Axillary brachial plexus block for treatment of severe forearm ischemia after arterial cannulation in an extremely low birth‐weight infant

Breschan, Christian; Kraschl, Raimund; Jost, Robert; Marhofer, Peter; Likar, Rudolf

doi:10.1111/j.1460-9592.2004.01282.x

Cited by 47 publications

(28 citation statements)

References 14 publications

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“…The report by Bhakta and Zaheer 1 suggests that RAS is mediated by selective activation of sympathetic axons innervating the radial artery. This hypothesis is supported by a smattering of reports indicating that block of sympathetic outflow, secondary to stellate ganglion block 13 or brachial plexus block, 14,15 can reduce RAS. In a related manner, a ''preemptive'' stellate ganglion block, prior to harvesting the radial artery as a graft for coronary artery bypass, can improve graft blood flow by decreasing the severity of its spasm.…”

mentioning

confidence: 82%

Radial artery spasm: Should we worry?

Backman

2017

Can J Anesth/J Can Anesth

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mentioning

confidence: 82%

Radial artery spasm: Should we worry?

Backman

2017

Can J Anesth/J Can Anesth

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“…In the modern medical field, variations in the positional relationships of the brachial plexus and axillary arteries may be associated with unexpected failure or complications of clinical procedures. For example, positional variation of the axillary artery may result in incomplete axillary block (Stan et al, 1995) since it is the palpable landmark of the axillary sheath when performing an axillary anesthetic block (Breschan et al, 2004). This kind of variation may also increase the incidence of brachial plexus injury after cannulation (Sabik et al, 2004).…”

Section: Segmental Arterial Variation With Unified Cordsmentioning

confidence: 99%

Intersegmental origin of the axillary artery and accompanying variation in the brachial plexus

2009

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The wide anatomical variation of the brachial plexus and the axillary artery has been thoroughly explored in previous studies. However, there has been little information reported on the variation in the relationship between the brachial plexus and the axillary artery. The principal feature of this relationship is the passage of the axillary artery through the loop of the median nerve, which occurs in normal arteries derived from the seventh intersegmental artery. In this study, we analyzed the abnormal position and course of the axillary artery related to the brachial plexus in 607 axillae of 306 cadavers. We found 12 unusual axillary arteries that did not pass through the median loop. Eleven arteries were determined to be ninth intersegmental arteries and one as the sixth intersegmental artery. All ninth intersegmental arteries ran caudally to the brachial plexus. In six cases of this type, abnormal connections interfering with the normal arterial position were observed in the brachial plexus. In another five cases of this type, the lateral and medial cords merged and the axillary artery passed anteromedial to the plexus. The sixth intersegmental axillary artery pierced the musculocutaneous nerve which is from the unified lateral and medial cords. This study discussed the how the anomalous structure of the brachial plexus could involve the deterioration of the course of the axillary artery.

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“…Furthermore, it stops afferent impulses and inhibits peripheral vasoconstriction because of a reduction of the pain-induced release of catecholamines, cortisol and antidiuretic hormone [10]. The efficacy of PNB has been described both to induce vasodilatation after LI due to brachial artery cannulation [4,9] and also as an alternative therapeutic approach in neonates with thrombosis when standard fibrinolytic treatment is contraindicated [5].…”

Section: Discussionmentioning

confidence: 99%