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https://www.readbyqxmd.com/read/29777144/benefits-in-radical-mastectomy-protocol-a-randomized-trial-evaluating-the-use-of-regional-anesthesia
#1
Marcio Matsumoto, Eva M Flores, Pedro P Kimachi, Flavia V Gouveia, Mayra A Kuroki, Alfredo C S D Barros, Marcelo M C Sampaio, Felipe E M Andrade, João Valverde, Eduardo F Abrantes, Claudia M Simões, Rosana L Pagano, Raquel C R Martinez
Surgery is the first-line treatment for early, localized, or operable breast cancer. Regional anesthesia during mastectomy may offer the prevention of postoperative pain. One potential protocol is the combination of serratus anterior plane block (SAM block) with pectoral nerve block I (PECS I), but the results and potential benefits are limited. Our study compared general anesthesia with or without SAM block + PECS I during radical mastectomy with axillary node dissection and breast reconstruction using evaluations of pain, opioid consumption, side effects and serum levels of interleukin (IL)-1beta, IL-6 and IL-10...
May 18, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29777135/n-methyl-d-aspartate-receptor-subtype-2b-antagonist-ro-25-6981-attenuates-neuropathic-pain-by-inhibiting-postsynaptic-density-95-expression
#2
Ling-Er Huang, Shao-Hui Guo, Lalita Thitiseranee, Yan Yang, Yan-Feng Zhou, Yong-Xing Yao
Postsynaptic density-95 (PSD-95) is a synaptic scaffolding protein that plays a crucial role in the development of neuropathic pain. However, the underlying mechanism remains unclear. To address the role of PSD-95 in N-methyl-D-aspartate receptor subtype 2B (NR2B) -mediated chronic pain, we investigated the relationship between PSD-95 activation and NR2B function in the spinal cord, by using a rat model of sciatic nerve chronic constriction injury (CCI). We demonstrate that the expression levels of total PSD-95 and cAMP response element binding protein (CREB), as well as phosphorylated NR2B, PSD-95, and CREB, in the spinal dorsal horn, and the interaction of NR2B with PSD-95 were increased in the CCI animals...
May 18, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29775120/successful-improvement-of-pain-symptomatology-in-a-suspected-case-of-cramp-fasciculation-syndrome-via-interventional-pain-treatment
#3
Anita Gupta, Lucas First, Celeste A Swain
Peripheral nerve hyperexcitability (PNH) syndromes are a rare set of neuromuscular disorders that include cramp-fasciculation syndrome (CFS) and Isaacs syndrome (IS). Successful treatment of these diseases has been achieved with antiepileptic medications; however, chronic pain symptoms can persist. We provide a case report of a 25-year-old female who has suffered from painful severe muscle spasms and fasciculations since childhood. With CFS as our working diagnosis, a treatment regimen using interventional pain techniques, including sympathetic chain blocks, ketamine infusions, and trigger point injections, resulted in a significant decrease in the patient's chronic pain symptoms...
May 18, 2018: Journal of Pain & Palliative Care Pharmacotherapy
https://www.readbyqxmd.com/read/29770535/ultrasound-guided-transversus-thoracic-plane-block-parasternal-block-and-fascial-planes-hydrodissection-for-internal-mammary-post-thoracotomy-pain-syndrome
#4
Emanuele Piraccini, Giulia Biondi, Helen Byrne, Morena Calli, Daniele Bellantonio, Giovanni Musetti, Stefano Maitan
INTRODUCTION: Pectoral Nerves Block (PECS) and Serratus Plane Block (SPB) have been used to treat persistent post-surgical pain after breast and thoracic surgery, however they cannot block the internal mammary region, so a residual pain may occur in that region. Parasternal block (PSB) and Thoracic Transversus Plane Block (TTP) anesthetize the anterior branches of T2-6 intercostal nerves thus they can provide analgesia to the internal mammary region. METHODS: We describe a 60-year-old man suffering from right post thoracotomy pain syndrome with residual pain located in the internal mammary region after a successful treatment with PECS and SPB We performed a PSB and TTP and hydrodissection of fascial planes with triamcinolone and Ropivacaine...
May 16, 2018: European Journal of Pain: EJP
https://www.readbyqxmd.com/read/29763654/obturator-neuromodulation-with-laparoscopic-placement-of-an-obturator-lead-for-the-treatment-of-intractable-opioid-dependent-chronic-pelvic-pain-due-to-obturator-neuralgia
#5
Richard P Marvel
Chronic pelvic pain(CPP) is a common condition in women that can have a devastating effect on quality of life. Some of the most severe forms of CPP are related to peripheral nerve injuries causing persistent neuropathic pain. This is a case of a young woman with severe opioid dependent chronic pelvic and right groin pain due to obturator neuralgia. She had failed a multitude of treatments including multiple medications, manual physical therapy, nerve blocks, surgical neurolysis and spinal cord stimulation without significant benefit...
May 12, 2018: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/29762332/extended-release-liposomal-bupivacaine-injection-exparel-for-early-postoperative-pain-control-following-palatoplasty
#6
Kristopher M Day, Narayanan M Nair, Larry A Sargent
INTRODUCTION: Liposomal bupivacaine (LB) is a long-acting local anesthetic reported to decrease postoperative pain in adults. The authors demonstrate the safe use of LB in pediatric patients with improved pain control following palatoplasty. MATERIALS AND METHODS: Retrospective patient series of all single-surgeon palatoplasty patients treated at a tertiary craniofacial center from August 2014 to December 2015 were included. All patients received 1.3% LB intraoperatively as greater palatal nerve and surgical field blocks in 2-flap V-Y pushback palatoplasty...
May 14, 2018: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/29762321/greater-occipital-nerve-decompression-for-occipital-neuralgia
#7
Anson Jose, Shakil Ahmed Nagori, Probodh K Chattopadhyay, Ajoy Roychoudhury
The aim of the study was to evaluate the effectiveness of greater occipital nerve decompression for the management of occipital neuralgia. Eleven patients of medical refractory occipital neuralgia were enrolled in the study. Local anaesthetic blocks were used for confirming diagnosis. All of them underwent surgical decompression of greater occipital nerve at the level of semispinalis capitis and trapezial tunnel. A pre and postoperative questionnaire was used to compare the severity of pain and number of pain episodes/month...
May 14, 2018: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/29762181/intraneural-ultrasound-guided-sciatic-nerve-block-minimum-effective-volume-and-electrophysiologic-effects
#8
Gianluca Cappelleri, Andrea Luigi Ambrosoli, Marco Gemma, Valeria Libera Eva Cedrati, Federico Bizzarri, Giorgio Francesco Danelli
BACKGROUND: Both extra- and intraneural sciatic injection resulted in significant axonal nerve damage. This study aimed to establish the minimum effective volume of intraneural ropivacaine 1% for complete sensory-motor sciatic nerve block in 90% of patients, and related electrophysiologic variations. METHODS: Forty-seven consecutive American Society of Anesthesiologists physical status I-II patients received an ultrasound-guided popliteal intraneural nerve block following the up-and-down biased coin design...
May 15, 2018: Anesthesiology
https://www.readbyqxmd.com/read/29761638/ultra-sound-guided-neurolysis-of-six-genicular-nerves-of-knee-for-intractable-pain-from-knee-osteoarthritis-a-case-series
#9
Arif Ahmed, Divesh Arora
INTRODUCTION: Among the elderly populations, the chronic osteoarthritis of knee joint is one of the leading cause of disability and causes considerable pain, joint stiffness and functional limitations. Although knee replacement is a good option for the grade IV osteoarthritis, but many patients failed to undergo surgery due to co-morbidities or other reasons. METHODS: Four patient with severe pain from grade III and IV osteoarthritis of knee joint had underwent ultrasound guided alcohol neurolysis of the six genicular nerves of knee joint after a positive genicular nerve block with local anesthetics...
May 14, 2018: Pain Practice: the Official Journal of World Institute of Pain
https://www.readbyqxmd.com/read/29758039/effects-of-palonosetron-for-prophylaxis-of-postoperative-nausea-and-vomiting-in-high-risk-patients-undergoing-total-knee-arthroplasty-a-prospective-randomized-double-blind-placebo-controlled-study
#10
Jung-Hee Ryu, Young-Tae Jeon, Byunghun Min, Jin-Young Hwang, Hye-Min Sohn
BACKGROUND: The preemptive multimodal pain protocols used in total knee arthroplasty (TKA) often cause emesis postoperatively. We investigated whether palonosetron prophylaxis reduces postoperative nausea and vomiting (PONV) in high-risk patients after TKA. METHODS: We randomized 120 female patients undergoing TKA to receive either palonosetron (0.075 mg, intravenous) or no antiemetic prophylaxis (0.9% saline, control group). All patients were given spinal anesthesia, a continuous femoral nerve block, and fentanyl-based intravenous patient controlled analgesia...
2018: PloS One
https://www.readbyqxmd.com/read/29757796/mental-nerve-blocks-for-lip-brachytherapy-a-case-report
#11
Osama Hafez, Robert S Ackerman, Trip Evans, Sephalie Y Patel, Devang M Padalia
High dose rate interstitial brachytherapy is a commonly performed procedure for carcinoma of the lower lip. Placement of the brachytherapy catheters can be painful and may require monitored anesthesia care or general anesthesia. We present the use of bilateral mental nerve blocks with minimal sedation to facilitate placement of brachytherapy catheters.
May 15, 2018: A&A practice
https://www.readbyqxmd.com/read/29757778/a-contemporary-analysis-of-medicolegal-issues-in-obstetric-anesthesia-between-2005-and-2015
#12
Vesela P Kovacheva, Ethan Y Brovman, Penny Greenberg, Ellen Song, Arvind Palanisamy, Richard D Urman
BACKGROUND: Detailed reviews of closed malpractice claims have provided insights into the most common events resulting in litigation and helped improve anesthesia care. In the past 10 years, there have been multiple safety advancements in the practice of obstetric anesthesia. We investigated the relationship among contributing factors, patient injuries, and legal outcome by analyzing a contemporary cohort of closed malpractice claims where obstetric anesthesiology was the principal defendant...
May 10, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29756651/optical-signature-of-nerve-tissue-exploratory-ex-vivo-study-comparing-optical-histological-and-molecular-characteristics-of-different-adipose-and-nerve-tissues
#13
Andrea J R Balthasar, Torre M Bydlon, Hans Ippel, Marjolein van der Voort, Benno H W Hendriks, Gerald W Lucassen, Geert-Jan van Geffen, Maarten van Kleef, Paul van Dijk, Arno Lataster
BACKGROUND: During several anesthesiological procedures, needles are inserted through the skin of a patient to target nerves. In most cases, the needle traverses several tissues-skin, subcutaneous adipose tissue, muscles, nerves, and blood vessels-to reach the target nerve. A clear identification of the target nerve can improve the success of the nerve block and reduce the rate of complications. This may be accomplished with diffuse reflectance spectroscopy (DRS) which can provide a quantitative measure of the tissue composition...
May 14, 2018: Lasers in Surgery and Medicine
https://www.readbyqxmd.com/read/29753264/perineural-dexamethasone-successfully-prolongs-adductor-canal-block-when-assessed-by-objective-pinprick-sensory-testing-a-prospective-randomized-dose-dependent-placebo-controlled-equivalency-trial
#14
James D Turner, Daryl S Henshaw, Robert S Weller, J Douglas Jaffe, Christopher J Edwards, J Wells Reynolds, Gregory B Russell, Sean W Dobson
STUDY OBJECTIVE: To determine whether perineural dexamethasone prolongs peripheral nerve blockade (PNB) when measured objectively; and to determine if a 1 mg and 4 mg dose provide equivalent PNB prolongation compared to PNB without dexamethasone. SETTING: Multiple studies have reported that perineural dexamethasone added to local anesthetics (LA) can prolong PNB. However, these studies have relied on subjective end-points to quantify PNB duration. The optimal dose remains unknown...
May 8, 2018: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/29752841/anatomical-consideration-of-the-occipital-cutaneous-nerves-and-artery-for-the-safe-treatment-of-occipital-neuralgia
#15
Kang-Jae Shin, Hong-San Kim, Jehoon O, Hyun-Jin Kwon, Hun-Mu Yang
INTRODUCTION: There is no standardized approach to the greater occipital nerve (GON) block technique for treating occipital neuralgia. The aim of the present study was to validate the previously-suggested guidelines for conventional injection techniques and to provide navigational guidelines for safe GON block. METHODS & MATERIALS: The GON, lesser occipital nerve (LON) and occipital artery (OA) were carefully dissected in the occipital region of embalmed cadavers...
May 12, 2018: Clinical Anatomy
https://www.readbyqxmd.com/read/29750695/proximal-versus-distal-continuous-adductor-canal-blocks-does-varying-perineural-catheter-location-influence-analgesia-a-randomized-subject-masked-controlled-clinical-trial
#16
Jacklynn F Sztain, Bahareh Khatibi, Amanda M Monahan, Engy T Said, Wendy B Abramson, Rodney A Gabriel, John J Finneran, Richard H Bellars, Patrick L Nguyen, Scott T Ball, Francis B Gonzales, Sonya S Ahmed, Michael C Donohue, Jennifer A Padwal, Brian M Ilfeld
BACKGROUND: A continuous adductor canal block provides analgesia after surgical procedures of the knee. Recent neuroanatomic descriptions of the thigh and knee led us to speculate that local anesthetic deposited in the distal thigh close to the adductor hiatus would provide superior analgesia compared to a more proximal catheter location. We therefore tested the hypothesis that during a continuous adductor canal nerve block, postoperative analgesia would be improved by placing the perineural catheter tip 2-3 cm cephalad to where the femoral artery descends posteriorly to the adductor hiatus (distal location) compared to a more proximal location at the midpoint between the anterior superior iliac spine and the superior border of the patella (proximal location)...
May 9, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29749407/peripheral-n-methyl-d-aspartate-receptor-localization-and-role-in-gastric-acid-secretion-regulation-immunofluorescence-and-pharmacological-studies
#17
Iuliia Golovynska, Tatiana V Beregova, Tatiana M Falalyeyeva, Ludmila I Stepanova, Sergii Golovynskyi, Junle Qu, Tymish Y Ohulchanskyy
The enteric nervous system (ENS) and a glutamate receptor (GluR), N-methyl-D-aspartate receptor (NMDAR), participate in gastric acid secretion (GAS) regulation. NMDARs are localized in different stomach cells; however, knowledge of NMDAR expression and function in the ENS is limited. In the present study, we clarified the types of stomach cells that express the NMDARs that are involved in GAS regulation. The pharmacological method of isolated stomach perfusion by Ghosh and Shild combined with direct mapping of NMDARs by fluorescence microscopy in the rat stomach was employed...
May 10, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29747078/mechanisms-of-acetylcholinesterase-protection-against-sarin-and-soman-by-adenosine-a-1-receptor-agonist-n-6-cyclopentyladenosine
#18
Ariana Beste, DeCarlos E Taylor, Tsung-Ming Shih, Thaddeus P Thomas
Organophosphorus nerve agents (NAs) irreversibly inhibit acetylcholinesterase (AChE), the enzyme responsible for breaking down the neurotransmitter acetylcholine (ACh). The over accumulation of ACh after NA exposure leads to cholinergic toxicity, seizure, and death. Current medical countermeasures effectively mitigate peripheral symptoms, however; the brain is often unprotected. Alternative acute treatment with the adenosine A1 receptor agonist N6 -cyclopentyladensosine (CPA) has previously been demonstrated to prevent AChE inhibition as well as to suppress neuronal activity...
May 7, 2018: Computational Biology and Chemistry
https://www.readbyqxmd.com/read/29746989/increased-expression-of-transcription-factor-sry-box-containing-gene-11-sox11-enhances-neurite-growth-by-regulating-neurotrophic-factor-responsiveness
#19
Michael P Jankowski, Lauren Miller, H Richard Koerber
The peripherally projecting axons of dorsal root ganglion (DRG) neurons readily regenerate after damage while their centrally projecting branches do not regenerate to the same degree after injury. One important reason for this inconsistency is the lack of pro-regeneration gene expression that occurs in DRG neurons after central injury relative to peripheral damage. The transcription factor SRY-Box containing gene 11 (Sox11) may be a crucial player in the regenerative capacity of axons as previous evidence has shown that it is highly upregulated after peripheral axon damage but not after central injury...
May 7, 2018: Neuroscience
https://www.readbyqxmd.com/read/29746445/a-cadaveric-study-investigating-the-mechanism-of-action-of-erector-spinae-blockade
#20
Jason Ivanusic, Yasutaka Konishi, Michael J Barrington
BACKGROUND AND OBJECTIVES: Erector spinae block is an ultrasound-guided interfascial plane block first described in 2016. The objectives of this cadaveric dye injection and dissection study were to simulate an erector spinae block to determine if dye would spread anteriorly to the involve origins of the ventral and dorsal branches of the spinal nerves. METHODS: In 10 unembalmed human cadavers, 20 mL of 0.25% methylene blue dye was injected bilaterally into the plane between the fifth thoracic transverse process and erector spinae muscle...
May 10, 2018: Regional Anesthesia and Pain Medicine
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