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Biomedical subjects

P Poirier

Publications and source records attributed to P Poirier.

At least 37 records · Page 2Linked to original sources
PubMed2000

Bronchial stump aspergillosis.

Two cases of bronchial stump aspergillosis were diagnosed 5 and 6 years after pneumonectomy for lung cancer. In each case, the fungal mass was endoscopically removed using standard forceps. A recurrence of the fungal mass persisted until all visible protruding nylon threads in the airway lumen were destroyed with a Nd:YAG laser. Removal of the visible suture is necessary for eliminating the infection. No additional local or systemic antifungal therapy is needed.

Aspergillosis↗
PubMed2000

Responses of cells to stationary and moving sound stimuli in the anterior ectosylvian cortex of cats.

The azimuthal, directional and angular speed sound selectivities of single units were examined in the posterior part of the anterior ectosylvian cortex. Broadband noise bursts and simulated moving sounds were delivered from 16 loudspeakers fixed on the horizontal plane in a quasi-anechoic sound-isolation chamber. The activity of 78 neurons was recorded and quantitatively analyzed. Most cells responded to at least the static sound. The relative strengths of their responses suggested that the cells could be classed as omnidirectional (37.2%), contralateral hemifield (29.5%), ipsilateral hemifield (2.5%) and azimuth (7.7%) selective. The remaining 23.1% could not be classified. All cells responded to a simulated moving sound displaced at five different speeds. A majority (88%) of them showed some directional preference in that they discharged at least twice as strongly for one direction as for the other for at least one speed. 14.7% displayed angular speed selectivity. Different patterns of neuronal discharges were evoked. For static sounds, most of the cells gave ON-type responses. A large proportion (60%) of the cells responded in a sustained manner to maintained stimulation. Among these, 68% also gave sustained discharges to moving sounds. The spatial tuning and the directional and angular speed selectivity of neurons in the posterior part of the AEC suggest that this area is involved in the processing of static and moving sounds.

Acoustic Stimulation↗
PubMed2000

Significant interaction between the nonprescription antihistamine diphenhydramine and the CYP2D6 substrate metoprolol in healthy men with high or low CYP2D6 activity.

The prototype "classic" over-the-counter antihistamine diphenhydramine was shown to interact with the polymorphic P450 enzyme CYP2D6. This project was undertaken to investigate (1) whether diphenhydramine inhibits the biotransformation of the clinically relevant CYP2D6 substrate metoprolol in vitro and (2) whether this in vitro interaction results in a clinically significant pharmacokinetic and pharmacodynamic drug interaction in vivo. In vitro incubations were carried out with microsomes obtained from lymphoblastic cells transfected with CYP2D6 complementary deoxyribonucleic acid to determine the type and extent of inhibition. We then randomized 16 subjects with genetically determined high (extensive metabolizers) or low (poor metabolizers) CYP2D6 activity to receive metoprolol (100 mg) in the presence of steady-state concentrations of diphenhydramine or placebo. In vitro, diphenhydramine was a potent competitive inhibitor of metoprolol alpha-hydroxylation, exhibiting an inhibitory constant of 2 micromol/L and increasing the Michaelis-Menten constant of metoprolol sixfold. In vivo, diphenhydramine decreased metoprolol oral and nonrenal clearances twofold and metoprolol-->alpha-hydroxymetoprolol partial metabolic clearance 2.5-fold in extensive metabolizers (all P < .05) but not in poor metabolizers (P > .2). Although the hemodynamic response to metoprolol was unaltered by diphenhydramine in poor metabolizers (P > .05), metoprolol-related effects on heart rate, systolic blood pressure, and Doppler-derived aortic blood flow peak velocity were more pronounced and lasted significantly longer in extensive metabolizers receiving diphenhydramine compared with poor metabolizers and extensive metabolizers receiving placebo. We conclude that diphenhydramine inhibits the metabolism of metoprolol in extensive metabolizers, thereby prolonging the negative chronotropic and inotropic effects of the drug. Clinically relevant drug interactions may occur between diphenhydramine and many CYP2D6 substrates, particularly those with a narrow therapeutic index.

Adrenergic beta-Antagonists↗
PubMed2000

Directionality derived from pinna-cue spectral notches in cat dorsal cochlear nucleus.

We tested two hypotheses to determine whether dorsal cochlear nucleus (DCN) neurons are specialized to derive directionality from spectral notches: DCN neurons exhibit greater spectral-dependent directionality than ventral cochlear nucleus (VCN) neurons, and spectral-dependent directionality depends on response minima (nulls) produced by coincidence of best frequency (BF) and spectral-notch center frequency. Single-unit responses to 50-ms noise and tone bursts were recorded in barbiturate-anesthetized cats (BFs: 4-37 kHz). Units were classified using BF tone poststimulus time histograms. Pauser, onset-G (type II interneurons), and some chopper units were recorded from the DCN. Primary-like, onset-CIL (onset other than onset-G), and most choppers in the sample were recorded from the VCN. Many pauser and onset-G units were highly directional to noise. Chopper, onset-CIL, and primary-like units (collectively referred to as C-O-P units) were not. The difference in directionality depends on a monaural mechanism as pausers were more directional to monaural noise than C-O-P units. Contralateral inhibition produced a small increase in pauser directionality to noise simulation but had no effect on directionality of C-O-P units. Pauser and C-O-P units exhibited similar low directionality to BF tone, showing that the difference in noise directionality between groups depends on spectral cues. These results show that spectral-dependent directionality is a DCN specialization. Azimuth functions of highly directional units exhibited response nulls, and there was a linear relationship between BFs in the range of 8-13 kHz and azimuthal locations of nulls. This relationship parallels the known spatial distribution of spectral-notch center frequencies on the horizontal plane. Furthermore spatial receptive fields of pausers show response nulls that follow the expected diagonal trajectory of the spectral notch in this frequency range. These results show that DCN spectral-dependent directionality depends on response nulls produced by coincidence of unit BF and spectral-notch center-frequency.

Acoustic Stimulation↗
PubMed2000

Directionality derived from differential sensitivity to monaural and binaural cues in the cat's medial geniculate body.

Azimuth tuning of high-frequency neurons in the primary auditory cortex (AI) is known to depend on binaural disparity and monaural spectral (pinna) cues present in broadband noise bursts. Single-unit response patterns differ according to binaural interactions, strength of monaural excitatory input from each ear, and azimuth sensitivity to monaural stimulation. The latter characteristic has been used as a gauge of neural sensitivity to monaural spectral directional cues. Azimuth sensitivity may depend predominantly on binaural disparity cues, exclusively on monaural spectral cues, or on both. The primary goal of this study was to determine whether each cortical response pattern corresponds to a similar pattern in the medial geniculate body (MGB) or whether some patterns are unique to the cortex. Single-unit responses were recorded from the ventral nucleus (Vn) and lateral part of the posterior group of thalamic nuclei (Po), tonotopic subdivisions of the MGB. Responses to free-field presentation of noise bursts that varied in azimuth and sound pressure level were obtained using methods identical to those used previously in field AI. Many units were azimuth sensitive, i.e., they responded well at some azimuths, and poorly, if at all, at others. These were studied further by obtaining responses to monaural noise stimulation, approximated by reversible plugging of one ear. Monaural directional (MD) cells were sensitive to the azimuth of monaural noise stimulation, whereas binaural directional (BD) cells were either insensitive to its azimuth or monaurally unresponsive. Thus BD and MD cells show differential sensitivity to monaural spectral cues. Monaural azimuth sensitivity could not be used to interpret the spectral sensitivity of predominantly binaural cells that exhibited strong binaural facilitation because they were either unresponsive or poorly responsive to monaural stimulation. The available evidence suggests that some such cells are sensitive to spectral cues. The results do not indicate the presence of any response types in AI that are not present in the MGB. Vn and Po contain similar classes of MD and BD cells. Because Po neurons project to the anterior auditory field, neurons in this cortical area also are likely to exhibit differential sensitivity to binaural disparity and monaural spectral cues. Comparison of these MGB data with a published report of cochlear nucleus (CN) single-unit azimuth tuning shows that MGB sensitivity to spectral cues is considerably stronger than CN sensitivity.

Acoustic Stimulation↗
PubMed2000

Impact of time interval from the last meal on glucose response to exercise in subjects with type 2 diabetes.

We evaluate the influence of the time interval from the last meal on the blood glucose response to exercise in men with type 2 diabetes. Nineteen men with type 2 diabetes participated in an exercise training program carried out at 60% of maximal oxygen uptake (VO2peak) for 1 h, 3 times a week. Capillary whole blood glucose was measured immediately before and after each exercise session, and the time interval from the last meal (breakfast, lunch, or dinner) was recorded. Seven time intervals were considered (fasted overnight and 0-1, 1-2, 2-3, 3-4, 4-5, and 5-8 h postmeal). A total of 1,045 exercise sessions were analyzed. There was no change in blood glucose levels when individuals were in the fasted state (mean +/- SE, 8.1 +/- 0.2 vs. 8.1 +/- 0.1 mmol/L; before vs. after, respectively). However, blood glucose decreased by 28 +/- 1% at 0-1 h, by 33 +/- 1% at 1-2 h, by 35 +/- 1% at 2-3 h, by 38 +/- 2% at 3-4 h, by 43 +/- 2% at 4-5 h, and by 23 +/- 3% at 5-8 h (all P < 0.001). These results demonstrate that 1 h of ergocycle exercise has no clinical impact on blood glucose when performed in the fasted state in men with type 2 diabetes, whereas a significant decrease in blood glucose should be expected when the same exercise is performed postprandially.

Adult↗
PubMed1999

Role of Cryptosporidium parvum as a pathogen in neonatal diarrhoea complex in suckling and dairy calves in France.

This study was carried out to find the importance of Cryptosporidium parvum in diarrhoea of neonatal calves in two types of breeding - suckling and dairy calves - in France. Different agents causing neonatal diarrhoea, E. coli, rotavirus, coronavirus, Salmonella and Cryptosporidium were systematically researched in faeces. 1. Suckling calves: In 40 livestock farms selected for diarrhoea, 311 calves 4 to 10 days old which had diarrhoea for less than 24h or no diarrhoea, were included in the study. A prophylaxis of neonatal diarrhoea had been carried out in 21 of the 40 livestock farms. On D0 (inclusion day), the mean age was 6 days, 82% presented a good initial general condition and 76.2% had a good appetite; 48.6% were diarrhoeic but 91.3% presented no sign of dehydration. Only 6.1% were infected by E. coli K99, 14.3% by rotavirus, 6.8% by coronavirus, 0.3% by Salmonella but 50% excreted C. parvum oocysts. This later percentage increases up to 84% and 86% by D3 and D7, respectively . We note that 16% of the 4-day-old calves on D0 are excreting oocysts and this percentage increases as a function of the age of the calf on D0 to reach 90% to 95% by the age of 8 days. 10 out of 12 dead calves excreted C. parvum oocysts. From D0 to D14 the other pathogen agents show a relative or a decreasing stability. 2. Dairy calves: 382 calves which had diarrhoea for less than 24 h or no diarrhoea, aged 8 to 15 days coming from six industrial livestock farms were included in the study. On D0, 99% of the calves presented a good initial general condition, 99.7% had a good appetite and no calf was dehydrated. At this date (D0), 16.8% of the calves excreted cryptosporidia. This percentage increases up to 23% and 51.8% on D3 and D8, respectively, then decreases to 31.9% on D14. The pressure of the other pathogenicagents remains relatively stable, excepted for rotavirus on D7 (from 9.9% on D0 to 27.2% on D7, then 12.6% on D14) which does not explain the concomitantpeak in diarrhoea because the infection by rotavirus on D7 is more frequent in non-diarrhoeic calves than in diarrhoeic calves. Our results show that Cryptosporidium prevalence is higher in suckling than in dairy calves and C. parvum constitutes actually in both cases the major aetiological agent of neonatal diarrhoea.

Animals↗
PubMed1999

Localization of moving sounds by hemispherectomized subjects.

The objective of the present study was to evaluate the localization abilities of the residual auditory structures in hemispherectomized subjects (Hs) during monaural and binaural listening. The monaural stimulus presentations were aimed at evaluating the relative contribution of crossed and uncrossed afferents to the perception of a moving auditory target. Three Hs and ten control subjects (Cs) were asked to localize a simulated moving sound source of fixed intensity presented on the horizontal plane. The moving stimulus was delivered randomly through 16 loudspeakers which were mounted at 10 degree intervals on a calibrated perimeter frame located inside an anechoic chamber. The apparent movement traveled in either direction over three different distances in the peri-central and lateral fields. Listeners had to report the movement trajectory by pointing with the index finger where they thought the beginning and the ending of the stimulus occurred on the perimeter. Hs were less accurate than Cs in the binaural condition, suggesting that the residual hemisphere and/or subcortical structures are not by themselves as efficient to accurately analyze motion as when the two hemispheres are present. In the monaural testing conditions, most of the subjects showed a prominent lateral displacement of the perceived localization towards the functional ear. However, all subjects, particularly the Cs, were able to perceive different lengths of trajectories although they did not discriminate the direction of the motion. For the Hs, the pattern of performance differed for each subject. One right Hs was more accurate for localizing the sources delivered on the side of the functional ear when relying on crossed-input. A left Hs was able to detect the appropriate side of the moving sound source even when it was presented on the side to the obstructed ear. The other left Hs who had developed normally until the age of 5, was more affected by the hemidecortication in both the binaural and the monaural listening conditions. These findings suggest that it is possible to detect moving sounds in the absence of binaural cues and without the integration carried out by both cerebral hemispheres. However it appears that interaural disparities and bihemispheric integration are required for finer analysis.

Acoustic Stimulation↗
PubMed1997

Positional, directional and speed selectivities in the primary auditory cortex of the cat.

Responses of high-frequency primary auditory cortex (A1) neurons of the cat to noise stimulation were obtained in a quasianechoic chamber using a static and an apparently moving stimulus presented at similar azimuths. Simulated motion toward right or left as well as different simulated velocities were used. Under static stimulation, most units were contralateral-preferring followed by ipsilateral- and midline-preferring. Some were omnidirectional and a few were unclassifiable. Width of tuning was similar for contralateral-, ipsilateral- and midline-preferring units. Overall, about 25% were finely tuned (< 20 degrees) and the remaining were broadly tuned (> or =20 degrees). All cells sampled with static stimulation responded to apparent motion. About one quarter of the units were sensitive to the direction of the simulated moving noise in that they responded at least twice as much to one direction as to the other. Almost all directional contralateral-preferring units responded more when the apparent motion was directed toward ipsilateral azimuths, whereas all directional ipsilateral-preferring units responded preferentially to contralaterally oriented motion. In some units, up to five apparent speeds were tested. About half the units were not speed-selective (46%). The other cells were tuned to a preferential speed (40%), decreased their response as the apparent speed increased (10%) or displayed direction-dependent speed selectivity (4%). These results indicate that moving-sound sources are processed by some A1 single units.

Acoustic Stimulation↗
PubMed1997

A novel supraclavicular approach to brachial plexus block.

We describe a novel supraclavicular approach to the brachial plexus. Designated as the intersternocleidomastoid technique, this new approach was tested in unembalmed cadavers. It was then applied for evaluation to 150 ASA grade I or II patients scheduled for elective surgery or physiotherapy of the upper limb or for treatment of reflex sympathetic dystrophy associated with painful shoulder. The new approach was easy to master because of a very simple surface landmark, i.e., the triangle formed by the sternocleidomastoid heads, which were visible and palpable in most patients studied (90%). The procedure was effective intraoperatively, providing satisfactory anesthesia in 140 patients (93%), partially satisfactory blocks in 6 (4%), and unsatisfactory blocks in only 4 (3%). The catheter entry point is cephalad enough not to obscure the surgical field on the shoulder. Catheter insertion was successful in 63 of 70 patients. Postoperative analgesia was provided for 48 h or more in 45 patients and for 24 h in 18 patients. Only minor complications were observed: asymptomatic phrenic nerve block in 89 patients (60%), transient Horner's syndrome in 15 (10%), transient recurrent laryngeal nerve blockade in 2, and misplacement of the catheter into the subclavian vein in 1 patient. No pneumothorax was observed.

Adult↗
PubMed1997

Monaural spectral contrast mechanism for neural sensitivity to sound direction in the medial geniculate body of the cat.

Monaural spectral contrast mechanism for neural sensitivity to sound direction in the medial geniculate body of the cat. J. Neurophysiol. 78: 2754-2771, 1997. Central auditory neurons vary in sound direction sensitivity. Insensitive cells discharge well to all sound source directions, whereas sensitive cells discharge well to certain directions and poorly to others. High-frequency neurons in the latter group are differentially sensitive to binaural and monaural directional cues present in broadband noise (BBN). Binaural directional (BD) cells require binaural stimulation for directional sensitivity; monaural directional (MD) cells are sensitive to the direction of monaural stimuli. A model of MD sensitivity was tested using single-unit responses. The model assumes that MD cells derive directional sensitivity from pinna-derived spectral cues (head related transfer function, HRTF). This assumption was supported by the similarity of effects that pinna orientation produces on locations of HRTF patterns and on locations of MD cell azimuth function peaks and nulls. According to the model, MD neurons derive directional sensitivity by use of excitatory/inhibitory antagonism to compare sound pressure in excitatory and inhibitory frequency domains, and a variety of observations are consistent with this idea. 1) Frequency response areas of MD cells consist of excitatory and inhibitory domains. MD cells exhibited a higher proportion of multiple excitatory domains and narrower excitatory frequency domains than BD cells, features that may reflect specialization for spectral-dependent directional sensitivity. 2) MD sensitivity requires sound pressure in excitatory and inhibitory frequency domains. Directional sensitivity was evaluated using stimuli with frequency components confined exclusively to excitatory domains (E-only stimuli) or distributed in both excitatory and inhibitory domains (E/I stimuli). Each of 13 MD cells that were tested exhibited higher directional sensitivity to E/I than to E-only stimuli; most MD cells exhibited relatively low directional sensitivity when frequency components were confined exclusively to excitatory domains. 3) MD sensitivity derives from excitatory/inhibitory antagonism (spectral inhibition). Comparison of responses to best frequency and E/I stimuli provided strong support for spectral inhibition. Although spectral facilitation conceivably could contribute to directional sensitivity with direction-dependent increases in response, the results did not show this to be a significant factor. 4) Direction-dependent decreases in responsiveness to BBN reflect increased sound pressure in inhibitory relative to excitatory frequency domains. This idea was tested using the strength of two-tone inhibition, which is a function of stimulus levels in inhibitory relative to excitatory frequency domains. The finding that two-tone inhibition was stronger at directions where BBN responses were minimal than at directions where they were maximal supports the model.

Acoustic Stimulation↗
PubMed1997

Mitral balloon valvuloplasty in pregnancy: limiting radiation and procedure time by using transesophageal echocardiography.

A 35-year-old female with mitral stenosis was admitted to hospital in her 23rd week of gestation for management of disabling dyspnea and paroxysmal nocturnal dyspnea. She was in New York Heart Association functional class III and underwent successful percutaneous balloon mitral valvuloplasty with significant improvement of her symptoms. To limit radiation exposure and procedure time, transesophageal echocardiography was used in combination with pulsed fluoroscopy. The remainder of her pregnancy was uncomplicated and she gave birth to a healthy baby at 38 weeks' gestation.

Adult↗
PubMed1997

[Fingertips and nailbed injuries in children. Apropos of 241 cases].

PURPOSE OF THE STUDY: The authors studied long-term outcome of fingertip trauma in children, as its management remains controversial. MATERIAL AND METHODS: 241 cases with a mean follow-up of 2.5 years were analysed. Epidemiologic data were studied as well as functional and esthetic sequelae regarding nailbed as well as fingertips, depending on treatment. RESULTS: 42 per cent nail deformities, and 40 per cent sensory disturbances were found. Only 14 nailbeds were sutured, leading to 12 normal nails (86 per cent) when not sutured nailbeds led to 52 per cent normal nails. We obtained 60 per cent excellent and good results. DISCUSSION: We compared our results with those of other authors performing the same procedures; when most care is given to perionychium repair fewer nail deformities are found. The nail must be removed in order to explore the whole nailbed, using optic magnification. A small and adsorbable suture is preferable for better repair. Every injury involving the nail is liable to interfere with nail regrowth: parents and child must be warned of this risk. CONCLUSION: The importance of adequate management, a good overall view, and accurate treatment of nailbed injuries, especially in children, should be stressed, in order to avoid functional and cosmetic sequelae.

Accidents, Home↗
PubMed1996

Role of body fat loss in the exercise-induced improvement of the plasma lipid profile in non-insulin-dependent diabetes mellitus.

The study was designed to examine the impact of exercise training on the plasma lipid profile in non-insulin-dependent diabetes mellitus (NIDDM) and, more particularly, to determine the relationship between changes in body fat mass and changes in the lipid profile. Eleven men with NIDDM exercised for 1 hour thrice per week on an ergocycle over a 6-month period at 60% maximal oxygen uptake (Vo2max). Diet and hypoglycemic agents were kept constant throughout this period. Vo2max, body composition, fasting plasma glucose and insulin levels, glycosylated hemoglobin, and the lipid profile were determined at baseline, in the middle (3 months), and at the end (6 months) of the training program. When the subjects were considered as a group, the only significant effect of training was on Vo2max, which increased from 32.2 +/- 1.2 mL/kg/min at baseline to 38.0 +/- 1.7 mL/kg/min at 6 months (P < .001). When the data were analyzed on an individual basis, significant associations were observed between changes in body fat mass and changes in the low-density lipoprotein (LDL) cholesterol/high-density lipoprotein (HDL) cholesterol ratio (r = .62,P = .04) or triglyceride (TG) levels (r = .64,P = .03). These data indicate that fat loss, not training per se, favorably alters the lipid profile of subjects with NIDDM who participate in an aerobic physical-conditioning program.

Adipose Tissue↗
PubMed1996

[An experimental short-term study of intramuscular integration of macroporous biphasic calcium phosphate ceramics. Application to the achievement of biocomposite flaps].

The aim of this research is to prefabricate a bicomposite flap, which can be defined as a composite structure of foreign material and living tissue. An animal model was developed by vascularizing spherical implants of macroporous biphasic calcium phosphate by a latissimus dorsi muscle flap in rabbits. The experiment was divided into three stages to compare the role of blood flow in the flap and autologous marrow bone cells. Biological apatite precipitation inside the macropores requires both factors and allows further clinical applications.

Animals↗
PubMed1995

Binaural noise stimulation of auditory callosal fibers of the cat: responses to interaural time delays.

The corpus callosum, the principal neocortical commissure, allows for the interhemispheric transfer of lateralized information between the hemispheres. The aim of the present experiment was to study callosal transfer of auditory information in the cat, with particular reference to its contribution to sound localization. The corpus callosum was approached under direct visual control, and axonic responses were recorded under light anesthesia using glass micro-pipettes. Results showed that auditory information is transmitted in the posterior portion of the callosum. Diotic presentations, in which interaural time delay was manipulated, indicated that, for a large number of fibers, the largest excitatory or inhibitory interactions were obtained at null interaural time delay, a condition which supports the notion of a callosal contribution to auditory midline fusion. However, an important number of callosal fibers was also found to be excited maximally at specific, non-zero interaural time delays, suggesting that they preferred sounds situated at spatial locations other than the midline. The results are discussed in relation to those obtained electrophysiologically for the visual and somesthesic modalities and in terms of results obtained in human and animal behavioral experiments.

Acoustic Stimulation↗
PubMed1995

A new axillary approach for continuous brachial plexus block. A clinical and anatomic study.

Catheter insertion in the neurovascular space by axillary approach allows a continuous brachial plexus block and/or postoperative analgesia. We developed a perivenous technique whereby the approach to the neurovascular sheath is guided under fluoroscopy by a preopacified axillary vein. A randomized study compared this technique to the technique of Selander in ASA grade I-II patients scheduled for surgery or painful physiotherapy of the hand. The study was performed in 36 patients randomly divided into two groups. In Group 1 (n = 18), the catheter was placed according to the technique described by Selander. In Group 2 (n = 18), the catheter was placed using our perivenous technique. A complete block was obtained in all the patients of Group 2 vs only 50% of the patients in Group 1 (P < 0.05). In Group 1 a partial block was observed in 17%, with failure in 33% of the patients. There was no difference in the two groups regarding the time required to perform either technique, the duration of the complete block, the pain score, or the amount of continuously administrated bupivacaine during the first 48 h postoperatively. The plasma concentrations of total bupivacaine (high-performance liquid chromatography) were low in successful blocks, with no differences in the two groups; the median value was 0.68 microgram/mL (95% confidence interval: 0.62-0.89). The concentrations were higher (P < 0.01) in failed blocks; the median value was 1.69 micrograms/mL (95% confidence interval: 0.58-2.8). A complementary anatomic study of three arms from fresh cadavers allowed verification of the correct localization of the Teflon cannula and flexible catheter, as well as homogeneous diffusion of the methylene blue inside the brachial plexus. The perivenous technique for continuous axillary brachial plexus block may improve the success rate due to its radiologic and accurate location of the neurovascular sheath.

Adult↗