Regional anesthesia in the obese patient can be challenging and possibly carries a greater failure rate as compared with that in the non-obese patient. We retrospectively reviewed our prospectively gathered peripheral block data to determine the influence of body weight on success rate of the supraclavicular block. Obesity was defined as body mass index > or =30. The overall success rate was 97.3% in nonobese and 94.3% in obese patients (P < 0.01). Residents completed 80% of the blocks in nonobese patients and 73% in obese patients (P < 0.01). No difference in acute complications was observed. Obesity is associated with a slight decrease in success rate of supraclavicular block and an increase in its relative difficulty without apparent effect on acute complications.
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http://dx.doi.org/10.1213/01.ane.0000198341.53062.a2 | DOI Listing |
Curr Drug Saf
January 2025
Anesthesiology, Surgical Intensive Care and Pain Medicine Department, Faculty of Medicine, Kafr-El Sheikh University, Kafr-El Sheikh, Egypt.
Background: For surgical procedures of the upper limbs, ultrasound-guided supraclavicular brachial plexus block (SCBPB) represents a safe substitute for general anesthesia. The present study evaluated the effectiveness and safety of incorporating 1μg/kg dexmedetomidine (DEX) into 20 ml bupivacaine, as opposed to using 20 ml and 30 ml bupivacaine without additives, in SCBPB.
Methods: This randomized, controlled, double-blind study included 75 patients assigned to elective upper-limb surgery under the mid-humerus level.
Cureus
December 2024
Anaesthesiology, Gajra Raja Medical College, Jaya Arogya Group of Hospitals, Gwalior, IND.
Introduction: The brachial plexus block is one of the peripheral blocks, beneath which the majority of upper limb surgical procedures are carried out. During upper limb surgery, a supraclavicular nerve block is an excellent substitute for general anesthesia.
Aim: This is a clinical comparative study of dexmedetomidine, dexamethasone, and clonidine as adjuvants to local anesthetics in supraclavicular brachial plexus block.
J Med Ultrasound
November 2024
Department of Anesthesiology, Ibra Hospital, Ibra, Oman.
Background: It is very well known that the supraclavicular nerve (SCN) which occupies the inferior part of the superficial cervical plexus basically originates from the ventral rami of C2-C4, then travels caudally into the investing layer of the deep cervical fascia (IL-DCF) alternatively termed the "prevertebral fascia."
Methods: This cadaveric study (a total of 6 soft-embalmed cadavers and bilateral dissections, i.e.
A A Pract
January 2025
From the Department of Anesthesia, Perioperative and Pain Medicine, Lahey Hospital and Medical Center, Burlington, Massachusetts.
After vascular puncture and catheterization, arteries can have many complications that impede blood flow such as vasospasm, thrombosis, and emboli generation, among other complications. Treatment depends on severity of ischemic symptoms and can range from as mild as applying local heat packs to surgical thrombectomy. We present a case of digital ischemia secondary to vascular puncture that was successfully treated with a supraclavicular nerve block, resulting in the vascular surgery team canceling an emergent surgery.
View Article and Find Full Text PDFReg Anesth Pain Med
December 2024
Department of Anaesthesiology, Intensive Care and Pain Therapy, Saarland University Hospital and Saarland University Faculty of Medicine, Homburg, Germany.
Introduction: Regional anesthesia is frequently used for upper limb surgeries and postoperative pain control. Different approaches to brachial plexus blocks are similarly effective but may differ in the frequency and severity of iatrogenesis. We, therefore, examined large-scale registry data to explore the risks of typical complications among different brachial plexus block sites for regional anesthesia.
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