Intraplexal nerve transfer is defined as nerve transfer of a nerve within the brachial plexus with intact spinal cord connections to a more important injured nerve. For elbow flexion, the most popular one for the upper arm brachial plexus injury is the “Oberlin” nerve transfer. Transferring a part of the ulnar nerve to the branch to the biceps (Oberlin 1) and possibly transferring a part of the...

BACKGROUND A prospective, double blind study was performed to compare the clinical effect of vertical infraclavicular and supraclavicular brachial plexus block using a nerve stimulator for upper limb surgery. METHODS One hundred patients receiving upper limb surgery under infraclavicular or supraclavicular brachial plexus block were enrolled in this study. The infraclavicular brachial plexus ...

introduction the brachial plexus, a complex network of nerves, innervates to the upper limbs. variation in the course of the nerves in the upper limb is common. case presentation this paper describes two cases of upper limb variations in a cadaver dissected at lorestan university of medical sciences. in the first variation, the median nerve in the arm has a different route, so that the median m...

OBJECTIVE To investigate the feasibility of a non-stimulation needle with an external indwelling cannula for upper-limb surgery and acute postoperative pain management. METHODS 62 patients undergoing either scheduled or emergency upper-limb surgery received brachial plexus block of modified interscalene or axillary brachial and then postoperative patient-controlled analgesia (PCA) with local ...

The brachial plexus is formed by the union of the ventral rami of the inferior four cervical (C5-C8) and first thoracic (T1) nerves (Figure 1). The C5 nerve usually receives a small contribution from the fourth-cervical nerve and the T1 nerve normally receives one from the second thoracic nerve. The brachial plexus supplies cutaneous and muscular innervation to the upper limb(s) and any injury ...

Brachial plexus injury is very rare in neurosurgical practice, so many neurosurgeons have never experienced this problem in Japan. This study describes a clinical analysis of 16 patients aged 5 to 62 years (mean 32.9 years) who presented at our institution with brachial plexus injuries. Nine patients presented with paralysis and seven with paresis. Head injury was the most common associated inj...

BACKGROUND AND OBJECTIVES There are several approaches to the brachial plexus depending on the experience of the anesthesiologist and the site of the surgery. Posterior brachial plexus block may be an alternative for shoulder, clavicle and proximal humerus surgery. This study aims at presenting the results of patients submitted to posterior brachial plexus block with 0.5% ropivacaine and the ai...

BACKGROUND Restoration of flexion in the elbow is the priority in the management of brachial plexus injuries. Current techniques of reconstructions, combining both nerve grafting and nerve transfer, allow more extensive repair, with additional targets: shoulder, elbow extension, hand. The transfer of intercostal nerves onto the nerve of the triceps long head is used to restore elbow extension. ...

BACKGROUND The interscalene brachial plexus block is widely used for pain control and anesthetic purposes during shoulder arthroscopic surgeries and surgeries of the upper extremities. However, it is known that interscalene brachial plexus block is not appropriate for upper limb surgeries because it does not affect the lower trunk (C8-T1, ulnar nerve) of the brachial plexus. METHODS A low app...

Axillary brachial plexus block is an effective method of anaesthesia for the surgeries performed on the hand, forearm and distal third of the arm. However it has the risk of serious complications such as cardiovascular and central nervous system toxicity. Levobupivacaine is a long acting amide local anaesthetic used for epidural, caudal, spinal, infiltration and peripheral nerve blocks. Levobup...