Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Sep 2009
Diabetes mellitus, independent of body mass index, is associated with a "higher success" rate for supraclavicular brachial plexus blocks.
The prevalence of obesity and diabetes mellitus continues to rise in industrialized countries. The impact of diabetes on the practice of peripheral nerve block anesthesia, however, has not been fully elucidated. The authors retrospectively evaluated the influence of diabetes, body mass index (BMI), age, and sex on the success of supraclavicular block (SCB) placed with a landmark-based paresthesia technique. ⋯ We speculate that the "higher success" of SCB in patients with diabetes may be explained by: (i) higher sensitivity of diabetic nerve fibers to local anesthetics, (ii) possible unknown intraneural penetration before injection, and/or (iii) preexisting neuropathy with accompanying decreased sensation. In the absence of additional follow-up on these patients, these data should generate outcomes research addressing dose-response curves for patients with diabetes or at risk for diabetes.
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Reg Anesth Pain Med · Sep 2009
Letter Case ReportsUltrasound-guided infraclavicular nerve block and the cephalic vein.