Search Our Scientific Publications & Authors

Vet Anaesth Analg 2020 May 15. Epub 2020 May 15.

Department of Comparative, Diagnostic, and Population Medicine, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA.

Objective: To describe a lateral ultrasound (US)-guided approach to the radial, ulnar, median and musculocutaneous (RUMM) nerves through a single proximal in-plane insertion in cats and to determine whether one or two injection points are required to successfully stain all the target nerves.

Study Design: Prospective study.

Animals: A total of eight client-owned healthy cats and 12 cat cadavers. Read More

J Reconstr Microsurg 2020 Jul 29. Epub 2020 Jul 29.

Department of Plastic and Reconstructive Surgery, Johns Hopkins School of Medicine, Baltimore, Maryland.

Background:  The radial forearm free flap (RFFF) is a staple of microsurgical reconstruction. Significant attention has been paid to donor-site morbidity, particularly vascular and aesthetic consequences. Relatively few authors have discussed peripheral nerve morbidity such as persistent hypoesthesia, hyperesthesia, or allodynia in the hand and wrist or neuroma formation in the wrist and forearm. Read More

Muscle Nerve 2020 Jun 18. Epub 2020 Jun 18.

Clinical Unit "Eleous" at Religious Community "All Saints Parish in Minsk Eparchy of Belarusian Orthodox Church,", Minsk, Belarus.

Introduction: The main goal of this study was to determine the contribution of the anterior forearm muscles to the compound muscle action potential (CMAP) recorded from the extensor digitorum (ED) after proximal stimulation.

Methods: Twenty-one healthy volunteers and 114 patients with compressive and traumatic radial neuropathies were examined. Stimulation was carried out at six different points: distal third of the upper arm; Erb's point; axilla; medial upper arm; antecubital fossa; and ulnar groove. Read More

JSES Int 2020 Mar 16;4(1):21-24. Epub 2019 Dec 16.

Department of Orthopaedic Surgery, Yamagata University Faculty of Medicine, Yamagata, Japan.

Background: A number of treatments for lateral epicondylitis of the elbow have been described. We have developed a strategy for the treatment of this condition.

Methods: We diagnosed lateral epicondylitis of the elbow in 86 patients. Read More

BMC Anesthesiol 2020 May 28;20(1):130. Epub 2020 May 28.

Laboratory and Clinical Research Institute for Pain, Department of Anaesthesiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Queen Mary Hospital, Room 424, Block K, 102, Pokfulam Road, Hong Kong SAR, China.

Background: It is unclear whether regional anesthesia with infraclavicular nerve block or general anesthesia provides better postoperative analgesia after distal radial fracture fixation, especially when combined with regular postoperative analgesic medications. The aim of this study was to compare the postoperative analgesic effects of regional versus general anesthesia.

Methods: In this prospective, observer blinded, randomized controlled trial, 52 patients undergoing distal radial fracture fixation received either general anesthesia (n = 26) or regional anesthesia (infraclavicular nerve block, n = 26). Read More

Am Fam Physician 2020 Jun;101(11):654-664

Uniformed Services University of the Health Sciences, Bethesda, MD, USA.

Procedural anesthesia is administered by family physicians for a variety of conditions, including neuropathies, fracture reduction, foreign body removals, and complex wound management. A nerve block may be preferred because it provides effective regional anesthesia with less anesthetic. Nerve blocks require a thorough understanding of relevant anatomy, aiding the physician in optimizing the anesthesia effect while minimizing complications. Read More

Anesth Pain Med 2019 Dec 1;9(6):e92695. Epub 2019 Dec 1.

Department of Anesthesiology, Pain Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

Background: Regional anesthesia provides safe anesthesia for upper extremity surgery. Axillary plexus block approach for hand and forearm surgery is commonly used. The use of adjuvants in combination with local anesthetics for peripheral nerve blocks enhances the quality and duration of anesthesia and postoperative analgesia. Read More

Pak J Pharm Sci 2020 Jan;33(1):79-83

Tracheal Diseases Research Center, Department of Anesthesiology and Critical Care, Akhtar Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Higher sodium ions in saline diluted local anesthetic may reduce the anesthetic action of the drug as injected around the nerves. However, the impact of local anesthetic dilution agents on the quality of peripheral nerve blockades has not yet been widely investigated. This study was aimed at evaluating the impact of lidocaine dilution with normal saline vs dextrose 5% on onset time of supraclavicular approach to brachial plexus block. Read More

Eur J Pain 2020 May 27;24(5):956-966. Epub 2020 Feb 27.

Department of Human Neuroscience, Sapienza University, Rome, Italy.

Background: In this neurophysiological study, we aimed at verifying the nociceptive selectivity of the new, micropatterned electrode (150IDE), recently designed to generate an electric field limited to the intraepidermal free nerve endings.

Methods: Using the new 150IDE, we recorded evoked potentials after stimulation of the face and hand dorsum in 22 healthy participants and in patients with exemplary conditions selectively affecting the nociceptive system. We also measured the peripheral conduction velocity at the upper arm and verified the nociceptive selectivity of 150IDE assessing the effect of a selective block of nociceptive nerve fibres of radial nerve with local anaesthetic infiltration. Read More

Cochrane Database Syst Rev 2020 02 7;2:CD006080. Epub 2020 Feb 7.

Cairo University, KasrAlAiny School of Medicine, Cairo, Egypt.

Background: Fracture of the distal radius is a common clinical problem. A key method of surgical fixation is percutaneous pinning, involving the insertion of wires through the skin to stabilise the fracture. This is an update of a Cochrane Review published in 2007. Read More

Oper Orthop Traumatol 2020 Feb 2;32(1):23-28. Epub 2020 Jan 2.

Klinik für Unfallchirurgie, Orthopädie und Plastische Chirurgie, Universitätsmedizin Göttingen, Göttingen, Deutschland.

Objective: Peripheral nerve blocks in hand surgery.

Indications: Short operations on the hand.

Contraindications: Long operations, polyneuropathy, local anesthesia allergy. Read More

BMJ Case Rep 2019 Dec 23;12(12). Epub 2019 Dec 23.

Department of Neurological Surgery, Radiology and Mechanical Engineering and Stroke and Applied Neuroscience Center, University of Washington, Seattle, Washington, USA.

Access site complications from transradial approaches for endovascular interventions are uncommon and many are preventable. Complications described in the literature include hematoma, radial artery occlusion, vasospasm, and even compartment syndrome. Mild post-procedure discomfort reported by patients is typically self-limited and managed symptomatically with oral analgesics. Read More

Anaesth Intensive Care 2019 Nov;47(6):532-540

Department of Anaesthesia and Pain Management, Concord Repatriation General Hospital, Sydney, Australia.

Anaesthesia 2019 Dec 3. Epub 2019 Dec 3.

Department of Anesthesia, Peri-operative Medicine and Pain Management, Dalhousie University, Nova Scotia Health Authority and IWK Health Centre, Halifax, NS, Canada.

The objective of this study was to evaluate whether the failure rate of ultrasound-guided axillary brachial plexus block is similar in obese patients compared with non-obese patients when performed as the primary anaesthetic technique. We recruited 105 obese (body mass index ≥ 30 kg.m ) and 144 non-obese patients to this prospective, observational, cohort study conducted at two Canadian centres. Read More

Vet Anaesth Analg 2020 Jan 17;47(1):82-87. Epub 2019 Aug 17.

Department of Surgery, School of Veterinary Medicine and Animal Science, University of São Paulo, São Paulo, SP, Brazil.

Objective: To provide ultrasonographic mapping of the axillary region of dogs to facilitate identification of the major branches of the brachial plexus in relation to the axillary artery.

Study Design: Prospective study.

Animals: A total of two dog cadavers and 50 client-owned, healthy dogs weighing >15 kg. Read More

J Pediatr Orthop B 2020 Mar;29(2):126-132

Department of Plastic, Reconstructive and Hand Surgery, Oxford University Hospitals NHS Foundation Trust, Headington, Oxford, UK.

Traumatic and iatrogenic neurological complications associated with paediatric supracondylar humeral fractures are well recognised. The severity of the nerve injury associated with supracondylar humeral fractures can be difficult to assess clinically and relies upon clinical progression or absence of recovery and neurophysiology. It is accepted that complete nerve palsy with neurophysiological complete block and absence of clinical recovery after three months requires surgical exploration and reconstruction. Read More

J Anaesthesiol Clin Pharmacol 2019 Jul-Sep;35(3):373-378

Department of Anaesthesiology, Pramukhswami Medical College, Karamsad, Anand, Gujarat, India.

Background And Aims: This study aims to compare the single-point injection and double-point injection technique of ultrasound-guided supraclavicular block with regard to the success rate, time taken to perform the procedure, onset and duration of sensory and motor block, and complications.

Material And Methods: A total of 60 American Society of Anesthesiologists physical status I and II patients between 20 and 50 years of age, with body mass index ≤30 kg/m posted for forearm surgeries, with anticipated surgical duration more than 1 h were randomly divided into two groups: group S (single-point injection) and group D (double-point injection technique). After locating the brachial plexus with ultrasound, needle was inserted from lateral to medial direction to reach the plexus. Read More

Eplasty 2019 29;19:e19. Epub 2019 Jul 29.

Division of Plastic Surgery, University of Louisville, Louisville.

Carpal tunnel syndrome is the most common entrapment neuropathy involving the upper extremity. As such, various nonoperative techniques have been developed to aid in management of mild to moderate disease, including local steroid injection. However, definitive guidelines for needle/injection location have not been defined, especially in relation to diminishment of iatrogenic injury to the median nerve. Read More

Zhen Ci Yan Jiu 2019 Aug;44(8):594-8

Department of Anesthesiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang Province, China; Wencheng County People's Hospital, Wenzhou 325300, Zhejiang Province.

Objective: To investigate the effect of transcutaneous electrical acupoint stimulation (TEAS) on pulmonary function, superoxide dismutase (SOD) activity, and malondialdehyde (MDA) content in patients using tourniquet after lower extremity surgery.

Methods: A total of 40 patients who underwent lower extremity surgery were equally randomized into control group and TEAS group by using a random number table. All patients underwent lumbar epidural anesthesia combined with block anesthesia. Read More

Clin Anat 2020 May 22;33(4):578-584. Epub 2019 Aug 22.

CEU San Pablo University School of Medicine, Madrid, Spain.

Axillary plexus blockade is a common technique in clinical practice with a well-known pattern of structures around the brachial artery. Historically, the only proper response to radial nerve stimulation was considered to be extension of the hand and wrist. Twenty-five axillary blockades were assessed by ultrasound and neurostimulation; the principal objective was to correlate the needle position over the radial nerve with the anatomical and histological structure of that nerve. Read More

Medicina (Kaunas) 2019 Jul 23;55(7). Epub 2019 Jul 23.

First Department of Anesthesiology, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece.

Brachial plexus block is commonly used in shoulder surgery, as it provides satisfactory surgical conditions and adequate postoperative pain control. However, there are contradictory reports regarding the addition of tramadol to the injected regional anesthetic solution. We performed a prospective randomized study to evaluate the effectiveness of tramadol as an adjuvant to ropivacaine during interscalene brachial plexus block and assess its impact on the opioid consumption and the early postoperative pain in patients that underwent shoulder surgery. Read More

J Bone Joint Surg Am 2019 Jul;101(13):1168-1176

Department of Clinical Science and Education, Karolinska Institutet, Södersjukhuset, Stockholm, Sweden.

Background: Most patients undergoing surgery for the treatment of a distal radial fracture are treated in a day-surgery setting and are given either general anesthesia (GA) or regional anesthesia (RA). The main purpose of this study was to investigate the impact of the anesthesia method on patients' postoperative opioid consumption during the first 3 days following surgery.

Methods: This was a single-center randomized clinical trial. Read More

World J Clin Cases 2019 May;7(10):1191-1199

Department of Orthopedics, The Second Xiangya Hospital, Central South University, Changsha 410011, Hunan Province, China.

Background: Joint stiffness after elbow surgery is not a rare complication, and is always accompanied by deformity. The causes of joint stiffness are multiple in different patients, and divided into intrinsic and extrinsic causes. Herein, we report an unusual case of posttraumatic elbow stiffness due to multiple and rare causes. Read More

Acta Clin Croat 2018 Sep;57(3):487-496

1Faculty of Medicine, University of Belgrade, Belgrade, Serbia; 2Department of Peripheral Nerve Surgery, Functional Neurosurgery and Pain Management Surgery, Clinic for Neurosurgery, Clinical Center of Serbia, Belgrade, Serbia; 3Section for Neurosurgery, Department of Surgery, Ćuprija General Hospital, Ćuprija, Serbia; 4Department of Neurosurgery, Military Medical Academy, Belgrade, Serbia; 5Department of Neurosurgery, Kragujevac Clinical Center, Kragujevac, Serbia; 6Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia; 7Neuroradiology Department, Center for Radiology and MRI, Clinical Center of Serbia, Belgrade, Serbia; 8Department of Neurosurgery, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia; 9University of Applied Health Sciences.

- Missile injuries are among the most devastating injuries in general traumatology. Traumatic brachial plexus injuries are the most difficult injuries in peripheral nerve surgery, and most complicated to be surgically treated. Nevertheless, missile wounding is the second most common mechanism of brachial plexus injury. Read More

Vet Anaesth Analg 2019 Jul 9;46(4):523-528. Epub 2019 Mar 9.

The University Veterinary Teaching Hospital, The School of Veterinary Science, The University of Sydney, Camperdown, New South Wales, Australia. Electronic address:

Objective: To compare two needle insertion techniques in a novel lateral approach to the radial, ulnar, median and musculocutaneous (RUMM) nerve block in cat cadavers.

Study Design: Prospective, cadaveric experimental study.

Animals: A group of 18 feline cadavers. Read More

J Hand Surg Eur Vol 2019 Nov 1;44(9):932-936. Epub 2019 May 1.

Department of Anatomy, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka.

The purpose of this study was to identify surface anatomy of digital nerves in relation to the pigmented border of digits. Three-hundred and sixty digital nerves in 36 preserved adult cadaveric hands were dissected under magnification. The digital nerves were constantly located anterior to the pigmented border. Read More

Anesth Essays Res 2019 Jan-Mar;13(1):163-168

Department of Community Medicine, Shri B. M. Patil Medical College and Hospital, Vijayapura, Karnataka, India.

Background: Axillary brachial plexus block (ABPB) is safest among other methods of brachial plexus block because of its ease and reliability. The two approaches of ultrasonography-guided ABPB are perivascular (PV) and perineural (PN).

Aims: This study was conducted to compare primary outcomes such as performance time, onset of the block, number of needle passes, block success rate, duration of sensory and motor block, and complications between ultrasound-guided PV and PN ABPB in patients posted for upper limb surgeries. Read More

Vet Anaesth Analg 2019 May 25;46(3):384-394. 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 Jun;12(11):426-429

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

PM R 2019 06 7;11(6):665-668. Epub 2019 Mar 7.

Non-surgical Sports Medicine Division, Andrews Sports Medicine and Orthopedic Center, Andrews Sports Medicine Institute, Birmingham, AL.

De Quervain tenosynovitis is an overuse syndrome associated with inflammation of the tendons in the first dorsal compartment of the wrist. Management includes activity modification, splinting, and corticosteroid injections. In refractory cases, surgical release may be performed, which may be complicated by incomplete release, tendon subluxation, or radial nerve injury. 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

J Hand Surg Eur Vol 2019 Mar 3;44(3):310-316. Epub 2018 Dec 3.

Consultant Hand and Orthopaedic Trauma Surgeon, The Royal Alexandra Hospital, NHS Greater Glasgow and Clyde, Paisley, Scotland, UK.

Isolated posterior interosseous nerve palsy is an uncommon condition and its management is controversial. Existing literature is sparse and a treatment algorithm based on existing best evidence is absent. A comprehensive review was undertaken to elucidate the causes of spontaneous posterior interosseous nerve palsy and suggest a management strategy based on the current evidence. 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

PM R 2019 01 16;11(1):90-93. Epub 2019 Jan 16.

Department of Physical Medicine and Rehabilitation, University of Texas Health Sciences Center at Houston, Houston, and TIRR Memorial Hermann, Houston, TX.

This case describes a 16-year-old boy who suffered a severe traumatic brain injury. The patient gradually recovered but developed debilitating spasticity mainly in left triceps muscle, abnormal positioning of shoulder girdle complex, and shoulder pain. Phenol (6%) was injected to axillary and radial nerves under the guidance of electrical stimulation and ultrasound imaging at 10 weeks after the initial injury. 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