scholarly journals Effectiveness of additional thoracic paravertebral block in improving anesthetic effects of regional anesthesia for proximal humeral fracture surgery in elderly patients: study protocol for a randomized controlled trial

2019 ◽  
Author(s):  
Xiaofeng Wang ◽  
Hui Zhang ◽  
Zhenwei Xie ◽  
Qingfu Zhang ◽  
Wei Jiang ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Regional Anesthesia ◽  
Proximal Humeral Fracture ◽  
Humeral Fracture ◽  
Paravertebral Block ◽  
Cervical Plexus ◽  
Thoracic Paravertebral Block ◽  
Cervical Plexus Block ◽  
Plexus Block ◽  
Fracture Surgery

Abstract Background The innervation of shoulder-upper arm area is complicated and unclear. Ultrasound-guided brachial plexus combined with cervical plexus block is probably inadequate for the anesthesia of proximal humeral surgery. Missing blockade of T1-T2 nerves may be the reason. The primary aim of this trial is to investigate the effectiveness of additional T2 thoracic paravertebral block (TPVB) in improving the anesthetic effects of regional anesthesia for elderly patients in proximal humeral fracture surgery. Methods We have designed a two-armed, parallel, randomized controlled trial (RCT) to compare the anesthetic effects of ultrasound-guided brachial and cervical plexus block with or without additional T2 TPVB in terms of the following outcomes: success rate, sensory block and safety. The elderly patients over 65 years old, referred for anterior approach proximal humeral fracture surgery, will be enrolled. Each participant will be randomly assigned 1:1 to receive IC block (combined interscalene brachial plexus with superficial cervical plexus block) or ICTP block (combined thoracic paravertebral block with IC block). The primary outcome is the success rate of surgical anesthesia. The secondary outcomes are as follows: sensory block at surgical area, proportion of participants who need supplementary anesthesia (remifentanil or conversion to general anesthesia), cumulative doses of intraoperative vasoactive medications and adverse events. The necessary sample size is estimated to be 80 patients according to the data of our pilot study. Discussion This RCT aims to demonstrate that whether combined T2 TPVB with brachial and cervical plexus block can provide better anesthetic effects of regional anesthesia in elderly patients undergoing proximal humeral fracture surgery.

scholarly journals Effectiveness of additional thoracic paravertebral block in improving anesthetic effects of regional anesthesia for proximal humeral fracture surgery in elderly patients: study protocol for a randomized controlled trial

2020 ◽  
Author(s):  
xiaofeng wang ◽  
Hui Zhang ◽  
Zhenwei Xie ◽  
Qingfu Zhang ◽  
Wei Jiang ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Brachial Plexus ◽  
Regional Anesthesia ◽  
Proximal Humeral Fracture ◽  
Humeral Fracture ◽  
Cervical Plexus ◽  
Thoracic Paravertebral Block ◽  
Cervical Plexus Block ◽  
Plexus Block ◽  
Fracture Surgery

Abstract Background: The innervation of shoulder-upper extremity area is complicated and unclear. Regional anesthesia with brachial plexus and cervical plexus block is probably inadequate for the proximal humeral surgery. Missing blockade of T1-T2 nerves may be the reason. We conduct this prospective randomized controlled trial (RCT) to explore whether additional T2 thoracic paravertebral block (TPVB) can improve the success rate of regional anesthesia for elderly patients in proximal humeral fracture surgery. Methods: The patients aged 65 or older, referred for anterior approach proximal humeral fracture surgery, will be enrolled. Each patient will be randomly assigned 1:1 to receive IC block (combined interscalene brachial plexus with superficial cervical plexus block) or ICTP block (combined thoracic paravertebral block with brachial plexus and superficial cervical plexus block). The primary outcome is the success rate of regional anesthesia without rescue analgesic methods. The secondary outcomes are as follows: sensory block at surgical area, proportion of patients who need rescue anesthesia (intravenous remifentanil or conversion to general anesthesia), cumulative doses of intraoperative vasoactive medications and adverse events. The total sample size is estimated to be 80 patients. Discussion: This RCT aims to confirm whether additional T2 TPVB can provide better anesthetic effects of regional anesthesia with brachial and cervical plexus block in elderly patients undergoing proximal humeral surgery.

scholarly journals Ultrasound-Guided Combined Interscalene-Cervical Plexus Block for Surgical Anesthesia in Clavicular Fractures: A Retrospective Observational Study

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Onur Balaban ◽  
Turan Cihan Dülgeroğlu ◽  
Tayfun Aydın
Keyword(s):  
General Anesthesia ◽  
Regional Anesthesia ◽  
Fracture Repair ◽  
Complication Rates ◽  
Clavicular Fracture ◽  
Ultrasound Guided ◽  
Cervical Plexus ◽  
Cervical Plexus Block ◽  
Plexus Block ◽  
Fracture Surgery

Objective. We aim to report our experiences regarding the implementation of the ultrasound-guided combined interscalene-cervical plexus block (CISCB) technique as a sole anesthesia method in clavicular fracture repair surgery. Materials and Methods. Charts of patients, who underwent clavicular fracture surgery through this technique, were reviewed retrospectively. We used an in-plane ultrasound-guided single-insertion, double-injection combined interscalene-cervical plexus block technique. During the performance of each block, the block areas were visualized by using a linear transducer, and the needles were advanced by using the in-plane technique. Block success and complication rates were evaluated. Results and Discussion. 12 patients underwent clavicular fracture surgery. Surgical regional anesthesia was achieved in 100% of blocks. None of the patients necessitated conversion to general anesthesia during surgery. There were no occurrences of acute complications. Conclusions. The ultrasound-guided combined interscalene-cervical plexus block was a successful and effective regional anesthesia method in clavicular fracture repair. Prospective comparative studies would report the superiority of the regional technique over general anesthesia.

scholarly journals Sedation and Regional Anesthesia for Deep Brain Stimulation in Parkinson’s Disease

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Onur Ozlu ◽  
Sema Sanalbas ◽  
Dilek Yazicioglu ◽  
Gulten Utebey ◽  
Ilkay Baran
Keyword(s):  
Deep Brain Stimulation ◽  
Regional Anesthesia ◽  
Brain Stimulation ◽  
Conscious Sedation ◽  
Cervical Plexus ◽  
Superficial Cervical Plexus Block ◽  
Cervical Plexus Block ◽  
Scalp Block ◽  
Plexus Block ◽  
Deep Brain

Objective. To present the conscious sedation and the regional anesthesia technique, consisting of scalp block and superficial cervical plexus block, used in our institution for patients undergoing deep brain stimulation (DBS) for the treatment of Parkinson’s disease (PD). Methods. The study included 26 consecutive patients. A standardized anesthesia protocol was used and clinical data were collected prospectively. Results. Conscious sedation and regional anesthesia were used in all cases. The dexmedetomidine loading dose was 1 μg kg−1 and mean infusion rate was 0.26 μg kg−1 h−1 (0.21) [mean total dexmedetomidine dose: 154.68 μg (64.65)]. Propofol was used to facilitate regional anesthesia. Mean propofol dose was 1.68 mg kg (0.84) [mean total propofol dose: 117.72 mg (59.11)]. Scalp block and superficial cervical plexus block were used for regional anesthesia. Anesthesia related complications were minor. Postoperative pain was evaluated; mean visual analog scale pain scores were 0 at the postoperative 1st and 6th hours and 4 at the 12th and 24th hours. Values are mean (standard deviation). Conclusions. Dexmedetomidine sedation along with scalp block and SCPB provides good surgical conditions and pain relief and does not interfere with neurophysiologic testing during DBS for PD. During DBS the SCPB may be beneficial for patients with osteoarthritic cervical pain. This trial is registered with Clinical Trials Identifier NCT01789385.

scholarly journals Combined Interscalene and Superficial Cervical Plexus Block for Clavicle Surgery: Case Series

2019 ◽  
Vol 2 (1) ◽  
pp. 95-97
Author(s):  
Kiran Kumar K.C. ◽  
Sundar Hyoju ◽  
Pawan kumar Raya ◽  
Chhanda Budhathoki ◽  
Ram Prasad Sharma ◽  
...  
Keyword(s):  
Regional Anesthesia ◽  
Brachial Plexus Block ◽  
Clavicle Fracture ◽  
Case Series ◽  
Anesthetic Technique ◽  
Cervical Plexus ◽  
Interscalene Brachial Plexus Block ◽  
Superficial Cervical Plexus Block ◽  
Cervical Plexus Block ◽  
Plexus Block

General Anesthesia is preferred over regional anesthesia in clavicle surgery. We report 3 cases of clavicle fracture which was performed under USG guided combined Interscalene and Superficial cervical plexus block. All the patients were comfortable and there was no need for additional analgesia. Thus regional anesthesia can be used as a sole anesthetic technique in patients with clavicle fracture and can be an alternative where general anaesthesia and its adverse effects needs to be avoided. Keywords: clavicle fracture; interscalene brachial plexus block; superficial cervical plexus block. Correspondance: Dr.

scholarly journals Thyroid Surgeries under bilateral superficial cervical plexus block – A Case Series

2021 ◽  
Vol 7 (2) ◽  
Keyword(s):  
Regional Anesthesia ◽  
Thyroid Surgery ◽  
Case Series ◽  
Moderate Intensity ◽  
Ultrasound Guided ◽  
Cervical Plexus ◽  
Superficial Cervical Plexus Block ◽  
Cervical Plexus Block ◽  
Plexus Block ◽  
Anesthesia Procedure

Superficial cervical plexus block is a simple regional anesthesia procedure which can be performed by landmark guided as well as ultrasound-guided techniques. It has been used to provide anesthesia or analgesia for various procedures involving superficial surgeries in the neck and shoulder. The pain after thyroid surgery is of mild to moderate intensity and of short duration. I describe 12 cases in which bilateral superficial cervical plexus block was performed to conduct awake thyroid surgeries. Keywords: Thyroid surgery, Superficial cervical plexus block, regional anesthesia, neck surgeries, analgesia.

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