Introduction: Bilateral brachial plexus blocks can be an alternative to general anaesthesia in the surgery of arm, forearm, wrist, or hand. This study aims to report a case in which a risky patient underwent amputation surgery under regional anaesthesia.
Case Presentation: A 64-year-old male was admitted to the hospital for an amputation operation. Ultrasonography revealed normal findings regarding internal organs, aside from grade II increased echogenicity of both kidneys and a small bladder cyst. Echocardiography revealed mildly left ventricular dilation, moderate systolic left ventricular dysfunction, ejection fraction 38%, left ventricular wall hypokinesia with left ventricular dilation. The amputation was performed under a bilateral supraclavicular brachial plexus block with the guidance of ultrasound.
Discussion: Theoretically, there are some advantages to regional anaesthesia in comparison to general anaesthesia, such as decreasing the ordinary body response to stress in the presence of low levels of cortisol and catecholamines, increasing blood flow and peripheral vasodilatation, decreasing hypercoagulability, lower risk of arterial and venous thrombosis and it aids to prevent endotracheal intubation and mechanical ventilation.
Conclusion: Bilateral brachial plexus blocks, as a type of regional anaesthesia under ultrasound guidance, can be depended upon as a reliable substitute for general anaesthesia in perilous conditions.
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http://dx.doi.org/10.1016/j.amsu.2022.103378 | DOI Listing |
Neurol Int
December 2024
Department of Neuroscience "Rita Levi Montalcini", University of Turin, 10126 Turin, Italy.
Background: Post-traumatic pseudomeningoceles are common findings after a brachial or lumbar plexus trauma, in particular after nerve root avulsion. Unlike meningoceles, pseudomeningoceles are CSF full-filled cysts confined by the paraspinous soft tissue, along the normal nerve course, in communication with the spinal subarachnoid spaces. Normally no more than a radiological finding at MRI, in rare instances they might be symptomatic due to their size or might constitute an obstacle during a reconstructive surgery.
View Article and Find Full Text PDFCureus
November 2024
Department of Orthopedics, Royal Berkshire NHS Foundation Trust, Reading, GBR.
Neurovascular complications associated with clavicular shaft fractures can manifest at presentation, develop gradually over time, or potentially be iatrogenically induced. Conducting a thorough neurovascular examination and, when warranted, pursuing further investigation through modalities such as CT angiogram, MRI, and nerve conduction studies (NCS) are crucial for early diagnosis and pre-operative planning. This comprehensive approach enhances patient outcomes by facilitating timely intervention and addressing any underlying neurovascular issues associated with the fracture.
View Article and Find Full Text PDFJ Am Acad Orthop Surg
December 2024
From the Department of Orthopaedic Surgery, University of Utah, Salt Lake City, UT (Graesser), the Washington University School of Medicine in St. Louis, Mallinckrodt Institute of Radiology, St. Louis, MO (Parsons), and the Department of Orthopaedic Surgery, Washington University School of Medicine in St. Louis, St. Louis, MO (Olafsen, Dy, and Brogan).
Traumatic peripheral nerve injuries represent a spectrum of conditions and remain challenging to diagnose and prognosticate. High-resolution ultrasonography and magnetic resonance neurography have emerged as useful diagnostic modalities in the evaluation of traumatic peripheral nerve and brachial plexus injuries. Ultrasonography is noninvasive, is able to rapidly interrogate large areas and multiple nerves, allows for a dynamic assessment of nerves and their surrounding anatomy, and is cost-effective.
View Article and Find Full Text PDFAnn Ital Chir
December 2024
Department of Hand & Foot and Reconstructive Microsurgery, The First Hospital of Qinhuangdao, 066000 Qinhuangdao, Hebei, China.
Aim: To explore the effectiveness and safety of Osborne's ligament suspension and ulnar nerve anterior transposition (OLSUNAT) in conjunction with transcutaneous electrical nerve stimulation (TENS) for managing cubital tunnel syndrome (CTS).
Methods: A total of 116 individuals diagnosed with CTS who underwent OLSUNAT in our hospital between October 2020 and December 2023 were retrospectively selected. They were divided into a treatment group (62 cases) and a control group (54 cases) based on whether they received subsequent TENS.
Reg Anesth Pain Med
December 2024
Anesthesia and Pain Management, Toronto Western Hospital, Toronto, Ontario, Canada
Background: The addition of intravenous dexamethasone can significantly prolong analgesia and reduce opioid-related side effects after brachial plexus blockade, but the most effective administration time is yet unknown. The objective of this study is to determine if the timing of administration of dexamethasone affects the duration of analgesia after supraclavicular brachial plexus block.
Methods: This is a double-blind, placebo-controlled, randomized trial performed at a single-center, tertiary academic health sciences center.
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