There are many different approaches to ultrasound-guided supraclavicular brachial plexus block (US-SCBPB), and each has a different success rate and complications. The most commonly performed US-SCBPB is the corner pocket approach in which the needle is advanced very close to the subclavian artery and pleura. Therefore, it may be associated with a risk of subclavian artery puncture or pneumothorax. We advanced the needle into the central part of the neural cluster after penetrating the sheath of the brachial plexus in US-SCBPB. We refer to this new method as the "central cluster approach." In this approach, the needle does not have to advance close to the subclavian artery or pleura. The aim of this study was to evaluate the clinical outcomes of the central cluster approach in US-SCBPB.
The aim of this study was to evaluate changes in RBC aggregation and deformability over 24 hr and suggest specific shear stress values for detecting RBC deformability in a mouse endotoxemia model using lipopolysaccharide (LPS).Six-week-old male BALB/c mice received LPS (20 mg/kg) intraperitoneally. Aggregation indices (AIs) and T1/2 were measured to assess RBC aggregation, and elongation indices (EIs) were used to assess RBC deformability at shear stress values of 0.3, 0.5, 1, 3, 7, 10, 15 and 20 Pascals (Pa) 0, 30 min, 1, 2, 4, 6, 9, 12, 18 and 24 hours after the LPS injection.No significant differences were detected in the AIs during the study period, however, T1/2 shortened significantly 2, 6, 12, 18, and 24 hr after the LPS injection. The EIs increased significantly 24 hr after LPS injection at 0.5 and 1 Pa shear stress, whereas it decreased significantly at 10 Pa of shear stress 24 hr after the LPS injection.Altered RBC deformability was detectable 24 hr after the LPS injection and T1/2 may be a sensitive marker for detecting changes in RBC aggregation. The EIs should be measured at 1 Pa to detect changes in RBC deformability in LPS-induced septic mice.
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