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https://www.readbyqxmd.com/read/28936608/the-effect-of-an-increased-pulse-width-on-the-pattern-of-motor-response-unilateral-versus-bilateral-during-the-tsui-test-in-labouring-parturients-a-randomized-crossover-trial
#1
Paul Zakus, Ricardo Bittencourt, Kristi Downey, Ban C H Tsui, Jose C A Carvalho
BACKGROUND AND OBJECTIVES: The typical response to the Tsui test performed via an epidural catheter placed in the lumbar area is the unilateral motor response of the lower limbs. Studies show that longer pulse widths can stimulate peripheral nerves at a lower threshold current from a farther distance. Therefore, we designed a study to test the hypothesis that epidural catheter stimulation with a 1.0-msec pulse width would increase the incidence of bilateral motor response in parturients when compared with stimulation with a 0...
September 21, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28928555/continuous-femoral-nerve-blockade-versus-epidural-analgesia-for-postoperative-pain-relief-in-knee-surgeries-a-randomized-controlled-study
#2
Suma Vishwanatha, Sandhya Kalappa
BACKGROUND: Peripheral neural blockade provides effective analgesia with potentially less side effects than an epidural blockade. The present study was undertaken to compare continuous femoral nerve blockade (CFNB) with continuous epidural analgesia (CEA) for postoperative pain control in knee surgeries. MATERIALS AND METHODS: The patients belonging to the American Society of Anesthesiologists Class I and II scheduled for various knee surgeries under spinal anesthesia were enrolled in this study...
July 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28913502/regional-anesthesia-for-a-total-knee-arthroplasty-on-an-adult-patient-with-spastic-diplegia-and-an-intrathecal-baclofen-pump
#3
Elird Bojaxhi, David R Salek, Courtney E Sherman, Roy A Greengrass
We describe the clinical presentation of a patient with spastic diplegia, and its unique perioperative challenges. Opioids and antispasmodic medications are the primary therapy for managing pain and spasticity in the perioperative setting. However, such combination results in several side-effects and their sedative properties are synergistic. A 64-year-old woman with a history of spastic diplegia and an intrathecal baclofen pump for the treatment of her lower extremity spasticity was scheduled for a third elective left knee arthroplasty...
April 2017: Rom J Anaesth Intensive Care
https://www.readbyqxmd.com/read/28902893/correlation-of-optic-nerve-sheath-diameter-with-directly-measured-intracranial-pressure-in-korean-adults-using-bedside-ultrasonography
#4
Jin Pyeong Jeon, Si Un Lee, Sung-Eun Kim, Suk Hyung Kang, Jin Seo Yang, Hyuk Jai Choi, Yong Jun Cho, Seung Pil Ban, Hyoung Soo Byoun, Young Soo Kim
OBJECTIVES: The correlation of optic nerve sheath diameter (ONSD) as seen on ultrasonography (US) and directly measured intracranial pressure (ICP) has been well described. Nevertheless, differences in ethnicity and type of ICP monitor used are obstacles to the interpretation. Therefore, we investigated the direct correlation between ONSD and ventricular ICP and defined an optimal cut-off point for identifying increased ICP (IICP) in Korean adults with brain lesions. METHODS: This prospective study included patients who required an external ventricular drainage (EVD) catheter for ICP control...
2017: PloS One
https://www.readbyqxmd.com/read/28898151/postoperative-analgesia-for-shoulder-surgery
#5
Neel Desai
Both arthroscopic and open surgery of the shoulder are associated with significant postoperative pain. Use of opioids can result in adverse systemic effects, so a multi-modal analgesic approach and complementary analgesic techniques should be considered to minimize the postoperative opioid requirement. Single shot interscalene block provides effective pain control of early and limited duration which can be extended with a catheter. Continuous interscalene block should be considered for more invasive shoulder procedures...
September 2, 2017: British Journal of Hospital Medicine
https://www.readbyqxmd.com/read/28890429/exploring-the-umbilical-and-vaginal-port-during-minimally-invasive-surgery
#6
Andrea Tinelli, Daniel A Tsin, Antonello Forgione, Ricardo Zorron, Giovanni Dapri, Antonio Malvasi, Tahar Benhidjeb, Radmila Sparic, Farr Nezhat
This article focuses on the anatomy, literature, and our own experiences in an effort to assist in the decision-making process of choosing between an umbilical or vaginal port. Umbilical access is more familiar to general surgeons; it is thicker than the transvaginal entry, and has more nerve endings and sensory innervations. This combination increases tissue damage and pain in the umbilical port site. The vaginal route requires prophylactic antibiotics, a Foley catheter, and a period of postoperative sexual abstinence...
September 1, 2017: Journal of the Turkish German Gynecological Association
https://www.readbyqxmd.com/read/28883682/role-of-mri-in-diagnosis-of-ruptured-intracranial-dermoid-cyst
#7
Sefedin Muçaj, Mehmet Sahin Ugurel, Kreshnike Dedushi, Naser Ramadani, Naim Jerliu
INTRODUCTION: Intracranial dermoid cystic tumors account for <1% of all intracranial masses. CASE REPORT: A 52-year-old male, having headaches, nausea and is presented with a history of 2 episodes of new onset seizures. On presentation, the patient had a normal physical exam, including a complete neurological and cranial nerve exam. METHODS: Precontrast MRI; TSE/T2Wsequence in axial/coronal planes; 3D - HI-resolution T1W sagittal; FLAIR/T2W axial; FLAIR/T2W, Flash/T2W oblique coronal plane, GRE/T2W axial...
June 2017: Acta Informatica Medica: AIM
https://www.readbyqxmd.com/read/28862930/blood-pressure-response-to-main-renal-artery-and-combined-main-renal-artery-plus-branch-renal-denervation-in-patients-with-resistant-hypertension
#8
Karl Fengler, Sebastian Ewen, Robert Höllriegel, Karl-Philipp Rommel, Saaraaken Kulenthiran, Lucas Lauder, Bodo Cremers, Gerhard Schuler, Axel Linke, Michael Böhm, Felix Mahfoud, Philipp Lurz
BACKGROUND: Single-electrode ablation of the main renal artery for renal sympathetic denervation showed mixed blood pressure (BP)-lowering effects. Further improvement of the technique seems crucial to optimize effectiveness of the procedure. Because sympathetic nerve fibers are closer to the lumen in the distal part of the renal artery, treatment of the distal main artery and its branches has been shown to reduce variability in treatment effects in preclinical studies and a recent randomized trial...
August 10, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28861197/comparison-of-the-effect-of-continuous-femoral-nerve-block-and-adductor-canal-block-after-primary-total-knee-arthroplasty
#9
Seung Suk Seo, Ok Gul Kim, Jin Hyeok Seo, Do Hoon Kim, Youn Gu Kim, Beyoung Yun Park
BACKGROUND: This study aimed to compare the effects of femoral nerve block and adductor canal block on postoperative pain, quadriceps strength, and walking ability after primary total knee arthroplasty. METHODS: Between November 2014 and February 2015, 60 patients underwent primary total knee arthroplasty. Thirty patients received femoral nerve block and the other 30 received adductor canal block for postoperative pain control. Before spinal anesthesia, the patients received nerve block via a catheter (20 mL 0...
September 2017: Clinics in Orthopedic Surgery
https://www.readbyqxmd.com/read/28855188/an-excitatory-reflex-from-the-superficial-peroneal-nerve-to-the-bladder-in-cats
#10
Michelle Yu, Jamie Uy, Xuewen Jiang, Xing Li, Cameron Jones, Bing Shen, Jicheng Wang, James R Roppolo, William C de Groat, Changfeng Tai
This study in α-chloralose anesthetized cats discovered an excitatory peroneal nerve-to-bladder reflex. A urethral catheter was used to infuse the bladder with saline and record bladder pressure changes. Electrical stimulation was applied to the superficial peroneal nerve to trigger a reflex bladder activity. With the bladder distended at a volume about 90% of bladder capacity, superficial peroneal nerve stimulation (PNS) at 1-3 Hz and threshold (T) intensity for inducing muscle twitching on the posterior thigh induced large amplitude (40-150 cmH2O) bladder contractions...
August 30, 2017: American Journal of Physiology. Renal Physiology
https://www.readbyqxmd.com/read/28844420/a-prospective-randomized-controlled-trial-to-identify-the-optimal-postoperative-pain-management-in-shoulder-arthroplasty-liposomal-bupivacaine-versus-continuous-interscalene-catheter
#11
Vani J Sabesan, Rajin Shahriar, Graysen R Petersen-Fitts, James D Whaley, Therese Bou-Akl, Matthew Sweet, Marc Milia
BACKGROUND: Shoulder arthroplasty is the fastest growing joint replacement surgery in the United States, and optimal postoperative pain management is critical to optimize outcomes for these surgeries. Liposomal bupivacaine (LB) has gained popularity for its potential to provide extended postoperative pain relief with possibly fewer side effects. The goal of this study was to assess the impact of LB compared with continuous interscalene nerve block (CISB) in terms of postoperative pain control, outpatient pain scores, and patient-reported and functional outcomes after shoulder arthroplasty surgery...
August 22, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28836847/evaluation-of-a-modified-infraorbital-approach-for-a-maxillary-nerve-block-for-rhinoscopy-with-nasal-biopsy-of-dogs
#12
Kristen M Fizzano, Andrew K Claude, Lan-Hsin Kuo, Jeffrey B Eells, Simone B Hinz, Brittany E Thames, Matthew K Ross, Robert L Linford, Robert W Wills, Alicia K Olivier, Todd M Archer
OBJECTIVE To determine whether a maxillary nerve block via a modified infraorbital approach, applied before rhinoscopy and nasal biopsy of dogs, would decrease procedural nociception, minimize cardiorespiratory anesthetic effects, and improve recovery quality. ANIMALS 8 healthy adult hound-type dogs PROCEDURES In a crossover study, dogs received 0.5% bupivacaine (0.1 mL/kg) or an equivalent volume of saline (0.9% NaCl) solution as a maxillary nerve block via a modified infraorbital approach. A 5-cm, 20-gauge over-the-needle catheter was placed retrograde within each infraorbital canal, and bupivacaine or saline solution was administered into each pterygopalatine region...
September 2017: American Journal of Veterinary Research
https://www.readbyqxmd.com/read/28835278/alpha1a-adrenoceptor-antagonist-improves-underactive-bladder-associated-with-diabetic-cystopathy-via-bladder-blood-flow-in-rats
#13
Saori Yonekubo, Satoshi Tatemichi, Kazuyasu Maruyama, Mamoru Kobayashi
BACKGROUND: Patients with diabetes experience lower urinary tract symptoms. Cystopathy may evolve into underactive bladder (UAB), depending on the degree and duration of the symptoms. In the present study, we aimed to investigate the effects of silodosin, an alpha1A-adrenoceptor (AR) antagonist, on UAB in a rat model of diabetes mellitus (DM). METHODS: Female Sprague-Dawley rats (6 weeks old) were administered streptozotocin (STZ) (50 mg/kg, i.v.) to establish a DM model...
August 23, 2017: BMC Urology
https://www.readbyqxmd.com/read/28833764/ganglionated-plexi-as-neuromodulation-targets-for-atrial-fibrillation
#14
Eue-Keun Choi, Ye Zhao, Thomas H Everett, Peng-Sheng Chen
The autonomic nervous system plays an important role in the genesis of atrial fibrillation and is one of the candidate targets for atrial fibrillation therapy. This review focuses on the role of the autonomic nervous system in atrial fibrillation development and discusses the results of the ganglionated plexi catheter and surgical ablation in preclinical and clinical studies. The heart is innervated by the extrinsic and intrinsic autonomic nervous systems. The intrinsic autonomic nervous system consists of multiple ganglionated plexi and axons, which innervate the neighboring atrial myocardium and control their electrophysiological properties...
August 18, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28831314/surgery-averted-using-a-novel-minimally-invasive-approach-to-treat-very-severe-radial-artery-spasm
#15
Anthony A Cochet, Daniel A Bellin
A 42-year-old male admitted with a non-ST elevation myocardial infarction was referred for invasive angiographic assessment. Based on preprocedural assessment, the right radial artery approach was selected. Despite possessing none of the consensus risk factors for radial artery spasm, in addition to receiving standard arterial spasm prophylaxis and conscious sedation, the patient suffered very severe radial artery spasm with initial catheter placement, resulting in entrapment of a 5 Fr pigtail catheter within the left ventricle...
2017: Case Reports in Cardiology
https://www.readbyqxmd.com/read/28822609/transient-vocal-cord-paralysis-following-central-venous-hemodialysis-catheter-insertion
#16
Gül Pamukçu Günaydın, Selahattin Gürü, Elif Aslan Taş, Fatih Tanrıverdi, Gülhan Kurtoğlu Çelik
In this article, we present a case of recurrent laryngeal nerve palsy not caused by nerve injury but due to local anesthetic infiltration that was applied prior to central venous catheterization. A 47-year-old female patient was admitted to emergency room with fatigue and nausea and was diagnosed with acute renal failure. Right jugular venous catheterization was performed for emergency hemodialysis with Seldinger technique using middle approach. Within minutes and immediately after the procedure the patient complained of hoarseness and shortness of breath, and she had stridor in her physical exam...
August 15, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28818859/renal-denervation-suppresses-coronary-hyperconstricting-responses-after-drug-eluting-stent-implantation-in-pigs-in-vivo-through-the-kidney-brain-heart-axis
#17
Hironori Uzuka, Yasuharu Matsumoto, Kensuke Nishimiya, Kazuma Ohyama, Hideaki Suzuki, Hirokazu Amamizu, Susumu Morosawa, Michinori Hirano, Tomohiko Shindo, Yoku Kikuchi, Kiyotaka Hao, Takashi Shiroto, Kenta Ito, Jun Takahashi, Koji Fukuda, Satoshi Miyata, Yoshihito Funaki, Hatsue Ishibashi-Ueda, Satoshi Yasuda, Hiroaki Shimokawa
OBJECTIVE: Drug-eluting stent-induced coronary hyperconstricting responses remain an important issue. The adventitia harbors a variety of components that potently modulate vascular tone, including sympathetic nerve fibers (SNF) and vasa vasorum. Catheter-based renal denervation (RDN) inhibits sympathetic nerve activity. We, thus, examined whether RDN suppresses drug-eluting stent-induced coronary hyperconstricting responses, and if so, what mechanisms are involved. APPROACH AND RESULTS: Protocol 1: pigs implanted with everolimus-eluting stents into the left coronary arteries underwent coronary angiography at 1 month after implantation for assessment of coronary vasomotion and adventitial SNF formation...
August 17, 2017: Arteriosclerosis, Thrombosis, and Vascular Biology
https://www.readbyqxmd.com/read/28816280/-analysis-of-outcomes-of-tension-free-mid-urethral-sling-procedure-in-women-with-mixed-urinary-incontinence
#18
W Y Zhang, X P Zhang, H Hu, J W Chen, X H Liu, K X Xu
OBJECTIVE: To evaluate the medium and long term outcomes of tension-free mid-urethral sling in the treatment of female patients with mixed urinary incontinence (MUI). METHODS: Twenty-six patients who underwent the tension-free mid-urethral sling procedure for MUI from April, 2010 to September, 2016, were followed up. Four of the 26 patients underwent retropubic tension free mid-urethral sling (TVT), and 22 of them underwent transurethral middle obturator sling (TOT)...
August 18, 2017: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/28806216/psoas-versus-femoral-blocks-a-registry-analysis-of-risks-and-benefits
#19
Hagen Bomberg, Andrea Huth, Stefan Wagenpfeil, Paul Kessler, Hinnerk Wulf, Thomas Standl, André Gottschalk, Jens Döffert, Werner Hering, Jürgen Birnbaum, Claudia Spies, Bernd Kutter, Jörg Winckelmann, Gerald Burgard, Oliver Vicent, Thea Koch, Daniel I Sessler, Thomas Volk, Alexander Raddatz
BACKGROUND AND OBJECTIVES: Psoas blocks are an alternative to femoral nerve blocks and have the potential advantage of blocking the entire lumbar plexus. However, the psoas muscle is located deeply, making psoas blocks more difficult than femoral blocks. In contrast, while femoral blocks are generally easy to perform, the inguinal region is prone to infection. We thus tested the hypothesis that psoas blocks are associated with more insertion-related complications than femoral blocks but have fewer catheter-related infections...
August 11, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28796131/beyond-ultrasound-guidance-for-regional-anesthesiology
#20
De Q Tran, André P Boezaart, Joseph M Neal
Despite its popularity, ultrasound (US)-guided regional anesthesiology is associated with significant limitations. The latter can be attributed to either the US machine (ie, decreased ability to insonate deep neural structures, as well as the thoracic spine) or the operator. Shortcomings associated with the operator can be explained by errors in perception (ie, ambiguous criteria for needle/catheter tip-to-nerve proximity and subparaneural local anesthetic injection) or interpretation. Perhaps the greatest confusion afflicting US-guided regional anesthesiology originates from an intellectual misconception pertaining to its application...
September 2017: Regional Anesthesia and Pain Medicine
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