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Ulnar Nerve Block

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1. The Blocking Flap for Ulnar Nerve Instability After In Situ Release: Technique and a Grading System of Ulnar Nerve Instability to Guide Treatment (PubMed)

The Blocking Flap for Ulnar Nerve Instability After In Situ Release: Technique and a Grading System of Ulnar Nerve Instability to Guide Treatment In situ ulnar nerve release has been gaining popularity as a simple, effective, and low-morbidity procedure for the treatment of cubital tunnel syndrome. One concern with the technique is how to manage the unstable ulnar nerve after release. It is unclear how much nerve subluxation will lead to problems and surprisingly there is no grading system (...) to assess ulnar nerve instability. I propose such a grading system, as well as a new technique to stabilize the unstable ulnar nerve. The blocking flap technique consists of raising a rectangular flap off the flexor/pronator fascia and attaching it to the posterior subcutaneous flap so that it blocks the nerve from subluxation/dislocation.

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2017 Techniques in hand & upper extremity surgery

2. Systemic dexmedetomidine is not as efficient as perineural dexmedetomidine in prolonging an ulnar nerve block. (PubMed)

Systemic dexmedetomidine is not as efficient as perineural dexmedetomidine in prolonging an ulnar nerve block. We tested the joint hypotheses that both perineural and systemic dexmedetomidine prolong the duration of an ulnar nerve block (UNB) compared with ropivacaine alone and that systemic dexmedetomidine is noninferior compared with perineural dexmedetomidine in block prolongation.We performed bilateral UNBs in 22 healthy volunteers on two separate days. On the first day, each arm (...) was randomized to either 4 mL ropivacaine 5 mg/mL+1 mL dexmedetomidine 100 µg/mL (Perineural) or 4 mL ropivacaine 5 mg/mL+1 mL saline (Systemic). On the subsequent treatment day, each arm was randomized to 1 mL of saline plus 4 mL of ropivacaine at either 7.5 mg/mL(HiRopi) or 5 mg/mL (NoDex). The primary outcome measure was the duration of sensory block assessed by mechanical discrimination.Mean sensory block duration was longer in both the Perineural (14.4 hours, 95% CI 13.1 to 15.6) and Systemic treatments

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2019 Regional Anesthesia and Pain Medicine Controlled trial quality: predicted high

3. Systemic dexmedetomidine is not as efficient as perineural dexmedetomidine in prolonging an ulnar nerve block. (PubMed)

Systemic dexmedetomidine is not as efficient as perineural dexmedetomidine in prolonging an ulnar nerve block. We tested the joint hypotheses that both perineural and systemic dexmedetomidine prolong the duration of an ulnar nerve block (UNB) compared with ropivacaine alone and that systemic dexmedetomidine is noninferior compared with perineural dexmedetomidine in block prolongation.We performed bilateral UNBs in 22 healthy volunteers on two separate days. On the first day, each arm (...) was randomized to either 4 mL ropivacaine 5 mg/mL+1 mL dexmedetomidine 100 µg/mL (Perineural) or 4 mL ropivacaine 5 mg/mL+1 mL saline (Systemic). On the subsequent treatment day, each arm was randomized to 1 mL of saline plus 4 mL of ropivacaine at either 7.5 mg/mL(HiRopi) or 5 mg/mL (NoDex). The primary outcome measure was the duration of sensory block assessed by mechanical discrimination.Mean sensory block duration was longer in both the Perineural (14.4 hours, 95% CI 13.1 to 15.6) and Systemic treatments

2019 Regional Anesthesia and Pain Medicine Controlled trial quality: predicted high

4. Perineural Dexmedetomidine for Ulnar Nerve Block.

Perineural Dexmedetomidine for Ulnar Nerve Block. Perineural Dexmedetomidine for Ulnar Nerve Block. - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more. Perineural Dexmedetomidine for Ulnar Nerve Block (...) by (Responsible Party): Jakob Hessel Andersen, Zealand University Hospital Study Details Study Description Go to Brief Summary: The aim of this trial is to investigate if dexmedetomidine prolongs the duration of an ulnar nerve block. By using healthy volunteers the investigators can perform bilateral ulnar nerve blocks and thereby control for a systemic effect to clarify if the effect is actually peripheral or systemic. The investigators hypothesis is that dexmedetomidine as an adjunct to a local anaesthetic

2017 Clinical Trials

5. Ulnar Nerve Block

Ulnar Nerve Block Ulnar Nerve Block Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Ulnar Nerve Block Ulnar Nerve Block Aka: Ulnar (...) Nerve Block , Regional Anesthesia of the Ulnar Nerve II. Indications Anesthesia of distribution III. Precautions Avoid injecting directly into Avoid injection into ulnar artery IV. Preparation Needle: 27 gauge 1.5 inch Anesthetic: 1%: 10 ml V. Technique: Ulnar Nerve Block at wrist Injection site 1: Palmar branch of the Between flexor carpi ulnaris tendon and ulnar artery Inject at depth of 1-2 cm at proximal wrist crease Needle parallel to wrist crease toward radius Injection site 2: Dorsal branch

2018 FP Notebook

6. Nerve blocks at the wrist for carpal tunnel release revisited: the use of sensory-nerve and motor-nerve stimulation techniques. (PubMed)

endoscopic carpal-tunnel release performed under median and ulnar nerve blocks at the wrist were prospectively studied. The blocks were performed with a nerve stimulator. Nerve-stimulation techniques were explained to the patient before the block was performed. The patient was trained to inform the anesthetist of their perception of an electrical paresthesia that was synchronized to the nerve stimulator. The anesthetist recorded the first response of the patient to nerve stimulation: sensory (S), sensory (...) group and control group. At 20 minutes, the block was complete for the median and ulnar nerves in 96.4% and 85% of the nerve-stimulation patients and control patients (P < .05). Two patients in the control group experienced painful mechanical paresthesia. Neither permanent nor transient nerve injuries were observed during or after the nerve block or surgery.This study describes how infrequently an initial motor response is identified when a nerve stimulator is used on the median nerve at the wrist

2017 Regional Anesthesia and Pain Medicine

7. Efficacy of the C8 Nerve Root Block During Interscalene Block for Anesthesia of the Posterior Aspect of the Shoulder

to T1 dermatomal blockade graded from 0 to 2 (0 = no cold sensation, 1 = reduced cold sensation, and 2 = normal cold sensation) by applying ice to the shoulder Motor blockade [ Time Frame: 30 minutes after interscalene block ] Motor blockade of the radial, ulnar, median, musculocutaneous, and axillary nerves graded from 0 to 2 (0 = complete block, 1 = partial block, and 2 = no block) Ipsilateral hemidiaphragmatic blockade [ Time Frame: Before interscalene block and 30 minutes after interscalene (...) Efficacy of the C8 Nerve Root Block During Interscalene Block for Anesthesia of the Posterior Aspect of the Shoulder Efficacy of the C8 Nerve Root Block During Interscalene Block for Anesthesia of the Posterior Aspect of the Shoulder - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number

2018 Clinical Trials

8. Can we gain an advantage by combining distal median, radial and ulnar nerve blocks with supraclavicular block? A randomized controlled study. (PubMed)

Can we gain an advantage by combining distal median, radial and ulnar nerve blocks with supraclavicular block? A randomized controlled study. The aim of this study was to compare the combined ultrasound-guided supraclavicular brachial plexus block (SCB) and distal median, radial, and ulnar nerve blocks, with the supraclavicular block alone.Sixty-two patients undergoing upper extremity surgery were randomized to supraclavicular only (Group S, n = 31) or supraclavicular + distal (Group SD, n = 31 (...) ) group. Patients in Group S received 32 mL of 1.5 % lidocaine + epinephrine 5 µg/mL, while those in Group SD received 20 mL of 1.5 % lidocaine + epinephrine 5 µg/mL followed by distal median, radial, and ulnar nerve blocks using equal volumes of 2 % lidocaine + 0.5 % levobupivacaine (4 mL/nerve). Sensory and motor blocks of the ulnar, median, radial and musculocutaneous nerves were assessed every 5 min starting at the 10th minute. The imaging, needling and performance times were recorded. Also

2014 Journal of anesthesia Controlled trial quality: uncertain

9. Pigmented border as a new surface landmark for digital nerve blocks: a cross sectional anatomical study. (PubMed)

Pigmented border as a new surface landmark for digital nerve blocks: a cross sectional anatomical study. The purpose of this study was to identify surface anatomy of digital nerves in relation to the pigmented border of digits. Three-hundred and sixty digital nerves in 36 preserved adult cadaveric hands were dissected under magnification. The digital nerves were constantly located anterior to the pigmented border. The median curvilinear distance along the skin from the pigmented border (...) to the digital nerves of the index, middle, ring and little fingers was 1.4 mm. In the thumb, this distance was 2.4 and 3.7 mm on the radial and ulnar sides, respectively. The digital nerve was located 2.4 mm deep to the skin in all fingers. The median angle to the nerve from the skin at the pigmented border was 30°. These dimensions differed in the thumb compared with the rest of the fingers. We conclude that the pigmented border of digits is a reliable anatomical landmark to locate digital nerves.

2019 Journal of Hand Surgery - European

10. Occupation-based intervention versus rote exercise in modified constraint-induced movement therapy for patients with median and ulnar nerve injuries: A randomized controlled trial. (PubMed)

Occupation-based intervention versus rote exercise in modified constraint-induced movement therapy for patients with median and ulnar nerve injuries: A randomized controlled trial. To investigate effect of practice type during modified constraint-induced movement therapy on hand function in patients with chronic median and ulnar nerve injuries.A prospective, single-blinded, randomized controlled clinical trial.Participants' private home.A convenience sample of 36 outpatient participants (...) in subjective measures at post-test and follow up (Canadian occupational performance measure: mean change 4.7 vs. 2.1 for performance, P< 0.001 and mean change 5.3 vs. 2.6 for satisfaction, P< 0.001), it was significant just at follow up for box and block and static two-point discrimination.Practice content of constraint-induced movement therapy is a critical part of its effectiveness on improving outcomes following peripheral nerve repair in favour of occupation-based intervention in present study.

2016 Clinical rehabilitation Controlled trial quality: uncertain

11. Ultrasound-guided peripheral forearm nerve block for digit fractures in a pediatric emergency department. (PubMed)

Ultrasound-guided peripheral forearm nerve block for digit fractures in a pediatric emergency department. Although ultrasound-guided peripheral nerve block (UGPNB) has recently been introduced into pediatric emergency departments (EDs), knowledge of its use is still limited among pediatric emergency physicians. Ultrasound-guided ulnar nerve block (UGUNB) is a form of peripheral nerve block available for controlling the pain caused by phalangeal injuries, but studies of its use in pediatric (...) patients are still scarce. The aim of this case series was to describe the experience of UGUNB use for pediatric phalangeal fractures in a pediatric ED setting. In all the patients with phalangeal fractures, the ulnar nerve was successfully visualized using a hockey-stick type transducer. Approximately 0.1-0.2 mg/kg of 1% lidocaine was used as the nerve block. The procedure was effective for pain control, and fracture reduction was successfully performed without the need for rescue analgesia. This case

2018 American Journal of Emergency Medicine

12. Comparison of axillary nerve block duration using mepivacaine in non-insulin diabetic or renal insufficiency patients: a controlled observational matched multicentre trial. (PubMed)

patients (HP).We prospectively included consecutive patients aged 18-80 years, with DP (N.=37), RP (N.=32) and HP (N.=48) scheduled for distal upper limb surgery. Before surgery, an axillary nerve block (20 mL mepivacaine 15 mg.mL-1) was performed with an ultrasound approach combined with nerve stimulation. Five mL was injected for each nerve: median, ulnar, radial, musculocutaneous nerves. The primary endpoint measured was the duration of sensory block. For statistical analysis, each HP patient (...) Comparison of axillary nerve block duration using mepivacaine in non-insulin diabetic or renal insufficiency patients: a controlled observational matched multicentre trial. Although studies in diabetic patients demonstrated delayed recovery after long-acting local anesthetic, its effects with short-acting LA remains to be determined. Using mepivacaine, the authors evaluated the duration of axillary nerve blocks in diabetic (DP), renal failure (creatinine clearance <30 mL.min-1) (RP) and healthy

2018 Minerva anestesiologica

13. Dexamethasone Versus Dexmedetomidine as Adjuvants for Nerve Blocks

of 14 points out of a maximum of 16 points Sensory and motor block score [ Time Frame: 30 minutes post injection ] Sensorimotor block assessed every 5 minutes until 30 minutes using a 16-point composite score evaluating sensory and motor block of musculocutaneus, medium, radial and ulnar nerves. Sensation will be assessed with ice in each nerve territory with a 0 to 2 point scale. 0= no block, patients can feel cold; 1= analgesic block, patient can feel touch but not cold; 2= anesthetic block (...) Dexamethasone Versus Dexmedetomidine as Adjuvants for Nerve Blocks Dexamethasone Versus Dexmedetomidine as Adjuvants for Nerve Blocks - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more. Dexamethasone Versus

2018 Clinical Trials

14. Effect of a lateral infraclavicular brachial plexus block on the axillary and suprascapular nerves as determined by electromyography - a cohort study. (PubMed)

isometric contraction of the medial deltoid muscle (axillary nerve) and the infraspinatus muscle (suprascapular nerve) from baseline to 30 min after the block procedure. A reduction in electromyography of > 50% defined a successful block. The impact of the block on the shoulder nerves was compared with the surgical target nerves of the arm and hand (musculocutaneous, radial, median and ulnar nerves). Twenty patients were included. The medians of the relative changes in the surface electromyography were (...) Effect of a lateral infraclavicular brachial plexus block on the axillary and suprascapular nerves as determined by electromyography - a cohort study. We aimed to examine to what extent a lateral infraclavicular brachial plexus block affected the axillary and the suprascapular nerve. We included patients undergoing hand surgery anaesthetised with a lateral infraclavicular brachial plexus block. Our primary outcome was the relative change in surface electromyography during maximum voluntary

2018 Anaesthesia

15. Management of an Acute Exacerbation of Chronic Neuropathic Pain in the Emergency Department: A Case to Support Ultrasound-Guided Forearm Nerve Blocks. (PubMed)

lead to prolonged ED stays, undesired admissions, and subsequent increased health care costs.We describe the case of a 51-year-old woman who presented to the ED on two separate occasions for left forearm pain secondary to chronic ulnar neuropathy. During her first ED visit, the patient received multiple rounds of intravenous opiates and required hospital admission, which was complicated by opiate-induced hypotension. During her second visit, she underwent an ultrasound-guided ulnar nerve block (...) Management of an Acute Exacerbation of Chronic Neuropathic Pain in the Emergency Department: A Case to Support Ultrasound-Guided Forearm Nerve Blocks. Acute on chronic neuropathic pain is often refractory to analgesics and can be challenging to treat in the emergency department (ED). In addition, systemic medications such as opiates and nonsteroidal inflammatory drugs have risks, including hypotension and kidney injury, respectively. Difficulties in managing pain in patients with neuropathy can

2018 Journal of Emergency Medicine

16. An Indicator of Successful Peripheral Nerve Block

, sensory and motor block assessments will be carried out by blinded observer every 5 min after needle removal for 30 min in the regions of the radial, median, ulnar, and musculocutaneous nerves of the forearm. Skin temperature measurements will be performed from both the anesthetized side and the contralateral arm before the procedure and every 5 min for 30 min by a blinded observer. Before the block, the color changing nail polish will be applied to all hand nails of the patient. An independent (...) An Indicator of Successful Peripheral Nerve Block An Indicator of Successful Peripheral Nerve Block - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more. An Indicator of Successful Peripheral Nerve Block

2018 Clinical Trials

17. Effect of Ultrasound-guided Nerve Block With 0.75% Ropivacaine at the Mid-forearm on the Prevalence of Moderate to Severe Pain After Hand Surgery. (PubMed)

groups: group R (n = 15) and group NS (n = 15). We combined an ultrasound-guided supraclavicular brachial plexus block with mid-forearm median, radial, and ulnar nerve block in all patients. The supraclavicular brachial plexus was blocked with 20 mL of 1.5% lidocaine, and the mid-forearm nerves were blocked with 15 mL of either 0.75% ropivacaine (group R) or normal saline (5 mL each nerve) (group NS). A blinded observer provided a numeric rating pain score at 1, 2, 6, 12, 24, and 48 hours after (...) Effect of Ultrasound-guided Nerve Block With 0.75% Ropivacaine at the Mid-forearm on the Prevalence of Moderate to Severe Pain After Hand Surgery. This study tested the hypothesis that ultrasound-guided mid-forearm nerve block with 0.75% ropivacaine reduces the prevalence of moderate to severe pain after wrist and hand surgery, and provides prolonged postoperative analgesia with minimal motor blockade.Thirty patients undergoing elective wrist and hand surgery were randomly assigned to 1 of 2

2018 Clinical therapeutics Controlled trial quality: uncertain

18. Regional haemodynamic changes after selective block of the four principal nerves in the arm: A double-blind randomised controlled study. (PubMed)

Qinquan Q Gao Fang F eng ClinicalTrials.gov NCT02139982 PDF-2014-07-061 Department of Health United Kingdom Journal Article Randomized Controlled Trial England Eur J Anaesthesiol 8411711 0265-0215 IM Arm blood supply innervation surgery Brachial Plexus Double-Blind Method Female Humans Male Median Nerve Nerve Block Peripheral Nerves Regional Blood Flow drug effects Ulnar Nerve Vasodilation 2016 3 18 6 0 2016 3 18 6 0 2018 1 27 6 0 ppublish 26986777 10.1097/EJA.0000000000000433 (...) Regional haemodynamic changes after selective block of the four principal nerves in the arm: A double-blind randomised controlled study. 26986777 2018 01 26 2018 01 26 1365-2346 33 8 2016 08 European journal of anaesthesiology Eur J Anaesthesiol Regional haemodynamic changes after selective block of the four principal nerves in the arm: A double-blind randomised controlled study. 599-601 10.1097/EJA.0000000000000433 Li Ting T From the Department of Anaesthesiology, The Second Affiliated

2018 European Journal of Anaesthesiology Controlled trial quality: uncertain

19. The ultrasound-guided selective nerve block in the upper arm: an approach of retaining the motor function in elbow. (PubMed)

hypothesis is that a selective nerve block of the arm would result in a different motor block of the elbow, compared to the axillary block.A sample size of 24 patients who were undergoing elective surgery (ASA I-III) of the wrist, hand or forearm was randomly divided into two groups: Arm Group (n = 12) and Axillary Group (n = 12). The Arm Group received ultrasound-guided block of the median, ulnar, and medial antebrachial cutaneous nerves at the level of upper-median 1/3 of the arm, and a block (...) The ultrasound-guided selective nerve block in the upper arm: an approach of retaining the motor function in elbow. Proximal brachial plexus blocks can lead to an extended period of motor paralysis and delay the return of motor function. This could influence patient satisfaction, and extend hospitalizations. The aim of the study is to compare a selective distal nerve block of the arm to a proximal axillary block, both ultrasound-guided, in terms of their motor block intensity of the elbow. Our

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2018 BMC Anesthesiology Controlled trial quality: uncertain

20. Double-injection technique assisted by a nerve stimulator for ultrasound-guided supraclavicular brachial plexus block results in better distal sensory-motor block: A randomised controlled trial. (PubMed)

Double-injection technique assisted by a nerve stimulator for ultrasound-guided supraclavicular brachial plexus block results in better distal sensory-motor block: A randomised controlled trial. To evaluate the efficacy of a nerve stimulator when used with ultrasound-guided double injection in supraclavicular brachial plexus block.We hypothesised that targeting the inferior trunk of the plexus guided by a nerve stimulator would obtain a higher success rate of ulnar nerve blockade than (...) block. In the MDI group (n = 45), half the volume was deposited within the brachial plexus sheath guided by ultrasound, next to the inferior trunk and verified by nerve stimulation; the remaining volume was deposited in the main neural cluster. In the double-injection group (n = 45), the first half volume was deposited on ultrasound guidance alone. Sensory-motor blockade of the musculocutaneous, median, radial, ulnar nerves and surgical anaesthesia, performance time, number of needle passes

2016 European Journal of Anaesthesiology Controlled trial quality: predicted high

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