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Xianghe Wang - One of the best experts on this subject based on the ideXlab platform.
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effect of local anesthetic volume 20 ml vs 30 ml ropivacaine on electromyography of the Diaphragm and pulmonary function after ultrasound guided supraclavicular brachial plexus block a randomized controlled trial
Regional Anesthesia and Pain Medicine, 2019Co-Authors: Xiuxia Bao, Juanjuan Huang, Haorong Feng, Yuying Qian, Yajie Wang, Qunying Zhang, Xianghe WangAbstract:Background and objectives Diaphragmatic Paralysis following supraclavicular brachial plexus block (SCBPB) is ascribed to phrenic nerve palsy. This study investigated the effect of 2 volumes of 0.375% ropivacaine on efficacy of block as a surgical anesthetic and as an analgesic and examined Diaphragm compound muscle action potentials (CMAPs) and pulmonary function before and after SCBPB. Methods Eighty patients scheduled for removal of hardware for internal fixation after healing of an upper limb fracture distal to the shoulder were randomized to receive ultrasound-guided SCBPC for surgical anesthesia with 20 mL (Group A) or 30 mL (Group B) 0.375% ropivacaine. The latency and amplitude of Diaphragm CMAPs and forced vital capacity (FVC), FVC% predicted, and forced expiratory volume in 1 s (FEV1) were measured before and 30 min after SCBPB. Results Block success as primary anesthetic in addition to analgesia was 81% in Group A and 91% in Group B. There were no obvious differences in the effectiveness of analgesia between the two groups. The mean time to onset of motor block was significantly longer in Group A (8.1±2.7 min) than in Group B (5.4 ± 2.8 min; p Conclusions The incidence rates of phrenic nerve palsy and Diaphragm Paralysis were reduced, and lung function was less impaired in patients who received 20 mL vs 30 mL of 0.375% ropivacaine without any differences in block success. Selecting a lower volume of anesthetic for nerve block may be especially beneficial in obese patients or patients with cardiopulmonary disease. Trial registration number ChiCTR-IND-17012166.
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effect of local anesthetic volume 20 ml vs 30 ml ropivacaine on electromyography of the Diaphragm and pulmonary function after ultrasound guided supraclavicular brachial plexus block a randomized controlled trial
Regional Anesthesia and Pain Medicine, 2019Co-Authors: Juanjuan Huang, Haorong Feng, Yuying Qian, Yajie Wang, Qunying Zhang, Huansheng Hu, Xianghe WangAbstract:Background and objectives Diaphragmatic Paralysis following supraclavicular brachial plexus block (SCBPB) is ascribed to phrenic nerve palsy. This study investigated the effect of 2 volumes of 0.375% ropivacaine on efficacy of block as a surgical anesthetic and as an analgesic and examined Diaphragm compound muscle action potentials (CMAPs) and pulmonary function before and after SCBPB. Methods Eighty patients scheduled for removal of hardware for internal fixation after healing of an upper limb fracture distal to the shoulder were randomized to receive ultrasound-guided SCBPC for surgical anesthesia with 20 mL (Group A) or 30 mL (Group B) 0.375% ropivacaine. The latency and amplitude of Diaphragm CMAPs and forced vital capacity (FVC), FVC% predicted, and forced expiratory volume in 1 s (FEV1) were measured before and 30 min after SCBPB. Results Block success as primary anesthetic in addition to analgesia was 81% in Group A and 91% in Group B. There were no obvious differences in the effectiveness of analgesia between the two groups. The mean time to onset of motor block was significantly longer in Group A (8.1±2.7 min) than in Group B (5.4 ± 2.8 min; p Conclusions The incidence rates of phrenic nerve palsy and Diaphragm Paralysis were reduced, and lung function was less impaired in patients who received 20 mL vs 30 mL of 0.375% ropivacaine without any differences in block success. Selecting a lower volume of anesthetic for nerve block may be especially beneficial in obese patients or patients with cardiopulmonary disease. Trial registration number ChiCTR-IND-17012166.
Juanjuan Huang - One of the best experts on this subject based on the ideXlab platform.
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effect of local anesthetic volume 20 ml vs 30 ml ropivacaine on electromyography of the Diaphragm and pulmonary function after ultrasound guided supraclavicular brachial plexus block a randomized controlled trial
Regional Anesthesia and Pain Medicine, 2019Co-Authors: Xiuxia Bao, Juanjuan Huang, Haorong Feng, Yuying Qian, Yajie Wang, Qunying Zhang, Xianghe WangAbstract:Background and objectives Diaphragmatic Paralysis following supraclavicular brachial plexus block (SCBPB) is ascribed to phrenic nerve palsy. This study investigated the effect of 2 volumes of 0.375% ropivacaine on efficacy of block as a surgical anesthetic and as an analgesic and examined Diaphragm compound muscle action potentials (CMAPs) and pulmonary function before and after SCBPB. Methods Eighty patients scheduled for removal of hardware for internal fixation after healing of an upper limb fracture distal to the shoulder were randomized to receive ultrasound-guided SCBPC for surgical anesthesia with 20 mL (Group A) or 30 mL (Group B) 0.375% ropivacaine. The latency and amplitude of Diaphragm CMAPs and forced vital capacity (FVC), FVC% predicted, and forced expiratory volume in 1 s (FEV1) were measured before and 30 min after SCBPB. Results Block success as primary anesthetic in addition to analgesia was 81% in Group A and 91% in Group B. There were no obvious differences in the effectiveness of analgesia between the two groups. The mean time to onset of motor block was significantly longer in Group A (8.1±2.7 min) than in Group B (5.4 ± 2.8 min; p Conclusions The incidence rates of phrenic nerve palsy and Diaphragm Paralysis were reduced, and lung function was less impaired in patients who received 20 mL vs 30 mL of 0.375% ropivacaine without any differences in block success. Selecting a lower volume of anesthetic for nerve block may be especially beneficial in obese patients or patients with cardiopulmonary disease. Trial registration number ChiCTR-IND-17012166.
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effect of local anesthetic volume 20 ml vs 30 ml ropivacaine on electromyography of the Diaphragm and pulmonary function after ultrasound guided supraclavicular brachial plexus block a randomized controlled trial
Regional Anesthesia and Pain Medicine, 2019Co-Authors: Juanjuan Huang, Haorong Feng, Yuying Qian, Yajie Wang, Qunying Zhang, Huansheng Hu, Xianghe WangAbstract:Background and objectives Diaphragmatic Paralysis following supraclavicular brachial plexus block (SCBPB) is ascribed to phrenic nerve palsy. This study investigated the effect of 2 volumes of 0.375% ropivacaine on efficacy of block as a surgical anesthetic and as an analgesic and examined Diaphragm compound muscle action potentials (CMAPs) and pulmonary function before and after SCBPB. Methods Eighty patients scheduled for removal of hardware for internal fixation after healing of an upper limb fracture distal to the shoulder were randomized to receive ultrasound-guided SCBPC for surgical anesthesia with 20 mL (Group A) or 30 mL (Group B) 0.375% ropivacaine. The latency and amplitude of Diaphragm CMAPs and forced vital capacity (FVC), FVC% predicted, and forced expiratory volume in 1 s (FEV1) were measured before and 30 min after SCBPB. Results Block success as primary anesthetic in addition to analgesia was 81% in Group A and 91% in Group B. There were no obvious differences in the effectiveness of analgesia between the two groups. The mean time to onset of motor block was significantly longer in Group A (8.1±2.7 min) than in Group B (5.4 ± 2.8 min; p Conclusions The incidence rates of phrenic nerve palsy and Diaphragm Paralysis were reduced, and lung function was less impaired in patients who received 20 mL vs 30 mL of 0.375% ropivacaine without any differences in block success. Selecting a lower volume of anesthetic for nerve block may be especially beneficial in obese patients or patients with cardiopulmonary disease. Trial registration number ChiCTR-IND-17012166.
M. Green - One of the best experts on this subject based on the ideXlab platform.
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long term recovery of Diaphragm strength in neuralgic amyotrophy
European Respiratory Journal, 1999Co-Authors: P D Hughes, John Moxham, Michael I Polkey, M. GreenAbstract:Diaphragm Paralysis is a recognized complication of neuralgic amyotrophy that causes severe dyspnoea. Although recovery of strength in the arm muscles, when affected, is common, there are little data on recovery of Diaphragm function. This study, therefore, re-assessed Diaphragm strength in cases of bilateral Diaphragm Paralysis due to neuralgic amyotrophy that had previously been diagnosed at the authors institutions. Fourteen patients were recalled between 2 and 11 yrs after the original diagnosis. Respiratory muscle and Diaphragm strength were measured by volitional manoeuvres as maximal inspiratory pressure and sniff transDiaphragmatic pressure. Cervical magnetic phrenic nerve stimulation was used to give a nonvolitional measure of Diaphragm strength: twitch transDiaphragmatic pressure. Only two patients remained severely breathless. Ten of the 14 patients had evidence of some recovery of Diaphragm strength, in seven cases to within 50% of the lower limit of normal. The rate of recovery was variable: one patient had some recovery after 2 yrs, and the rest took 3 yrs or more. In conclusion, in most patients with Diaphragm Paralysis due to neuralgic amyotrophy, some recovery of the Diaphragm strength occurs, but the rate of recovery may be slow.
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cervical magnetic stimulation of the phrenic nerves in bilateral Diaphragm Paralysis
American Journal of Respiratory and Critical Care Medicine, 1997Co-Authors: G H Mills, Michael I Polkey, J Moxham, D Kyroussis, C H Hamnegard, S Wragg, M. GreenAbstract:Cervical magnetic stimulation (CMS) produces a greater twitch transDiaphragmatic pressure (TwPdi) than electrical stimulation. This may be because CMS produces rib cage muscle activation, thus producing an inspiratory action independent of the Diaphragm. Alternatively, CMS could merely stiffen the rib cage, allowing the Diaphragm to act efficiently, by contracting against a stable rib cage. To examine these two hypotheses we studied five patients with isolated bilateral Diaphragm Paralysis using CMS and bilateral electrical phrenic stimulation (BES). TwPdi, twitch esophageal pressure (TwPes), and twitch gastric pressure (TwPgas) were measured. We also assessed maximal sniff esophageal and transDiaphragmatic pressures (SnPes) (SnPdi), maximal inspiratory and expiratory mouth pressures (MIP) (MEP), and fall in VC on moving from an upright to a supine position. Respiratory muscle strength tests were consistent with bilateral Diaphragm Paralysis, and the MEPs confirmed normal expiratory muscle function. The p...
Haorong Feng - One of the best experts on this subject based on the ideXlab platform.
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effect of local anesthetic volume 20 ml vs 30 ml ropivacaine on electromyography of the Diaphragm and pulmonary function after ultrasound guided supraclavicular brachial plexus block a randomized controlled trial
Regional Anesthesia and Pain Medicine, 2019Co-Authors: Xiuxia Bao, Juanjuan Huang, Haorong Feng, Yuying Qian, Yajie Wang, Qunying Zhang, Xianghe WangAbstract:Background and objectives Diaphragmatic Paralysis following supraclavicular brachial plexus block (SCBPB) is ascribed to phrenic nerve palsy. This study investigated the effect of 2 volumes of 0.375% ropivacaine on efficacy of block as a surgical anesthetic and as an analgesic and examined Diaphragm compound muscle action potentials (CMAPs) and pulmonary function before and after SCBPB. Methods Eighty patients scheduled for removal of hardware for internal fixation after healing of an upper limb fracture distal to the shoulder were randomized to receive ultrasound-guided SCBPC for surgical anesthesia with 20 mL (Group A) or 30 mL (Group B) 0.375% ropivacaine. The latency and amplitude of Diaphragm CMAPs and forced vital capacity (FVC), FVC% predicted, and forced expiratory volume in 1 s (FEV1) were measured before and 30 min after SCBPB. Results Block success as primary anesthetic in addition to analgesia was 81% in Group A and 91% in Group B. There were no obvious differences in the effectiveness of analgesia between the two groups. The mean time to onset of motor block was significantly longer in Group A (8.1±2.7 min) than in Group B (5.4 ± 2.8 min; p Conclusions The incidence rates of phrenic nerve palsy and Diaphragm Paralysis were reduced, and lung function was less impaired in patients who received 20 mL vs 30 mL of 0.375% ropivacaine without any differences in block success. Selecting a lower volume of anesthetic for nerve block may be especially beneficial in obese patients or patients with cardiopulmonary disease. Trial registration number ChiCTR-IND-17012166.
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effect of local anesthetic volume 20 ml vs 30 ml ropivacaine on electromyography of the Diaphragm and pulmonary function after ultrasound guided supraclavicular brachial plexus block a randomized controlled trial
Regional Anesthesia and Pain Medicine, 2019Co-Authors: Juanjuan Huang, Haorong Feng, Yuying Qian, Yajie Wang, Qunying Zhang, Huansheng Hu, Xianghe WangAbstract:Background and objectives Diaphragmatic Paralysis following supraclavicular brachial plexus block (SCBPB) is ascribed to phrenic nerve palsy. This study investigated the effect of 2 volumes of 0.375% ropivacaine on efficacy of block as a surgical anesthetic and as an analgesic and examined Diaphragm compound muscle action potentials (CMAPs) and pulmonary function before and after SCBPB. Methods Eighty patients scheduled for removal of hardware for internal fixation after healing of an upper limb fracture distal to the shoulder were randomized to receive ultrasound-guided SCBPC for surgical anesthesia with 20 mL (Group A) or 30 mL (Group B) 0.375% ropivacaine. The latency and amplitude of Diaphragm CMAPs and forced vital capacity (FVC), FVC% predicted, and forced expiratory volume in 1 s (FEV1) were measured before and 30 min after SCBPB. Results Block success as primary anesthetic in addition to analgesia was 81% in Group A and 91% in Group B. There were no obvious differences in the effectiveness of analgesia between the two groups. The mean time to onset of motor block was significantly longer in Group A (8.1±2.7 min) than in Group B (5.4 ± 2.8 min; p Conclusions The incidence rates of phrenic nerve palsy and Diaphragm Paralysis were reduced, and lung function was less impaired in patients who received 20 mL vs 30 mL of 0.375% ropivacaine without any differences in block success. Selecting a lower volume of anesthetic for nerve block may be especially beneficial in obese patients or patients with cardiopulmonary disease. Trial registration number ChiCTR-IND-17012166.
Yuying Qian - One of the best experts on this subject based on the ideXlab platform.
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effect of local anesthetic volume 20 ml vs 30 ml ropivacaine on electromyography of the Diaphragm and pulmonary function after ultrasound guided supraclavicular brachial plexus block a randomized controlled trial
Regional Anesthesia and Pain Medicine, 2019Co-Authors: Xiuxia Bao, Juanjuan Huang, Haorong Feng, Yuying Qian, Yajie Wang, Qunying Zhang, Xianghe WangAbstract:Background and objectives Diaphragmatic Paralysis following supraclavicular brachial plexus block (SCBPB) is ascribed to phrenic nerve palsy. This study investigated the effect of 2 volumes of 0.375% ropivacaine on efficacy of block as a surgical anesthetic and as an analgesic and examined Diaphragm compound muscle action potentials (CMAPs) and pulmonary function before and after SCBPB. Methods Eighty patients scheduled for removal of hardware for internal fixation after healing of an upper limb fracture distal to the shoulder were randomized to receive ultrasound-guided SCBPC for surgical anesthesia with 20 mL (Group A) or 30 mL (Group B) 0.375% ropivacaine. The latency and amplitude of Diaphragm CMAPs and forced vital capacity (FVC), FVC% predicted, and forced expiratory volume in 1 s (FEV1) were measured before and 30 min after SCBPB. Results Block success as primary anesthetic in addition to analgesia was 81% in Group A and 91% in Group B. There were no obvious differences in the effectiveness of analgesia between the two groups. The mean time to onset of motor block was significantly longer in Group A (8.1±2.7 min) than in Group B (5.4 ± 2.8 min; p Conclusions The incidence rates of phrenic nerve palsy and Diaphragm Paralysis were reduced, and lung function was less impaired in patients who received 20 mL vs 30 mL of 0.375% ropivacaine without any differences in block success. Selecting a lower volume of anesthetic for nerve block may be especially beneficial in obese patients or patients with cardiopulmonary disease. Trial registration number ChiCTR-IND-17012166.
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effect of local anesthetic volume 20 ml vs 30 ml ropivacaine on electromyography of the Diaphragm and pulmonary function after ultrasound guided supraclavicular brachial plexus block a randomized controlled trial
Regional Anesthesia and Pain Medicine, 2019Co-Authors: Juanjuan Huang, Haorong Feng, Yuying Qian, Yajie Wang, Qunying Zhang, Huansheng Hu, Xianghe WangAbstract:Background and objectives Diaphragmatic Paralysis following supraclavicular brachial plexus block (SCBPB) is ascribed to phrenic nerve palsy. This study investigated the effect of 2 volumes of 0.375% ropivacaine on efficacy of block as a surgical anesthetic and as an analgesic and examined Diaphragm compound muscle action potentials (CMAPs) and pulmonary function before and after SCBPB. Methods Eighty patients scheduled for removal of hardware for internal fixation after healing of an upper limb fracture distal to the shoulder were randomized to receive ultrasound-guided SCBPC for surgical anesthesia with 20 mL (Group A) or 30 mL (Group B) 0.375% ropivacaine. The latency and amplitude of Diaphragm CMAPs and forced vital capacity (FVC), FVC% predicted, and forced expiratory volume in 1 s (FEV1) were measured before and 30 min after SCBPB. Results Block success as primary anesthetic in addition to analgesia was 81% in Group A and 91% in Group B. There were no obvious differences in the effectiveness of analgesia between the two groups. The mean time to onset of motor block was significantly longer in Group A (8.1±2.7 min) than in Group B (5.4 ± 2.8 min; p Conclusions The incidence rates of phrenic nerve palsy and Diaphragm Paralysis were reduced, and lung function was less impaired in patients who received 20 mL vs 30 mL of 0.375% ropivacaine without any differences in block success. Selecting a lower volume of anesthetic for nerve block may be especially beneficial in obese patients or patients with cardiopulmonary disease. Trial registration number ChiCTR-IND-17012166.