• Title/Summary/Keyword: Axillary nerve

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Dexamethasone or Dexmedetomidine as Local Anesthetic Adjuvants for Ultrasound-guided Axillary Brachial Plexus Blocks with Nerve Stimulation

  • Lee, Myeong Jong;Koo, Dae Jeong;Choi, Yu Sun;Lee, Kyu Chang;Kim, Hye Young
    • The Korean Journal of Pain
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    • v.29 no.1
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    • pp.29-33
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    • 2016
  • Background: The purpose of this study was to evaluate the effect of dexamethasone or dexmedetomidine added to ropivacaine on the onset and duration of ultrasound-guided axillary brachial plexus blocks (BPB). Methods: Fifty-one ASA physical status I-II patients with elective forearm and hand surgery under axillary brachial plexus blocks were randomly allocated to receive 20 ml of 0.5% ropivacaine with 2 ml of isotonic saline (C group, n = 17), 20 ml of 0.5% ropivacaine with 2 ml (10 mg) of dexamethasone (D group, n = 17) or 20 ml of 0.5% ropivacaine with 2 ml ($100{\mu}g$) of dexmedetomidine (DM group, n = 17). A nerve stimulation technique with ultrasound was used in all patients. The onset time and duration of sensory blocks were assessed. Results: The duration of the sensory block was extended in group D and group DX compared with group C (P < 0.05), but there was no significant difference between group D and group DX. However, there were no significant differences in onset time in all three groups. Conclusions: Dexamethasone 10 mg and dexmedetomidine $100{\mu}g$ were equally effective in extending the duration of ropivacaine in ultrasound-guided axillary BPB with nerve stimulation. However, neither drug has significantly effects the onset time.

A Novel Approach to the Treatment of Shoulder Pain (오십견 치료에 대한 새로운 지견)

  • Choi, Joong-Rieb
    • The Korean Journal of Pain
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    • v.4 no.2
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    • pp.168-178
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    • 1991
  • It has been generally known that shoulder pains are attributed to the degenerative changes around the shoulder joint. However, many patients who complain of pain or limited range of motion of the shoulder have no definite pathology on X-ray or laboratory examinations. I examined 134 patients with shoulder pain and found the fact that compression of the axillary nerve, which leads to contraction of the deltold muscle or teres minor muscle, resulted in pain and limited range of motion in many cases. Accordingly, relieving the compression of the axillary nerve by laser stimulation or local anesthetic infiltration on the identified trigger point, anti-inflammatory medication, muscle relaxant together with ordinary physical therapy was found to be very effective in the treatment of shoulder pain.

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Variation of the Axillary Arch in Korean Cadaver (한국인 시신에서 랑거겨드랑활의 변이)

  • Jeong, Hyun-Seok;Jo, Seong-Woo;Lee, Jae-Ho
    • Anatomy & Biological Anthropology
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    • v.31 no.4
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    • pp.167-170
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    • 2018
  • Axillary arch is relatively common variation of muscle in the axilla. There were several attentions on axillary arch due to its anatomical and surgical importance. During educational dissection, a variant muscle was found in right arm of 68-year-old female cadaver. The variation of muscle originated from the lateral edge of the latissimus dorsi muscle as muscular form. And then, it crossed the axillary artery and median nerve as tendinous form. Finally it became wide as muscular form and inserted into the pectoralis major. We reported this variant muscle and discussed its clinical significances.

Ultrasound-guided Continuous Axillary Brachial Plexus Block Using a Nerve Stimulating Catheter: EpiStim Catheter

  • Choi, Sang Sik;Lee, Mi Kyoung;Kim, Jung Eun;Kim, Se Hee;Yeo, Gwi Eun
    • The Korean Journal of Pain
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    • v.28 no.4
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    • pp.287-289
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    • 2015
  • Brachial plexus block (BPB) under ultrasound guidance has come to be widely used. However, nerve injury has been reported following ultrasound-guided BPB. We hypothesized that BPB under ultrasound guidance in conjunction with real-time electrical nerve stimulation would help us prevent nerve injury and do more successful procedure. Here, we report the successful induction and maintenance of ultrasound-guided BPB and the achievement of good peri- and postoperative pain control using a conductive catheter, the EpiStim$^{(R)}$.

Anterior Dislocation of the Shoulder with Rotator Cuff tear Over the 5th Decades of Age (40대 이후 발생한 견관절 탈구와 회전근 개 파열)

  • Moon, Young-Lae;Lee, Sang-Hong;Kim, Jeoung-Ho
    • Journal of the Korean Arthroscopy Society
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    • v.6 no.2
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    • pp.131-135
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    • 2002
  • Object : To evaluate the prognostic factors of the rotator cuff tear after anterior dislocation of the shoulder over the 5th decades of age. Methods : We evaluated twelve patients who had rotator cuff tears combined with primary anterior dislocation of the glenohumeral joint between May 1995 and October 1998. Their age were ranged from 42 to 67-years-old. Two of them were initially presumed to have an injury of the axillary nerve and associated with avulsion fracture of the greater tuberosity. Among twelve patients who had rotator cuff tears, 8 cases had massive, 3 cases had medium and one case had a small sized tear. Results : All the tears of the rotator cuff were repaired and the results were obtained by UCLA shoulder rating scale. Ten cases of them revealed more than good results except for 2 cases who had been unhappy triad of the shoulder injury. Conclusions : In the case of anterior dislocation of shoulder, it is necessary to check the injury of rotator cuff and axillary nerve in the middle age group. If these injuries are combined, proper rotator cuff repair and axillary nerve rehabilitation program would be asked for better results.

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Isolated Musculocutaneous Nerve Palsy after the Reverse Total Shoulder Arthroplasty

  • Kim, Sung-Guk;Choi, Chang-Hyuk
    • Clinics in Shoulder and Elbow
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    • v.19 no.2
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    • pp.101-104
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    • 2016
  • Reverse total shoulder arthroplasty has been performed with promising results in rotator cuff tear arthropathy. However, the global complication of the reverse total shoulder arthroplasty is relatively higher than that of the conventional total shoulder arthroplasty. Neurologic complications after reverse total shoulder arthroplasty are rare but there are sometimes remaining sequelae. The cause of the neurologic complication is multifactorial, including arm traction, position and the design of the implant. Most cases of neurologic palsy following reverse total shoulder arthroplasty occur in the axillary nerve and the radial nerve. The authors report on a case of a 71-year-old man with isolated musculocutaneous nerve palsy after reveres total shoulder arthroplasty with related literature.

Musculocutaneous and Median Neuropathy after MiraDry® Procedure for Axillary Hyperhidrosis (다한증 치료 기구인 MiraDry®에 의한 근피 및 정중신경 손상 증례)

  • Kim, Youngmin;Yoon, Mi-Jeong;Park, Sunha;Kim, Min Wook
    • Clinical Pain
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    • v.20 no.2
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    • pp.135-140
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    • 2021
  • MiraDry®, a microwave thermolysis device, is comparably new non-surgical agent in the field of eradication of sweat glands for treating axillary hyperhidrosis and osmidrosis. So far, altered sensation, swelling, and compensatory sweating are widely known as adverse effects of MiraDry®. Of the few reported MiraDry®-induced neuropathy cases, median and ulnar neuropathies are common. Although, one case has described radial nerve and posterior cord damage with maximized stimulation intensity, musculocutaneous nerve damage induced by MiraDry® has not been reported. Here, we report a case of a 30-year-old woman experiencing left hand weakness after receiving MiraDry® at a local dermatology clinic. Left brachial plexopathy, mainly involving the median nerve and the musculocutaneous nerve with partial axonotmesis, was confirmed by electrodiagnostic studies. Ultrasound evaluation showed corresponding results. This is the first case report of the musculocutaneous neuropathy by MiraDry®.