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Regional nerve blocks

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https://www.readbyqxmd.com/read/27913981/the-challenges-of-anaesthesia-and-pain-relief-in-hip-fracture-care
#1
Rachel Cowan, Jun Hao Lim, Terence Ong, Ashok Kumar, Opinder Sahota
The care of the older person with hip fracture is complicated by their comorbid condition, limited physiological reserve, cognitive impairment and frailty. Two aspects of hip fracture management that have received considerable attention are how best to manage the pain associated with it and the ideal mode of anaesthesia. Existing literature has reported on the suboptimal treatment of pain in this orthogeriatric cohort. With recent advancements in medical care, a number of options have emerged as alternatives to conservative systemic analgesia...
December 3, 2016: Drugs & Aging
https://www.readbyqxmd.com/read/27904211/post-operative-pain-management-in-shoulder-surgery-suprascapular-and-axillary-nerve-block-by-arthroscope-assisted-catheter-placement
#2
H Çağdaş Basat, D Hakan Uçar, Mehmet Armangil, Berk Güçlü, Mehmet Demirtaş
BACKGROUND: Postoperative pain management is the part of shoulder surgery to improve patient satisfaction, start rehabilitation process rapidly and decrease for hospital stay. Various treatment modalities have been used for pain management, but they have some limitations, side effects and risks. Throughout intraoperative and postoperative period, nerve blocks have been used more popularly than others because of efficacy. For the regional nerve block, local anesthetic should be infiltrated close to the nerve for maximum effect...
November 2016: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/27897312/the-feasibility-of-micro-ultrasound-as-a-tool-to-image-peripheral-nerves
#3
A Chandra, R Eisma, P Felts, S Munirama, G A Corner, C E M Demore, G McLeod
Despite widespread use of ultrasound imaging to guide needle placement, the incidence of transient and permanent nerve damage as a complication of regional anaesthesia has not changed over the last decade. In view of the controversy surrounding intraneural injection there is a need to understand the structural changes caused by subepineural and subperineural needle penetration. Clinical ultrasound machines do not provide adequate anatomical resolution, and anaesthetists have difficulty judging the precise location of the needle tip relative to the epineurium...
November 29, 2016: Anaesthesia
https://www.readbyqxmd.com/read/27872858/17%C3%AE-estradiol-promotes-schwann-cell-proliferation-and-differentiation-accelerating-early-remyelination-in-a-mouse-peripheral-nerve-injury-model
#4
Yan Chen, Wenjie Guo, Liangzhi Xu, Wenjuan Li, Meng Cheng, Ying Hu, Wenming Xu
Estrogen induces oligodendrocyte remyelination in response to demyelination in the central nervous system. Our objective was to determine the effects of 17β-estradiol (E2) on Schwann cell function and peripheral nerve remyelination after injury. Adult male C57BL/6J mice were used to prepare the sciatic nerve transection injury model and were randomly categorized into control and E2 groups. To study myelination in vitro, dorsal root ganglion (DRG) explant culture was prepared using 13.5-day-old mouse embryos...
2016: BioMed Research International
https://www.readbyqxmd.com/read/27842565/regional-anesthesia-for-painful-injuries-after-disasters-rapid-study-protocol-for-a-randomized-controlled-trial
#5
Adam C Levine, Carrie Teicher, Adam R Aluisio, Tess Wiskel, Pola Valles, Miguel Trelles, Justin Glavis-Bloom, Rebecca F Grais
BACKGROUND: Lower extremity trauma during earthquakes accounts for the largest burden of disaster-related injuries. Insufficient pain management is common in resource-limited disaster settings, and regional anesthesia (RA) may reduce pain in injured patients beyond current standards of care. To date, no controlled trials have been conducted to evaluate the use of RA for pain management in a disaster setting. METHODS/DESIGN: The Regional Anesthesia for Painful Injuries after Disasters (RAPID) study aims to evaluate whether regional anesthesia (RA), either with or without ultrasound (US) guidance, can reduce pain from earthquake-related lower limb injuries in a disaster setting...
November 14, 2016: Trials
https://www.readbyqxmd.com/read/27822180/axonal-cleaved-caspase-3-regulates-axon-targeting-and-morphogenesis-in-the-developing-auditory-brainstem
#6
Sarah E Rotschafer, Michelle R Allen-Sharpley, Karina S Cramer
Caspase-3 is a cysteine protease that is most commonly associated with cell death. Recent studies have shown additional roles in mediating cell differentiation, cell proliferation and development of cell morphology. We investigated the role of caspase-3 in the development of chick auditory brainstem nuclei during embryogenesis. Immunofluorescence from embryonic days E6-13 revealed that the temporal expression of cleaved caspase-3 follows the ascending anatomical pathway. The expression is first seen in the auditory portion of VIIIth nerve including central axonal regions projecting to nucleus magnocellularis (NM), then later in NM axons projecting to nucleus laminaris (NL), and subsequently in NL dendrites...
2016: Frontiers in Neural Circuits
https://www.readbyqxmd.com/read/27810549/technical-modifications-for-intraoral-quadrangular-le-fort-ii-osteotomy
#7
Clemens Klug, Julia Cede
PURPOSE: The intraoral quadrangular Le Fort II osteotomy (IQLFIIO) represents a reliable surgical method in cases of midfacial deficiency with good functional, esthetic, and stable long-term results. PATIENTS AND METHODS: In this technical note, we present 3 surgical modifications to previous reports: 1) inferior orbital rim osteotomy by angulated piezosurgical instruments, thereby avoiding the use of chisels in the orbital region; 2) osteosynthetic fixation only laterally at the zygomatic buttress with 2 L-shaped miniplates, thus avoiding paranasal osteosynthesis; and 3) advancement step camouflage in the lateral infraorbital region with a compound mass of autologous bone chips and fibrin glue with the intention to reduce bone block-associated side effects...
October 6, 2016: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/27810215/development-of-a-peripheral-nerve-stimulator-guided-technique-for-equine-pudendal-nerve-blockade
#8
K Gallacher, L C Santos, L Campoy, A J Bezuidenhout, R O Gilbert
The aim of this study was to develop and evaluate a procedure for equine pudendal nerve block using a peripheral nerve locator. In the first experiment, six ponies were used to determine the relationship between elicited muscle contractions (anal, perineal or both) and nerves serving the perineal region (pudendal, caudorectal and perineal nerves) when methylene blue dye was injected using the electrolocation technique. This experiment showed that the pudendal nerve was approached effectively when both anal and perineal twitch were elicited during electrolocation...
November 2016: Veterinary Journal
https://www.readbyqxmd.com/read/27810148/introduction-of-a-novel-ultrasound-guided-extrathoracic-sub-paraspinal-block-for-control-of-perioperative-pain-in-nuss-procedure-patients
#9
Robert B Bryskin, Daniel K Robie, Frederick M Mansfield, Eugene B Freid, Siam Sukumvanich
BACKGROUND: A safe and effective method of multilevel thoracic pain control remains an elusive goal in patients undergoing the Nuss procedure. The aim of our study was to develop a nonopioid centered approach using a novel regional technique as part of a quality improvement initiative. METHODS: The proposed ultrasound-guided technique positions multi-perforated soaker catheter deep to the paraspinal muscles from T2 to T11. The project was conducted in two phases...
October 14, 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27799295/the-m1-muscarinic-receptor-antagonist-vu0255035-delays-the-development-of-status-epilepticus-after-organophosphate-exposure-and-prevents-hyperexcitability-in-the-basolateral-amygdala
#10
Steven L Miller, Vassiliki Aroniadou-Anderjaska, Volodymyr I Pidoplichko, Taiza H Figueiredo, James P Apland, Jishnu K S Krishnan, Maria F M Braga
Exposure to organophosphorus toxins induces seizures that progress to status epilepticus (SE), which can cause brain damage or death. Seizures are generated by hyperstimulation of muscarinic receptors, subsequent to inhibition of acetylcholinesterase; this is followed by glutamatergic hyperactivity, which sustains and reinforces seizure activity. It has been unclear which muscarinic receptor subtypes are involved in seizure initiation and the development of SE in the early phases after exposure. Here, we show that pretreatment of rats with the selective M1 receptor antagonist, VU0255035 [N-(3-oxo-3-(4-(pyridine-4-yl)piperazin-1-yl)propyl)-benzo[c][1,2,5]thiadiazole-4 sulfonamide], significantly suppressed seizure severity and prevented the development of SE for about 40 minutes after exposure to paraoxon or soman, suggesting an important role of the M1 receptor in the early phases of seizure generation...
January 2017: Journal of Pharmacology and Experimental Therapeutics
https://www.readbyqxmd.com/read/27792212/postoperative-analgesia-for-elective-total-knee-arthroplasty-under-subarachnoid-anesthesia-with-opioids-comparison-between-epidural-femoral-block-and-adductor-canal-block-techniques-with-and-without-perineural-adjuvants-a-prospective-randomized-clinical-trial
#11
José R Ortiz-Gómez, Marta Perepérez-Candel, José M Vázquez-Torres, José M Rodriguez-Del Río, Berta Torrón-Abad, Inocencia Fornet-Ruiz, Francisco J Palacio-Abizanda
BACKGROUND: Optimal control of acute postoperative pain and prevention of chronic persistent pain in total knee arthroplasty (TKA) remain a challenge. The main hypothesis was that nerve blocks improve postoperative analgesia especially if perineural adjuvants are added. METHODS: Immediate postoperative pain (24 h) was evaluated every hour in 639 patients using a verbal rating 11-point scale for patient self-reporting of pain (VRS-11). All patients received subarachnoid anesthesia and were randomly allocated in 8 groups: control group, epidural (EA) and single shots femoral (FNB) or adductor canal blocks (ACB), both with and without adjuvants: dexamethasone (+Dexa) or dexmedetomidine (+Dexm)...
October 28, 2016: Minerva Anestesiologica
https://www.readbyqxmd.com/read/27787895/regional-nerve-blocks-improve-pain-and-functional-outcomes-in-hip-fracture-a-randomized-controlled-trial
#12
R Sean Morrison, Eitan Dickman, Ula Hwang, Saadia Akhtar, Taja Ferguson, Jennifer Huang, Christina L Jeng, Bret P Nelson, Meg A Rosenblatt, Jeffrey H Silverstein, Reuben J Strayer, Toni M Torrillo, Knox H Todd
OBJECTIVES: To compared outcomes of regional nerve blocks with those of standard analgesics after hip fracture. DESIGN: Multisite randomized controlled trial from April 2009 to March 2013. SETTING: Three New York hospitals. PARTICIPANTS: Individuals with hip fracture (N = 161). INTERVENTION: Participants were randomized to receive an ultrasound-guided, single-injection, femoral nerve block administered by emergency physicians at emergency department (ED) admission followed by placement of a continuous fascia iliaca block by anesthesiologists within 24 hours (n = 79) or conventional analgesics (n = 82)...
October 27, 2016: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/27785390/clinical-results-of-autologous-bone-augmentation-harvested-from-the-mandibular-ramus-prior-to-implant-placement-an-analysis-of-104-cases
#13
Andreas Sakkas, Konstantinidis Ioannis, Karsten Winter, Alexander Schramm, Frank Wilde
Background: The aim of this study was the evaluation of the clinical success and complication rates associated with autologous bone grafts harvested from the mandibular ramus for alveolar ridge augmentation and the identification of possible risk factors for graft failure. Methods: In a consecutive retrospective study 86 patients could be included. In these patients a total of 104 bone grafts from the mandibular ramus were harvested for alveolar ridge augmentation. Medical history, age of patient, smoking status, periodontal status and complications were recorded...
2016: GMS Interdisciplinary Plastic and Reconstructive Surgery DGPW
https://www.readbyqxmd.com/read/27785096/an-electronic-surgical-order-undertaking-patient-education-and-obtaining-informed-consent-for-regional-analgesia-before-the-day-of-surgery-reduce-block-related-delays
#14
Brandon S Brooks, Joydip Barman, Brent A Ponce, Alisa Sides, Thomas R Vetter
BACKGROUND: Obtaining patient informed consent for a regional analgesia block on the day of surgery can result in surgical case delays. We hypothesized that implementing a preoperative electronic surgical order, undertaking patient education, and obtaining informed consent for a regional block in our preoperative assessment clinic prior to the day of surgery would reduce surgical case delays attributed to our regional anesthesia pain service and increase the percentage of patients for whom our regional anesthesia pain service was requested to provide a block...
2016: Local and Regional Anesthesia
https://www.readbyqxmd.com/read/27761032/ultrasound-guided-truncal-blocks-a-new-frontier-in-regional-anaesthesia
#15
Arunangshu Chakraborty, Rakhi Khemka, Taniya Datta
The practice of regional anaesthesia is rapidly changing with the introduction of ultrasound into the working domain of the anaesthesiologist. New techniques are being pioneered. Among the recent techniques, notable are the truncal blocks, for example, the transversus abdominis plane block, rectus sheath block, hernia block and quadratus lumborum block in the abdomen and the pectoral nerves (Pecs) block 1 and 2, serratus anterior plane block and intercostal nerve block. This narrative review covers the brief anatomical discourse along with technical description of the ultrasound-guided truncal blocks...
October 2016: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/27753708/perioperative-nerve-injury-after-peripheral-nerve-block-in-patients-with-previous-systemic-chemotherapy
#16
Arnoley S Abcejo, Hans P Sviggum, Michelle L Mauermann, James R Hebl, Carlos B Mantilla, Andrew C Hanson, Yi Lin, Adam K Jacob
BACKGROUND AND OBJECTIVES: There are multiple risk factors for developing perioperative nerve injury (PNI). Perioperative nerve injury after peripheral nerve blockade (PNB) is rare. Exposure to systemic chemotherapy may cause peripheral neuropathy, but its role as a risk factor for PNI after PNB is unknown. The objective of this retrospective study was to determine the incidence of PNI in patients undergoing PNB as part of extremity surgery after prior exposure to systemic chemotherapy...
November 2016: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/27752812/interventions-to-optimize-recovery-after-laparoscopic-appendectomy-a-scoping-review
#17
James K Hamill, Jamie-Lee Rahiri, Gamage Gunaratna, Andrew G Hill
BACKGROUND: No enhanced recovery after surgery protocol has been published for laparoscopic appendectomy. This was a review of evidence-based interventions that could optimize recovery after appendectomy. METHODS: Interventions for the review Clinical pathway, fast-track or enhanced recovery protocols; needlescopic approach; single incision laparoscopic (SIL) approach; natural orifice transluminal endoscopic surgery (NOTES); regional nerve blocks; intraperitoneal local anaesthetic (IPLA); drains...
October 17, 2016: Surgical Endoscopy
https://www.readbyqxmd.com/read/27729812/dorsal-clitoral-nerve-injury-following-transobturator-midurethral-sling
#18
Chailee F Moss, Lynn A Damitz, Richard H Gracely, Alice C Mintz, Denniz A Zolnoun, A Lee Dellon
INTRODUCTION: Transobturator slings can be successfully used to treat stress urinary incontinence and improve quality of life through a minimally invasive vaginal approach. Persistent postoperative pain can occur and pose diagnostic and therapeutic dilemmas. Following a sling procedure, a patient complained of pinching clitoral and perineal pain. Her symptoms of localized clitoral pinching and pain became generalized over the ensuing years, eventually encompassing the entire left vulvovaginal region...
2016: Journal of Pain Research
https://www.readbyqxmd.com/read/27729319/pain-management-after-outpatient-shoulder-arthroscopy-a-systematic-review-of-randomized-controlled-trials
#19
William J Warrender, Usman Ali M Syed, Sommer Hammoud, William Emper, Michael G Ciccotti, Joseph A Abboud, Kevin B Freedman
BACKGROUND: Effective postoperative pain management after shoulder arthroscopy is a critical component to recovery, rehabilitation, and patient satisfaction. PURPOSE: This systematic review provides a comprehensive overview of level 1 and level 2 evidence regarding postoperative pain management for outpatient arthroscopic shoulder surgery. STUDY DESIGN: Systematic review. METHODS: We performed a systematic review of the various modalities reported in the literature for postoperative pain control after outpatient shoulder arthroscopy and analyzed their outcomes...
October 11, 2016: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/27727021/automatic-segmentation-and-probe-guidance-for-real-time-assistance-of-ultrasound-guided-femoral-nerve-blocks
#20
Erik Smistad, Daniel Høyer Iversen, Linda Leidig, Janne Beate Lervik Bakeng, Kaj Fredrik Johansen, Frank Lindseth
Ultrasound-guided regional anesthesia can be challenging, especially for inexperienced physicians. The goal of the proposed methods is to create a system that can assist a user in performing ultrasound-guided femoral nerve blocks. The system indicates in which direction the user should move the ultrasound probe to investigate the region of interest and to reach the target site for needle insertion. Additionally, the system provides automatic real-time segmentation of the femoral artery, the femoral nerve and the two layers fascia lata and fascia iliaca...
January 2017: Ultrasound in Medicine & Biology
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