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neurostimulation blocks

Shaylyn H Montgomery, Colleen M Shamji, Grace S Yi, Cynthia H Yarnold, Stephen J Head, Scott C Bell, Stephan K W Schwarz
BACKGROUND AND OBJECTIVES: Ultrasound-guided subsartorial saphenous nerve block is commonly used to provide complete surgical anesthesia of the foot and ankle in combination with a popliteal sciatic nerve block. However, in part owing to its small caliber and absence of a prominent vascular landmark in the subsartorial plane distal to the adductor canal, the saphenous nerve is more difficult to reliably block than the sciatic nerve in the popliteal fossa. Although the saphenous nerve is a sensory nerve only, neurostimulation can be used to elicit a "tapping" sensation on the anteromedial aspect of the lower leg extending toward the medial malleolus...
November 29, 2016: Regional Anesthesia and Pain Medicine
Brian M Ilfeld, Stuart A Grant
No abstract text is available yet for this article.
September 28, 2016: Regional Anesthesia and Pain Medicine
Ki Jinn Chin, Javier E Cubillos, Husni Alakkad
BACKGROUND: Regional anaesthesia comprising axillary block of the brachial plexus is a common anaesthetic technique for distal upper limb surgery. This is an update of a review first published in 2006 and previously updated in 2011 and 2013. OBJECTIVES: To compare the relative effects (benefits and harms) of three injection techniques (single, double and multiple) of axillary block of the brachial plexus for distal upper extremity surgery. We considered these effects primarily in terms of anaesthetic effectiveness; the complication rate (neurological and vascular); and pain and discomfort caused by performance of the block...
September 2, 2016: Cochrane Database of Systematic Reviews
Serbülent Gökhan Beyaz, Hande Özocak, Tolga Ergönenç, Ali Fuat Erdem, Onur Palabıyık
Thoracic paravertebral block (TPVB) can be performed with or without general anaesthesia for various surgical procedures. TPVB is a popular anaesthetic technique due to its low side effect profile and high analgesic potency. We used 20 mL of 0.5% levobupivacaine for a single injection of unilateral TPVB at the T7 level with neurostimulator in a 63 year old patient with co-morbid disease who underwent cholecystectomy. Following the application patient lost consciousness, and was intubated. Haemodynamic instability was normalised with rapid volume replacement and vasopressors...
February 2014: Turkish Journal of Anaesthesiology and Reanimation
Huaijiang Wang, Liandi Li, Chengshi Xu, Xiangdong Qu, Zhijun Qu, Geng Wang
PURPOSE: This study was designed to investigate the risk of local anesthetic toxicity and efficacy of simultaneous bilateral axillary brachial plexus block performed under the guidance of ultrasound or a neurostimulator. METHODS: One hundred and twenty patients who were anesthetized with bilateral axillary plexus block simultaneously between February 2012 and March 2014 were enrolled in the study. The patients were anesthetized under the guidance of a neurostimulator (group N, n = 60) or ultrasound (group U, n = 60)...
August 2016: Journal of Anesthesia
Diana Chieira, Luis Conceição, Edgar Semedo, Valentina Almeida
Osler-Weber-Rendu syndrome, or hereditary haemorrhagic telangiectasia (HHT), is an autosomal dominant vascular dysplasia characterised by mucocutaneous telangiectases and arteriovenous malformations (AVMs). Diagnosis is clinical and treatment is supportive. The authors demonstrate a safe anaesthetic approach for a patient with HHT. A 53-year-old woman with a left trochanteric fracture was scheduled for urgent orthopaedic surgery. She was diagnosed as having HHT and presented with recurrent epistaxis, telangiectases and gastrointestinal AVMs...
April 28, 2016: BMJ Case Reports
Anatoli Stav, Leonid Reytman, Michael-Yohay Stav, Isaak Portnoy, Alexander Kantarovsky, Offer Galili, Shmuel Luboshitz, Roger Sevi, Ahud Sternberg
OBJECTIVE: We hypothesized that ultrasound (US)-guided technique of the supra- and infraclavicular and axillary approaches of brachial plexus block (BPB) will produce a high quality of surgical anesthesia for operations below the shoulder independently of the approach and body mass index (BMI). Intercostobrachial and medial brachial cutaneous nerves will be blocked separately because they are not a part of the brachial plexus. METHODS: This is a prospective randomized observer-blinded study...
April 19, 2016: Rambam Maimonides Medical Journal
De Q H Tran, Tom C R V Van Zundert, Julian Aliste, Phatthanaphol Engsusophon, Roderick J Finlayson
In teaching centers, primary failure of thoracic epidural analgesia can be due to multiple etiologies. In addition to the difficult anatomy of the thoracic spine, the conventional end point-loss-of-resistance-lacks specificity. Furthermore, insufficient training compounds the problem: learning curves are nonexistent, pedagogical requirements are often inadequate, supervisors may be inexperienced, and exposure during residency is decreasing. Any viable solution needs to be multifaceted. Learning curves should be explored to determine the minimal number of blocks required for proficiency...
May 2016: Regional Anesthesia and Pain Medicine
Anna Ambrosini, Jean Schoenen
BACKGROUND: In many patients suffering from primary headaches, the available pharmacological and behavioural treatments are not satisfactory. This is a review of (minimally) invasive interventions targeting pericranial nerves that could be effective in refractory patients. METHODS: The interventions we will cover have in common pericranial nerves as targets, but are distinct according to their rationale, modality and invasiveness. They range from nerve blocks/infiltrations to the percutaneous implantation of neurostimulators and surgical decompression procedures...
March 22, 2016: Cephalalgia: An International Journal of Headache
Adam Wallace, Elaine Wirrell, Daniel L Kenney-Jung
Dravet syndrome (DS) is an intractable pediatric epilepsy syndrome, starting in early childhood. This disorder typically manifests with febrile status epilepticus, and progresses to a multifocal epilepsy with febrile and non-febrile seizures with encephalopathy. Most cases are due to a mutation in the SCN1A gene. This article reviews treatments for DS, with an emphasis on pharmacotherapy. While many medications are used in treating the seizures associated with DS, these patients typically have medically refractory epilepsy, and polytherapy is often required...
June 2016: Paediatric Drugs
Paolo Martelletti, Maria Adele Giamberardino, Dimos-Dimitrios Mitsikostas
No abstract text is available yet for this article.
August 2016: Expert Review of Neurotherapeutics
Erkan Kurt, Tess van Eijk, Dylan Henssen, Inge Arnts, Monique Steegers
Chronic intractable shoulder pain (CISP) is defined as shoulder pain which is present for longer than 6 months and does not respond to standard treatments like medication, physical therapy, rehabilitation, selective nerve blocks and local infiltrations, or orthopedic procedures. The etiology of CISP may be very diverse, varying from many orthopedic conditions to non-orthopedic conditions. The fact that the suprascapular nerve is one of the most important nerves supplying the shoulder region makes this nerve an interesting target in treating patients suffering shoulder pain...
January 2016: Pain Physician
Lisa K Mouzi, Olivia Adams, Germaine Cuff, Elaan Lukasiewicz, Elise Champeil, Arthur Atchabahian
OBJECTIVE: Our aim was to establish a plasma concentration curve for ropivacaine following femoral nerve blockade and to ascertain whether the resulting plasma concentrations differ significantly depending on whether neurostimulation (NS) or ultrasound (US) guidance was used. METHODS: Sixteen male and female subjects aged 18 to 80 who were scheduled to undergo unilateral total knee replacement or anterior cruciate ligament reconstruction under general or spinal anaesthesia, and for whom a femoral nerve block was indicated for postoperative analgesia, were enrolled in this prospective, randomised study...
February 2016: Anaesthesia, Critical Care & Pain Medicine
Matthew S Robbins, Carrie E Robertson, Eugene Kaplan, Jessica Ailani, Larry Charleston, Deena Kuruvilla, Andrew Blumenfeld, Randall Berliner, Noah L Rosen, Robert Duarte, Jaskiran Vidwan, Rashmi B Halker, Nicole Gill, Avi Ashkenazi
The sphenopalatine ganglion (SPG) has attracted the interest of practitioners treating head and face pain for over a century because of its anatomical connections and role in the trigemino-autonomic reflex. In this review, we discuss the anatomy of the SPG, as well as what is known about its role in the pathophysiology of headache disorders, including cluster headache and migraine. We then address various therapies that target the SPG, including intranasal medication delivery, new SPG blocking catheter devices, neurostimulation, chemical neurolysis, and ablation procedures...
February 2016: Headache
Heather Smith, Youngwon Youn, Ryan C Guay, Andras Laufer, Julie G Pilitsis
Invasive analgesic therapies provide an alternative to medical management of chronic pain. With the increasing incidence of chronic pain not only in the United States but worldwide, more therapies have evolved to address the growing need for pain relief options. These therapies include spinal injections, nerve blocks, radiofrequency ablation, neurostimulation, and intrathecal drug delivery.
January 2016: Medical Clinics of North America
J Brookes, R Sondekoppam, K Armstrong, V Uppal, S Dhir, M Terlecki, S Ganapathy
BACKGROUND: Clear visibility of the needle and catheter tip is desirable to perform safe and successful ultrasound-guided peripheral nerve blocks. This can be challenging with deeper blocks in obese patients. This study compared the visibility of echogenic and non-echogenic block needles and catheters in proximal sciatic blocks when performed with a low-frequency curved probe. METHODS: Seventy-eight patients undergoing total knee joint arthroplasty were randomized to receive an ultrasound-guided continuous sciatic nerve block using either a non-echogenic needle and stimulating catheter or an echogenic needle and echogenic non-stimulating catheter...
December 2015: British Journal of Anaesthesia
Amol Soin, Zi-Ping Fang, Jon Velasco
Some of the more common peripherally mediated pain disorders are postamputation stump pain and phantom pain. These disabling conditions have proven difficult to treat. Here we aim to illustrate an option to treat postamputation pain using peripheral neurostimulation techniques. Traditional peripheral neuromodulation techniques use standard stimulation parameters and work by stimulation of nerve tissues which are then felt by the patient as a tingling sensation or paresthesia. Recently introduced high-frequency (10 kHz) electrical nerve block [HFAC (high-frequency alternating current) block] via a surgically implanted peripheral nerve cuff electrode results in true conduction block which actually blocks action potentials emanating from the painful neuroma and thus suppresses pain without tingling or paresthesia felt by the patient...
2015: Progress in Neurological Surgery
Hui-Jun Yang, Ji Young Yun, Young Eun Kim, Yong Hoon Lim, Han-Joon Kim, Sun Ha Paek, Beom S Jeon
The number of deep brain stimulation (DBS) hardware complications has increased during the past decade. In cases of abnormally high lead impedance with no evidence of a macroscopic fracture, optimal treatment options have not yet been established. Here, we present the case of a 49-year-old woman with a 12-year history of Parkinson's disease who received bilateral subthalamic nucleus DBS in March 2006. The patient showed good control of parkinsonism until December 24, 2010, when she awoke with abrupt worsening of parkinsonian symptoms...
2015: Neuropsychiatric Disease and Treatment
Foad Elahi, Chandan G Reddy
Persistent idiopathic facial pain can be extremely difficult and significantly challenging to manage for the patient and the clinician. Pharmacological treatment of these painful conditions is not always successful. It has been suggested that the autonomic reflex plays an important role in the pathophysiology of headaches and facial neuralgia. The key structure in the expression of cranial autonomic symptoms is the sphenopalatine ganglion (SPG), also known as the pterygopalatine ganglion. The role of the SPG in the pathophysiology of headaches and facial pain has become clearer in the past decade...
May 2015: Pain Physician
Yoshiaki Ohi, Daisuke Kato, Masayuki Mizuno, Toyohiro Sato, Yoshino Ueki, Cesario V Borlongan, Kosei Ojika, Akira Haji, Noriyuki Matsukawa
Hippocampal cholinergic neurostimulating peptide (HCNP) regulates acetylcholine synthesis in the septal hippocampus through the quantitative increase of choline acetyltransferase levels in the septal nucleus both in vitro and in vivo. Additionally, HCNP-precursor protein transgenic (HCNP-pp Tg) mice display depressive behavior. To examine the physiological function of HCNP and/or HCNP-pp on hippocampal neural activity, we investigated whether overexpression of HCNP-pp strengthened the efficiency of neural activity in the hippocampus...
June 15, 2015: Neuroscience Letters
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