Ultrasound-guided regional anesthesia (UGRA) in the emergency department: a scoping review.

Introduction: While many studies have been published on Ultrasound-guided regional anesthesia in the Emergency Department (ED), there has been no previous study assessing the current state of the literature based in the form of a scoping review.

Objective: The purpose of this study is to evaluate the current state of the literature on UGRA performed in the ED setting.

Methods: EMBASE, MEDLINE, CINAHL, and Cochrane databases were searched for studies.

Radial nerve injuries in humeral fractures: case series and medico-legal implications.

Introduction: Radial nerve injury following humeral fracture is the most common peripheral nerve injury associated with long bone fractures. The purpose of this study is to analyse our treatment protocols and long-term outcomes of humeral fractures associated with radial nerve injury which were surgically treated at the I.R.

Variability between human experts and artificial intelligence in identification of anatomical structures by ultrasound in regional anaesthesia: a framework for evaluation of assistive artificial intelligence.

Background: ScanNavAnatomy Peripheral Nerve Block (ScanNav™) is an artificial intelligence (AI)-based device that produces a colour overlay on real-time B-mode ultrasound to highlight key anatomical structures for regional anaesthesia. This study compares consistency of identification of sono-anatomical structures between expert ultrasonographers and ScanNav™.

Methods: Nineteen experts in ultrasound-guided regional anaesthesia (UGRA) annotated 100 structures in 30 ultrasound videos across six anatomical regions.

Brachial Plexus Injury Following Fracture-Dislocation of the Proximal Humerus: A Case Report.

Fracture-dislocations of the proximal humerus with brachial plexus injury are exceedingly rare, and although infrequently encountered, it is important to recognize this complication due to its potentially devastating impact. We present the case of a 75-year-old female who sustained the described injury following a fall onto their left arm, demonstrating combined sensory and motor deficits in the radial, median, and ulnar distribution of the left forearm and hand shortly afterward. Immediate management involved closed reduction under anesthesia, resulting in the improvement of neurological symptoms.

Ultrasound-guided supracondylar radial nerve block for closed reduction of a distal radius fracture in the emergency department: Case report.

Background: Closed reduction and a closed cast are common treatments for patients with acute distal radius fractures in the emergency room. Many of the common analgesic techniques such as hematoma block may not be effective, which can hinder the stabilization and reduction of fractures.

Case Report: An 81-year-old woman who had a Colle's fracture (metaphyseal fracture with dorsal angulation) of the left distal radius arrived at the emergency room.

Anterior Congenital Radial Head Dislocation in an Adult with Associated Posterior Interosseous Nerve Palsy.

Introduction: Anterior congenital radial head dislocation (CRHD) is a rare abnormality that is less commonly seen in the adult population. Most of the time, adult-onset symptoms are due to the prolonged dislocation of the radiocapitellar joint that has been present since birth. One of the possible complications of having a prolonged radial head dislocation is the presence of neuropathies such as posterior interosseous nerve (PIN) palsy.

Cords of the Brachial Plexus and Their Branches Positioned Laterally to the Axillary Artery.

The brachial plexus, which supplies the upper limb, extends from the interscalene triangle in the root of the neck to the axilla and is closely related to the subclavian and axillary arteries. Variations in the formation, branching pattern, and relations are profound, and it is generally stated that variant anatomy of the plexus appears to be a rule rather than an exception. In previous studies, it was hypothesized that the anomalous development of the subclavian-axillary stem and the persistence of intersegmental arteries could induce variations in the plexus.

Permanent Peripheral Nerve Stimulator for Complex Regional Pain Syndrome of the Forearm and Hand.

A 51-year-old woman with diabetes and depression was referred to the anesthesia pain clinic with a 15-year history of complex regional pain syndrome type I of the right forearm and hand in the radial sensory nerve distribution. There was no recognized antecedent trauma and she had failed both medical treatment and radial sensory nerve decompression surgery. An ultrasound-guided local anesthetic block of the radial nerve in the upper arm resulted in partial and temporary improvement in pain.

Electrodiagnostic Findings Using Radial Motor Segmental Conduction Study and Inching Test in Patients With Radial Neuropathy.

Objectives: The aims of this study were to characterize the electrodiagnostic findings of radial neuropathy using motor segmental conduction study and to determine the utility of subsequent inching test in precise lesion localization.

Design: Twenty-three patients with radial neuropathy were evaluated using radial neuropathy using motor segmental conduction study with three-point stimulation. The pathomechanism of the lesions according to the radial neuropathy using motor segmental conduction study was classified into three groups: conduction block, mixed lesion (combination of conduction block and axonal degeneration), and axonal degeneration.

Costoclavicular Brachial Plexus Block Facilitates Painless Upper Extremity Reduction: A Case Report.

Introduction: The costoclavicular brachial plexus block (CCBPB) has emerged as a more effective approach to regional anesthesia of the upper extremity. The costoclavicular space is the anterior portion of the superior thoracic aperture, located between the clavicle and first rib. The brachial plexus cords traverse this space clustered together in a superficial location lateral to the axillary artery and share a consistent topographical relationship to one another.

Flexor Pronator Slide Under Local Anesthesia without a Tourniquet for Non-Ischemic Contractures of the Forearm.

Background: The flexor pronator slide is an effective treatment option for ischemic contracture and contracture related to spastic cerebral palsy, but little is known about the use of the flexor pronator slide in other non-ischemic contractures. I propose a flexor pronator slide to simultaneously correct wrist and finger flexor contractures and preserve the muscle resting length. To avoid overcorrection of the deformity, I propose the use of a wide-awake local anesthesia with no tourniquet (WALANT) procedure, in which the patient is able to continually assist the surgeon in assessing the contracture release and improvement in finger movement.

Localisation of the centre of the highest region of muscle spindle abundance of anterior forearm muscles.

The centre of the highest region of muscle spindle abundance (CHRMSA) in the intramuscular nerve-dense region has been suggested as the optimal target location for injecting botulinum toxin A to block muscle spasms. The anterior forearm muscles have a high incidence of spasticity. However, the CHRMSA in the intramuscular nerve-dense region of the forearm anterior muscle group has not been defined.

Comparative Study of Radial and Median Nerve Blocks with Hematoma Block under Ultrasound Guide in Distal Radius Fracture Reduction: A Randomized Clinical Trial.

Background: Distal radius fractures are one of the most common upper extremity fractures, and their incidence continues to increase due to an aging population and an increase in osteoporosis. Various methods of analgesia for distal radius fractures have been described-including hematoma blocks and nerve blocks. Hematoma blocks are a simple and effective method of providing analgesia; nonetheless, their efficacy may be limited in some cases.

Comparison of USG-Guided Supraclavicular Brachial Plexus Block by Single-Point Versus Multiple-Point Injection Technique: A Prospective Randomized Trial.

Background This study investigated the success rate of ultrasonography (USG)-guided supraclavicular block using a single-point injection technique comparing it with multiple-point injection technique, in terms of nerve sparing, time taken to perform the procedure, time taken to onset of sensory and motor block. Materials and methods A total of 204 patients of American Society of Anesthesiologists (ASA) Status I and II, aged 18-60 years, with body mass index (BMI) ≤30 kg/m, posted for upper limb surgeries were given USG-guided supraclavicular brachial plexus block with 15 mL of 0.5% Ropivacaine.

Functional recovery of wrist surgery with regional versus general anesthesia: a prospective observational study.

Purpose: Regional anesthesia may favour postoperative rehabilitation by inhibiting peripheral sensitization and secondary hyperalgesia. The literature on this subject is limited. In the present FUNCTION study, we sought to compare the functional recovery post orthopedic wrist surgery with regional versus general anesthesia.