The Experts below are selected from a list of 282 Experts worldwide ranked by ideXlab platform
Frank G. Gress - One of the best experts on this subject based on the ideXlab platform.
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efficacy of endoscopic ultrasound guided celiac Plexus block and celiac Plexus neurolysis for managing abdominal pain associated with chronic pancreatitis and pancreatic cancer
Journal of Clinical Gastroenterology, 2010Co-Authors: Marina S Kaufman, Gurpreet Singh, Ronald Conchaparra, Jonathan A Erber, Carlos G Micames, Frank G. GressAbstract:Background/GoalsEndoscopic ultrasound (EUS)-guided celiac Plexus block (CPB) and celiac Plexus neurolysis (CPN) have become important interventions in the management of pain due to chronic pancreatitis and pancreatic cancer. However, only a few well-structured studies have been performed to evaluate
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Endoscopic Ultrasound-Guided Celiac Plexus Block and Celiac Plexus Neurolysis
Clinical Gastroenterology, 2010Co-Authors: Alejandra Castillo-roth, Frank G. GressAbstract:Endoscopic ultrasound-guided celiac Plexus block and celiac Plexus neurolysis are two techniques used to control pain associated with chronic pancreatitis and pancreatic cancer, respectively. These procedures are safe, have few absolute contraindications, and are relatively well tolerated. Celiac Plexus block and celiac Plexus neurolysis use bupivacaine followed by triamcinolone or ethyl alcohol, respectively. On average, the long-term effect of celiac Plexus block is 3 months, and repeat blocks can be administered. Direct celiac Plexus ganglia neurolysis is gaining acceptance in clinical practice, and further research is needed to evaluate the effectiveness of this technique.
Geert J Van Geffen - One of the best experts on this subject based on the ideXlab platform.
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hemidiaphragmatic paresis can be avoided in ultrasound guided supraclavicular brachial Plexus block
Regional Anesthesia and Pain Medicine, 2009Co-Authors: Steven H Renes, Harald C Rettig, M J M Gielen, Hubertus H Spoormans, Geert J Van GeffenAbstract:Background and Objectives: Supraclavicular brachial Plexus block is associated with 50% to 67% incidence of hemidiaphragmatic paresis as a result of phrenic nerve block. We examined whether ultrasound-guided compared with nerve stimulation supraclavicular brachial Plexus block using 0.75% ropivacaine results in a lower incidence of hemidiaphragmatic paresis. Methods: In a prospective randomized observer-blinded controlled trial, 60 patients scheduled for elective elbow, forearm, wrist, or hand surgery under supraclavicular brachial Plexus block without sedation were included. Supraclavicular brachial Plexus block was performed with 20 mL of 0.75% ropivacaine using either ultrasound or nerve stimulation guidance. Ventilatory function was assessed by ultrasound examination of hemidiaphragmatic movement and spirometry. Results: None of the 30 patients in the ultrasound group showed complete or partial paresis of the hemidiaphragm (95% confidence interval, 0.00-0.14), whereas in the nerve stimulation group, 15 patients showed complete paresis of the hemidiaphragm and 1 patient showed partial paresis of the hemidiaphragm (0% versus 53%, respectively; P Conclusions: Ultrasound-guided supraclavicular brachial Plexus block, using 20 mL of 0.75% ropivacaine with the described technique, is not associated with hemidiaphragmatic paresis.
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ultrasound guided low dose interscalene brachial Plexus block reduces the incidence of hemidiaphragmatic paresis
Regional Anesthesia and Pain Medicine, 2009Co-Authors: Steven H Renes, Harald C Rettig, M J M Gielen, Oliver H G Wildersmith, Geert J Van GeffenAbstract:Background and Objectives: Interscalene brachial Plexus block is associated with 100% incidence of hemidiaphragmatic paresis as a result of phrenic nerve block. We examined whether an ultrasound (US)-guided interscalene brachial Plexus block performed at the level of root C7 versus a nerve stimulation interscalene brachial Plexus block, both using 10 mL of ropivacaine 0.75%, resulted in a lower incidence of hemidiaphragmatic paresis. Methods: In a prospective randomized controlled trial, 30 patients scheduled for elective shoulder surgery under combined general anesthesia and interscalene brachial Plexus block were included. Interscalene brachial Plexus block using the same dose was performed using either US or nerve stimulation guidance of ropivacaine for both groups. General anesthesia was standardized. Ventilatory function was assessed using spirometry, and movement of the hemidiaphragm was assessed by US. Results: Two patients in the US group showed complete paresis of the hemidiaphragm, but in the nerve stimulation group, 12 patients showed complete and 2 patients had partial paresis of the hemidiaphragm (13% versus 93%, respectively; P Conclusions: Ultrasound-guided interscalene brachial Plexus block performed at the level of root C7 using 10 mL of ropivacaine 0.75% reduces the incidence of hemidiaphragmatic paresis.
Steven H Renes - One of the best experts on this subject based on the ideXlab platform.
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hemidiaphragmatic paresis can be avoided in ultrasound guided supraclavicular brachial Plexus block
Regional Anesthesia and Pain Medicine, 2009Co-Authors: Steven H Renes, Harald C Rettig, M J M Gielen, Hubertus H Spoormans, Geert J Van GeffenAbstract:Background and Objectives: Supraclavicular brachial Plexus block is associated with 50% to 67% incidence of hemidiaphragmatic paresis as a result of phrenic nerve block. We examined whether ultrasound-guided compared with nerve stimulation supraclavicular brachial Plexus block using 0.75% ropivacaine results in a lower incidence of hemidiaphragmatic paresis. Methods: In a prospective randomized observer-blinded controlled trial, 60 patients scheduled for elective elbow, forearm, wrist, or hand surgery under supraclavicular brachial Plexus block without sedation were included. Supraclavicular brachial Plexus block was performed with 20 mL of 0.75% ropivacaine using either ultrasound or nerve stimulation guidance. Ventilatory function was assessed by ultrasound examination of hemidiaphragmatic movement and spirometry. Results: None of the 30 patients in the ultrasound group showed complete or partial paresis of the hemidiaphragm (95% confidence interval, 0.00-0.14), whereas in the nerve stimulation group, 15 patients showed complete paresis of the hemidiaphragm and 1 patient showed partial paresis of the hemidiaphragm (0% versus 53%, respectively; P Conclusions: Ultrasound-guided supraclavicular brachial Plexus block, using 20 mL of 0.75% ropivacaine with the described technique, is not associated with hemidiaphragmatic paresis.
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ultrasound guided low dose interscalene brachial Plexus block reduces the incidence of hemidiaphragmatic paresis
Regional Anesthesia and Pain Medicine, 2009Co-Authors: Steven H Renes, Harald C Rettig, M J M Gielen, Oliver H G Wildersmith, Geert J Van GeffenAbstract:Background and Objectives: Interscalene brachial Plexus block is associated with 100% incidence of hemidiaphragmatic paresis as a result of phrenic nerve block. We examined whether an ultrasound (US)-guided interscalene brachial Plexus block performed at the level of root C7 versus a nerve stimulation interscalene brachial Plexus block, both using 10 mL of ropivacaine 0.75%, resulted in a lower incidence of hemidiaphragmatic paresis. Methods: In a prospective randomized controlled trial, 30 patients scheduled for elective shoulder surgery under combined general anesthesia and interscalene brachial Plexus block were included. Interscalene brachial Plexus block using the same dose was performed using either US or nerve stimulation guidance of ropivacaine for both groups. General anesthesia was standardized. Ventilatory function was assessed using spirometry, and movement of the hemidiaphragm was assessed by US. Results: Two patients in the US group showed complete paresis of the hemidiaphragm, but in the nerve stimulation group, 12 patients showed complete and 2 patients had partial paresis of the hemidiaphragm (13% versus 93%, respectively; P Conclusions: Ultrasound-guided interscalene brachial Plexus block performed at the level of root C7 using 10 mL of ropivacaine 0.75% reduces the incidence of hemidiaphragmatic paresis.
Vincent W S Chan - One of the best experts on this subject based on the ideXlab platform.
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ultrasound guided supraclavicular brachial Plexus block
Anesthesia & Analgesia, 2003Co-Authors: Vincent W S Chan, Anahi Perlas, Regan Rawson, Olusegun OdukoyaAbstract:In this study, we evaluated state-of-the-art ultrasound technology for supraclavicular brachial Plexus blocks in 40 outpatients. Ultrasound imaging was used to identify the brachial Plexus before the block, guide the block needle to reach target nerves, and visualize the pattern of local anesthetic
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brachial Plexus examination and localization using ultrasound and electrical stimulation a volunteer study
Anesthesiology, 2003Co-Authors: Anahi Perlas, Vincent W S Chan, Martin E SimonsAbstract:Background Current techniques of brachial Plexus block are “blind,” and nerve localization can be frustrating and time consuming. Previous studies on ultrasound-assisted brachial Plexus blocks are mostly performed with scanning probes of 10 MHz or less. The authors tested the usefulness of a state-of-the-art, high-resolution ultrasound probe (up to 12 MHz) in identifying the brachial Plexus in five locations of the upper extremity and in guiding needle advancement to target before nerve stimulation. Methods In this prospective observational study, 15 volunteers underwent brachial Plexus examination using an L12–L5 MHz probe and a Philips-ATL 5000 ultrasound unit in the interscalene, supraclavicular, infraclavicular, axillary, and midhumeral regions. Thereafter, an insulated block needle was advanced under direct ultrasound guidance to target nerves before confirmation by electrical nerve stimulation in five volunteers in each of the interscalene, supraclavicular, and axillary regions. The quality of brachial Plexus images, anatomic variations, and the technique of needle advancement for nerve localization were recorded. Results The brachial Plexus components were successfully identified in the transverse view as round to oval hypoechoic structures with small internal punctuate echos in all regions examined except the infraclavicular area (visualized in 27% of the cases). The authors’ technique of advancing the needle in-line with the ultrasound beam allowed moment-by-moment observation of the needle shaft and tip movement at the time of nerve localization. Hypoechoic structures were stimulated electrically and confirmed to be nerves. Conclusions These preliminary data show that the high-resolution L12–L5 probe provides good quality brachial Plexus ultrasound images in the superficial locations i.e., the interscalene, supraclavicular, axillary, and midhumeral regions. The needle technique described here for ultrasound-assisted nerve localization provides real-time guidance and is potentially valuable for brachial Plexus blocks.
Olusegun Odukoya - One of the best experts on this subject based on the ideXlab platform.
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ultrasound guided supraclavicular brachial Plexus block
Anesthesia & Analgesia, 2003Co-Authors: Vincent W S Chan, Anahi Perlas, Regan Rawson, Olusegun OdukoyaAbstract:In this study, we evaluated state-of-the-art ultrasound technology for supraclavicular brachial Plexus blocks in 40 outpatients. Ultrasound imaging was used to identify the brachial Plexus before the block, guide the block needle to reach target nerves, and visualize the pattern of local anesthetic
