Plexus brachialis block as part of balanced analgesia in a sheep undergoing arthrodesis of the carpus

2019 ◽  
Vol 46 (5) ◽  
pp. 710-711
Author(s):  
Anneleen J.H.C. Michielsen ◽  
Stijn Schauvliege
Keyword(s):  
Plexus Brachialis ◽  
Balanced Analgesia

Mammakarzinom: Plastisch-chirurgische Strategie bei ausgedehnten Thoraxwandrezidiven und Infiltration des Plexus brachialis

2005 ◽  
Vol 127 (06) ◽  
pp. 407-411 ◽  
Author(s):  
P. Vogt ◽  
K. Busch ◽  
M. Spies ◽  
L. Lahoda ◽  
S. Kall ◽  
...  
Keyword(s):  
Plexus Brachialis ◽  
Chirurgische Strategie

Schadensersatz wegen falscher Lagerung während einer OP

2007 ◽  
Vol 12 (05) ◽  
pp. 17-17
Keyword(s):  
Plexus Brachialis

Sachverhalt: Der Kläger beansprucht Schadensersatz und Schmerzensgeld aufgrund behaupteter ärztlicher Behandlungs- und Aufklärungsfehler. Neben einer (angeblich) unzureichenden Aufklärung im Zusammenhang mit der bei der Operation eines Hodenbruchs vorgenommenen Rückenlagerung habe eine nicht sachgerechte Lagerung zur Schädigung des rechten Plexus brachialis geführt.

Prolonged brachial plexus neuropathy: a rare complication following protracted endometriosis surgery in Lloyd-Davies position

2021 ◽  
Vol 14 (11) ◽  
pp. e243408
Author(s):  
Anna Katrina Hay ◽  
Anna McDougall ◽  
Peter Hinstridge ◽  
Sanjeev Rajakuldendran ◽  
Wai Yoong
Keyword(s):  
Brachial Plexus ◽  
Brachial Plexus Injury ◽  
Rare Complication ◽  
Patient Positioning ◽  
Sensory Innervation ◽  
Plexus Brachialis ◽  
Clinical Anatomy ◽  
Reduction Strategies ◽  
Risk Reduction Strategies ◽  
Endometriosis Surgery

Brachial plexus injury is a rare but potentially serious complication of laparoscopic surgery. Loss of motor and/or sensory innervation can have a significant impact on the patient’s quality of life following otherwise successful surgery. A 38-year-old underwent elective laparoscopic management of severe endometriosis during which she was placed in steep head-down tilt Lloyd-Davies position for a prolonged period. On awakening from anaesthesia, the patient had no sensation or movement of her dominant right arm. A total plexus brachialis injury was suspected. As advised by a neurologist, an MRI brachial plexus, nerve conduction study and electromyography were requested. She was managed conservatively and made a gradual recovery with a degree of residual musculocutaneous nerve neuropathy. The incidence of brachial plexus injury following laparoscopy is unknown but the brachial plexus is particularly susceptible to injury as a result of patient positioning and prolonged operative time. Patient positioning in relation to applied clinical anatomy is explored and risk reduction strategies described.

scholarly journals Multimodal Analgesia in Perioperative Settings: Improvement Perspectives / Multimodāla Analgēzija Perioperatīvajā Periodā: Uzlabošanas Iespējas

2014 ◽  
Vol 68 (5-6) ◽  
pp. 222-227
Author(s):  
Iveta Golubovska ◽  
Aleksejs Miščuks ◽  
Ēriks Rudzītis
Keyword(s):  
Pain Management ◽  
Lower Extremity ◽  
Pain Intensity ◽  
Severe Pain ◽  
Rating Scale ◽  
Multimodal Analgesia ◽  
Numeric Rating Scale ◽  
Plexus Brachialis ◽  
Single Shot ◽  
Maximum Pain

Abstract The aim of this study was to evaluate the intensity of pain in orthopaedic hospital patients and to identify unsatisfactory pain management and possibilities for improvements in the future. Data collection included Numeric Rating Scale (NRS) scores, which characterised the intensity of pain. Maximum pain on the day of surgery, mean pain on the day of surgery (D0), and mean pain on first (D1) and second (D2) postoperative days were documented. The pain of an intensity from 0 to 3 was defined as mild pain, 4 to 6 as moderate pain, and 6 to 10 as severe pain. Maximum severe pain intensity on the day of surgery was experienced by 20.5% of patients, moderate by 45.8%, and mild by 33.6%. The reported mean pain intensity according to type of surgery was as follows: hip replacement- 2.79 ± 1.6 (D0), 2.09 ± 1.4 (D1), and 1.35 ± 1.2 (D2); knee replacement - 3.39 ± 1.7 (D0), 2.98 ± (D1), 1.82 ± 1.36, and (D2); upper extremity surgery - 3.59 ± 1.9 (D0), 3.4 ± 1.7 (D1), and 2.1 ± 1.5 (D2); lower extremity surgery - 4.1 ± 2.1 (D0), 3.49 ± 1.42 (D1), and 2.58 ± 1.4 (D2); spine surgery - 3.31 ± 1.58 (D0), 2.88 ± 1.96 (D1), and 1.83 ± 1.74 (D2). Patients in the lower extremity group experienced unacceptable mean pain. The maximum pain intensity on day of surgery was experienced by patients after single-shot plexus brachialis block anaesthesia (5.24 ± 2.4). Well-designed multimodal analgesia with special attention to single shot techniques may improve pain management and functional outcomes after orthopaedic surgery.

Operative Behandlung von geburtstraumatischen Läsionen des Plexus brachialis

1997 ◽  
Vol 145 (10) ◽  
pp. 1080-1085 ◽  
Author(s):  
G. Antoniadis ◽  
K. Mohr ◽  
V. Braun ◽  
H.-P. Richter
Keyword(s):  
Operative Behandlung ◽  
Plexus Brachialis

scholarly journals ANALYSIS OF THE ANATOMIC VARIATIONS OF THE BRACHIAL PLEXUS AND ITS BRANCHES AT THE LEVEL OF FORMATION AND BRANCHING OF ITS TRUNCI

2018 ◽  
pp. 001
Author(s):  
Milutin Mrvaljević ◽  
Srbislav Pajić ◽  
Pavle Popović ◽  
Jovan Grujić ◽  
Marko Petrović ◽  
...  
Keyword(s):  
Brachial Plexus ◽  
Traffic Accidents ◽  
Anterior Part ◽  
Nerve Fibers ◽  
Plexus Brachialis ◽  
Systematic Research ◽  
Upper Arm ◽  
Anterior Edge ◽  
Wide Range ◽  
Spinal Roots

Although the terminal branches of brachial plexus that originate from lateral and medial fasciculus are well protected by muscle mass and vascular-neuronal petal of axilla and upper arm, the number of traumatic damage and injuries increases, according to the published reports of neurosurgeons working on pathology of peripheral nerves, as well as traumatologists, orthopedics, microsurgeons and plastic surgeons. This is certainly contributed by urbanization, industrialization, migration and increased number of traffic accidents. Knowing the microstructure of the peripheral nerve truncus leads to the possibility of applying various techniques of nerve grafting, as well as possibility of re-implantation of detached spinal roots, seen in traction injuries of brachial plexus, in which the mechanism of injury needs to be considered. Considering frequent injuries of terminal branches of lateral and medial fasciculus and a substantial pathology of plexus brachialis, the aim of our research was to study surgical-anatomical relations between terminal branches of medial and lateral fasciculus and substantial morphology of terminal branches of both fasciculi, particularly regarding the place and way of formation, as well as the number of their anastomoses. The studies of the terminal branches of medial and lateral fasciculus on our preparation materials are based on the dissection of axilla and anterior part of the upper arm, on 50 cadavers, adults of both genders, at Institute of Anatomy and Institute of Forensic Medicine at School of Medicine in Belgrade. The way of formation of the terminal branches of lateral fasciculus on our preparation materials was always the same. These branches were usually formed after the bifurcation or diverging of lateral fasciculus to radix lateralis nervi mediani and musculocutaneous nerve. Exceptionally, after fusion of lateral fasciculus and medial root of nervus medianus, there is no bifurcation, and formed nervous truncus is a result of existence of the pre- or postfixational type of brachial plexus. Analyzing our preparation materials, we determined that high bifurcation of lateral fasciculus (LF) exists in 18% of cases and that it is projected in the line of anterior edge of clavicle. Medium high bifurcation of LF is projected in the line of the top of the acromion of scapula and is seen in 61% of all cases. Low bifurcation is usually placed in the line of inferior edge of pectoral minor muscle, in 8% of cases. Fasciculus without bifurcation is noticed in 13% of cases. Measuring the shortest distance between anterior edge of clavicle and the point of bifurcation of LF resulted in a wide range from 0.5 to 9.7 cm, with 4.2 cm average. In cases of transplantation, implantation and re-implantation of nervous trunci of plexus brachialis, it is very important to consider the shape and the thickness of nervous truncus, the number of fasciculi, the number of nerve fibers, as well as the quantity and schedule of peri- and intrafascicular connective tissue, providing the normal irrigation of the nerve. Finally, we can conclude that mentioned facts prompted us to undertake a systematic research of great terminal branches of plexus brachialis that originate from lateral and medial fasciculus, trying to ensure that our anatomical findings receive a comprehensive clinical confirmation.

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