Related Experiment Video
Updated: May 31, 2026
13:01
Intraluminal Middle Cerebral Artery Occlusion (MCAO) Model for Ischemic Stroke with Laser Doppler Flowmetry Guidance in Mice
Published on: May 8, 2011
Axillary brachial plexus blockade in moyamoya disease?
Saban Yalcin1, Hasan Cece, Halil Nacar
1Department of Anesthesiology, Reanimation, Harran University Medical Faculty, Şanliurfa, Turkey.
Indian Journal of Anaesthesia
|June 30, 2011
Summary
Peripheral nerve blockade, like axillary brachial plexus blockade, offers stable hemodynamics and allows neurological monitoring in Moyamoya disease patients. This approach is crucial for managing oxygen supply and demand in the brain during surgery.
Area of Science:
- Neurology
- Anesthesiology
- Vascular Surgery
Background:
- Moyamoya disease involves progressive steno-occlusive changes in intracranial carotid arteries, leading to impaired cerebral blood flow and metabolism.
- Maintaining stable oxygen supply and demand balance in the brain is critical during the perioperative period for these patients.
Purpose of the Study:
- To evaluate the utility of peripheral nerve blockade for anesthetic management in a patient with Moyamoya disease.
- To assess the feasibility of axillary brachial plexus blockade for surgical intervention in a Moyamoya patient.
Main Methods:
- A case report detailing the anesthetic management of a Moyamoya disease patient undergoing surgery for a radius fracture.
- Axillary brachial plexus blockade was employed to provide anesthesia and analgesia, facilitating neurological status monitoring.
Main Results:
- The axillary brachial plexus blockade provided excellent neurological status monitoring.
- Hemodynamic stability was maintained throughout the perioperative period, which is vital for Moyamoya disease patients.
Conclusions:
- Peripheral nerve blockade, specifically axillary brachial plexus blockade, is a viable and beneficial anesthetic technique for Moyamoya disease patients.
- This method supports the critical goal of preserving cerebral oxygen balance and hemodynamic stability in this high-risk patient population.
Related Concept Videos
01:22Spinal Nerves: Plexus I
Nerve plexuses are networks of interlacing nerves that serve as communication hubs to distribute and organize nerve action across various body regions. The nerve plexuses are organized into the cervical plexus located in the neck region, brachial plexus in the shoulder area, lumbar plexus found in the lower back, sacral plexus situated in the pelvis, and coccygeal plexus located in the coccygeal region.
The Cervical Plexus
The cervical plexus, formed by the anterior rami of the first four...
The Cervical Plexus
The cervical plexus, formed by the anterior rami of the first four...
01:29Neuromuscular Junction And Blockade
The site of chemical communication between a motor neuron and a muscle fiber is called the neuromuscular junction (NMJ). The end of the motor neuron at the NMJ divides into a cluster of synaptic end bulbs. The cytoplasm of these bulbs consists of synaptic vesicles enclosing acetylcholine molecules, the principal neurotransmitter released at the NMJ. The region opposite the synaptic bulb that ends in the muscle fiber is called the motor end plate, which has acetylcholine receptors. Within the...
01:27Nondepolarizing (Competitive) Neuromuscular Blockers: Pharmacological Actions
Nondepolarizing neuromuscular blockers prevent the membrane depolarization of muscle cells and inhibit muscle contraction. These are usually administered with anesthetics to achieve complete muscle relaxation. Upon administration, these drugs first block the small, rapidly contracting muscles of the face and hands, followed by the larger muscles of the trunk and the intercostal muscles. The diaphragm is the last muscle to be affected.
Although all competitive neuromuscular blockers are designed...
Although all competitive neuromuscular blockers are designed...
01:16Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia
Intravenous regional anesthesia or the Bier block technique is used to anesthetize a specific limb or extremity. It uses exsanguinated or blood-drained vessels to transport local anesthetics or LAs to the peripheral nerve trunks. Lidocaine without vasoconstrictors like epinephrine is most commonly used for this technique. Other drugs used are prilocaine, ropivacaine, and chloroprocaine. Bupivacaine is not recommended for this technique due to its high cardiac toxicity.
One of the advantages of...
One of the advantages of...
01:19Depolarizing Blockers: Pharmocokinetics
Depolarizing blockers are administered through intravenous injection. Succinylcholine is the most common choice of depolarizing blockers in emergency clinical practices. Although they have a rapid onset, they readily diffuse away from the motor end plate into the extracellular fluid. They are metabolized by enzymes such as liver butyrylcholinesterase and plasma pseudocholinesterases. This produces a short duration of action, typically 5-10 minutes long, unlike nondepolarizing blockers, which...
01:17Nondepolarizing (Competitive) Neuromuscular Blockers: Mechanism of Action
Nondepolarizing neuromuscular blockers induce paralysis by competitively blocking nicotinic acetylcholine receptors at the muscle end plate. Examples include pancuronium, mivacurium, vecuronium, and rocuronium. These quaternary ammonium derivatives are administered intravenously, are poorly absorbed, and are excreted via the kidneys.
Competitive antagonists prevent acetylcholine from binding to its receptor, inhibiting membrane depolarization. Without conformational changes or intrinsic...
Competitive antagonists prevent acetylcholine from binding to its receptor, inhibiting membrane depolarization. Without conformational changes or intrinsic...