Echogenicity and ultrasound visibility of peripheral nerves of the upper extremity

Stolz, Lori; Acuña, Josie; Gaskin, Kevin; Murphy, Amanda; Friedman, Lucas; Stears-Ellis, Summer; Javedani, Parisa P.; Stolz, Uwe; Adhikari, Srikar

doi:10.11152/mu-1240

Cited by 13 publications

(7 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The feasibility of the suprascapular nerve block was evaluated by the procedure time, that is, the time between needle‐patient contact and end of local anaesthetic injection. Practitioners were also asked to define the visualisation of the suprascapular nerve on ultrasound according to a semi‐quantitative scale of 0–2, where 0 is absent (defined as an invisible nerve structure) and 2 is good (defined as optimum visibility of the nerve) .…”

Section: Methodsmentioning

confidence: 99%

Hemidiaphragmatic paralysis following ultrasound‐guided anterior vs. posterior suprascapular nerve block: a double‐blind, randomised control trial

et al. 2020

View full text Add to dashboard Cite

Summary Interscalene brachial plexus block provides analgesia for shoulder surgery but is associated with hemidiaphragmatic paralysis. Before considering a combined suprascapular and axillary nerve block as an alternative to interscalene brachial plexus block, evaluation of the incidence of diaphragmatic dysfunction according to the approach to the suprascapular nerve is necessary. We randomly allocated 84 patients undergoing arthroscopic shoulder surgery to an anterior or a posterior approach to the suprascapular nerve block combined with an axillary nerve block using 10 ml ropivacaine 0.375% for each nerve. The primary outcome was the incidence of hemidiaphragmatic paralysis diagnosed by ultrasound. Secondary outcomes included: characterisation of the hemidiaphragmatic paralysis over time; numeric rating scale pain scores; oral morphine equivalent consumption; and patient satisfaction. The incidence of hemidiaphragmatic paralysis was 40% (n = 17) vs. 2% (n = 1) in the anterior and posterior groups, respectively (p < 0.001). In one third of patients with hemidiaphragmatic paralysis, it persisted beyond the eighth hour. The median (interquartile range [range]) oral morphine equivalent consumption was significantly higher in the posterior approach when compared with the anterior approach, whether in the recovery area (20 [5–31 (0–60)] mg vs. 7.5 [0–14 (0–52)] mg, respectively; p = 0.004) or during the first 24 h (82 [61–127 (12–360) mg] vs. 58 [30–86 (0–160)] mg, respectively; p = 0.01). Patient satisfaction was comparable between groups (p = 0.6). Compared with the anterior approach, diaphragmatic function is best preserved with the posterior needle approach to the suprascapular nerve block.

show abstract

Section: Methodsmentioning

confidence: 99%

Hemidiaphragmatic paralysis following ultrasound‐guided anterior vs. posterior suprascapular nerve block: a double‐blind, randomised control trial

et al. 2020

View full text Add to dashboard Cite

show abstract

“…A literature review was performed with the assistance of a librarian and a list of specific UGRA concepts and techniques was assembled. This included items from published peer‐reviewed manuscripts and textbooks in EM and anesthesia literature 12–26 . Online resources and resources that were not subject to peer review were not reviewed for possible curriculum elements.…”

Section: Methodsmentioning

confidence: 99%

“…This included items from published peer-reviewed manuscripts and textbooks in EM and anesthesia literature. [12][13][14][15][16][17][18][19][20][21][22][23][24][25][26] Online resources and resources that were not subject to peer review were not reviewed for possible curriculum elements. A multi-institutional expert panel of 13 EM physicians with advanced ultrasound training was assembled via a convenience sample.…”

Section: Methodsmentioning

confidence: 99%

Defining an Ultrasound‐guided Regional Anesthesia Curriculum for Emergency Medicine

Tucker

Peterson

Mink

et al. 2020

AEM Education and Training

View full text Add to dashboard Cite

Objectives: Ultrasound-guided regional anesthesia (UGRA) can be a powerful tool in the treatment of painful conditions commonly encountered in emergency medicine (EM) practice. UGRA can benefit patients while avoiding the risks of procedural sedation and opioid-based systemic analgesia. Despite these advantages, many EM trainees do not receive focused education in UGRA and there is no published curriculum specifically for EM physicians. The objective of this study was to identify the components of a UGRA curriculum for EM physicians.Methods: A list of potential curriculum elements was developed through an extensive literature review. An expert panel was convened that included 13 ultrasound faculty members from 12 institutions and from a variety of practice environments and diverse geographical regions. The panel voted on curriculum elements through two rounds of a modified Delphi process. Results:The panelists voted on 178 total elements, 110 background knowledge elements, and 68 individual UGRA techniques. A high level of agreement was achieved for 65 background knowledge elements from the categories: benefits to providers and patients, indications, contraindications, risks, ultrasound skills, procedural skills, sterile technique, local anesthetics, and educational resources. Ten UGRA techniques achieved consensus: interscalene brachial plexus, supraclavicular brachial plexus, radial nerve, median nerve, ulnar nerve, serratus anterior plane, fascia iliaca, femoral nerve, popliteal sciatic nerve, and posterior tibial nerve blocks. Conclusions:The defined curriculum represents ultrasound expert opinion on a curriculum for training practicing EM physicians. This curriculum can be used to guide the development and implementation of more robust UGRA education for both residents and independent providers.

show abstract

“…В связи с этим совершенно очевидна необходимость предоперационной диагностики размеров грудоспинного (донора) и мышечно-кожного (реципиента) нервов [12]. Однако в опубликованных исследованиях отсутствуют сведения о возможности определения на предоперационном этапе истинных размеров мышечно-кожного и грудоспинного нерва, а также других нервов у конкретного больного для выбора оптимального способа пересадки [13,14]. При этом доказано, что конституциональные особенности строения организма человека обусловливают особенности его вариантой анатомии, которые отображаются на функционировании органов и систем, что важно учитывать в клинической практике [15].…”

Section: оригинальные статьиunclassified

Anatomic grounds for the transposition of the thoracodorsal nerve in case of neurotization of brachial plexus nerve damage

et al. 2021

View full text Add to dashboard Cite

РЕЗЮМЕЦель. Выявление топографо-анатомических и конституциональных особенностей грудоспинного и мышечно-кожного нервов плечевого сплетения.Материалы и методы. Проведена антропометрия 45 трупов с определением роста, длины туловища и верхней конечности, окружности шеи, грудной клетки, плеча и предплечья, поперечных размеров плеч, грудной клетки и таза, переднезаднего размера грудной клетки, обхвата шеи. После анатомического препарирования плечевого сплетения проведена морфометрия всех его компонентов (длины, толщины нервов и углов их отхождения).Результаты. Цефалический тип плечевого сплетения с участием спинального нерва С4 установлен в 7%, каудальный тип с включением спинального нерва Th2 -в 4% случаев. В 4% случаев отсутствует мышечно-кожный нерв, двуглавую мышцу плеча при этом иннервирует срединный нерв. В 93% случаев грудоспинной нерв отходит от заднего вторичного пучка по задненижней поверхности, в 7% это ветвь подмышечного нерва. Обхват шеи имеет прямые значимые корреляции с длиной грудоспинного нерва -чем больше обхват шеи, тем больше длина нерва. У женщин выведены уравнения линейной регрессии, на основании которых можно вычислить предположительную длину грудоспинного нерва при известном значении ширины грудной клетки.Заключение. Длина грудоспинного нерва является определяющей детерминантой возможности его пересадки в позицию мышечно-кожного. В качестве внешнего биомаркера размеров нерва-донора и нерва-реципиента целесообразно использовать размеры обхвата шеи и для достоверности у женщин -ширину грудной клетки. Ключевые слова: плечевое сплетение, морфометрия, грудоспинной нерв, мышечно-кожный нерв, транспозиция. Конфликт интересов. Авторы декларируют отсутствие явных и потенциальных конфликтов интересов, связанных с публикацией настоящей статьи. Источник финансирования. Авторы заявляют об отсутствии финансирования. Соответствие принципам этики. Исследование одобрено локальной этической комиссией КрасГМУ (протокол № 91 от 11.09.2018).

show abstract

Echogenicity and ultrasound visibility of peripheral nerves of the upper extremity

Cited by 13 publications

References 12 publications

Hemidiaphragmatic paralysis following ultrasound‐guided anterior vs. posterior suprascapular nerve block: a double‐blind, randomised control trial

Hemidiaphragmatic paralysis following ultrasound‐guided anterior vs. posterior suprascapular nerve block: a double‐blind, randomised control trial

Defining an Ultrasound‐guided Regional Anesthesia Curriculum for Emergency Medicine

Anatomic grounds for the transposition of the thoracodorsal nerve in case of neurotization of brachial plexus nerve damage

Contact Info

Product

Resources

About