Local anaesthesia vs. brachial plexus block in trapeziometacarpal joint arthroplasty.

Introduction: An established anaesthetic procedure used during total trapeziometacarpal joint (TMCJ) arthroplasty is the brachial plexus block (BPB). It was hypothesized that local anaesthesia (LA) provides advantages in overall cost, enables intraoperative assessment of the prosthesis, and minimises the anaesthetic risk. In this study, LA to BPB was compared and outcomes, safety, and overall patient satisfaction were analyzed.

Long term functional outcome for the cubital tunnel syndrome after endoscopic assisted release of the ulnar nerve.

Introduction: The endoscopic assisted release for cubital tunnel syndrome (CuTS) gained popularity in recent years with unclear long-term results. This study aims to evaluate long term results regarding functional and subjective outcomes after endoscopic assisted release for the CuTS.

Materials And Methods: Thirty one patients who have been treated by endoscopic assisted release for CuTS between 2006 and 2013 were followed up both clinically and with a questionnaire with a mean follow up of 152 months (range 120-204 months).

Novel Use of Motor-Evoked Potential Monitoring During Magnetic Resonance Imaging-Guided Soft-Tissue Cryoablation: A Case Report.

Motor-evoked potential (MEP) monitoring is an electrophysiologic technique useful for testing peripheral motor nerve integrity during cryoablation cases with risk of nerve injury. Previously, neuromonitoring within the magnetic resonance imaging (MRI) suite for cryoablation has not been performed as magnetic needles are used which could cause magnetic field interactions with neuromonitoring leads. We present the first report of a patient who underwent MEP monitoring during MRI-guided cryoablation of a vascular malformation adjacent to the brachial plexus.

A Comprehensive Review of Topography and Axon Counts in Upper-Extremity Peripheral Nerves: A Guide for Neurotization.

Purpose: Currently, no comprehensive database detailing topography and axon counts exists. This study aims to review the axon counts and topography of the major peripheral motor nerves of the upper extremity to allow for optimal surgical planning for peripheral nerve reconstruction via neurotization.

Methods: Peer-reviewed journal articles were identified through PubMed, ScienceDirect, Google Scholar, and CENTRAL.

Injury Patterns, Imaging Findings, and Prognosis for Muscle Strength Recovery in Surgical Infraclavicular Brachial Plexus Injuries.

Purpose: Historically, infraclavicular brachial plexus injuries (IBPIs) were considered neuropraxic injuries that would improve with nonsurgical intervention. However, more recent studies suggest that these injuries may benefit from surgical intervention. The aims of this retrospective study were to (1) describe injury patterns and associated injuries of isolated, traumatic IBPIs, (2) evaluate the concordance of preoperative ultrasound and magnetic resonance neurography with surgical findings of patients who underwent surgical intervention for IBPIs, and (3) describe outcomes of surgical intervention for these injuries.

Proximal median nerve neuropathy: electrodiagnostic and ultrasound findings in 62 patients.

Objectives: Proximal median nerve (PMN) neuropathies are caused by lesions proximal to the carpal tunnel, which include the forearm, elbow, upper arm, and brachial plexus. Differentiating between carpal tunnel syndrome and PMN neuropathies is important to guide management and is based on clinical, electrodiagnostic (EDX), and ultrasound (US) findings. This study describes the clinical, EDX, and US features in 62 patients with PMNs.

Peripheral Nerve Stimulation Implantation Combining Ultrasound With Microendoscopy for Management of Chronic Neuropathic Pain: A Case Series Study.

Background: Peripheral nerve stimulation (PNS) has emerged as a minimally invasive percutaneous procedure addressing neuropathic pain. However, the percutaneous cylindrical lead ultrasound-guided implantation procedure requires expertise that limits widespread PNS utilization. To overcome these challenges, a microinvasive endoscopy device has very recently been developed, enhancing the precision of PNS implantation by providing accurate visualization of the targeted nerve.

Post ChAdOx1 nCoV-19 Corona Virus Vaccine (Recombinant) (Covishield) Brachial Plexitis - Report of Two Cases Along with Review of Literature.

Various neurological complications have been linked with vaccines ranging from encephalitis, stroke, ADEM to GBS and many more. Although both viral as well as bacterial vaccines have been reported to cause neurological adverse events, brachial plexitis following vaccination is very uncommon. Vaccination drive against COVID-19 was started on 16th Jan 2021 in India.

Long-Term Outcomes of Obstetric Brachial Plexus Injury: A Single-Center Experience.

Obstetric brachial plexus injury (OBPI) is an important preventable complication of the birth process. While most cases recover in the early period, a substantial number result in sequelae. Despite established risk factors, there are cases that occur without any apparent risk factors.

Results of the Nerve Transfers and Secondary Procedures to Restore Shoulder and Elbow Function in Traumatic Upper Brachial Plexus Palsy.

Damage to the upper trunk of the brachial plexus, often caused by high-energy trauma, leads to significant functional impairment of the upper limb. This injury primarily affects the C5 and C6 roots, resulting in paralysis of muscles critical for shoulder and elbow function. If spontaneous nerve regeneration does not occur within 3-6 months post-injury, surgical intervention, including nerve transfers, is recommended to restore function.

Axillary Peripheral Nerve Schwannoma: A Rare Occurrence in the Torso.

A schwannoma is a benign, solitary, noninvasive, and encapsulated tumor that originates from Schwann cells of the peripheral nerve sheath commonly found in the head and neck. A rare case of a benign schwannoma in the axillary region of a 34-year-old male patient is presented here accompanied by a discussion on the known entities of peripheral nerve schwannoma as well as the clinical and radiological findings coupled with treatment techniques. The patient presented with a left axillary mass of seven years gradually progressing in size which is associated with pain in the left arm.

Comparison of Latissimus Dorsi versus Teres Major Tendon Transfer to Restore External Rotation of the Shoulder in Patients with Erb Palsy.

The transfer of latissimus dorsi (LD) and teres major (TM) have been described for restoration of external rotation (ER) and shoulder abduction in neonatal brachial plexus palsy (NBPP). The aim of this prospective randomised study is to compare the outcomes of LD versus TM transfer in the treatment of internal rotation contracture of the shoulder in children with NBPP. The study was conducted from February 2014 to January 2018 and included NBPP patients with internal rotation contracture of the shoulder.

The anatomical structure of the brachial plexus of the guinea pig (cavia porcellus).

Background: In this study, we described the anatomy of the brachial plexus of the guinea pig (Cavia porcellus). The description of the brachial plexus anatomy can contribute to the knowledge of the neuroanatomy of small mammals. Furthermore, it is a source of information for clinicians performing brachial plexus anesthesia in exotic animals such as the guinea pig (Cavia porcellus).

Longitudinal analysis of serum intestinal fatty acid-binding protein in a patient with non-occlusive mesenteric ischemia following brachial plexus block-induced hypotension: a case study.

Intestinal fatty acid-binding protein (I-FABP) is a promising biomarker for small-bowel ischemia including non-occlusive mesenteric ischemia (NOMI). A 75-year-old woman with diabetic nephropathy sustained a distal radius fracture. Two days later, she underwent a brachial plexus block to facilitate orthopedic surgery, which resulted in hypotension.

Effect of different modes of administration of esketamine combined with supraclavicular brachial plexus block on the incidence of rebound pain after upper limb fracture surgery: study protocol for a single-centre, double-blinded, randomised controlled trial.

Background: Supraclavicular brachial plexus block (SCB) is a common regional analgesic technique for upper limb fracture surgery, but it often leads to rebound pain. Our primary aim is to determine whether different administration methods of esketamine can reduce rebound pain in patients undergoing SCB for upper limb fracture surgery.

Methods/design: This study is designed as a single-centre, double-blinded, prospective, randomised controlled trial.

Deafferentation in Pain Medicine: A Narrative Review of Mechanisms and Management.

Deafferentation is an umbrella term that includes several clinical conditions. The exact mechanism is not yet known, and the different clinical conditions do not necessarily share common pathophysiology. It includes both non-painful and painful conditions, including cancer pain conditions.

Surgical treatment of neonatal brachial plexus palsy: A cohort study using the Pediatric Health Information System (PHIS) database.

Purpose: This study aims to explore demographic disparities, regional and institutional variations, surgical timing, narcotic use, and management trends in neonatal brachial plexus palsy (NBPP) patients due to limited published literature.

Methods: We conducted a retrospective cohort study using the Pediatric Health Information System (PHIS) database of NBPP patients who underwent surgery within the first 2 years of life. Patients were stratified into two groups based on age at surgery: ≤ 8 months and > 8 months.

Evaluation and Diagnostic-Treatment Approaches of Brachial Plexus Injuries in Adults.

Background: Brachial plexus injury (BPI), as one of the most devastating injuries in adults, has various negative consequences such as profound functional impairment, debilitating pain, significant mental health consequences, and economic impacts. We aimed to review the evaluation and diagnostic-treatment Approaches of BPI in adults through a review study.

Methods: An electronic literature search was completed in Google Scholar, Springer, PubMed, and Science Direct databases from 1980 to 2023.

Clinical value of esketamine combined with ropivacaine in rebound pain after brachial plexus block in patients with upper limb fractures.

Objective: To analyze the clinical value of the combination of esketamine and ropivacaine in alleviating rebound pain in patients with upper limb fractures following brachial plexus block.

Methods: A total of 149 patients with unilateral upper limb fractures who underwent open reduction and internal fixation surgery under brachial plexus block anesthesia from November 2021 to August 2022 were selected as the subjects for the study and randomly divided into the esketamine group (RNK group) and the ropivacaine group (R group). The incidence of rebound pain at 48 h postoperatively, intraoperative mean arterial pressure (MAP) and heart rate (HR), the onset time and duration of blockade, the Numeric Rating Scale (NRS) scores for pain at rest and with activity during the perioperative period, the dosage, numbers of compressions, and effective compressions of postoperative patient-controlled analgesia with sufentanil, and occurrence of adverse reactions were assessed and compared between the two groups.

The Psychological Impact of Adult Traumatic Brachial Plexus Injury.

Background: Adult traumatic brachial plexus injuries (BPIs) present a significant medical challenge, potentially leading to life-altering consequences for patients' upper extremity pain and function. However, the psychological impact on patients has not been extensively studied.

Methods: Adult patients with traumatic BPIs treated at 2 tertiary referral centers in the United States from 2015 to 2019 were retrospectively identified.

Median nerve impairment in leprosy: how does it differ from the classic carpal tunnel syndrome?

Background:  Carpal tunnel syndrome (CTS) has already been described as a possible form of neural leprosy presentation. However, the median nerve can be involved in this neuropathy in proximal segments and, sometimes, with an asymmetric impairment of the digital branches.

Objective:  To detail the pattern of median nerve impairment through nerve conduction study (NCS) and ultrasound evaluation.

Imaging features of the brachial plexus in neurogenic thoracic outlet syndrome: A case report.

Neurogenic thoracic outlet syndrome (NTOS) is characterized by the compression of the brachial plexus in the thoracic outlet region, caused by various etiologies. We report a case with clinical symptoms and imaging findings from ultrasound and magnetic resonance imaging (MRI) of NTOS due to an elongated C7 transverse process and a fibrous band of the middle scalene muscle, which was confirmed in decompression surgery.

Costoclavicular block as a diaphragm-sparing nerve block for shoulder surgery: a randomized controlled trial.

Backgrounds: Distal nerve block approaches have been explored to reduce hemidiaphragmatic paresis (HDP) more effectively than interscalene block (ISB). However, these approaches are associated with a high incidence of HDP. The costoclavicular block (CCB) provides effective analgesia while reducing HDP.