Objectives: To compare three techniques of brachial plexus blockade for emergency surgery of the upper limb.
Study Design: Prospective, randomised study.
Patients: One hundred eleven patients admitted to an emergency surgical service, randomly assigned to three groups.
Methods: The patients were given 2% lidocaine with epinephrine 20 mL and 0.5% bupivacaine 20 mL. The three groups were as follows: brachial plexus block using a peripheral nerve stimulator (group St, n = 38); transarterial brachial plexus blockade with injection of 2/3 of the anaesthetic in back of and 1/3 in front of the artery (group TAP, n = 36); transarterial brachial plexus blockade with one single injection in back of the artery (group TP, n = 37). The success rate, time required to perform the technique, latency of analgesia, quality of motor blockade, and adverse effects were compared between the three groups. Analysis of variance was used to compare quantitative data and chi 2 test were used for qualitative data.
Results: Rates of success varied between 65 and 75%. Success rates, latency of analgesia and quality of motor blockade were not significantly different between groups. Time to perform the technique was longer when using a nerve stimulator.
Conclusion: As these three techniques for brachial plexus block in emergency surgery are comparable, no one can be recommended instead of the others.
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http://dx.doi.org/10.1016/s0750-7658(98)80104-4 | DOI Listing |
J Brachial Plex Peripher Nerve Inj
January 2025
Integrative Neuromedicine, Community Hospital Herdecke, Witten/Herdecke University, Herdecke, Germany.
To date, there are no uniform guidelines for the treatment of obstetric plexus lesions in German-speaking countries. An end-to-end direct suture after resection of trunk neuroma is recommended for surgical treatment if tension-free coaptation is possible, whereas the use of autologous nerve grafts bridging the gap between the adaptation margins is advised by consensus if tension-free coaptation is impossible. The aim of the study was to investigate which reconstruction strategy may provide a better recovery of motor function for patients after obstetric brachial plexus lesion.
View Article and Find Full Text PDFJBJS Rev
November 2024
Division of Plastic and Reconstructive Surgery, University of Colorado School of Medicine, Anschutz Medical Center, Aurora, Colorado.
Background: Modern nerve-to-nerve transfers are a significant advancement in peripheral nerve surgery. Nerve transfers involve transferring donor nerves or branches to recipient nerves close to the motor end unit, leading to earlier reinnervation and preservation of the musculotendinous units in proximal nerve injuries. After nerve reinnervation, function may be superior to traditional tendon transfer techniques in terms of strength and independent motion.
View Article and Find Full Text PDFPlast Surg (Oakv)
January 2025
Division of Plastic and Reconstructive Surgery, Saint Louis University Hospital, St. Louis, MO, USA.
Brachial plexus birth injury (BPBI) is a condition affecting newborns and involves damage to the nerve fibers compromising the brachial plexus during birth. Although most newborns recover spontaneously, a large subset require surgery to regain function, and others will have permanent disability despite intervention. Deciding when to pursue surgical intervention remains a challenge for clinicians treating BPBI.
View Article and Find Full Text PDFCureus
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 Perianesth Nurs
January 2025
Department of Anesthesiology, Ningbo No.6 Hospital, Ningbo University School of Medicine, Ningbo, Zhejiang, China. Electronic address:
Brachial plexus block is the predominant anesthetic method used for upper-limb surgical procedures in pregnant patients. The innovative method of brachial plexus block in the costoclavicular space has shown enhanced reliability and effectiveness for postoperative analgesia. We report a case of a pregnant woman who underwent surgery for a humeral fracture.
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