vein and artery and lying between the latissimus dorsi and serratus lateralis can be raised and transferred as a local or free flap. This flap has been used to reconstruct the gliding mechanism in block adhesions of the flexor tendons at wrist level. It has also been used for staged tendon and nerve reconstruction at the same site. Technical details for raising the flap are described and other flaps for similar purposes are suggested. Results of five hands in four cases, including one failure, are detailed...
April 1986: Journal of Reconstructive Microsurgery
P K Donski, U Büchler, R Ganz
Recent experience with bone healing seems to advocate vascularized bone grafts in cases of large bone gaps or significant scarring, following irradiation, in the presence of low-grade infection, and in congenital pseudarthrosis of the tibia. When extensive bone and skin replacement are needed, the microvascular procedures currently available may not meet specific reconstructive requirements. To augment the advantages of the vascularized fibular graft for tibial substitution (strength, straightness, length, and predictability of vascular supply) with the benefits of free skin, muscle, or musculocutaneous flaps, separate on-demand harvesting of these tissue units and their microvascular combination can be useful in selected cases...
May 1986: Annals of Plastic Surgery
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