Pulmonary Complications

Urmey, William F.

doi:10.1016/b978-1-4160-2392-0.50019-4

Cited by 3 publications

(2 citation statements)

References 63 publications

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“…The historical incidence of pneumothorax after supraclavicular block was 0.5% to 6.1%, which reflected experience with classic supraclavicular approaches, wherein the anesthetizing needle was guided toward the apical pleura. 361 The plumb-bob and subclavian perivascular approaches were designed in part to lessen the risk of pneumothorax. 80 The risk of pneumothorax in tall, thin patients may be further reduced by initially directing the needle 45 degrees cephalad during the supine plumb-bob technique, rather than directly toward the floor; this magnetic resonance imaging finding has not been confirmed clinically.…”

Section: Diagnosis and Evaluation Of Neurological Complicationsmentioning

confidence: 99%

Upper Extremity Regional Anesthesia

Neal¹,

Gerancher

Hebl

et al. 2009

Regional Anesthesia and Pain Medicine

302

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Brachial plexus blockade is the cornerstone of the peripheral nerve regional anesthesia practice of most anesthesiologists. As part of the American Society of Regional Anesthesia and Pain Medicine's commitment to providing intensive evidence-based education related to regional anesthesia and analgesia, this article is a complete update of our 2002 comprehensive review of upper extremity anesthesia. The text of the review focuses on (1) pertinent anatomy, (2) approaches to the brachial plexus and techniques that optimize block quality, (4) local anesthetic and adjuvant pharmacology, (5) complications, (6) perioperative issues, and (6) challenges for future research.Upper extremity regional anesthesia has been a mainstay of the anesthesiologist's armamentarium since Hall 1 first reported the use of cocaine to block the brachial plexus in 1884. Recognizing that upper extremity neural blockade represents the most frequent use of peripheral nerve blocks in most anesthesiologists' practice, 2 in 2001, the American Society of Regional Anesthesia and Pain Medicine (ASRA) undertook a critical review of all available English-language publications pertinent to this topic. The resulting extensive source document was synthesized into a comprehensive review article 3 that was published in 2002; both the source and the review documents will be updated approximately every 5 years.Rather than publishing only new material that has become available since 2002, the original review article has been completely revised so that readers may continue to view the subject matter in its entirety. New topics in this review include ultrasound-guided brachial plexus block, continuous catheter-based analgesia, and a collection of new images * by medical illustrator, Jennifer Gentry (www.gentryvisualization.com). This review summarizes the essential scholarly work available from the source document, which can be viewed at Copyright © 2009 by American Society of Regional Anesthesia and Pain Medicine Address correspondence to: Joseph M. Neal, MD, 1100 Ninth Ave (B2-AN), Seattle, WA 98101 (anejmn@vmmc.org). The contents of this article are solely the responsibility of the authors and do not necessarily represent the official views of this entity. James P. Rathmell, MD, served as acting editor-in-chief for this article.Financial support: None. NIH Public Access Author ManuscriptReg Anesth Pain Med. Author manuscript; available in PMC 2010 March 1. Published in final edited form as:Reg Anesth Pain Med. 2009 ; 34(2): 134-170. doi:10.1097/AAP.0b013e31819624eb. NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript www.asra.com. This review article strives (1) to serve as a review of pertinent anatomy, (2) to compare the effectiveness of brachial plexus approaches and techniques, (3) to present available evidence to guide selection of pharmacological agents, (4) to describe the complications inherent to upper extremity anesthesia, (5) to consider pertinent perioperative issues, and (6) to identify informational gaps and empha...

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Section: Diagnosis and Evaluation Of Neurological Complicationsmentioning

confidence: 99%

Upper Extremity Regional Anesthesia

Neal¹,

Gerancher

Hebl

et al. 2009

Regional Anesthesia and Pain Medicine

302

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“…However, the 100% incidence of phrenic nerve block limits the use of an interscalane brachial plexus block in patients with limited pulmonary reserve ( 11 ). In certain patients with severe COPD, this can result in respiratory failure which might require tracheal intubation and mechanical ventilation ( 12 ). The volume of local anesthetic used for an interscalene block usually varies from 5 to 20 mls.…”

Section: Discussionmentioning

confidence: 99%

Above Elbow Amputation Under Brachial Plexus Block at Supraclavicular and Interscalene Levels

et al. 2015

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Introduction:The brachial plexus block is a commonly performed procedure in the anesthetic practice today. It is performed for analgesia as well as anesthesia for upper limb procedures. It has been used for amputation and replantation surgeries of the upper limb.Case presentation:We present the case of a 68-year-old gentleman who had brachial plexus block at supraclavicular and interscalene levels as the sole anesthetic for undergoing above elbow amputation. He was deemed to be very high risk for a general anesthetic as he suffered from severe chronic obstructive pulmonary disease (COPD) and a very poor exercise tolerance (NYHA Class III). The supraclavicular brachial plexus block was supplemented with an interscalene brachial plexus block due to inadequate surgical anesthesia encountered with the former. The procedure was successfully completed under regional anesthesia.Conclusions:The brachial plexus block can be performed at different levels in the same patient to achieve desired results, while employing sound anatomical knowledge and adhering to the maximum safe dose limit of the local anesthetic.

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Complications of Supraclavicular Techniques

Alemanno

2013

Anesthesia of the Upper Limb

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Pulmonary Complications

Cited by 3 publications

References 63 publications

Upper Extremity Regional Anesthesia

Upper Extremity Regional Anesthesia

Above Elbow Amputation Under Brachial Plexus Block at Supraclavicular and Interscalene Levels

Complications of Supraclavicular Techniques

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