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Case series: Septa can influence local anesthetic spread during infraclavicular brachial plexus blocks

Morimoto, Maki; Popovic, Jovan; Kim, Jung T; Kiamzon, Harald; Rosenberg, Andrew D
PURPOSE: To ultrasonically identify the presence of septae within the neurovascular sheath and to assess their effect on local anesthetic spread when performing infraclavicular brachial plexus blocks. CLINICAL FEATURES: Thirty ASA status I and II patients scheduled for minor hand surgeries were enrolled in the study. Ultrasound guided infraclavicular brachial plexus blocks were performed on 28 patients. The images of the local anesthetic spread and the effect of the septum within the neurovascular sheath were analyzed. Septae were present in four of six patients where unilateral local anesthetic spread was seen. Septae were not visualized in the 22 patients with unrestricted local anesthetic spread after the initial injection. All 28 patients underwent their planned operations successfully with adequate anesthesia. CONCLUSIONS: Our study shows that the presence of septae within the neurovascular sheath may influence the pattern of local anesthetic spread associated with the infraclavicular approach to brachial plexus blocks
PMID: 18056210
ISSN: 0832-610x
CID: 76335

Ultrasound-guided lumbar plexus block for open reduction and internal fixation of hip fracture [Case Report]

Morimoto, Maki; Kim, Jung T; Popovic, Jovan; Jain, Sudheer; Bekker, Alex
PURPOSE: Ultrasound technology has been applied to increase both efficacy and safety of certain peripheral nerve blocks. This case report describes the first successful ultrasound-guided lumber plexus block. CLINICAL FEATURES: We describe a 91-year-old woman with aortic stenosis who successfully underwent open reduction and internal fixation of a fractured right hip with a lumbar plexus block. Ultrasound provided direct visualization to help identify the anatomical structures and guide the block needle during performance of the block. Complete block of the lumbar plexus was attained within 15 min, and the surgical procedure was performed uneventfully. CONCLUSION: The use of ultrasound has gained popularity to perform peripheral nerve blocks. In this case report, a successful lumbar plexus block was performed with ultrasound guidance. By direct visualization, using this technology may potentially reduce complications associated with lumbar plexus blocks
PMID: 17309721
ISSN: 1533-2500
CID: 71212

Current practice of ultrasound-assisted regional anesthesia

Popovic, Jovan; Morimoto, Maki; Wambold, Daniel; Blanck, Thomas J J; Rosenberg, Andrew D
PMID: 17309722
ISSN: 1533-2500
CID: 71213

Advances in ultrasound guided regional anesthesia

Popovic J; Morimoto M; Blanck TJJ; Rosenberg AD
ORIGINAL:0005725
ISSN: 0095-2273
CID: 67941