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Anomalous Brachial Plexus and their Relationship to the Subclavian Artery in the Supraclavicular Region

June 10, 2024/1,480 Comments/in Volume 5; Issue 1: January-June 2024/by Ijraijraadmin

Vol 5 | Issue 1 | January-June 2024 | Page 30-31| Pooja Jadhao, Sandeep Diwan DOI: https://doi.org/10.13107/ijra.2024.v05.i01.088 Authors: Pooja Jadhao [1], Sandeep Diwan [1] [1] Department of Anaesthesiology, Sancheti Hospital and Rehabilitation Centre, Pune, Maharashtra, India. Address of Correspondence Dr. Pooja Jadhao, Department of Anaesthesiology, Sancheti Hospital and Rehabilitation Centre, Pune, Maharashtra, India. E-mail: poojajadhao533@gmail.com […]

The Fate of Lumbar Epidural Catheters in the Postoperative Period- A Retrospective Single-center Audit

December 10, 2023/3,359 Comments/in Volume 4; Issue 2: July-December 2023/by Ijraijraadmin

Vol 4 | Issue 2 | July-December 2023 | Page 14-17 | Sandeep Diwan, Himaunshu Dongre, Parag Sancheti DOI: https://doi.org/10.13107/ijra.2023.v04i02.077 Submitted: 26-06-2023; Reviewed: 18-07-2023; Accepted: 23-10-2023; Published: 10-12-2023 Authors: Sandeep Diwan [1], Himaunshu Dongre [1], Parag Sancheti [2] [1] Department of Anesthesiology, Sancheti Hospital, Pune, Maharashtra, India. [2] Department of Orthopaedics, Sancheti Hospital, Pune, […]

Anomalous Brachial Plexus and their Relationship to the Subclavian Artery in the Supraclavicular Region

June 10, 2024/1,480 Comments/in Volume 5; Issue 1: January-June 2024/by Ijraijraadmin

The Fate of Lumbar Epidural Catheters in the Postoperative Period- A Retrospective Single-center Audit

December 10, 2023/3,359 Comments/in Volume 4; Issue 2: July-December 2023/by Ijraijraadmin

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Anomalous Brachial Plexus and their Relationship to the Subclavian Artery in the Supraclavicular Region

June 10, 2024/1,480 Comments/in Volume 5; Issue 1: January-June 2024/by Ijraijraadmin

Vol 5 | Issue 1 | January-June 2024 | Page 30-31| Pooja Jadhao, Sandeep Diwan

DOI: https://doi.org/10.13107/ijra.2024.v05.i01.088

Authors: Pooja Jadhao [1], Sandeep Diwan [1]

[1] Department of Anaesthesiology, Sancheti Hospital and Rehabilitation Centre, Pune, Maharashtra, India.

Address of Correspondence
Dr. Pooja Jadhao,
Department of Anaesthesiology, Sancheti Hospital and Rehabilitation Centre, Pune, Maharashtra, India.
E-mail: poojajadhao533@gmail.com

Abstract

The brachial plexus at supraclavicular division level is superior and lateral to the subclavian artery. Thus needle tip positions are already published in literature. However we report the brachial plexus divisions on the medial side of the subclavian artery. This might result in inadequate or failed blocks with landmark guided technique. Moreover with ultrasound needle tip needs to advance medial to artery making it more difficult in expert hands too. Ultrasound imaging of brachial plexus helps in identifying anamolous position of brachial plexus divisions.
Keywords- Brachial plexus divisions, Subclavian artery, Ultrasound

References

1. Kessler J, Gray AT. Sonography of scalene muscle anomalies for brachial plexus block. Reg Anesth Pain Med. 2007; 32:172-3.
2. Chin KJ, Niazi A, Chan V. Anomalous brachial plexus anatomy in the supraclavicular region detected by ultrasound. Anesth Analg.2008;107:729-31
3. Padur AA, Kumar N, Shanthakumar SR, Shetty SD, Prabhu GS, Patil J. Unusual and unique variant branches of lateral cord of brachial plexus and its clinical implications ‒ A cadaveric study. J Clin Diagn Res. 2016;10:AC01-4.
4. Royse CF, Sha S, Soeding PF, Royse AG. Anatomical study of the brachial plexus using surface ultrasound. Anaesth Intensive Care 2006; 34:203–10.
5. Ramanujam V, Kirk PV. Anatomy variation of brachial plexus trunks during supraclavicular nerve block: clinical image. Braz J Anesthesiol. 2022 Nov-Dec;72(6):834-835.
6. Chan VW, Perlas A, Rawson R, Odukoya O. Ultrasound-guided supraclavicular brachial plexus block. Anesth Analg 2003;97: 1514–7.

How to Cite this Article: Jadhao P, Diwan S | Anomalous Brachial Plexus and their Relationship to the Subclavian Artery in the Supraclavicular Region | International Journal of Regional Anaesthesia | January-June 2024; 5(1): 30-31 | DOI: https://doi.org/10.13107/ijra.2024.v05.i01.88

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The Fate of Lumbar Epidural Catheters in the Postoperative Period- A Retrospective Single-center Audit

December 10, 2023/3,359 Comments/in Volume 4; Issue 2: July-December 2023/by Ijraijraadmin

Vol 4 | Issue 2 | July-December 2023 | Page 14-17 | Sandeep Diwan, Himaunshu Dongre, Parag Sancheti

DOI: https://doi.org/10.13107/ijra.2023.v04i02.077

Submitted: 26-06-2023; Reviewed: 18-07-2023; Accepted: 23-10-2023; Published: 10-12-2023

Authors: Sandeep Diwan [1], Himaunshu Dongre [1], Parag Sancheti [2]

[1] Department of Anesthesiology, Sancheti Hospital, Pune, Maharashtra, India.
[2] Department of Orthopaedics, Sancheti Hospital, Pune, Maharashtra, India.

Address of Correspondence
Dr. Himaunshu Dongre,
Department of Anesthesiology, Sancheti Hospital, Pune, Maharashtra State, India.
E-mail: himaunshu.dongre@gmail.com

Abstract

This paper describes a retrospective audit of fate of epidural catheters in post operative period in adults and elderly patients (more than 65 years) receiving epidural infusion analgesia (EIA) in a single institute. Epidural catheters can either migrate inwards (inward migration of epidural catheter or IMEC) otherwise, outwards (outward migration of epidural catheter or OMEC). The OMEC can lead to failure of epidural analgesia and loss of infusate. The primary aim was to evaluate the incidence of OMEC. The secondary aim was, disconnections, kinking, knotting and breakage of catheter. The primary and secondary aim together were considered as fate of epidural catheter. Our study demonstrates the OMEC occurred at 1.12%, disconnection at 7.32%, kink and knot at 1.12% and 0.016% respectively A good communication at all levels (anesthesiologist-handlers at each level-nursing staff), in event of raised incidence (inform the QHC and concerned anesthesiologist) is mandatory to avoid mishandling of epidural assembly. After identifying some of the causes including the dressing material and fixation methods, changes were implemented which will be audited in the subsequent study.
Keywords: Epidural catheter migration, Audit, Observational Study

References

1. McWilliam A, Smith A. National UK audit projects in anaesthesia. Continuing Education in Anaesthesia, Critical Care & Pain 2008;8:5.
2. Shaw C, Costain DW. Guidelines for medical audit: seven principles. Br Med J 1989; 299: 498– 9.
3. Gülcü N, Karaaslan K, Koçoğlu H, Gümüş E. A new method for epidural catheter fixation. Agri. 2007; 19:33-7.
4. Chadwick VL, Jones M, Poulton B, Fleming BG. Epidural catheter migration: a comparison of tunnelling against a new technique of catheter fixation. Anaesth Intensive Care. 2003; 31:518-22.
5. Bishton IM, Martin PH, Vernon JM, Liu WH. Factors influencing epidural catheter migration. Anaesthesia 1992; 47: 610– 12.
6. Kumar N, Chambers WA. Tunnelling epidural catheters: a worthwhile exercise? Anaesthesia. 2000; 55:625-6.
7. Coupé M, al-Shaikh B. Evaluation of a new epidural fixation device. Anaesthesia. 1999 ; 54:98-9.
8. Bougher RJ, Corbett AR, Ramage DT. The effect of tunnelling on epidural catheter migration Anaesthesia 1996; 51: 191– 4.
9. Burstal R, Wegener F, Hayes C, Lantry G. Subcutaneous tunnelling of epidural catheters for postoperative analgesia to prevent accidental dislodgement: a randomized controlled trial. Anaesth Intensive Care. 1998; 26:147-51.
10. Tripathi M, Pandey M. Epidural catheter fixation: subcutaneous tunnelling with a loop to prevent displacement. Anaesthesia. 2000; 55:1113-6.
11. Clark MX, O’Hare K, Gorringe J, Oh T. The effect of the Lockit epidural catheter clamp on epidural migration: a controlled trial. Anaesthesia. 2001; 56: 865-70.

How to Cite this Article: Diwan S, Dongre H, Sancheti P | The Fate of Lumbar Epidural Catheters in the Postoperative Period- A Retrospective Single-center Audit | International Journal of Regional Anaesthesia | July-December 2023; 4(2): 14-17 | DOI: https://doi.org/10.13107/ijra.2023.v04i02.077

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Half Sized Blog Element (Multi Author Style)

Anomalous Brachial Plexus and their Relationship to the Subclavian Artery in the Supraclavicular Region

The Fate of Lumbar Epidural Catheters in the Postoperative Period- A Retrospective Single-center Audit

Anomalous Brachial Plexus and their Relationship to the Subclavian Artery in the Supraclavicular Region

The Fate of Lumbar Epidural Catheters in the Postoperative Period- A Retrospective Single-center Audit

Full Sized Blog Element (Big Preview Pic)

Anomalous Brachial Plexus and their Relationship to the Subclavian Artery in the Supraclavicular Region

Authors: Pooja Jadhao [1], Sandeep Diwan [1]

(Abstract Text HTML) (Download PDF)

The Fate of Lumbar Epidural Catheters in the Postoperative Period- A Retrospective Single-center Audit

Authors: Sandeep Diwan [1], Himaunshu Dongre [1], Parag Sancheti [2]

(Abstract Text HTML) (Download PDF)

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