Objective: To investigate whether the separating brachial plexus block combined with preoperative analgesia by patient controlled analgesia (PCA) can be applied in tendon repair and postoperative active or passive functional exercise.
Methods: Two hundred and ten cases with tendon injury were randomly divided into 3 groups and all of the patients were administered Bupivacaine (0.25%), Papaverine (0.0625 mg/ml), and Dexamethasone (0.25 mg/ml) in separating brachial plexus block through axillary approach. Group A was control group, and preoperative analgesia was not applied. Preoperative analgesia was applied in group B and C. Tramadol and Ondansetron were administered in group B, Midazolam was administered besides Tramadol and Ondansetron in group C. The injection volume in the PCIA pump was increased to 100 ml by mixing physiologic saline. The pump was started after separating brachial plexus block in velocity of 2 ml/h, and its maintenance time was 48 h. The effect of separating brachial plexus block at 1, 2, 3, 6 and 12 h after finishing brachial plexus block was compared. The VAS, Ramesay assessment scoring were recorded at 0, 12, 24 and 48 h after starting pump.
Results: In each group, the effect of motor block became greater in the ascending order from 1, 2 to 3 h after finishing brachial plexus block, and less in the descending order from 3, 6 to 12 h after finishing brachial plexus block. Only at 6 and 12 h after finishing brachial plexus block, the effect of motor block of group B and group C was significantly less than that of group A (P < 0.05, < 0.01), the effect of motor block of group C was less than that of group B (P > 0.05). The effect of sensory block in the patients of all 3 groups was satisfactory. The VAS, Ramesay assessment scoring, effect of analgesia and sedation at 24 and 48 h after starting pump became greater in the ascending order from group A to group C, in which group B and group C were significantly greater than group A (P < 0.01).
Conclusions: The separating brachial plexus block combined with preoperative analgesia by 2 kinds of PCIA dispensation can be both applied in tendon repair, but the separating effect of brachial plexus block of group B was superior to the group C.
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J Clin Med
January 2025
Operative Research Unit of Anesthesia and Intensive Care, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200-00128 Roma, Italy.
Thoracic outlet syndrome (TOS) is an uncommon condition defined by the compression of neurovascular structures within the thoracic outlet. When conservative management strategies fail to alleviate symptoms, surgical decompression becomes necessary. The purpose of this study is to evaluate and compare the efficacy and safety of regional anesthesia (RA) using spontaneous breathing in contrast to general anesthesia (GA) for patients undergoing surgical intervention for TOS.
View Article and Find Full Text PDFBiomedicines
January 2025
Second Department of Internal Medicine, Division of Nephrology, Kansai Medical University, Hirakata 573-1010, Japan.
: Charcot-Marie-Tooth (CMT) disease is an inherited peripheral neuropathy primarily involving motor and sensory neurons. Mutations in INF2, an actin assembly factor, cause two diseases: peripheral neuropathy CMT-DIE (MIM614455) and/or focal segmental glomerulosclerosis (FSGS). These two phenotypes arise from the progressive degeneration affecting podocytes and Schwann cells.
View Article and Find Full Text PDFBr J Anaesth
January 2025
Department of Anaesthesia, University Hospital of Lausanne and University of Lausanne, Lausanne, Switzerland. Electronic address:
Background: We have previously demonstrated that an extrafascial injection of 20 ml of local anaesthetic for interscalene brachial plexus block (ISB) reduces the rate of hemidiaphragmatic paralysis by 70% compared with an intrafascial injection, with similar efficacy. In this double-blind trial, we tested the hypothesis that a local anaesthetic volume of 10 ml injected extrafascially would reduce the rate of hemidiaphragmatic paralysis vs a volume of 20 ml, while providing similar analgesia.
Methods: Sixty ASA physical status 1-3 patients scheduled for elective shoulder surgery under general anaesthesia were randomised to receive ultrasound-guided extrafascial ISB using ropivacaine 0.
Clin Neurophysiol
January 2025
Department of Clinical Neurophysiology, Rigshospitalet, Copenhagen, Denmark; Department of Clinical Medicine and Neuroscience, University of Copenhagen, Denmark; Department of Neurology, Rigshospitalet, Copenhagen, Denmark.
Objective: To investigate motor axonal excitability in multifocal motor neuropathy (MMN) associated with involuntary muscle activity.
Methods: Two MMN patients with continuous involuntary finger movements (MMNifm) were compared to 11 patients without movements (MMNnfm). Clinical examination, EMG of the abductor pollicis brevis muscle, nerve conduction studies, motor unit number estimation, excitability studies, and mathematical modeling were conducted in the patients with MMN and compared to controls.
J Cardiovasc Dev Dis
January 2025
Department of Cardiothoracic Surgery, Heart-Thorax Center, Klinikum Fulda, University Medicine Marburg, Campus Fulda, 36043 Fulda, Germany.
Objective: Cardiopulmonary bypass (CPB) via the right axillary artery (RAA) has become an alternative perfusion strategy, especially in complex aortic procedures. This study delineates our technique and outcome with direct axillary cannulation utilizing the Seldinger technique, which we adopted as the standard perfusion strategy in the sternum-sparing minimally invasive total coronary revascularization via left anterior thoracotomy (TCRAT) using CPB.
Methods: From November 2019 to December 2023, a total of 413 consecutive patients underwent nonemergent isolated coronary artery bypass grafting (CABG) via left anterior minithoracotomy on CPB with peripheral cannulation via the RAA and cardioplegic cardiac arrest, using this technique as a default strategy in the daily routine.
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