oalib
Search Results: 1 - 10 of 100 matches for " "
All listed articles are free for downloading (OA Articles)
Page 1 /100
Display every page Item
Comparison Of Infraclavicular Brachial Plexus Block With Supraclavicular Brachial Plexus Block In Upper Limb Surgeries. (A Study Of 100 Patients)
Sheetal Shah,kamla Mehta,Kirti Patel,Khyati Patel
NHL Journal of Medical Sciences , 2013,
Abstract: Comparative prospective study of two routes of Brachial plexus block – infraclavicular coracoid approach with conventional supraclavicular approach was carried out in 100 patients of ASA RISK I to III, undergoing elective or emergency surgeries on upper limb, at the level of elbow and below elbow. Patients were divided into 2 equal groups, Group I (Infraclavicular) and Group S (Supraclavicular), which were compared for block performance time, onset, quality and duration of block. The applied anatomy, methodology, complications and limitations have been emphasized. The study concludes that infraclavicular brachial plexus block with coracoid approach is a useful block without complications if practiced with precautions.
Infraclavicular Brachial Plexus Blockade in a Case with Ulnar Shaft Fracture
Mehmet Turan Inal,Canan Inal,Sermet Inal
Trakya Universitesi Tip Fakultesi Dergisi , 2008,
Abstract: The brachial plexus is a peripheral nerve system that is responsible for motor, sympathetic and sensorial innervations of upper extremity. Brachial plexus lies between neck and shoulder next to great vessels and lungs. The anesthesia of upper extremities and shoulder can be achieved by blockade of brachial plexus in different places. Brachial plexus can be blocked using interscalene, supraclavicular, infraclavicular and axillary methods. In this case report, we presented an infraclavicular brachial plexus blockade for a patient with ulnar shaft fracture.
Axillary brachial plexus blockade in moyamoya disease?  [cached]
Yalcin Saban,Cece Hasan,Nacar Halil,Karahan Mahmut
Indian Journal of Anaesthesia , 2011,
Abstract: Moyamoya disease is characterized by steno-occlusive changes of the intracranial internal carotid arteries. Cerebral blood flow and metabolism are strictly impaired. The goal in perioperative anaesthetic management is to preserve the stability between oxygen supply and demand in the brain. Peripheral nerve blockade allows excellent neurological status monitoring and maintains haemodynamic stability which is very important in this patient group. Herein, we present an axillary brachial plexus blockade in a moyamoya patient operated for radius fracture.
THE RESULTS OF USING A PART OF ULNAR NERVE FOR RESTORATION OF ELBOW FLEXION IN PATIENTS WITH UPPER BRACHIAL PLEXUS INJURY
R. Shahriar-Kamrani,S. M. Jafari M. R. Guiti
Acta Medica Iranica , 2005,
Abstract: In upper brachial plexus (C5-C6 or C5-C6-C7 roots) injuries, restoration of elbow flexion is the first aim. Several methods have been used to achieve this goal. Among these procedures, Oberlin’s method (transfer of part of ulnar nerve to the nerve to biceps muscle) is the newest one. From April 2002 to March 2003 we used this method in 9 cases, 8 males and 1 female, of upper brachial plexus injury with impaired active elbow flexion and intact ulnar nerve. Patients’ age ranged from 9 to 53 years. In 6 acute cases only Oberlin’s method was used and in 3 old cases this technique was combined with gracilis free muscle transfer. The minimum follow up period was 6 months. Six cases gained effective elbow flexion and 3 cases showed fair or poor results. No permanent impairment of ulnar nerve function was observed. We found Oberlin’s method to be a safe, simple and effective way to achieve elbow flexion in patients with upper brachial plexus injury.
Axillary Brachial Plexus Block  [PDF]
Ashish R. Satapathy,David M. Coventry
Anesthesiology Research and Practice , 2011, DOI: 10.1155/2011/173796
Abstract: The axillary approach to brachial plexus blockade provides satisfactory anaesthesia for elbow, forearm, and hand surgery and also provides reliable cutaneous anaesthesia of the inner upper arm including the medial cutaneous nerve of arm and intercostobrachial nerve, areas often missed with other approaches. In addition, the axillary approach remains the safest of the four main options, as it does not risk blockade of the phrenic nerve, nor does it have the potential to cause pneumothorax, making it an ideal option for day case surgery. Historically, single-injection techniques have not provided reliable blockade in the musculocutaneous and radial nerve territories, but success rates have greatly improved with multiple-injection techniques whether using nerve stimulation or ultrasound guidance. Complete, reliable, rapid, and safe blockade of the arm is now achievable, and the paper summarizes the current position with particular reference to ultrasound guidance. 1. Introduction The axillary approach to brachial plexus was first demonstrated in 1884 by William Halsted when he injected cocaine under direct vision [1]. In 1911, G. Hirschel performed the first percutaneous axillary block [2]. It was only after Burnham’s publication in 1959 [3] that this block gained popularity among anaesthetists. Since then, it has become the most used peripheral nerve block for forearm and hand surgery, especially due the low incidence of complications compared to the more proximal approaches to the brachial plexus. 2. The Brachial Plexus in the Axilla [4] The brachial plexus supplies the nerve supply to the upper limb and is formed by the ventral rami of the lower four cervical nerves and the first thoracic nerve. It consists of roots, trunks, divisions, and cords. The roots are arranged between the scalenus anterior and medius muscles, and they combine in the posterior triangle to form three trunks: upper, middle, and lower. On approaching the clavicle, each of the three trunks divides into an anterior and posterior division to supply the flexor and extensor compartments of the arm, respectively. Anterior divisions of the upper and middle trunk unite to form the lateral cord, anterior division of the lower trunk continues as the medial cord, and posterior divisions of all the three trunks assemble to from the posterior cord. The three cords enter the axilla at the apex and are arranged, according to the names, around the second and third parts of the axillary artery. In relation to the first part of the artery, however, the lateral and posterior cords are lateral, and
Comparison of visual and objective quantification of elbow and shoulder movement in children with obstetric brachial plexus palsy
Andrea E Bialocerkowski, Mary Galea
Journal of Brachial Plexus and Peripheral Nerve Injury , 2006, DOI: 10.1186/1749-7221-1-5
Abstract: Young children diagnosed with OBPP were recruited from the Royal Children's Hospital (Melbourne, Australia) Brachial Plexus registry. They participated in one measurement session where an experienced paediatric physiotherapist facilitated maximal elbow flexion and extension, shoulder abduction and extension through play, and quantified them on the Active Movement Scale. Two-dimensional motion analysis captured the same movements in degrees, which were then converted into Active Movement Score grades using normative reference data. The agreement between the objectively-quantified and therapist-rated grades was determined using percentage agreement and Kappa statistics.Thirty children with OBPP participated in the study. All were able to perform elbow and shoulder movements against gravity. Active Movement Score grades ranged from 5 to 7. Two-dimensional motion analysis revealed that full range of movement at the elbow and shoulder was rarely achieved. There was moderate percentage agreement between the objectively-quantified and therapist-rated methods of movement assessment however the therapist frequently over-estimated the range of movement, particularly at the elbow. When adjusted for chance, agreement was equal to chance.Visual estimates of elbow and shoulder movement in children with OBPP may not provide true estimates of motion. Future work is required to develop accurate, clinically-acceptable methods of quantifying upper limb active movements. Since few children attained full range of motion, elbow and shoulder movement should be monitored and maintained over time to reduce disability later in life.Obstetric brachial plexus palsy (OBPP) is a complication of childbirth, which is characterized by one or more nerve conduction blocks within the brachial plexus [1]. These blocks range in severity and location within the plexus and primarily affect the child's ability to move and effectively use their affected upper limb [2]. Thus the quantification of motor funct
Our experience on brachial plexus blockade in upper extremity surgery
Feyzi ?elik,Adnan Tüfek,Zeynep B.Y?ld?r?m,Orhan Tokg?z
Dicle Medical Journal , 2012,
Abstract: Objective: Peripheral nerve blocks are usually used either alone or along with general anesthesia for postoperative analgesia. We also aimed to present the results and experiences.Materials and methods: This retrospective study was conducted to scan the files of patients who underwent orthopedic upper extremity surgery with peripheral nerve block between September 2009 and October 2010. After ethics committee approval was obtained, 114 patients who were ASA physical status I-III, aged 18-70, performed upper extremity surgery in the Orthopedics and Traumatology Clinic were included to study. Patients’ demographic data, clinical diagnoses, premedication status, peripheral block type, local anesthetic dose, stimuplex needle types, hemodynamic parameters at the during surgery, the first postoperative analgesic requirements, complications and patient satisfaction were recorded.Results: Demographic data were similar to each other. Brachial plexus block was commonly performed for the forearm surgery. Infraclavicular block was performed the most frequently to patients. As the classical methods in the supine position were preferred in 98.2% of patients, Stimuplex A needle (B. Braun, Melsungen AG, Germany) have been used for blockage in 80.7% of patients. Also, in 54.4% of patients, 30 ml of local anesthetic solution composed of bupivacaine + prilocaine was used for blockade. Blocks applied to patients had provided adequate anesthesia.Conclusion: Since the brachial plexus blockade guided peripheral nerve stimulator for upper extremity surgery provide adequate depth of anesthesia and analgesia, it may be a good alternative to general anesthesia because of unwanted side effects
Comparison between partial ulnar and intercostal nerve transfers for reconstructing elbow flexion in patients with upper brachial plexus injuries
Ryosuke Kakinoki, Ryosuke Ikeguchi, Scott FM Dunkan, Ken Nakayama, Taiichi Matsumoto, Soichi Ohta, Takashi Nakamura
Journal of Brachial Plexus and Peripheral Nerve Injury , 2010, DOI: 10.1186/1749-7221-5-4
Abstract: Sixteen patients (13 men and three women) with BPIs for whom PUNT (eight patients) or ICNT (eight patients) had been performed to restore elbow flexion function were studied. The time required in obtaining M1, M3 (Medical Research Council scale grades recovery) for elbow flexion and a full range of elbow joint movement against gravity with the wrist and fingers extended maximally and the outcomes of a manual muscle test (MMT) for elbow flexion were examined in both groups.There were no significant differences between the PUNT and ICNT groups in terms of the age of patients at the time of surgery or the interval between injury and surgery. There were significantly more injured nerve roots in the ICNT group (mean 3.6) than in the PUNT group (mean 2.1) (P = 0.0006). The times required to obtain grades M1 and M3 in elbow flexion were significantly shorter in the PUNT group than in the ICNT group (P = 0.04 for M1 and P = 0.002 for M3). However, there was no significant difference between the two groups in the time required to obtain full flexion of the elbow joint with maximally extended fingers and wrist or in the final MMT scores for elbow flexion.PUNT is technically easy, not associated with significant complications, and provides rapid recovery of the elbow flexion. However, separation of elbow flexion from finger and wrist motions needed more time in the PUNT group than in the ICNT group. Although the final mean MMT score for elbow flexion in the PUNT group was greater than in the ICNT group, no statistically significant difference was found between the two groups.In 1994, Oberlin et al. performed partial ulnar nerve transfer (PUNT) to a branch of the musculocutaneous nerve (MCN) innervating the biceps brachii muscle (BBM) on patients with upper brachial plexus injuries (BPIs) and reported successful elbow flexion function without significant neurological deficits in the ulnar nerve [1]. In their procedure, because a part of the ulnar nerve can be harvested at the l
Extraordinary prolonged blockade following supraclavicular brachial plexus block with bupivacaine.
Jagdish Dureja,Nandita Kad,Jatin Lal,Anil Thakur
Indian Anaesthetists' Forum , 2009,
Abstract: Brachial plexus block is a useful anaesthetic technique for the upper limb surgery using Bupivacaine hydrochloride as anaesthetic agent for the block. A case of extraordinary prolonged block after administration of 0.375 % plain bupivacaine by the supraclavicular route is reported.
Bloqueio do plexo braquial, por via infraclavicular vertical, em paciente com doen?a pulmonar obstrutiva cr?nica: relato de caso
Concei??o, Diogo Brüggemann da;Helayel, Pablo Escovedo;Cecato, Fernanda;
Revista Brasileira de Anestesiologia , 2006, DOI: 10.1590/S0034-70942006000500008
Abstract: background and objectives: patients with chronic obstructive pulmonary disease (copd) have a higher risk of postoperative complications, especially when undergoing general anesthesia. brachial plexus blockade is an alternative for these patients when they undergo upper limb surgeries. the objective of this report is to present a case of infraclavicular brachial plexus blockade in patients with copd and a fractured elbow. case report: a female patient, 67 years old, 52 kg, physical status asa iii, with post-pneumonia bronchiectasis since nine years of age and an indication of osteosynthesis of the elbow. she presented productive cough regularly; after evaluation, her pneumologist cleared her for the surgery. the patient was monitored with non-invasive blood pressure. ecg, and pulse oximeter. infraclavicular brachial plexus blockade with 0.5% ropivacaine 30 ml was performed, without intercurrences. the patient was discharged from the hospital the following day. conclusions: infraclavicular brachial plexus blockade is an alternative for patients with copd and fracture of the elbow, due to its lower morbidity when compared to general anesthetic.
Page 1 /100
Display every page Item


Home
Copyright © 2008-2017 Open Access Library. All rights reserved.