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The anesthetic considerations while performing supraclavicular brachial plexus block in emergency surgical patients using a nerve stimulator
Regional anesthesia is favored in patients who undergo emergency extremity (limb) surgery, and specifically so in the absence of fasting status. In the absence of ultrasonic guidance, the nerve stimulator still remains a valuable tool in performing a brachial block, but its use is difficult in an em...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Medknow Publications & Media Pvt Ltd
2015
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4563968/ https://www.ncbi.nlm.nih.gov/pubmed/26417145 http://dx.doi.org/10.4103/0259-1162.156369 |
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author | Tantry, Thrivikrama Padur Shetty, Pramal Shetty, Rithesh Shenoy, Sunil P. |
author_facet | Tantry, Thrivikrama Padur Shetty, Pramal Shetty, Rithesh Shenoy, Sunil P. |
author_sort | Tantry, Thrivikrama Padur |
collection | PubMed |
description | Regional anesthesia is favored in patients who undergo emergency extremity (limb) surgery, and specifically so in the absence of fasting status. In the absence of ultrasonic guidance, the nerve stimulator still remains a valuable tool in performing a brachial block, but its use is difficult in an emergency surgical patient and greater cautious approach is essential. We identified the supraclavicular plexus by the nerve stimulation-motor response technique as follows. Anterior chest muscles contractions, diaphragmatic contraction, deltoid contractions, and posterior shoulder girdle muscle contractions when identified were taken as “negative response” with decreasing stimulating current. A forearm muscle contraction, especially “wrist flexion” and “finger flexion” at 0.5 mA of current was taken as “positive response.” If no positive response was identified, the “elbow flexion” was considered as the final positive response for successful drug placement. The series of patients had difficulty for administering both general and regional anesthesia and we considered them as complex scenarios. The risk of the block failure was weighed heavily against the benefits of its success. The described series includes patients who had successful outcomes in the end and the techniques, merits, and risks are highlighted. |
format | Online Article Text |
id | pubmed-4563968 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | Medknow Publications & Media Pvt Ltd |
record_format | MEDLINE/PubMed |
spelling | pubmed-45639682015-09-28 The anesthetic considerations while performing supraclavicular brachial plexus block in emergency surgical patients using a nerve stimulator Tantry, Thrivikrama Padur Shetty, Pramal Shetty, Rithesh Shenoy, Sunil P. Anesth Essays Res Case Report Regional anesthesia is favored in patients who undergo emergency extremity (limb) surgery, and specifically so in the absence of fasting status. In the absence of ultrasonic guidance, the nerve stimulator still remains a valuable tool in performing a brachial block, but its use is difficult in an emergency surgical patient and greater cautious approach is essential. We identified the supraclavicular plexus by the nerve stimulation-motor response technique as follows. Anterior chest muscles contractions, diaphragmatic contraction, deltoid contractions, and posterior shoulder girdle muscle contractions when identified were taken as “negative response” with decreasing stimulating current. A forearm muscle contraction, especially “wrist flexion” and “finger flexion” at 0.5 mA of current was taken as “positive response.” If no positive response was identified, the “elbow flexion” was considered as the final positive response for successful drug placement. The series of patients had difficulty for administering both general and regional anesthesia and we considered them as complex scenarios. The risk of the block failure was weighed heavily against the benefits of its success. The described series includes patients who had successful outcomes in the end and the techniques, merits, and risks are highlighted. Medknow Publications & Media Pvt Ltd 2015 /pmc/articles/PMC4563968/ /pubmed/26417145 http://dx.doi.org/10.4103/0259-1162.156369 Text en Copyright: © Anesthesia: Essays and Researches http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Case Report Tantry, Thrivikrama Padur Shetty, Pramal Shetty, Rithesh Shenoy, Sunil P. The anesthetic considerations while performing supraclavicular brachial plexus block in emergency surgical patients using a nerve stimulator |
title | The anesthetic considerations while performing supraclavicular brachial plexus block in emergency surgical patients using a nerve stimulator |
title_full | The anesthetic considerations while performing supraclavicular brachial plexus block in emergency surgical patients using a nerve stimulator |
title_fullStr | The anesthetic considerations while performing supraclavicular brachial plexus block in emergency surgical patients using a nerve stimulator |
title_full_unstemmed | The anesthetic considerations while performing supraclavicular brachial plexus block in emergency surgical patients using a nerve stimulator |
title_short | The anesthetic considerations while performing supraclavicular brachial plexus block in emergency surgical patients using a nerve stimulator |
title_sort | anesthetic considerations while performing supraclavicular brachial plexus block in emergency surgical patients using a nerve stimulator |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4563968/ https://www.ncbi.nlm.nih.gov/pubmed/26417145 http://dx.doi.org/10.4103/0259-1162.156369 |
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