scholarly journals Anatomical landmarks for the intercostal nerve blocks: a cross sectional cadaveric study

2019 ◽  
Vol 3 (2) ◽  
pp. 97
Author(s):  
Y. Mathangasinghe ◽  
U. M. J. E. Samaranayake ◽  
R. Wijayasinghe ◽  
M. Manchanayake ◽  
P. D. Seneviratne ◽  
...  
Keyword(s):  
Intercostal Nerve ◽  
Cadaveric Study ◽  
Anatomical Landmarks ◽  
Nerve Blocks ◽  
Cross Sectional

scholarly journals Subparaneural injection in popliteal sciatic nerve blocks evaluated by MRI

Open Medicine ◽  
2019 ◽  
Vol 14 (1) ◽  
pp. 346-353
Author(s):  
Benedikt Büttner ◽  
Alexander Schwarz ◽  
Caspar Mewes ◽  
Katalin Kristof ◽  
José Hinz ◽  
...  
Keyword(s):  
Sciatic Nerve ◽  
Local Anesthetic ◽  
Ultrasound Guidance ◽  
Resonance Imaging ◽  
Nerve Blocks ◽  
Cross Sectional ◽  
Neurological Sequelae ◽  
Patient Reported ◽  
Study Population ◽  
Intraneural Injection

AbstractIntraneural injection of a local anesthetic can damage the nerve, yet it occurs frequently during distal sciatic block with no neurological sequelae. This has led to a controversy about the optimal needle tip placement that results from the particular anatomy of the sciatic nerve with its paraneural sheath.The study population included patients undergoing lower extremity surgery under popliteal sciatic nerve block. Ultrasound-guidance was used to position the needle tip subparaneurally and to monitor the injection of the local anesthetic. Sonography and magnetic resonance imaging were used to assess the extent of the subparaneural injection.Twenty-two patients participated. The median sciatic cross-sectional area increased from 57.8 mm2 pre-block to 110.8 mm2 immediately post-block. An intraneural injection according to the current definition was seen in 21 patients. Two patients had sonographic evidence of an intrafascicular injection, which was confirmed by MRI in one patient (the other patient refused further examinations). No patient reported any neurological symptoms.A subparaneural injection in the popliteal segment of the distal sciatic nerve is actually rarely intraneural, i.e. intrafascicular. This may explain the discrepancy between the conventional sonographic evidence of an intraneural injection and the lack of neurological sequelae.

scholarly journals Visualization of injectate spread of intercostal nerve block: a cadaveric study

2018 ◽  
Vol 4 (1) ◽  
Author(s):  
Yuichi Ohgoshi ◽  
Yosuke Usui ◽  
Satoshi Terada ◽  
Yoshimasa Takeda ◽  
Aiji Ohtsuka ◽  
...  
Keyword(s):  
Nerve Block ◽  
Intercostal Nerve ◽  
Cadaveric Study ◽  
Intercostal Nerve Block

Cadaveric study identifying clinical sonoanatomy for proximal and distal approaches of ultrasound-guided intercostobrachial nerve block

2020 ◽  
Vol 45 (11) ◽  
pp. 853-859
Author(s):  
Artid Samerchua ◽  
Prangmalee Leurcharusmee ◽  
Krit Panjasawatwong ◽  
Kittitorn Pansuan ◽  
Pasuk Mahakkanukrauh
Keyword(s):  
Axillary Artery ◽  
Anatomical Variation ◽  
Intercostal Nerve ◽  
Cadaveric Study ◽  
Ultrasound Guided ◽  
Serratus Anterior ◽  
Adjacent Structures ◽  
Intercostobrachial Nerve ◽  
Inferior Border ◽  
Axillary Branches

Background and objectivesThe intercostobrachial nerve (ICBN) has significant anatomical variation. Localization of the ICBN requires an operator’s skill. This cadaveric study aims to describe two simple ultrasound-guided plane blocks of the ICBN when it emerges at the chest wall (proximal approach) and passes through the axillary fossa (distal approach).MethodsThe anatomical relation of the ICBN and adjacent structures was investigated in six fresh cadavers. Thereafter, we described two potential techniques of the ICBN block. The proximal approach was an injection medial to the medial border of the serratus anterior muscle at the inferior border of the second rib. The distal approach was an injection on the surface of the latissimus dorsi muscle at 3–4 cm caudal to the axillary artery. The ultrasound-guided proximal and distal ICBN blocks were performed in seven hemithoraxes and axillary fossae. We recorded dye staining on the ICBN, its branches and clinically correlated structures.ResultsAll ICBNs originated from the second intercostal nerve and 34.6% received a contribution from the first or third intercostal nerve. All ICBNs gave off axillary branches in the axillary fossa and ran towards the posteromedial aspect of the arm. Following the proximal ICBN block, dye stained on 90% of all ICBN’s origins. After the distal ICBN block, all terminal branches and 43% of the axillary branches of the ICBN were stained.ConclusionsThe proximal and distal ICBN blocks, using easily recognized sonoanatomical landmarks, provided consistent dye spread to the ICBN. We encourage further validation of these two techniques in clinical studies.

Blunt chest wall trauma: an overview

2019 ◽  
Vol 80 (12) ◽  
pp. 711-715
Author(s):  
Jonathan B Simon ◽  
Alex J Wickham
Keyword(s):  
Chest Wall ◽  
Management Strategies ◽  
Anaesthetic Techniques ◽  
Intercostal Nerve ◽  
Pulmonary Complications ◽  
Nerve Blocks ◽  
Chest Wall Mechanics ◽  
Rib Fixation ◽  
Chest Wall Trauma ◽  
Oral Analgesia

Trauma affecting the chest wall, even in isolation, can carry a significant morbidity and mortality and thus appropriate management is vital. Consequences of chest wall trauma may include significant pain, altered chest wall mechanics, hypoventilation, infection and respiratory failure. In order to best determine the appropriate management, risk stratification tools have been developed to identify patients at highest risk of complications who would most benefit from more invasive management strategies. Early optimization of analgesia is vital both for patient experience and to reduce the risk of pulmonary complications. The analgesic options range from multimodal oral analgesia to invasive regional anaesthetic techniques such as thoracic epidurals, paravertebral catheters, intercostal nerve blocks and fascial plane blocks. Other important considerations include provision of appropriate oxygen therapy, ventilation support and physiotherapy. For a selected group of patients with the most significant injuries, surgical rib fixation may be appropriate if chest wall mechanics are sufficiently impaired.

scholarly journals Extradural, paravertebral and intercostal nerve blocks for post-thoracotomy pain

1995 ◽  
Vol 75 (5) ◽  
pp. 541-547 ◽  
Author(s):  
K Perttunen ◽  
E Nilsson ◽  
J Heinonen ◽  
E L Hirvisalo ◽  
J A Salo ◽  
...  
Keyword(s):  
Intercostal Nerve ◽  
Nerve Blocks
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