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Long thoracic nerve block

Yeon Dong Kim, Jae Yong Yu, Junho Shim, Hyun Joo Heo, Hyungtae Kim
BACKGROUND: Recently, ultrasound has been commonly used. Ultrasound-guided interscalene brachial plexus block (IBPB) by posterior approach is more commonly used because anterior approach has been reported to have the risk of phrenic nerve injury. However, posterior approach also has the risk of causing nerve injury because there are risks of encountering dorsal scapular nerve (DSN) and long thoracic nerve (LTN). Therefore, the aim of this study was to evaluate the risk of encountering DSN and LTN during ultrasound-guided IBPB by posterior approach...
July 2016: Korean Journal of Pain
Ching-Feng Wu, Ming-Ju Hsieh, Hung-Pin Liu, Diego Gonzalez-Rivas, Yun-Hen Liu, Yi-Cheng Wu, Yin-Kai Chao, Ching-Yang Wu
BACKGROUND: The establishment of a golden standard for post-operative analgesia after thoracic surgery remains an unresolved issue. Benefiting from the rapid development of single port video-assisted thoracoscopic surgery (VATS), a good candidate for the alleviation of patients' pain is the placement of an intercostal catheter (ICC) safely after uniport VATS. We hypothesized that continual infusion through ICC could provide effective analgesia for patients with only one wound and we evaluate its postoperative analgesic function in uniport VATS patients with or without intercostal nerve blockade...
June 2016: Journal of Thoracic Disease
Hazem M Alkosha, Yasser M Elkiran
BACKGROUND AND OBJECTIVE: Long-term results of sympathectomy in patients with complex regional pain syndrome (CRPS) type 2 varies widely among studies due to nonspecific or vague criteria of diagnosis and absence of outcome predictors that help good patient selection. The objective was to determine the predictors of long-term outcome of sympathectomy in patients with upper limb CRPS type 2. METHODS: A retrospective cohort, in which those who underwent thoracic sympathectomy for upper limb CRPS type 2 from 2007 to 2014, were included...
August 2016: World Neurosurgery
Poonam Shilal, Rohit Kumar Sarda, Kalpana Chhetri, Polly Lama, Binod Kumar Tamang
Pre and post-fixed variations at roots of the brachial plexus have been well documented, however little is known about the variations that exist in the branches which arise from the brachial plexus. In this paper, we describe about one such rare variation related to the dorsal scapular and the long thoracic nerve, which are the branches arising from the roots of the brachial plexus. The variation was found during routine dissection. The dorsal scapular nerve, which routinely arises from the fifth cervical nerve root (C5), was seen to receive contributions from C5 as well as sixth cervical nerve (C6), while the long thoracic nerve arose from C6 and seventh cervical nerves (C7) only...
June 2015: Journal of Clinical and Diagnostic Research: JCDR
Laxmaiah Manchikanti, Alan D Kaye, Mark V Boswell, Sanjay Bakshi, Christopher G Gharibo, Vahid Grami, Jay S Grider, Sanjeeva Gupta, Sachin Sunny Jha, Dharam P Mann, Devi E Nampiaparampil, Manohar Lal Sharma, Lindsay N Shroyer, Vijay Singh, Amol Soin, Ricardo Vallejo, Bradley W Wargo, Joshua A Hirsch
BACKGROUND: The therapeutic spinal facet joint interventions generally used for the treatment of axial spinal pain of facet joint origin are intraarticular facet joint injections, facet joint nerve blocks, and radiofrequency neurotomy. Despite interventional procedures being common as treatment strategies for facet joint pathology, there is a paucity of literature investigating these therapeutic approaches. Systematic reviews assessing the effectiveness of various therapeutic facet joint interventions have shown there to be variable evidence based on the region and the modality of treatment utilized...
July 2015: Pain Physician
Lauriane Beliez, Grégory Barrière, Sandrine S Bertrand, Jean-René Cazalets
Effective quadrupedal locomotor behaviors require the coordination of many muscles in the limbs, back, neck, and tail. Because of the spinal motoneuronal somatotopic organization, motor coordination implies interactions among distant spinal networks. Here, we investigated some of the interactions between the lumbar locomotor networks that control limb movements and the thoracic networks that control the axial muscles involved in trunk movement. For this purpose, we used an in vitro isolated newborn rat spinal cord (from T2 to sacrococcygeal) preparation...
April 15, 2015: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
V V Matinian, E I Belousova, A I Saltanov
Prolonged thoracic paravertebral block is a complex technique of regional anesthesia. For a long time paravertebral blocks were conducted under stimulation. Recently, techniques of paravertebral space (PVS) verification using ultrasound navigation were developed. The article deals with an anatomy and technique of ultrasound navigation for paravertebral space catheterization. Successful and safe block under ultrasound guidance requires: identification and visualization of paravertebral space; operator's skill in needle visualization in real time; experience in estimating the distribution of local anesthetic in PVS...
September 2014: Anesteziologiia i Reanimatologiia
Soutarou Taguchi, Tomohiko Nakamura, Takako Yamada, Hiromu Takamido, Manabu Doyu, Akira Takahashi
A 61-year-old man noted flu-like symptoms. Not long afterwards, he felt constipation, nausea, and blackout when standing or sitting. His blood pressure was 110/70 mmHg in the supine position. On sitting blood pressure dropped to 73/34 mmHg. Heart rate increased from 65 to 78 beats per minutes. He did not have fever, edema, or skin rash. The remainder of the general medical examination was normal. A neurological examination revealed normal higher mental, and sensori-motor functions. The blood test revealed leukocytosis 7,320/μl, LD 1,426 IU/l, IL-2R 921 U/ml, and CRP 11...
2015: Rinshō Shinkeigaku, Clinical Neurology
Ghada Mohammad Nabih Bashandy, Dina Nabil Abbas
BACKGROUND: The pectoral nerves (Pecs) block types I and II are novel techniques to block the pectoral, intercostobrachial, third to sixth intercostals, and the long thoracic nerves. They may provide good analgesia during and after breast surgery. Our study aimed to compare prospectively the quality of analgesia after modified radical mastectomy surgery using general anesthesia and Pecs blocks versus general anesthesia alone. METHODS: One hundred twenty adult female patients scheduled for elective unilateral modified radical mastectomy under general anesthesia were randomly allocated to receive either general anesthesia plus Pecs block (Pecs group, n = 60) or general anesthesia alone (control group, n = 60)...
January 2015: Regional Anesthesia and Pain Medicine
Partha Pal, Sayantan Ray, Pradipta Guha, Sisir Kumar Patra, Kaushik Kumar Das
The authors describe a case of 52-year-old male who presented with sudden onset deterioration of weakness of both lower limbs and retention of urine. He had 1 month history of gradually progressive weakness of legs. On examination, there were lower motor neuron signs in lower extremity, digital clubbing and a lump over left iliac fossa. Routine blood tests showed impaired glucose tolerance, confirmed by oral glucose tolerance test while renal parameters were normal. Magnetic resonance imaging of spine documented osteolytic lesions, long segment epidural mass in thoracic spine and a mass overlying the left iliac bone, both were revealed to be plasmacytoma following cytology...
September 2014: Indian Journal of Hematology & Blood Transfusion
David Burckett-St Laurent, Vincent Chan, Ki Jinn Chin
PURPOSE: The conventional ultrasound-guided interscalene block targets the C5 and C6 nerve roots at approximately the level of the cricoid cartilage where they lie in the groove between the anterior and middle scalene muscles. This technique, although effective at providing regional anesthesia of the shoulder, is associated with risks of phrenic nerve palsy, injury to the dorsal scapular and long thoracic nerves, and long-term postoperative neurologic symptoms. In this case report, we describe the ultrasound-guided superior trunk block...
December 2014: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
Kristin Julia Steinthorsdottir, Lorna Wildgaard, Henrik Jessen Hansen, René Horsleben Petersen, Kim Wildgaard
Video-assisted thoracic surgery (VATS) is emerging as the standard surgical procedure for both minor and major oncological lung surgery. Thoracic epidural analgesia (TEA) and paravertebral block (PVB) are established analgesic golden standards for open surgery such as thoracotomy; however, there is no gold standard for regional analgesia for VATS. This systematic review aimed to assess different regional techniques with regard to effect on acute postoperative pain following VATS, with emphasis on VATS lobectomy...
June 2014: European Journal of Cardio-thoracic Surgery
De Q H Tran, Worakamol Tiyaprasertkul, Andrea P González
The sensory innervation of the clavicle remains controversial. The supraclavicular, subclavian, and long thoracic/suprascapular nerves, alone or together, may be responsible for pain transmission after clavicular fracture and surgery. Peripheral nerve blocks used to anesthetize the clavicle include superficial cervical plexus blocks, interscalene blocks, and combined superficial cervical plexus-interscalene blocks. Future (randomized) trials are required to determine which constitutes the best option for emergency department (fracture) and operating room (surgical fixation) settings...
November 2013: Regional Anesthesia and Pain Medicine
R Blanco, T Parras, J G McDonnell, A Prats-Galino
We present a novel ultrasound-guided regional anaesthetic technique that may achieve complete paraesthesia of the hemithorax. This technique may be a viable alternative to current regional anaesthetic techniques such as thoracic paravertebral and central neuraxial blockade, which can be technically more challenging and have a higher potential side-effect profile. We performed the serratus block at two different levels in the midaxillary line on four female volunteers. We recorded the degree of paraesthesia obtained and performed fat-suppression magnetic resonance imaging and three-dimensional reconstructions of the spread of local anaesthetic in the serratus plane...
November 2013: Anaesthesia
Tuomo Rantanen, Timo Telaranta
BACKGROUND: Endoscopic thoracic sympathectomy has been used successfully in the treatment of blushing, excessive sweating, and social phobia. However, the adverse effects of endoscopic thoracic sympathectomy are more severe and frequent than the adverse effects of endoscopic sympathetic block (ESB). The use of different blocking levels for different indications in ESB according to the Lin-Telaranta classification further decreases the postoperative adverse effects. However, there are few data on the long-term results of ESB performed using the Lin-Telaranta classification...
October 2013: Surgical Endoscopy
Neil A Hanson, David B Auyong
BACKGROUND AND OBJECTIVES: The use of ultrasound for in-plane interscalene block shifts needle insertion to a more posterior approach through the middle scalene muscle, when compared with classic nerve stimulator techniques. Branches from the brachial plexus, including the dorsal scapular and long thoracic nerves, are often anatomically located within the middle scalene muscle. The aim of this study was to use ultrasound to identify and characterize the frequency and position of the dorsal scapular and long thoracic nerves located in the middle scalene muscle...
January 2013: Regional Anesthesia and Pain Medicine
Torsten Loop
Effective, aggressive treatment of pain accompanied with thoracic surgery is important and beneficial for patients, since severe postoperative pulmonary complications and long-term pain will be reduced. In this systematic issue evidence-based strategies in preventing and treating pain after thoracic surgery will be reviewed.
September 2012: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
R Blanco, M Fajardo, T Parras Maldonado
OBJECTIVE: The Pecs block (pectoral nerves block) is an easy and reliable superficial block inspired by the infraclavicular block approach and the transversus abdominis plane blocks. Once the pectoralis muscles are located under the clavicle the space between the two muscles is dissected to reach the lateral pectoral and the medial pectoral nerves. The main indications are breast expanders and subpectoral prosthesis where the distension of these muscles is extremely painful. MATERIAL AND METHODS: A second version of the Pecs block is described, called "modified Pecs block" or Pecs block type II...
November 2012: Revista Española de Anestesiología y Reanimación
W K Kwon, J W Choi, J E Kang, W S Kang, J A Lim, N S Woo, S A Lee, S H Kim
We hypothesised that relaxation of the serratus anterior muscle by long thoracic nerve (LTN) block could help pain relief after video-assisted thoracoscopic surgery. Patients undergoing thoracoscopic wedge resection for pneumothorax were randomly assigned to control or LTN block. LTN block was performed before induction of general anaesthesia. Pain was evaluated using a visual analogue scale before anaesthesia induction (T0), on arrival to the post-anaesthetic care unit (PACU) (T1), every ten minutes after arrival in the PACU for 30 minutes (T2, T3 and T4) and one hour and 24 hours after discharge from the PACU (T5 and T6)...
September 2012: Anaesthesia and Intensive Care
Ashok Jadon
Thoracic paravertebral block (TPVB) is gaining popularity for female breast surgeries due to various advantages like less nausea and vomiting and better post-operative pain relief, which helps in early ambulation and discharge from the hospital. Use of nerve stimulator during this block has further enhanced its success and safety profile. Male breast surgery is usually done either under general anaesthesia or local infiltrative anaesthesia combining with intravenous sedation. We postulated that the advantages of TPVB could be helpful for early mobilization and discharge of minor breast surgery in male patients...
May 2012: Indian Journal of Anaesthesia
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