Outstanding explanation. RN, needed cmc arthroplasty- had axillary block, then subclavicular rescue block. Axillary worked longer, with just local for Subclavicular, watching procedure( no Versed or anything) , my anatomy “ was off”. As stated 20 cc max, no > than 15 PSI. Well explained
Very helpful video and discussion. Many providers use the supraclavicular block "spinal of the arm" for these procedures of the elbow, forearm, and hand. In my training I find few providers performing axillary blocks. What is your take on this?
Hi Kodi. Either can be used. THink - axillary is more superficial, better visualized, you can control for blood vessels better, no phrenic nerve block (diaphragmatic paresis). Overall, in a busy hand surgery practice, axillary block in our experience is much easier to implement as standard than supraclavicular. Best regards
Evaluating the effectiveness of plexus anesthesia in upper limb surgery? Most patients still feel pain during skin incision and still need additional pre-anesthetic medication. Is there a way to make the patient better?
Another great video! What brand and gauge needles do you prefer to use? Yours show up so well on US. I struggle to see my needles sometimes using 21g stimuplex. It could just be my technique though.
Since they are using US for nerve localization, the neurostimulator is used as a safety measure for avoiding intraneural injection. With 0,5 mA you could be correctly placed, without a motor response.
You have a twitch when you are close to the nerve so you are in the right location. Ex if you have a twitch at 0.6 close to nerve but twitch at 0.4 your needle may be in the nerve and cause an injury! No twitch at 0.4 or 0.5 in his case means you are not injecting the nerve (document no twitch at 0.4 prior to injection) and causing injury.
I'm not a doctror but it's obvious that if you are getting a twitch from the nerve then you are in contact of this nerve and there is possibility that you just created the injury.
Fantastic as always Dr Hadzic. Could you please include a presentation on blocks for clavicular fracture fixation in your series? Thanking you in anticipation
Hi Chandrika! Thank you. This is a great suggestion. We will definitely put this on our list. Greetings to you and all your colleagues and make sure you subscribe to our channel so you don't miss these upcoming videos. Best Regards from NYSORA!!
Thanks Sandra. We have noticed this and regularly report such comments. However, we will pay more attention and contact RUclips support to avoid any unwanted interference to our channel. Thank you again!
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Outstanding explanation. RN, needed cmc arthroplasty- had axillary block, then subclavicular rescue block. Axillary worked longer, with just local for Subclavicular, watching procedure( no Versed or anything) , my anatomy “ was off”. As stated 20 cc max, no > than 15 PSI. Well explained
Hey Robert Martin! That is great also. Thank you for sharing! B-safe!
Best video ever in this topic…. Thank you and best regards from Germany 🇩🇪
Glad you liked it!
Always educative. Thank you Dr Hadzic for this beautiful crash course
Hi Olusola! Thank you so much for your kind words; we really appreciate your feedback.
Very helpful video and discussion. Many providers use the supraclavicular block "spinal of the arm" for these procedures of the elbow, forearm, and hand. In my training I find few providers performing axillary blocks. What is your take on this?
Hi Kodi. Either can be used. THink - axillary is more superficial, better visualized, you can control for blood vessels better, no phrenic nerve block (diaphragmatic paresis). Overall, in a busy hand surgery practice, axillary block in our experience is much easier to implement as standard than supraclavicular. Best regards
Evaluating the effectiveness of plexus anesthesia in upper limb surgery? Most patients still feel pain during skin incision and still need additional pre-anesthetic medication. Is there a way to make the patient better?
gracias maestro
Most Welcome Eddy! B-safe!
Another great video! What brand and gauge needles do you prefer to use? Yours show up so well on US. I struggle to see my needles sometimes using 21g stimuplex. It could just be my technique though.
I struggle too visualising the echogenic nerve stimulator needle
How to improve technique?
Very interesting video and explanation.
Glad you liked it!
Why the muscle twitch must be absent, doesn't a twitch mean the needle tip is in close proximity to the nerve? That's what we want
Since they are using US for nerve localization, the neurostimulator is used as a safety measure for avoiding intraneural injection. With 0,5 mA you could be correctly placed, without a motor response.
You have a twitch when you are close to the nerve so you are in the right location. Ex if you have a twitch at 0.6 close to nerve but twitch at 0.4 your needle may be in the nerve and cause an injury! No twitch at 0.4 or 0.5 in his case means you are not injecting the nerve (document no twitch at 0.4 prior to injection) and causing injury.
I'm not a doctror but it's obvious that if you are getting a twitch from the nerve then you are in contact of this nerve and there is possibility that you just created the injury.
Fantastic as always Dr Hadzic. Could you please include a presentation on blocks for clavicular fracture fixation in your series? Thanking you in anticipation
Hi Chandrika! Thank you. This is a great suggestion. We will definitely put this on our list. Greetings to you and all your colleagues and make sure you subscribe to our channel so you don't miss these upcoming videos. Best Regards from NYSORA!!
@@nysoravideo we all keenly await your videos
Thank you Dr! Very hepful.
Thank you very much!
it is good，and very useful！thank you！
Glad it was helpful!
Good job 👍, Admir! Love all your presentations
Hi Jacob! Thank you for your comment! Stay connected, a lot more is coming soon.
Thank you for this video
You're welcome! More videos coming soon!
thank you for sharing this.
Great. Thank you for watching. Filming the teaching process can be challenging! ;)
Great video, thank you!
Glad you liked it!
Please check spam comments. They are marking your channel.
Thanks Sandra. We have noticed this and regularly report such comments. However, we will pay more attention and contact RUclips support to avoid any unwanted interference to our channel. Thank you again!
@@nysoravideo I don't have a channel but I undestend you can block links comments. I hope that is useful.
Incredible, but at 4:38 minutes you said MC nerve lies between (Biceps Femoris) 😳😜
Thank you. Indeed. Biceps. ;)
@@DRBLUESNYC welcome Sir