Development and application of detachable upper limb operating table for field shelter / 医疗卫生装备

Objective To develop a detachable upper limb operation table for facilitating field surgery and improve the utilization rate of surgical shelter in field hospital.Methods The operating table was composed of a rectangular frame made of stainless steel and a table top of insulation board.The width of the rectangular frame was quartered,and two elastic fasteners were placed respectively at the points of a quarter and 3 quarters.The operating table came into being after the two fasteners were connected.Results The table had its height regulated as required and facilitated intraoperative X-ray exposure,and enhanced the efficiency and satisfaction of the surgeon and nurse.Conclusion The table gains advantages in size,carrying,operation and structure,and thus is applicable for upper limb operation in field shelter.

Development and application of detachable upper limb operating table for field shelter / 医疗卫生装备

Objective To develop a detachable upper limb operation table for facilitating field surgery and improve the utilization rate of surgical shelter in field hospital.Methods The operating table was composed of a rectangular frame made of stainless steel and a table top of insulation board.The width of the rectangular frame was quartered,and two elastic fasteners were placed respectively at the points of a quarter and 3 quarters.The operating table came into being after the two fasteners were connected.Results The table had its height regulated as required and facilitated intraoperative X-ray exposure,and enhanced the efficiency and satisfaction of the surgeon and nurse.Conclusion The table gains advantages in size,carrying,operation and structure,and thus is applicable for upper limb operation in field shelter.

Effect Observation of Ultrasound-guided Clavicular Brachial Plexus Block in Upper Limb Surgery / 中国药师

Objective: To observe the effect of ultrasound-guided clavicular brachial plexus block in upper limb surgery.Methods: Eighty patients undergoing upper limb surgery were enrolled and randomly divided into two groups: ultrasound-guided clavicular brachial plexus block group (ultrasound guidance group, n=40) and nerve stimulator-assisted positioning of the supraclavicular brachial plexus block group (nerve stimulator group,n =40).The block effect, anesthesia effect, anesthesia completion time, nerve block onset time, nerve block duration and complication were compared and analyzed statistically between the groups.Results: The completed rate of block was 97.5%in the ultrasound guidance group, which was significantly higher than that in the nerve stimulator group (65.0%) (P<0.05);the uncompleted rate was significantly lower than that in the nerve stimulator group.The fine/excellent rate of anesthesia was 95.0% , which was significantly higher than that of the nerve stimulator group (75.0%, 30/40) (P<0.05);the complete time of anesthesia and nerve block onset time were significantly shorter than those in the nerve stimulator group (P<0.05);the duration of nerve block was significantly longer than that in the nerve stimulator group (P<0.05);the incidence of complications was 7.5%), which was significantly lower than that of the nerve stimulator group (37.5%, 15/40) (P<0.05).Conclusion: In upper limb surgery, ultrasound-guided nerve stimulator assisted positioning of clavicular brachial plexus block is better than nerve stimulator assisted positioning of clavicular brachial plexus block.

Effect of dexmedetomidine on upper limb surgery during brachial plexus block anesthesia and its influence on cognitive function / 中国生化药物杂志

Objective To explore the effect of dexmedetomidine on upper limb surgery during brachial plexus block anesthesia and its influence on cognitive function.MethodsFrom May 2015 to May 2016, 60 cases of elbow joint operation patients were studied.The patients were randomly divided into control group (local anesthesia combined with physiological saline) and observation group (using local anesthesia drugs with dexmedetomidine).The mean arterial pressure and heart rate before and after anesthesia in two groups were compared.The changes of anesthesia and cognitive function, and the incidence of adverse reactions were compared between the two groups.ResultsCompared with before anesthesia, the mean arterial pressure and heart rate were significantly lower in the two groups (P<0.05).The mean arterial pressure and heart rate in the observation group were significantly lower than those in the control group (P<0.05).There was no significant difference between the two groups in the onset time of motor block sensory block, while the observation group was significantly longer than the control group (P<0.05).The control group patients with Ramsay score below 3 points, a total of 4 cases, accounting for the observation group of patients with Ramsay score of less than 3 points, a total of 24 cases, accounting for 80%, the observation group was significantly better than the control group (P<0.05) sedative effect.Compared with before anesthesia, two groups of patients with postoperative 20min MMSE score were lower, but the observation group MMSE score was significantly higher than that of the control group (P<0.05).There was no significant difference in adverse reactions between the two groups.ConclusionIn the following surgery, the use of local anesthesia combined with dexmedetomidine anesthesia can prolong the time of nerve tissue, and can obtain better sedation and pain, and has little effect on the cognitive function of patients.

Ultrasound Guided Low Approach Interscalene Brachial Plexus Block for Upper Limb Surgery

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 approach, ultrasound-guided interscalene brachial plexus block (LISB) was performed on twenty-eight patients undergoing surgery of the upper extremities. The patients were assessed five minutes and fifteen minutes after the block for the degree of block in each nerve and muscle as well as for any complications. RESULTS: At five minutes and fifteen minutes after the performance of the block, the degree of the block in the ulnar nerve was found to be 2.8 +/- 2.6 and 1.1 +/- 1.8, respectively, based on a ten-point scale. Motor block occurred in the median nerve after fifteen minutes in 26 of the 28 patients (92.8%), and in all of the other three nerves in all 28 patients. None of the patients received additional analgesics, and none experienced complications. CONCLUSIONS: The present study confirmed the achievement of an appropriate sensory and motor block in the upper extremities, including the ulnar nerve, fifteen minutes after LISB, with no complications.

A comparison of infraclavicular and supraclavicular approaches to the brachial plexus using neurostimulation / 대한마취과학회지

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 block was performed using the vertical technique with 30 ml of 0.5% ropivacaine. The supraclavicular brachial plexus block was performed using the plumb bob technique with 30 ml of 0.5% ropivacaine. The block performance-related pain was evaluated. This study observed which nerve type was stimulated, and scored the sensory and motor block. The quality of the block was assessed intra-operatively. The duration of the sensory and motor block as well as the complications were assessed. The patient's satisfaction with the anesthetic technique was assessed after surgery. RESULTS: There were no significant differences in the block performance-related pain, frequency of the stimulated nerve type, evolution of sensory and motor block quality, or the success of the block. There were no significant differences in the duration of the sensory and motor block. There was a significant difference in the incidence of Horner's syndrome. Two patients had a pneumothorax in the supraclavicular approach. There were no significant differences in the patient's satisfaction. CONCLUSIONS: Both infraclavicular and supraclavicular brachial plexus block had similar effects. The infraclavicular approach may be preferred to the supraclavicular approach when considering the complications.

Comparison of vertical infraclavicular brachial plexus block with 0.5% levobupivacaine and 0.5% ropivacaine for upper limb surgery / 대한마취과학회지

BACKGROUND: We performed a prospective, double blind study to compare the clinical effect of vertical infraclavicular brachial plexus block produced by 0.5% levobupivacaine and 0.5% ropivacaine for upper limb surgery. METHODS: We included 60 patients receiving upper limb surgery under infraclavicular brachial plexus block. The infraclavicular brachial plexus block was performed via the vertical technique with 30 ml of 0.5% levobupivacaine or 0.5% ropivacaine. We observed which nerve type was stimulated and scored the sensory and motor block. The quality of block was assessed intraoperatively. The duration of sensory and motor block and complications were assessed. RESULTS: There were no significant differences in frequencies of stimulated nerve type, evolution of sensory and motor block quality, or success of block. There were no significant difference in duration of sensory block, but duration of motor block was prolonged after 0.5% levobupivacaine. There were no complications. CONCLUSIONS: Both 0.5% levobupivacaine and 0.5% ropivacaine had similar effects in the vertical infraclavicular brachial plexus block.

A clinical comparison of vertical infraclavicular brachial plexus block using 0.75% or 0.5% ropivacaine for upper limb surgery / 대한마취과학회지

BACKGROUND: We performed a prospective, double blind study to compare the clinical effect of vertical infraclavicular brachial plexus block produced by 0.75% vs 0.5% ropivacaine for upper limb surgery. METHODS: We included 80 patients receiving upper limb surgery under infraclavicular brachial plexus block. The infraclavicular brachial plexus block was performed via the vertical technique with 30 ml of 0.75% or 0.5% ropivacaine. By observation, we determined nerve type was stimulated and scored the level of sensory block and motor block. The quality of blocks was assessed intra-operatively. The duration of sensory block and motor block and their complications were assessed. RESULTS: There were no significant differences in the frequency of stimulated nerve type, evolution of sensory and motor block quality, or success of block. There were no significant differences in the duration of sensory block and motor block. Vascular puncture was noted in 1 patient in the 0.75% ropivacaine. CONCLUSIONS: Both the 0.75% and 0.5% ropivacaine had similar effects in the vertical infraclavicular brachial plexus block.