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Vet Anaesth Analg 2019 Jan 25. Epub 2019 Jan 25.

Department of Veterinary Sciences, University of Pisa, Pisa, Italy. Electronic address:

Objective: To design and assess the perioperative analgesic efficacy of an ultrasound (US)-guided radial (R), ulnar (U), median (M) and musculocutaneous (Mc) nerve blocks, performed together in the axillary space by a single, in-plane approach.

Study Design: Anatomical research and prospective clinical study.

Animals: A group of three dog cadavers and 15 client-owned dogs undergoing orthopaedic thoracic limb surgery. Read More

Cureus 2019 Jan 24;11(1):e3949. Epub 2019 Jan 24.

Anesthesiology, Kutahya Health Sciences University, Kutahya, TUR.

A peripheral nerve block is a sufficient anesthesia method for hand surgeries, as it protects the patient from the complications of general anesthesia and provides postoperative analgesia. We report the first use of an ultrasound-guided mid-humeral radial nerve block in three cases of ganglion cyst excision from hand dorsum. The block provided efficient surgical anesthesia and postoperative analgesia for the excision of ganglion cysts at the hand dorsum. Read More

Arch Rheumatol 2018 Dec 23;33(4):464-472. Epub 2018 Mar 23.

Department of Physical Medicine and Rehabilitation, Uludağ University Faculty of Medicine, Bursa, Turkey.

Objectives: This study aims to investigate the effects of ultrasound-guided superficial branch of the radial nerve block on pain, function and quality of life in patients with hand osteoarthritis.

Patients And Methods: In this prospective, randomized and controlled single-blind study, 50 female patients (mean age 59.0±5. Read More

J Med Imaging (Bellingham) 2018 Oct 10;5(4):044004. Epub 2018 Nov 10.

SINTEF Medical Technology, Trondheim, Norway.

Ultrasound images acquired during axillary nerve block procedures can be difficult to interpret. Highlighting the important structures, such as nerves and blood vessels, may be useful for the training of inexperienced users. A deep convolutional neural network is used to identify the musculocutaneous, median, ulnar, and radial nerves, as well as the blood vessels in ultrasound images. Read More

Beijing Da Xue Xue Bao Yi Xue Ban 2019 Feb;51(1):177-181

Department of Anesthesiology, Peking University Third Hospital, Beijing 100191, China.

Objective: To compare the effects of ultrasound-guided interscalene brachial plexus block and C5-6 nerve root block for analgesia after shoulder arthroscopy.

Methods: In the study, 40 patients of ASA I-II were selected for elective general anesthesia to repair the shoulder ligament rupture in Peking University Third Hospital, who were randomly divided into two groups, respectively for the intermuscular brachial plexus block group (group I) and C5-6 nerve root block group (group C), n=20. The forty patients underwent ultrasound-guided brachial plexus block or C5-6 nerve root block before general anesthesia. Read More

Neurol India 2019 Jan-Feb;67(Supplement):S82-S91

Department of Neurosurgery, PD Hinduja Hospital, Mumbai, Maharashtra, India.

Objective: A retrospective analysis of surgically treated 354 cases of injection-related iatrogenic peripheral nerve injuries was performed. The purpose of this clinical study was to present our experience in the management of various types of injection-related peripheral nerve injuries and discuss various issues that are associated with this subset of peripheral nerve injuries.

Methods: Over a 17-year period, 354 cases of injection-related iatrogenic peripheral nerve injuries were managed surgically at the Department of Neurosurgery at P. Read More

Neuroradiology 2019 Mar 21;61(3):341-349. Epub 2019 Jan 21.

Center for Advanced Imaging Innovation and Research, Department of Radiology, New York University, New York, NY, USA.

Purpose: MRI methods that have reduced sensitivity to motion are attractive in pediatric applications. In spine imaging, physiologic motion such as respiration and cerebrospinal fluid pulsation can hamper diagnostic image quality. We compare a 3D T1-weighted non-Cartesian radial acquisition with a conventional Cartesian 2D turbo-spin-echo (TSE) acquisition in axial post-contrast spine imaging at 3T. Read More

A A Pract 2019 Jan 3. Epub 2019 Jan 3.

Departement of Orthopedic Surgery, Orthopedic Surgery, Rodez General Hospital, Rodez, France.

The outcome of upper limb tendon transfer surgery is improved when the patient is able to voluntarily contract specific muscles during the surgical procedure. Tumescent local anesthesia is suitable, but we describe an alternative option that involves the novel management of an axillary block. A 47-year-old man, injured in a motor vehicle crash, exhibited a thumb extensor deficit because of severe muscular trauma to the forearm. Read More

Medicine (Baltimore) 2018 Dec;97(49):e13455

Department of Physical Medicine and Rehabilitation, Tung's Taichung Metroharbor Hospital, Taichung, Taiwan.

Rationale: Compressive radial neuropathy by a synovial cyst in the radial tunnel during pregnancy is a rare occurrence. The management of radial nerve compression caused by a synovial cyst in a pregnant patient is a surgical dilemma owing to the fetal and maternal risks of treatment.

Patient Concerns And Diagnosis: A 37-year-old pregnant woman presented with progressive forearm pain at the gestational age of 12 weeks. Read More

Clin Anat 2019 Jan 20;32(1):2-8. Epub 2018 Oct 20.

Department of Anesthesiology, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain.

Our objective was to define the positions of the nerves around the brachial artery and, secondarily, to assess the risk of intraneural injection during dual guided axillary block. Sixty ultrasound-guided axillary blocks were performed. The locations of the musculocutaneous, median, ulnar, and radial nerves relative to the brachial artery were determined. Read More

BMC Anesthesiol 2018 10 19;18(1):143. Epub 2018 Oct 19.

Department of Anesthesiology, The First Affiliated Hospital of Wenzhou Medical College, 2 Fuxue Road, Wenzhou City, Zhejiang Province, 325000, China.

Background: Proximal brachial plexus blocks can lead to an extended period of motor paralysis and delay the return of motor function. This could influence patient satisfaction, and extend hospitalizations. The aim of the study is to compare a selective distal nerve block of the arm to a proximal axillary block, both ultrasound-guided, in terms of their motor block intensity of the elbow. Read More

Rev Bras Anestesiol 2019 Jan - Feb;69(1):104-108. Epub 2018 Oct 6.

Universidade Federal de São Paulo (Unifesp), Escola Paulista de Medicina (EPM), Grupo de Anestesia Regional da Disciplina de Anestesiologia, Dor e Medicina Intensiva, São Paulo, SP, Brasil.

Background: A patient's ability to move his/her fingers during hand surgery may be helpful to surgeons because it allows the effectiveness of the intervention evaluation and prediction of hand function in the postoperative period. The purpose of this case series is to demonstrate the efficacy of an ultrasound-guided peripheral nerve block technique to maintain the hand flexor and extensor muscles motor function and discuss the benefits of the technique for trigger finger surgery.

Case Report: Ten patients scheduled to undergo trigger finger surgery were selected. Read More

J Hand Surg Asian Pac Vol 2018 Sep;23(3):408-411

* Department of Orthopaedic Surgery, Tsuchiura Kyodo Hospital, Tsuchiura, Japan.

A 15-year-old male patient presented with difficulty extending his right thumb due to subluxation of the extensor pollicis longus (EPL) tendon. Physical examination showed that active motion of the thumb's metacarpophalangeal (MP) joint was 76° in flexion and -58° in extension. During active extension, the EPL tendon shifted onto the ulnar aspect of the MP joint, and the extensor pollicis brevis (EPB) tendon shifted onto the central dorsal course of the MP joint. Read More

Br J Anaesth 2018 Oct 23;121(4):883-889. Epub 2018 Aug 23.

Department of Anesthesiology, Intensive Care Medicine, Germany; Palliative Care Medicine and Pain Management, Berufsgenossenschaftliches Universitätsklinikum Bergmannsheil GmbH Bochum, Bochum, Germany.

Background: The posterolateral and medial aspect of the arm is supplied by the axillary (AXN) and intercostobrachial nerves (ICBN), which are not anaesthetised by an axillary brachial plexus block (ABPB). Blockade of the AXN and the ICBN has been reported in the quadrangular space (QS) posteriorly or by serratus plane block, respectively. An anterior ultrasound-guided approach to block the AXN and ICBN would be desirable to complete an ABPB at a single insertion site. Read More

JBJS Essent Surg Tech 2018 Mar 14;8(1):e7. Epub 2018 Mar 14.

Sheffield Teaching Hospitals, Sheffield, United Kingdom.

Effective anesthesia of the hand and wrist has many uses inside and outside the operating room. In the emergency department or fracture clinic, a wrist block may be used for closed reductions of dislocations and fractures or for effective inspection and treatment of wounds. In the operating room, surgery may be carried out under a wrist block alone or a wrist block may be used as an adjunct to general anesthesia as the block is an opiate-sparing option to facilitate outpatient surgery and to provide many hours of postoperative analgesia, particularly if administered prior to the commencement of surgery. Read More

Tex Heart Inst J 2018 06 1;45(3):186-187. Epub 2018 Jun 1.

Radial artery spasm is a known complication of transradial cardiac catheterization. However, severe spasm with sheath entrapment is rare. We describe such a case, and the condition's response to an alternative removal method after conventional efforts failed. Read More

Anaesthesia 2018 Oct 25;73(10):1251-1259. Epub 2018 Jul 25.

Department of Anaesthesiology, Nordsjaellands Hospital, University of Copenhagen, Denmark.

We aimed to examine to what extent a lateral infraclavicular brachial plexus block affected the axillary and the suprascapular nerve. We included patients undergoing hand surgery anaesthetised with a lateral infraclavicular brachial plexus block. Our primary outcome was the relative change in surface electromyography during maximum voluntary isometric contraction of the medial deltoid muscle (axillary nerve) and the infraspinatus muscle (suprascapular nerve) from baseline to 30 min after the block procedure. Read More

Reg Anesth Pain Med 2018 Nov;43(8):825-831

From the Department of Anesthesia and Intensive Care, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong, China.

Background And Objectives: It has recently been proposed that an infraclavicular brachial plexus block (BPB) at the costoclavicular (CC) space may overcome some of the limitations of the lateral sagittal (LS) approach. In this study, we hypothesized that the CC approach will produce faster onset of sensory blockade of the 4 major terminal nerves of the brachial plexus than the LS approach.

Methods: Forty patients undergoing elective upper extremity surgery under a BPB were randomized to receive either the LS (Gp-LS, n = 20) or CC approach (Gp-CC, n = 20) for infraclavicular BPB. Read More

Medicine (Baltimore) 2018 Jun;97(23):e10978

Department of Physical Medicine and Rehabilitation, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China.

Rationale: Perineural injection with dextrose could be a novel intervention for peripheral entrapment neuropathy. However, this intervention has not been reported for treating radial nerve palsy (RNP). Here, we present a case with RNP having outstanding improvement after 2 sessions of ultrasound-guided perineural injection with 5% dextrose (D5W). Read More

Clin Ther 2018 Jun 21;40(6):1014-1022. Epub 2018 May 21.

Department of Anesthesiology, First Affiliated Hospital, Wenzhou Medical University, Zhejiang, China. Electronic address:

Purpose: This study tested the hypothesis that ultrasound-guided mid-forearm nerve block with 0.75% ropivacaine reduces the prevalence of moderate to severe pain after wrist and hand surgery, and provides prolonged postoperative analgesia with minimal motor blockade.

Methods: Thirty patients undergoing elective wrist and hand surgery were randomly assigned to 1 of 2 groups: group R (n = 15) and group NS (n = 15). Read More

J Ultrasound Med 2019 Jan 6;38(1):239-242. Epub 2018 May 6.

Department of Anesthesiology, University of California, San Diego, California, USA.

The posterior antebrachial cutaneous nerve branches from the radial nerve proximal to the elbow and supplies sensation to the posterior aspect of the forearm. With a high-frequency linear transducer, the posterior antebrachial cutaneous nerve was identified in 8 healthy volunteers. Under aseptic conditions and with an ultrasound-guided in-plane technique, 1% lidocaine was injected circumferentially around the nerve. Read More

J Vasc Interv Radiol 2018 05;29(5):745-747

Department of Anesthesiology and Perioperative Medicine, University of California Los Angeles, 2200 N. Sepulveda Blvd., Manhattan Beach, CA 90266.

Minerva Anestesiol 2019 Feb 27;85(2):124-132. Epub 2018 Mar 27.

Department of Anesthesiology and Intensive Care Unit, Centre Hospitalier Regional Universitaire (CHRU) Lapeyronie, Montpellier, France.

Background: Although studies in diabetic patients demonstrated delayed recovery after long-acting local anesthetic, its effects with short-acting LA remains to be determined. Using mepivacaine, the authors evaluated the duration of axillary nerve blocks in diabetic (DP), renal failure (creatinine clearance <30 mL.min-1) (RP) and healthy patients (HP). Read More

Br J Anaesth 2018 Apr 24;120(4):836-845. Epub 2017 Nov 24.

Department of Anaesthesiology and General Intensive Care Medicine, Austria.

Background: Many clinicians require a solid understanding of the anatomical areas supplied by specific peripheral nerves. Virtually all pertinent medical textbooks claim that the entire (palmar and dorsal) surface of the hand is supplied by three (median, radial, and ulnar) nerves and that each of these covers a well-defined area. This study was designed to evaluate the sensory-distribution pattern of peripheral nerves in the hand. Read More

Exp Ther Med 2018 Mar 19;15(3):3006-3011. Epub 2018 Jan 19.

Department of Anesthesiology, Clinical Medical College of Yangzhou University, Subei People's Hospital of Jiangsu, Yangzhou, Jiangsu 225001, P.R. China.

Ultrasound-guided interscalene brachial plexus blockade (IBPB) has a relatively high success rate in shoulder surgery; however, whether multiple injections are superior to a single injection (SI) is currently unknown. In the present study, ultrasound-guided SI and triple-injection (TI) IBPBs were compared in a prospective randomized trial. A total of 111 patients undergoing arthroscopic shoulder surgery and presenting with an American Society of Anesthesiologists physical status grading of I-II were randomly allocated to receive IBPB with 15 ml of 1% ropivacaine as a SI or TI. Read More

Minerva Anestesiol 2018 Nov 5;84(11):1261-1269. Epub 2018 Feb 5.

Department of Anesthesiology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.

Background: Trapeziectomy is one of the most painful procedures in ambulatory surgery. This prospective randomized trial aimed to compare postoperative pain control using distal peripheral nerve blocks (dPNB) with a low concentration of a long-acting local anesthetic versus conventional systemic analgesia.

Methods: Fifty-two patients undergoing trapeziectomy were randomized to receive levobupivacaine 0. Read More

Can J Anaesth 2018 May 31;65(5):590. Epub 2018 Jan 31.

Department of Anesthesia, All India Institute of Medical Sciences, Patna, India.

Vet Anaesth Analg 2018 Mar 12;45(2):203-211. Epub 2017 Dec 12.

Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada.

Objectives: To describe the ventral spinal nerve rami contribution to the formation of the brachial plexus (BP), and to compare ease of performing and nerve staining between three blind techniques for BP blockade in dogs.

Study Design: Prospective, randomized, blind study.

Animals: A total of 18 dog cadavers weighing 28. Read More

Can J Anaesth 2018 May 10;65(5):591. Epub 2018 Jan 10.

University Hospital Kerry, Tralee, Co, Kerry, Ireland.

J Vasc Access 2018 Mar 19;19(2):177-183. Epub 2018 Feb 19.

1 Department of Surgery, Saiwaicho Memorial Hospital, Okayama City - Japan.

Introduction: Arteriovenous access (AVA)-related pain treated successfully with runoff-venous decompression of the causative nerve, following ultrasound (US)-assisted preoperative evaluation, has never been reported.

Case Presentation: A 57-year-old man suffering from constant exhausting pains along the outflow cephalic vein of the radiocephalic arteriovenous fistula at the wrist and the antecubital fossa, was treated surgically after the diagnosis of AVA-related pain derived from cephalic vein compression on two peripheral cutaneous nerves, the superficial radial nerve (SRN) and the lateral antebrachial cutaneous nerve (LACN).

Technique: The SRN and LACN, which ran along and/or provided sensory innervation to the painful regions in the upper limb, were traced using ultrasonography in the short axis and proved to be compressed by and in contact with veins where the pain existed, at the wrist and the antecubital fossa. Read More

Turk J Anaesthesiol Reanim 2017 Oct 1;45(5):289-296. Epub 2017 Oct 1.

Department of Anesthesiology and Reanimation, Oncology Training and Research Hospital, Ankara, Turkey.

Objective: In this study, we aimed to compare axillary brachial plexus block using the two-injection and four-injection techniques assisted with ultrasonography (USG) and nerve stimulator in patients operated for carpal tunnel syndrome with articaine. To evaluate which technique is more effective, we compared the onset time, effectiveness, and duration of block procedures, patient satisfaction, adverse effect of the drug, and complication rates of the motor and sensory blocks.

Methods: Sixty patients were randomly divided into two groups. Read More

Int J Surg Case Rep 2017 27;41:230-233. Epub 2017 Oct 27.

Department of Orthopedic Surgery, Niigata University, Niigata 951-8510, Japan.

Introduction: Generally, anatomical reduction of shaft fractures through operative treatment is necessary to restore the anatomical relationship of the forearm bones. However, a number of nerves and vessels are located in the proximal radius, which complicates surgery. In this study, we aimed to reduce postoperative complications by using a posterior approach. Read More

Pain Physician 2017 09;20(6):529-535

Department of Anesthesiology and Pain Medicine, Gachon University, Gil Medical Center, Incheon, South Korea.

Background: The cluster approach for supraclavicular brachial plexus block (SC-BPB) can be easily performed but may result in asymmetric local anesthetic (LA) spread. The authors hypothesized that the use of a cluster approach in each of the 2 planes would achieve better 3-dimensional LA distribution than the traditional single cluster approach.

Objectives: The purpose of the present study was to compare a double injection (DI) in 2 planes (one injection in each plane) with the traditional single injection (SI) cluster approach for ultrasound-guided SC-BPB. Read More

Can J Anaesth 2017 Nov 7;64(11):1111-1118. Epub 2017 Sep 7.

Department of Anaesthesia and Intensive Care, Nordsjællands Hospital, Copenhagen University Hospital, Dyrehavevej 29, 52B, 4th floor, 3400, Hillerød, Denmark.

Purpose: Increased distal skin temperature can be used to predict the success of lateral infraclavicular (LIC) block. We hypothesized that an "eyeball test" of specific infrared thermographic patterns after LIC block could be used to determine block success.

Methods: In this observational study, five observers trained in four distinct thermographic patterns independently evaluated thermographic images of the hands of 40 patients at baseline and at one-minute intervals for 30 min after a LIC block. Read More

J Clin Monit Comput 2018 Aug 4;32(4):779-784. Epub 2017 Sep 4.

Department of Anaesthesiology and Reanimation, Canakkale 18 Mart University, Canakkale, Turkey.

To investigate the topographic anatomy of the median, musculocutaneous, radial and ulnar nerves with respect to the axillary artery and to seek whether these configurations are associated with baseline descriptive data including age, gender, and body-mass index. This cross-sectional trial was carried out on 199 patients (85 women, 114 men; average age: 46.78 ± 15. Read More

Case Rep Cardiol 2017 2;2017:8487056. Epub 2017 Aug 2.

Department of Medicine, Cardiology Division, Brooke Army Medical Center, Ft. Sam Houston, TX, USA.

A 42-year-old male admitted with a non-ST elevation myocardial infarction was referred for invasive angiographic assessment. Based on preprocedural assessment, the right radial artery approach was selected. Despite possessing none of the consensus risk factors for radial artery spasm, in addition to receiving standard arterial spasm prophylaxis and conscious sedation, the patient suffered very severe radial artery spasm with initial catheter placement, resulting in entrapment of a 5 Fr pigtail catheter within the left ventricle. Read More

Can J Anaesth 2017 12 10;64(12):1269-1270. Epub 2017 Aug 10.

Department of Anesthesia and Intensive Care, University Hospital Kerry, Tralee, Ireland.

Plast Reconstr Surg Glob Open 2017 Jun 16;5(6):e1353. Epub 2017 Jun 16.

Department of Plastic Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Sahlgrenska University Hospital, Sweden; Department of Medical Physics and Biomedical Engineering, Sahlgrenska University Hospital, Sweden; Department of Physiology, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Sweden; and Department of Radiology, Sahlgrenska University Hospital, Sweden.

We report on a case of a trans-man patient, who underwent penile reconstruction with the use of a radial forearm flap, urethroplasty, vaginectomy and scrotoplasty, insertion of testicle implants, and penile erection implants, similar to previously described methods. One of the requirements for an ideal phalloplasty is the preservation of erogenous sensitivity, which is often demanded by the patients for fulfilling their sexual well-being. For the first time known to us, we use a functional magnetic resonance imaging following radial forearm flap phalloplasty with nerve anastomosis to assess the cortical activation after clitoral stimulation. Read More

Actas Dermosifiliogr 2017 Dec 12;108(10):947-949. Epub 2017 Jul 12.

Consulta privada, Bilbao, España.

Rev Bras Anestesiol 2018 Jan - Feb;68(1):62-68. Epub 2017 Jun 23.

Universidade Federal de São Paulo (UNIFESP), Escola Paulista de Medicina (EPM), Disciplina de Anestesiologia, Dor e Medicina Intensiva, São Paulo, SP, Brasil.

Introduction: Randomized prospective study comparing two perivascular techniques with the perineural technique for ultrasound-guided axillary brachial plexus block (US-ABPB). The primary objective was to verify if these perivascular techniques are noninferior to the perineural technique.

Method: 240 patients were randomized to receive the techniques: below the artery (BA), around the artery (AA) or perineural (PN). Read More

J Ultrason 2017 Mar 31;17(68):73-75. Epub 2017 Mar 31.

Department of Orthopedic Surgery, Suwa Central Hospital, Chino, Japan.

Posterior interosseous nerve palsy caused by a ganglion is not common and most previous patients were treated with excisional surgery. We treated a case conservatively with needle aspiration using ultrasonography, after a nerve conduction study. A 77-year-old man presented with impaired active finger extension of the left metacarpophalangeal joints. Read More

J Pak Med Assoc 2017 Apr;67(4):508-512

Anesthesiology Department, Ankara Numune Training and Research Hospital, Ankara, Turkey. .

Objective: To evaluate the characteristics of axillary plexus blockade applied using ultrasound only and using ultrasound together with nerve stimulator in patients undergoing planned forearm, wrist or hand surgery.

Methods: This randomised, prospective, double-blinded, single-centre study was conducted at Ankara Numune Training and Research Hospital, Ankara, Turkey, from November 2014 to August 2015, and comprised patients undergoing forearm, wrist or hand surgery. Participants were separated into 2 groups. Read More

BMC Anesthesiol 2017 04 17;17(1):58. Epub 2017 Apr 17.

Department of Anesthesiology, Critical Care and Pain Medicine, The Second Affiliated Hospital and Yuying Children's Hospital of WenZhou Medical University, 109 West Xueyuan Road, Wenzhou, 325027, China.

Background: Mivacurium is the shortest acting nondepolarizing muscle relaxant currently available; however, the effect of different dosages and injection times of intravenous mivacurium administration in children of different ages has rarely been reported. This study was aimed to evaluate the muscle relaxant effects and safety of different mivacurium dosages administered over different injection times in pediatric patients.

Methods: Six hundred forty cases of pediatric patients, aged 2 m-14 years, ASA I or II, were divided into four groups (Groups A, B, C, D) according to the age class (2-12 m, 13-35 m, 3-6 years and 7-14 years) respectively, also each group were divided into four subgroups by induction dose (0. Read More

Biol Open 2017 Apr 15;6(4):425-438. Epub 2017 Apr 15.

Research Institute of Electrical Communication, Tohoku University, 2-1-1 Katahira, Aoba ward, Sendai 980-8577, Japan.

Ophiuroids locomote along the seafloor by coordinated rhythmic movements of multi-segmented arms. The mechanisms by which such coordinated movements are achieved are a focus of interest from the standpoints of neurobiology and robotics, because ophiuroids appear to lack a central nervous system that could exert centralized control over five arms. To explore the underlying mechanism of arm coordination, we examined the effects of selective anesthesia to various parts of the body of ophiuroids on locomotion. Read More

J Vasc Access 2017 Mar 5;18(Suppl. 1):24-28. Epub 2017 Mar 5.

Department of Surgery and Hemodialysis Access Center, Shaare Zedek Medical Center, Jerusalem - Israel.

Autogenous fistulas and in particular radiocephalic fistulas are recommended as the first vascular access for hemodialysis. Unfortunately, the rates of early failure and non-maturation are very high. For more than a decade, brachial plexus block has been proposed as the anesthesia of choice for fistula creation due to its beneficial sympathectomy-like effect, causing vasodilation and attenuation of spasm. Read More

Reg Anesth Pain Med 2017 Jul/Aug;42(4):475-477

From the Department of Anesthesiology, Brooke Army Medical Center, Fort Sam Houston, TX.

Objective: Our objective was to describe the first reported use of an axillary brachial plexus block to treat the entrapment of a transradial artery catheter due to vasospasm.

Case Report: A 42-year-old man undergoing transradial arterial cardiac catheterization suffered arterial vasospasm causing the catheter to become entrapped and refractory to conservative (warm compresses) and standard pharmacologic interventions (intracatheter verapamil, intravenous infusions of nitroglycerin and nicardipine, and subcutaneous lidocaine and topical nitroglycerin). Anesthesia was consulted, and attempts at catheter removal under monitored anesthesia and general anesthesia failed. Read More