BACKGROUND According to some reports, left hemidiaphragmatic paralysis due to phrenic nerve injury may occur following cardiac surgery. The purpose of this study was to document the effects on phrenic nerve injury of whole body hypothermia, use of ice-slush around the heart and mammary artery harvesting. METHODS Electrophysiology of phrenic nerves was studied bilaterally in 78 subjects before...

AIM High cervical spinal cord injury is associated with high morbidity and mortality. Traditional treatments carry various complications such as infection, pacemaker failure and undesirable movement. Thus, a secure surgical strategy with fewer complications analogous to physiological ventilation is still required. We hope to offer one potential method to decrease the complications and improve s...

Approximately 5% of spinal cord-injured individuals suffer from respiratory muscle paralysis and require chronic mechanical ventilation. Unfortunately, this form of life support is associated with a number of undesirable side effects and discomforts. The only available alternative to mechanical ventilation is diaphragm pacing via bilateral phrenic nerve stimulation. This technique can provide p...

OBJECTIVE To evaluate the risk of phrenic nerve injury during ultrasound-guided stellate ganglion block (US-SGB) according to sonoanatomy of the phrenic nerve, and determine a safer posture for needle insertion by assessing its relationship with surrounding structure according to positional change. METHODS Twenty-nine healthy volunteers were recruited and underwent ultrasound in two postures,...

BACKGROUND In brachial plexus avulsion, a recent technique connects the ending of the disrupted musculocutaneous nerve to the side of the intact phrenic nerve to regain elbow flexion. This requires the phrenic nerve to perform a new double function: independent control of breathing and elbow flexion. Neuroplastic changes associated with acquisition of double nerve functions have not yet been in...

There is evidence that early diagnosis of postoperative phrenic nerve damage may improve outcome, by allowing early surgical treatment, in children following cardiac surgery. This has prompted the development of a simple method for measuring phrenic nerve latency at the bedside in children. We have evaluated the reproducibility of measurements made with this system in 11 children (4 months to 1...

During routine dissection in the department of anatomy, the following anatomical variations of the phrenic nerve were observed on the right side of the neck of a 30-year-old male cadaver. The phrenic nerve, in its early course close to its origin, gave a communicating branch to the C5 root of the brachial plexus. At the level of the root of neck just before entering the thorax, the phrenic nerv...

In nerve transfer, we transfer a physiologically active nerve to a distal, more important but irreparably paralyzed nerve. This surgical procedure is best done early within 6 months of the injury. Nerve transfer can be broadly classified into four categories: (1) Extraplexal; (2) Intraplexal and (3) Targeted nerve transfer. Prime extraplexal donors are the spinal accessory, phrenic and intercos...

In the treatment of brachial plexus injury, nerves that are functionally less important are transferred onto the distal ends of damaged crucial nerves to help recover neuromuscular function in the target region. For example, intercostal nerves are transferred onto axillary nerves, and accessory nerves are transferred onto suprascapular nerves, the phrenic nerve is transferred onto the musculocu...

Stimulation of the raphe pallidus nucleus produces facilitatory effects on respiratory activity. Numerous serotonergic projections from the raphe pallidus have been shown to terminate in the phrenic nucleus. This study was undertaken to examine the role of 5-hydroxytryptamine 1A (5-HT(1A)) receptors in the phrenic nucleus on the excitatory response of the phrenic nerve activity elicited from th...