Background/purpose: An improvement of the blood flow would be beneficial in microvascular upper-extremity reconstruction and in digit replantation. In the present work, skin perfusion changes and their duration due to axillary plexus block were quantified.
Methods: The peripheral blood flow of the upper extremities in 20 patients undergoing trapeziectomy under axillary plexus block was analyzed.
Results: Laser Doppler spectrophotometry was used to measure perfusion factors over a 12-h period, with the contralateral hand acting as the control. Axillary plexus block produced a significant increase of peripheral oxygen saturation (117 ± 35% vs. control 93 ± 22%, p = 0.019), peripheral blood flow (220 ± 166% vs. 130 ± 77%, p = 0.037), and velocity (164 ± 58% vs. 117 ± 45%, p = 0.011).
Conclusion: Axillary plexus block produces an improvement of peripheral tissue oxygen saturation of the upper extremities over the first 6 h after the inception of anesthesia. This suggests a potential benefit especially for critically perfused tissues.
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http://dx.doi.org/10.1159/000475813 | DOI Listing |
Medicine (Baltimore)
January 2025
Department of Anesthesiology, Yanbian University Hospital, Yanji, Jilin, P.R. China.
Rationale: Patients with atrial fibrillation and a large goiter have high perioperative risks and often cannot tolerate general anesthesia, making it necessary for us to explore new safe and effective anesthesia methods.
Patient Concerns: The patient presented with atrial fibrillation accompanied by rapid ventricular rate, a thrombus attached to the left atrial appendage, and a massive thyroid goiter compressing the airway.
Diagnosis: After the left humerus fracture surgery, the patient's internal fixation loosened and fractured, accompanied by infection, formation of sinus tracts, and suppuration.
Reg Anesth Pain Med
December 2024
Department of Anesthesia and Perioperative Medicine, University of Western Ontario, London, Ontario, Canada
Background: Innervation of the breast includes branches of thoracic intercostal nerves, the superficial cervical plexus, the brachial plexus, and the intercostobrachial nerve (ICBN). Commonly used blocks for breast surgery provide incomplete analgesia of the axillary region. This cadaveric study aims to identify and map the axillary sensory cutaneous nerves.
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.
View Article and Find Full Text PDFJ Cardiothorac Surg
December 2024
Centre for Human Anatomy Education, Department of Anatomy and Developmental Biology, Biomedical Discovery Institute, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Australia.
Arterial variations in the upper limb are of significant clinical importance, especially in procedures such as venepunctures, coronary artery bypass grafts, trauma reconstructive surgeries, brachial plexus nerve blocks, and breast reconstructions. This report presents previously undocumented arterial variations in the upper limbs in a 95-year-old female cadaveric donor. We observed bilateral superficial ulnar arteries originating at the cubital fossa, deviating from the previously reported origin at the proximal brachial artery.
View Article and Find Full Text PDFJ Pain Res
December 2024
Department of Anesthesiology, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, People's Republic of China.
Purpose: The suprascapular nerve is situated between the prevertebral fascia and the superficial layer of deep cervical fascia and on the surface of the middle and posterior scalene muscles before it reaches the suprascapular notch. Consequently, we hypothesized that injecting local anesthetics (LAs) there would introduce a new block approach for blocking the suprascapular nerve, ie, extra-prevertebral fascial block. We assessed the postoperative analgesic effect, as well as the incidence of diaphragmatic paralysis 30 minutes after the block.
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