To the Editor:—We read with interest the recent report by Martinez et al. regarding a combined infraclavicular plexus blockade with suprascapular nerve block for humeral head surgery in a patient with severe respiratory failure. However, we have some concerns with regard to the following points: First, it is not clearly stated whether the authors performed an infraclavicular plexus block using ...

BACKGROUND Interscalene brachial plexus block is currently the gold standard for intra- and post-operative pain management for patients undergoing arthroscopic shoulder surgery. However, it is associated with block related complications, of which effect on the phrenic nerve have been of most interest. Side effects caused by general anesthesia, when this is required, are also a concern. We hypot...

Interscalene brachial plexus block for arthroscopic shoulder surgery: a systematic review.

Adjuncts to local anaesthetics for brachial plexus block enhances the quality and duration of analgesia. The purpose of this study was to compare two alpha-2 agonists clonidine and dexmedetomidine, when added as adjuvant to ropivacaine, in respect to onset, duration of sensory and motor block along with duration of analgesia. After informed consent, Sixty ASA I and II patients scheduled for ele...

Brachial plexus regional anesthesia has been a mainstay of the anesthesiologist’s armamentarium since Hall1 first reported the use of cocaine to block upper extremity nerves in 1884. The American Society of Regional Anesthesia and Pain Medicine (ASRA) has sponsored a unique educational endeavor to provide practitioners and academicians alike with a comprehensive resource pertaining to brachial ...

BACKGROUND AND OBJECTIVES Brachial plexus block is used in surgical procedures of the upper limbs. The brachial plexus is a potential territory for absorption of local anesthetics. Studies on bupivacaine isomers have shown reduced cardiovascular toxicity of its levorotatory form (levobupivacaine). However, the anesthetic efficacy (sensorial and motor blockades) of levobupivacaine in neuroaxis b...

Objectives: Alpha-2-receptor agonist has been used as an additive to local anaesthetics for various regional anaesthetic techniques. We compared clonidine and dexmedetomidine as an adjuvant to local anaesthetic agent in ultrasound guided axillary brachial plexus block with respect to hemodynamic parameters, onset and duration of sensory, motor block and duration of analgesia. Methods: Ultrasoun...

Background The supraclavicular approach is considered to be the easiest and most effective approach to block the brachial plexus for upper limb surgeries. The classical approach using the anatomical landmark technique was associated with higher failure rates and complications. Ultrasonography (USG) guidance and peripheral nerve stimulator (PNS) have improved the success rates and safety margin....

This prospective comparative clinical study was performed to evaluate the effect of triamcinolone when added to bupivacaine during brachial plexus blockade in patients undergoing shoulder surgery. Interscalene brachial plexus blocks were performed on 910 patients before shoulder surgery. Of the patients, 574 were randomly allocated to receive steroids added to the injected local anesthetic and ...

BACKGROUND Emergency physicians often treat patients who require procedural sedation for the management of upper extremity fractures, dislocations, and abscesses (upper extremity emergencies). Unfortunately, procedural sedation is associated with several rare but potentially serious adverse effects and requires continuous hemodynamic monitoring and several dedicated staff members. The purpose o...