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surgery sciatic pain

Jacklynn F Sztain, John J Finneran, Amanda M Monahan, Bahareh Khatibi, Patrick L Nguyen, Sarah J Madison, Richard H Bellars, Rodney A Gabriel, Sonya S Ahmed, Alexandra K Schwartz, William T Kent, Michael C Donohue, Jennifer A Padwal, Brian M Ilfeld
We tested the hypothesis that during a continuous popliteal-sciatic nerve block, postoperative analgesia is improved with the catheter insertion point "deep" to the paraneural sheath immediately distal to the bifurcation between the tibial and common peroneal branches, compared with the traditional approach "superficial" to the paraneural sheath proximal to the bifurcation. The needle tip location was determined to be accurately located with a fluid bolus visualized with ultrasound; however, catheters were subsequently inserted without a similar fluid injection and visualization protocol (visualized air injection was permitted and usually implemented, but not required per protocol)...
August 9, 2018: Anesthesia and Analgesia
Qiang Wu, Li Liu
Opioid receptor like 1 (ORL1 ) receptor activation displayed an anti-nociceptive effect at spinal level for acute and neuropathic pain. SCH221510, an orally active non-peptide ORL1 agonist, was reported to be effective in treating neuropathic pain. The present study used ORL1 antagonist and siRNA to investigate that ORL1 activation mediates intrathecal SCH221510 analgesia in neuropathic pain induced by chronic constrictive injury (CCI) to rat sciatic nerve. Paw withdrawal latency and 50% mechanical threshold were measured for thermal and mechanical hypersensitivity in rats...
August 3, 2018: Journal of Molecular Neuroscience: MN
Sandra Velcic Brumnjak, Ivan Rakovac, Dijana Papez Kinkela, Kresimir Bukal, Branko Sestan, Vera Tulic, Elisa Velcic Janjetic, Vlatka Sotosek Tokmadzic
BACKGROUND Pain and surgical stress cause a pro-inflammatory response followed by downregulation of the immune response, which can increase the incidence of postoperative complications, such as infections or prolonged wound healing. T lymphocytes and natural killer (NK) cells have cytotoxic potential and are crucial components of cellular immunity, which is important for maintenance of immune balance. The aim of this study was to analyze the effects of 3 types of postoperative analgesia on the preservation and cytotoxic potential of T lymphocytes, NK cells, and their subpopulations, as well as NKT cells, in patients after total knee replacement (TKR) to find the most effective analgesic technique for mitigating immune suppression...
July 31, 2018: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
Rhian Alice Ceredig, Florian Pierre, Stéphane Doridot, Unai Alduntzin, Eric Salvat, Ipek Yalcin, Claire Gaveriaux-Ruff, Michel Barrot, Dominique Massotte
Peripheral delta opioid (DOP) receptors are essential for the anti-allodynic effect of the tricyclic antidepressant nortriptyline. However, the population of DOP-expressing cells affected in neuropathic conditions or underlying the anti-allodynic activity of antidepressants remains unknown. Using a mouse line in which DOP receptors were selectively ablated in cells expressing Nav1.8 sodium channels (DOP cKO), we established that these DOP peripheral receptors were mandatory for duloxetine to alleviate mechanical allodynia in a neuropathic pain model based on sciatic nerve cuffing...
July 30, 2018: European Journal of Neuroscience
Li Zhan, Rui Li, Yuhong Sun, Mengyun Dou, Wan Yang, Shufang He, Ye Zhang
The therapeutic effects of mitochondria-targeted antioxidants have been demonstrated in many pathological conditions, but their effect on neuropathic pain remains unclear. The objective was to study the therapeutic effects and mechanisms of mito-TEMPO (MT), as a nitroxide conjugated with a triphenylphosphonium moiety, on neuropathic pain in rats. Rats were randomly assigned to sham control (sham), chronic constrictive injury (CCI) or MT treatment groups (sham+MT and CCI+MT). All animals received CCI of the left sciatic nerve except those in the sham group...
July 26, 2018: Neuroreport
M T Berninger, J Friederichs, W Leidinger, P Augat, V Bühren, C Fulghum, W Reng
BACKGROUND: The aim of the study was to analyze the effect of local infiltration analgesia (LIA), peripheral nerve blocks, general and spinal anesthesia on early functional recovery and pain control in primary unicompartmental knee arthroplasty (UKA). METHODS: Between January 2016 until August 2016, 134 patients underwent primary UKA and were subdivided into four groups according to their concomitant pain and anesthetic procedure with catheter-based techniques of femoral and sciatic nerve block (group GA&FNB, n = 38) or epidural catheter (group SP&EPI, n = 20) in combination with general anesthesia or spinal anesthesia, respectively, and LIA combined with general anesthesia (group GA&LIA, n = 46) or spinal anesthesia (group SP&LIA, n = 30)...
July 24, 2018: BMC Musculoskeletal Disorders
Brian M Ilfeld, Scott T Ball, Rodney A Gabriel, Jacklynn F Sztain, Amanda M Monahan, Wendy B Abramson, Bahareh Khatibi, Engy T Said, Jesal Parekh, Stuart A Grant, Amorn Wongsarnpigoon, Joseph W Boggs
INTRODUCTION: The objective of the present feasibility study was to investigate the use of a new treatment modality-percutaneous peripheral nerve stimulation (PNS)-in controlling the often severe and long-lasting pain following total knee arthroplasty (TKA). METHODS: For patients undergoing a primary, unilateral TKA, both femoral and sciatic open-coil percutaneous leads (SPR Therapeutics, Cleveland, OH) were placed up to seven days prior to surgery using ultrasound guidance...
July 19, 2018: Neuromodulation: Journal of the International Neuromodulation Society
M T Berninger, J Friederichs, W Leidinger, P Augat, V Bühren, C Fulghum, W Reng
BACKGROUND: Postoperative pain control and enhanced mobilization, muscle strength and range of motion following total knee arthroplasty (TKA) are pivotal requisites to optimize rehabilitation and early recovery. The aim of the study was to analyze the effect of local infiltration analgesia (LIA), peripheral nerve blocks, general and spinal anesthesia on early functional recovery and pain control in primary total knee arthroplasty. METHODS: Between January 2016 until August 2016, 280 patients underwent primary TKA and were subdivided into four groups according to their concomitant pain and anesthetic procedure with catheter-based techniques of femoral and sciatic nerve block (group GA&FNB, n = 81) or epidural catheter (group SP&EPI, n = 51) in combination with general anesthesia or spinal anesthesia, respectively, and LIA combined with general anesthesia (group GA&LIA, n = 86) or spinal anesthesia (group SP&LIA, n = 61)...
July 18, 2018: BMC Musculoskeletal Disorders
Wei-Qiang Chen, Na Guo, Shan-Shan Wang, Ren Wang, Fei Huang, Shang-Rong Li
OBJECTIVE: To compare the perioperative outcomes and hemodynamic effects at induction of general laryngeal mask airway (LMA) anesthesia with lumbar plexus-sciatic nerve block (LPSB) and general anesthesia with endotracheal intubation (ET) in elderly patients undergoing hip surgery. METHODS: A total of 63 patients having open reduction internal fixation of an intertrochanteric fracture were randomly assigned to receive LMA anesthesia with LPSB or general anesthesia with ET...
September 2018: Archives of Gerontology and Geriatrics
Faisal Shamim, Malika Hameed, Nadeem Siddiqui, Shemila Abbasi
A case series of five high-risk patients with lower limb ischemia, sepsis, altered coagulation, and multi-organ dysfunction requiring emergent or urgent lower limb amputation is presented. Use of peripheral nerve blocks for below and above knee amputations is quite uncommon which provides better hemodynamic stability and pain management, especially in the very sick patients. The surgeries were successfully carried out under ultrasound-guided combined femoral and sciatic nerve blocks. All five patients obtained adequate level of block at the area of amputation...
April 2018: International Journal of Critical Illness and Injury Science
Yingcong Yang, Zhongyuan Xia, Qingtao Meng, Kang Liu, Yeda Xiao, Liwei Shi
This study was designed to examine the effect and mechanism of dexmedetomidine (Dex) on neuropathic pain (NP). The NP model was established by performing chronic sciatic nerve constriction injury (CCI). Seven days after CCI surgery, the rats were injected intraperitoneally with Dex, ZD7288 (an HCN channel inhibitor), and saline, respectively. The paw withdrawal threshold to mechanical stimulation and the thermal withdrawal latency tests were performed. After administration, the L4, L5 dorsal root ganglia (DRG) neurons of rats were isolated...
August 15, 2018: Neuroreport
Diogo Lino Moura, António Figueiredo
Objective: Retrospective case-control study on the authors' experience regarding arthroplasty in high congenital dislocations of the hip in adults. Methods: Sample with 11 high congenital hip dislocations (Hartofilakidis type C) that occurred in seven patients, who were submitted to hip arthroplasty by the same surgeon and with the same surgical technique. Mean follow-up period was 4.32 ± 2.67 years (minimum one year) and all patients were evaluated by the same examiner...
March 2018: Revista Brasileira de Ortopedia
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...
August 2018: Regional Anesthesia and Pain Medicine
Zhiyao Wang, Fan Liu, Min Wei, Yue Qiu, Chao Ma, Le Shen, Yuguang Huang
BACKGROUND: microRNA-146a-5p (miRNA-146a-5p) is a key molecule in the negative regulation pathway of TLRs and IL-1 receptor (TIR) signaling. Our recent study demonstrated that MyD88-dependent signaling pathway of TIR in the dorsal root ganglion (DRG) and spinal dorsal horn (SDH) plays a role in peripheral nerve injury-induced neuropathic pain. However, it was not clear whether and how miRNA-146a-5p regulates the TIR pathway of DRG and SDH in the development of neuropathic pain. METHODS: The sciatic nerve chronic constriction injury (CCI) model of rat was used to induce chronic neuropathic pain...
June 9, 2018: Journal of Neuroinflammation
Sun-Jung Yoon, Myung-Sik Park, Dean K Matsuda, Yun Ho Choi
BACKGROUND: Sciatic nerve injuries following total hip arthroplasty are disabling complications. Although degrees of injury are variable from neuropraxia to neurotmesis, mechanical irritation of sciatic nerve might be occurred by protruding hardware. This case shows endoscopic decompression for protruded acetabular screw irritating sciatic nerve, the techniques described herein may permit broader arthroscopic/endoscopic applications for management of complications after reconstructive hip surgery...
June 4, 2018: BMC Musculoskeletal Disorders
Peilong Dong, Xiaobo Tang, Rongrong Cheng, Jian Wang
BACKGROUND AND AIM: The severe pain after total knee arthroplasty (TKA) brings many patients more suffering, longer hospital stay and higher expenses. This study was designed to assess the relative efficacy of several clinical treatments for postoperative analgesia of TKA through network meta-analysis (NMA) based on multiple published randomized controlled trials. METHODS: Embase and PubMed were utilized to conduct this network meta-analysis from inception until 2016...
June 2, 2018: Clinical Journal of Pain
Hai-Xia Jiang, Bo-Wen Ke, Jin Liu, Gang Ma, Ke-Rong Hai, De-Ying Gong, Zheng Yang, Cheng Zhou
BACKGROUND: Neuropathic pain is often associated with depression. Enhancing endocannabinoids by fatty acid amide hydrolase (FAAH) inhibitors relieves neuropathic pain and stress-induced depressive-like behaviors in animal models. However, it is unclear whether FAAH inhibitor can relieve neuropathic pain-induced depression by or not by its antinociceptive effects. METHODS: Adult male Wistar rats with chronic constriction injury (CCI) to the sciatic nerve were treated with the systemic FAAH inhibitor URB597 (5...
May 31, 2018: Anesthesia and Analgesia
M Baeriswyl, P Taffé, K R Kirkham, I Bathory, V Rancati, X Crevoisier, S Cherix, E Albrecht
Animal data have demonstrated increased block duration after local anaesthetic injections in diabetic rat models. Whether the same is true in humans is currently undefined. We, therefore, undertook this prospective cohort study to test the hypothesis that type-2 diabetic patients suffering from diabetic peripheral neuropathy would have increased block duration after ultrasound-guided popliteal sciatic nerve block when compared with patients without neuropathy. Thirty-three type-2 diabetic patients with neuropathy and 23 non-diabetic control patients, scheduled for fore-foot surgery, were included prospectively...
June 2, 2018: Anaesthesia
Lisheng Hou, Xuedong Bai, Haifeng Li, Shi Cheng, Tianyong Wen, Qing He, Dike Ruan
STUDY DESIGN: A retrospective case report. OBJECTIVE: To report a case that transformed from type Castellvi-IIa sacralization to type Castellvi-IIIa following decompression and fusion surgery at transitional disc (TD). SUMMARY OF BACKGROUND DATA: Traditionally, lumbosacral transitional vertebra (LSTV) has been regarded as a congenital anomaly. No literature has ever reported that transformation from one type LSTV to another would happen after birth...
May 22, 2018: Spine
Zoher Naja, Ahmad Salah Naja, Omar Rajab, Anas Mugharbil, Abdul Rahman Shatila, Janah Al Hassan
Schwannoma is a common neoplasm in the peripheral and central nervous systems. Sciatic nerve schwanommas are rare. We report the case of a 50-year-old woman who was referred for treatment of persistent neuropathic pain in the left lower limb after resection of a schwannoma on the left S1 nerve root. The patient's history goes back when she was 27 years old and started to have electric-like pain in her lower left limb upon intercourse. Examination revealed a left ovarian cyst which was surgically removed. Her pain persisted despite taking nonsteroidal anti inflammatory drugs (NSAIDs)...
January 26, 2018: Scandinavian Journal of Pain
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