We wanted to determine whether 1 of 3 brachial plexus blocks was best for one of our most common surgeries, the cubital tunnel release with or without transposition of the ulnar nerve. Brachial plexus blocks can provide excellent results for upper extremity surgery, but we noticed inexplicable block failure for cubital tunnel releases with an incision in the proximal arm. In this case series, w...

BACKGROUND There is some debate about the proper site and arm position and the direction of the needle for the performance of ultrasound guided infraclavicular block. METHODS Using ultrasound, we compared the ease and success rate of a medial or a lateral approach to the brachial plexus for performing infraclavicular block in two groups of patients (n=202). The proximity of the needle to the ...

Three methods of blocking the brachial plexus with a supraclavicular approach are presented. The pros and cons of using this technique, as well as its usefulness, are discussed. The four most commonly used drugs for blocks also are examined. A 270% increase in blood flow to the arm is achieved by this block but, with the addition of epinephrine, it can be increased to 430%. The permeability of ...

To the Editor, We read with great interest the recently reported study of Chan et al.1 This study warrants comment due to the low success rates reported after axillary brachial plexus block, despite the authors’ internationally recognized experience with these techniques. The study compared regional anesthesia of the upper limb using an ultrasound-guided (US) approach (the most expensive techni...

Introduction The brachial plexus is a complex network of nerves extending from the neck to axilla supplying motor sensory and sympathetic fibers to the upper extremity and superficial muscles of the back. It is formed by the fusion of the anterior primary rami of the C5, C6, C7, C8, and T1 spinal nerves, with occasional communications from C4 and T2 making it either pre-fixed or post-fixed, res...

Background and objectives The paraneural sheath is a multilayered network of collagen fibers that surround the brachial plexus. Currently, there are no sonographic data on plexus, which this study aimed to evaluate. Methods Ultrasound imaging datasets 100 patients who received costoclavicular plexus block, using high-definition ultrasound imaging, were retrospectively reviewed. Video files, rep...

BACKGROUND The brachial plexus at the infraclavicular level runs deeper compared to its course proximally, giving rise to impaired needle visualisation due to the steep angle of needle insertion with the current ultrasound-guided approach. A new posterior parasagittal in-plane ultrasound-guided infraclavicular approach was introduced to improve needle visibility. However no further follow up st...

Background: Schwannoma is a benign encapsulated nerve sheath tumour that arises from the Schwann cells along course of and can affect third to 12th cranial nerves, peripheral autonomic nerves. was first described by Verocay in 1908. rarely affects brachial plexus, accounting for 5% all cases schwannoma. Case: 38year old female patient presented with left axillary mass noticed since 1 year. The ...

BACKGROUND This randomized, double-blinded, placebo-controlled study investigated the efficacy of patient-controlled regional analgesia using an infraclavicular brachial plexus perineural catheter and a portable infusion pump for outpatients undergoing moderately painful, upper extremity orthopedic surgery. METHODS Preoperatively, patients (n = 30) received an infraclavicular nerve block and ...

BACKGROUND The optimal site for local anesthetic placement during ultrasound-guided infraclavicular block remains controversial. METHODS Patients were randomized to receive lidocaine 2% 30 mL as a single injection posterior to the axillary artery (n = 51) or a triple injection ideally adjacent to each brachial plexus cord (n = 49). Pinprick sensory and motor block (3 = no block, 0 = complete ...