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Journal of the Korean Academy of Rehabilitation Medicine 2007;31(3):371-374.
Sonographically Guided Musculocutaneous Nerve Phenol Block for Elbow Flexor Spasticity: Case report.
Bang, In Keol , Kim, Chul , Ahn, Jae Ki , Park, Yoon Kyung , Reu, Hyun Woo , Jung, In Tak
Department of Rehabilitation Medicine, Inje University College of Medicine, Korea. lazania99@hnamail.net
주관절 굴근 경직에서 초음파 유도하의 근피신경 페놀차단술 -증례 보고-
방인걸, 김철, 안재기, 박윤경, 류현우, 정인탁
인제대학교 의과대학 재활의학교실
Abstract
Seven hemiplegic stroke patients suffering elbow flexor spasticity were selected for musculocutaneous nerve (MN) blocks. The MN was identified at the proximal 1/3 area on anteromedial surface of upper arm at supine position. An injectable monopolar EMG needle electrode was inserted into MN under real time ultrasonography. The 7% phenol solution was injected 0.2 ml at a time into MN until biceps brachii and brachialis muscle contractions were completely blocked at a maximum of 5 mA electrical stimulation. The total dose of injected phenol solution was 1.2∼2.2 ml. We examined modified Ashworth scale (MAS) of elbow flexor and elbow angle at the standing position. In all the subjects, MAS was decreased and elbow angle was increased after nerve block. Ultrasonography guidance makes it exact to identify MN and to inject neurolytic solution to target. It can lead minimal complications by using the least dosage of neurolytic drug. (J Korean Acad Rehab Med 2007; 31: 371-374)
Key Words: Musculocutaneous nerve, Sonography, Spasticity
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