Background And Objectives: Distal upper extremity surgery is commonly performed under regional anaesthesia, including intravenous regional anaesthesia (IVRA) and ultrasound-guided forearm nerve block. This study aimed to investigate if ultrasound-guided forearm nerve block is superior to forearm IVRA in producing a surgical block in patients undergoing carpal tunnel release.
Methods: In this observer-blinded, randomized controlled superiority trial, 100 patients undergoing carpal tunnel release were randomized to receive ultrasound-guided forearm nerve block (n = 50) or forearm IVRA (n = 50). The primary outcome was anaesthetic efficacy evaluated by classifying the blocks as complete vs incomplete. Complete anaesthesia was defined as total sensory block, incomplete anaesthesia as mild pain requiring more analgesics or need of general anaesthesia. Pain intensity on a numeric rating scale (0-10) was recorded. Surgeon satisfaction with hemostasis, surgical time, and OR stay time were recorded. Patient satisfaction with the quality of the block was assessed at POD 1.
Results: In total, 43 (86%) of the forearm nerve blocks were evaluated as complete, compared to 33 (66%) of the forearm IVRA (p = 0.019). After the forearm nerve block, pain intensity was lower at discharge (-1.76 points lower, 95% CI (-2.92, -0.59), p = 0.0006) compared to patients treated with forearm IVRA. No differences in pain experienced at the start of the surgery, during surgery, and at POD1, nor in surgical time or total OR stay were observed between groups. Surgeon (p = 0.0016) and patient satisfaction (p = 0.0023) were slightly higher after forearm nerve block.
Conclusion: An ultrasound-guided forearm nerve block is superior compared to forearm IVRA in providing a surgical block in patients undergoing carpal tunnel release.
Trial Registration: This trial was registered as NCT03411551.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7895351 | PMC |
| http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0246863 | PLOS |
Publication Analysis
Top Keywords
Similar Publications
MRI grading using the neuropathy score-reporting and data system with electrodiagnostic correlation in radial neuropathy around the elbow: a 13-year retrospective review.
Skeletal Radiol
January 2025
Department of Radiology, NYU Langone Orthopedic Hospital, 301 East 17Th Street, 6Th Floor, Radiology , New York, NY, 10003, USA.
Objective: To evaluate the Neuropathy Score-Reporting and Data System (NS-RADS) MRI grading system in conjunction with electrodiagnostic (EDx) testing for radial neuropathy at the elbow.
Materials And Methods: Patients presenting between 2010 and 2023 with suspected radial neuropathy who underwent both EDx testing in the form of electromyography and nerve conduction studies and MRI within a 12-month period were evaluated. Three blinded radiologists used the NS-RADS grading system to evaluate nerve entrapment (E grades), muscle denervation (M grades) proximally within the supinator/extensor carpi radialis brevis (ECRB), and more distally within the forearm extensor muscles.
Influence of Chronic Mental Stress on Taste and Pungency Due to End-of-Semester Examination.
J Nutr Sci Vitaminol (Tokyo)
January 2025
Mental stress is a known risk factor for lifestyle-related diseases. Previously, we reported that short-term stress sharpens the sense of taste and dulls the sense of pungency, but in this study, we examined the effects of chronic mental stress on taste and pungency by comparing normal days with end-of-semester examination days. Furthermore, the relationship between pungency measured on the tongue and the corresponding skin current value causing forearm pain was investigated.
View Article and Find Full Text PDFCapsaicin-induced secondary hyperalgesia differences between the trigeminal and spinal innervation.
Sci Rep
January 2025
Department of Biosciences, Universidade Estadual de Campinas (UNICAMP), Faculdade de Odontologia de Piracicaba (FOP), Piracicaba, Brazil.
This study compared the degree of secondary hyperalgesia and somatosensory threshold changes induced by topical capsaicin between spinal and trigeminal innervation. This crossover clinical trial included 40 healthy individuals in which 0.25 g of 1% capsaicin cream was randomly applied for 45 minutes to a circular area of 2 cm to the skin covering the masseter muscle and forearm in 2 different sessions, separated by at least 24 hours and no more than 72 hours (washout period).
View Article and Find Full Text PDFMechanical properties of the bicipital aponeurosis.
J Mech Behav Biomed Mater
December 2024
School of Engineering, University of Guelph, Guelph, Ontario, Canada. Electronic address:
As a biarticular muscle, the biceps brachii both supinates the forearm and flexes the elbow and shoulder, thus allowing the upper limb to perform a variety of activities of daily living (ADL). The biceps brachii originates on the coracoid apex as well as the supraglenoid tubercle and inserts on the radial tuberosity. At the distal end, the bicipital aponeurosis (BA) provides a transition of the biceps tendon into the antebrachial fascia.
View Article and Find Full Text PDFPredictors, Trends, and Outcomes of Parathyroid Autotransplantation in Pediatric Total Thyroidectomy.
J Surg Res
December 2024
Division of Pediatric Surgery, Johns Hopkins All Children's Hospital, Saint Petersburg, Florida. Electronic address:
Article Synopsis
- The study looks at trends and outcomes of parathyroid autotransplantation (PTAT) in children undergoing total thyroidectomy, analyzing data from a surgical database.
- Of the 2,444 patients analyzed, a small percentage underwent PTAT, with the procedure being performed more frequently by adult subspecialists and in cases with more extensive lymph node removal.
- The overall use of PTAT declined over the study period, and no significant differences in early postoperative complications or hospital stays were noted between those who had PTAT and those who did not.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!