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Nerve ultrasound

Philippe Magazzeni, Denis Jochum, Gabriella Iohom, Gérard Mekler, Eliane Albuisson, Hervé Bouaziz
BACKGROUND AND OBJECTIVES: For superficial surgery of anteromedial and posteromedial surfaces of the upper arm, the medial brachial cutaneous nerve (MBCN) and the intercostobrachial nerve (ICBN) must be selectively blocked, in addition to an axillary brachial plexus block. We compared efficacy of ultrasound-guided (USG) versus conventional block of the MBCN and the ICBN. METHODS: Eighty-four patients, undergoing upper limb surgery, were randomized to receive either USG (n = 42) or conventional (n = 42) block of the MBCN and the ICBN with 1% mepivacaine...
June 13, 2018: Regional Anesthesia and Pain Medicine
Brian M Ilfeld, Rodney A Gabriel, Engy T Said, Amanda M Monahan, Jacklynn F Sztain, Wendy B Abramson, Bahareh Khatibi, John J Finneran, Pia T Jaeger, Alexandra K Schwartz, Sonya S Ahmed
BACKGROUND AND OBJECTIVES: Percutaneous peripheral nerve stimulation (PNS) is an analgesic modality involving the insertion of a lead through an introducing needle followed by the delivery of electric current. This modality has been reported to treat chronic pain as well as postoperative pain the day following knee surgery. However, it remains unknown if this analgesic technique may be used in ambulatory subjects following foot procedures beginning within the recovery room immediately following surgery, and with only short series of patients reported to date, the only available data are derived from strictly observational studies...
June 13, 2018: Regional Anesthesia and Pain Medicine
Woojin Kwon, Seunguk Bang, Hyojung Soh, Won Jun Jeong, Sang Chul Lee, Byung Jo Choi
RATIONALE: Laparoscopic totally extraperitoneal (TEP) inguinal hernia repair is a rapidly evolving, minimally invasive treatment modality for inguinal hernia. Compared with open hernia repair, this method requires a smaller incision, has cosmetic advantages, and facilitates rapid recovery and early return to daily activities because of less postoperative pain. Because general anesthesia is essential for TEP hernia repair, it cannot be performed on patients who have an increased risk of developing complications when placed under general anesthesia...
June 2018: Medicine (Baltimore)
Bayram Kaymak, Murat Kara, Eda Gürçay, Gülümser Aydin, Levent Özçakar
BACKGROUND: Chemoneurolysis is used to treat focal spasticity in patients with upper motor neuron syndrome. CASE REPORT: Neurolytic substances (phenol/alcohol) injected nearby/in the main trunk of peripheral nerves can cause not only motor but also cutaneous nerves destruction. The latter is thought to be responsible for considerable side effects such as dysesthesia and paresthesia. During injections, targeting the primary motor branches originating from the main trunk while sparing cutaneous nerves will result in decrease/elimination of these side effects and better clinical improvement...
June 11, 2018: European Journal of Physical and Rehabilitation Medicine
Manish Saxena, Tariq Shour, Mussadiq Shah, Christopher B Wolff, Peter O O Julu, Vikas Kapil, David J Collier, Fu Liang Ng, Ajay Gupta, Armida Balawon, Jane Pheby, Anne Zak, Gurvinder Rull, Benjamin O'Brien, Roland E Schmieder, Melvin D Lobo
BACKGROUND: Renal denervation has no validated marker of procedural success. We hypothesized that successful renal denervation would reduce renal sympathetic nerve signaling demonstrated by attenuation of α-1-adrenoceptor-mediated autotransfusion during the Valsalva maneuver. METHODS AND RESULTS: In this substudy of the Wave IV Study: Phase II Randomized Sham Controlled Study of Renal Denervation for Subjects With Uncontrolled Hypertension, we enrolled 23 subjects with resistant hypertension...
June 12, 2018: Journal of the American Heart Association
Akinori Asai, Eisuke Kako, Tatsuya Hasegawa, Kazuya Sobue
Isaacs syndrome is a rare peripheral nerve hyperexcitability syndrome. The painful discharges in Isaacs syndrome are abolished by the blockade of the neuromuscular junction but not by peripheral nerve blocks (PNB). However, the efficacy of PNB for intraoperative and postoperative analgesia among those with Isaacs syndrome is unknown. A 41-year-old woman with Isaacs syndrome underwent open reduction and internal fixation of radius fractures. Ultrasound-guided bilateral axillary brachial plexus blocks were performed, followed by general anesthesia...
June 11, 2018: A&A practice
Sehnaz Tezcan, Funda Ulu Ozturk, Nihal Uslu, Merve Nalbant, Oya Umit Yemisci
OBJECTIVES: To evaluate the efficacy of low-level laser therapy on median nerve stiffness by using strain elastography in carpal tunnel syndrome (CTS). METHODS: This study included 37 wrists of 34 patients with mild or moderate CTS between January 2016 and August 2016. The control group comprised 17 patients (18 wrists) with CTS who were treated with wrist splinting for 3 weeks. The low-level laser therapy group included 17 patients (19 wrists) with CTS who were treated with a combination of splinting and low-level laser therapy, which was applied 5 times per week for 3 weeks...
June 11, 2018: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
Richard L Kahn, Jennifer Cheng, Yuliya Gadulov, Kara G Fields, Jacques T YaDeau, Lawrence V Gulotta
BACKGROUND AND OBJECTIVES: Perineural dexamethasone and intravenous (IV) dexamethasone have been shown to prolong peripheral nerve block duration. The effects of perineural and IV dexamethasone have only been compared at doses of 4 mg or greater. This triple-blind, randomized trial examined the effect of 1 mg IV versus perineural dexamethasone on interscalene block (ISB) analgesia duration. METHODS: Patients undergoing ambulatory shoulder arthroscopy received an ultrasound-guided ISB with 15 mL bupivacaine 0...
June 8, 2018: Regional Anesthesia and Pain Medicine
Y Canakci, O Koksal, V A Durak
Introduction: Headache is one of the most important complaints in emergency room (ER) admissions, and the rate of the increase in intracranial pressure in these cases should not be overlooked. This study was performed to investigate the value of the measurement of optic nerve sheath diameter (ONSD) by ocular ultrasound in ER patients with the complaint of headache and increase in intracranial pressure regarding this. Materials and Methods: : A total of 100 patients who applied to the ER with the complaint of headache were included in this prospective study...
June 2018: Nigerian Journal of Clinical Practice
O Varela, A Melone, R López-Menchaca, R Sevilla, D Callejo, S López-Álvarez, A Román Fernández, S García, I Mantilla, M Zaballos
OBJECTIVE: Interfascial blocks of the thoracic wall are being developed as an alternative to central blocks in breast surgery. However, there are few studies that have evaluated the anatomical extension of the local anaesthetic. The objective of this study was to analyse, using fluoroscopy, the spreading of two volumes (10 vs. 20ml) of radiological contrast in the serratus-intercostal plane block in an experimental pig model. MATERIAL AND METHODS: Ten Large-White breed pigs were selected to have a bilateral ultrasound serratus-intercostal plane block performed, with the administering of 10ml and 20ml of iopamidol in the right and left hemithorax, respectively...
June 7, 2018: Revista Española de Anestesiología y Reanimación
Christine C Johnson, Emil Stefan Vutescu, Theodore T Miller, O Kenechi Nwawka, Steve K Lee, Scott W Wolfe
Inadvertent median nerve harvest is a devastating complication of palmaris longus harvest. Accurate assessment of palmaris longus presence and dimensions preoperatively would minimize this risk and assure safe harvest. We hypothesized that ultrasound would accurately predict palmaris longus presence, length and diameter. Seventeen cadaveric forearms were studied using a LOGIQ-E9 ultrasound. Two radiologists assessed palmaris longus presence and dimensions. Each wrist was explored, and the tendon was harvested and measured...
January 1, 2018: Journal of Hand Surgery, European Volume
Karina Krajden Haratz, Yaakov Melcer, Zvi Leibovitz, Hagit Feit, Tally Kerman-Sagie, Dorit Lev, Shimon Ginath, Liat Gindes, Antonio Fernandes Moron, Gustavo Malinger
OBJECTIVE:  To construct prenatal age-specific reference intervals for sonographic measurements of the optic nerve sheath diameter (ONSD) during gestation in normal fetuses. MATERIALS AND METHODS:  Prospective cross-sectional study of fetuses assessed in antenatal ultrasound units between 2010 and 2014. The examination was based on a technique for the sonographic assessment of ONSD previously published by our group. The mean values and SDs of the ONSD were modeled as a function of the gestational week by curve estimation analysis based on the highest adjusted R2 coefficient...
June 7, 2018: Ultraschall in der Medizin
Si-Ru Chen, Yu-Ping Shen, Tsung-Yen Ho, Liang-Cheng Chen, Yung-Tsan Wu
RATIONALE: Perineural injection with dextrose could be a novel intervention for peripheral entrapment neuropathy. However, this intervention has not been reported for treating radial nerve palsy (RNP). Here, we present a case with RNP having outstanding improvement after 2 sessions of ultrasound-guided perineural injection with 5% dextrose (D5W). PATIENT CONCERNS: A 62-year-old woman presented with difficulty and weakness in extension of her left wrist and fingers after she slept with the arm compressed against her body...
June 2018: Medicine (Baltimore)
Yan-Bin Liu, Yin Wang, Zi-Qiang Chen, Jun Li, Wei Chen, Chuan-Feng Wang, Qiang Fu
BACKGROUND: The use of percutaneous endoscopic lumbar discectomy (PELD) is increasing in the treatment of lumbar disc herniations (LDH). Nerve and vessel injury may happen during the establishment of the transforaminal working channel. Also, there is usually exposure to intraop radiation when the C-arm is used to help establish the location of the transforaminal working channel. OBJECTIVE: To evaluate the accuracy and safety of the volume navigation technique for guiding transforaminal puncture in cadaver and clinical patient treatment...
May 2018: Pain Physician
Leonardo Kapural, Suneil Jolly, Joao Mantoan, Harish Badhey, Ty Ptacek
BACKGROUND: Chronic hip joint pain is a common condition with an estimated prevalence of 7% in men and 10% in women, in a population sample aged over 45. Conservative treatment can include physical therapy, weight loss, a variety of pharmacologic agents ranging from nonsteroidal antiinflammatory drugs (NSAIDS) to opioids, and intraarticular injections with various substances. Definitive treatment of hip pain, however, has primarily centered on hip arthroplasty. OBJECTIVE: We describe a novel anterior approach to cooled radiofrequency (RF) hip denervation under combined ultrasound (US) and fluoroscopy guidance to avoid the neurovascular femoral bundle and reach proper landmarks...
May 2018: Pain Physician
N S Buch, E Qerama, N B Finnerup, L Nikolajsen
Background and aims Injury to peripheral nerves associated with trauma, amputation, or surgery may lead to the formation of neuromas that can cause severe pain. Unfortunately, neuromas are frequently refractory to medical and surgical treatment. This ongoing study examines whether neuromas are more frequent in patients experiencing pain after peripheral nerve injury or amputation than in patients without pain. Methods In this observational cohort study, 80 patients with peripheral nerve injury or amputation will be recruited...
December 29, 2017: Scandinavian Journal of Pain
Brian Lee, Euan Stubbs
We present an unusual case of sartorius muscle tear presenting as acute meralgia paresthetica. A healthy 67-year old male was referred to our department with a one-week history of pain, numbness and bruising over his hip and anterolateral thigh. Extended ultrasound assessment revealed an intramuscular tear of sartorius, with acute hematoma surrounding the adjacent lateral femoral cutaneous nerve. Meralgia paresthetica from acute trauma is rare, with only three published cases relating to fractures of the anterior superior iliac spine...
May 29, 2018: Clinical Imaging
Hagen Bomberg, Laura Wetjen, Stefan Wagenpfeil, Jakob Schöpe, Paul Kessler, Hinnerk Wulf, Thomas Wiesmann, Thomas Standl, André Gottschalk, Jens Döffert, Werner Hering, Jürgen Birnbaum, Bernd Kutter, Jörg Winckelmann, Simone Liebl-Biereige, Winfried Meissner, Oliver Vicent, Thea Koch, Hartmut Bürkle, Daniel I Sessler, Thomas Volk
BACKGROUND: Ultrasound, nerve stimulation, and their combination are all considered acceptable ways to guide peripheral nerve blocks. Which approach is most effective and associated with the fewest complications is unknown. We therefore used a large registry to analyze whether there are differences in vascular punctures, multiple skin punctures, and unintended paresthesia. METHODS: Twenty-six thousand seven hundred and thirty-three cases were extracted from the 25-center German Network for Regional Anesthesia registry between 2007 and 2016 and grouped into ultrasound-guided puncture (n = 10,380), ultrasound combined with nerve stimulation (n=8173), and nerve stimulation alone (n = 8180)...
May 31, 2018: Anesthesia and Analgesia
Doo-Hwan Kim, Sooyoung Kim, Chan Sik Kim, Sukyung Lee, In-Gyu Lee, Hee Jeong Kim, Jong-Hyuk Lee, Sung-Moon Jeong, Kyu Taek Choi
Objectives: The pectoral nerve block type II (PECS II block) is widely used for postoperative analgesia after breast surgery. This study evaluated the analgesic efficacy of PECS II block in patients undergoing breast-conserving surgery (BCS) and sentinel lymph node biopsy (SNB). Methods: Patients were randomized to the control group ( n =40) and the PECS II group ( n =40). An ultrasound-guided PECS II block was performed after induction of anesthesia. The primary outcome measure was opioid consumption, and the secondary outcome was pain at the breast and axillary measured using the Numerical Rating Scale (NRS) 24 hours after surgery...
2018: Pain Research & Management: the Journal of the Canadian Pain Society
Jordi Gascon-Garcia, Caridad Bagur-Calafat, Montserrat Girabent-Farrés, Ramon Balius
OBJECTIVES: To use ultrasound imaging to show how the needles in dry needling applied in the carpal tunnel can reach the transverse carpal ligament, acting on it in the form of traction-stretching when the fascial winding technique is performed. The potential associated risks are also assessed. DESIGN: Validation study. PARTICIPANTS: Healthy volunteers (n = 18). METHODS: Four dry needling needles were applied to the carpal tunnel, only using anatomical references, according to the original approach known as "four-pole carpal dry needling", and manipulating the needles following the so-called fascial winding technique according to the authors, in the form of unidirectional rotation...
April 2018: Journal of Bodywork and Movement Therapies
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