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Saphenous Nerve Block

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https://www.readbyqxmd.com/read/27902645/effect-of-nerve-stimulation-use-on-the-success-rate-of-ultrasound-guided-subsartorial-saphenous-nerve-block-a-randomized-controlled-trial
#1
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
https://www.readbyqxmd.com/read/27898492/growth-hormone-regulates-the-sensitization-of-developing-peripheral-nociceptors-during-cutaneous-inflammation
#2
Xiaohua Liu, Kathryn J Green, Zachary K Ford, Luis F Queme, Peilin Lu, Jessica L Ross, Frank B Lee, Aaron T Shank, Renita C Hudgins, Michael P Jankowski
Cutaneous inflammation alters the function of primary afferents and gene expression in the affected dorsal root ganglia (DRGs). However specific mechanisms of injury-induced peripheral afferent sensitization and behavioral hypersensitivity during development are not fully understood. Recent studies in children suggest a potential role for growth hormone (GH) in pain modulation. GH modulates homeostasis and tissue repair after injury, but how GH effects nociception in neonates is not known. To determine if GH played a role in modulating sensory neuron function and hyper-responsiveness during skin inflammation in young mice, we examined behavioral hypersensitivity and the response properties of cutaneous afferents using an ex vivo hairy skin-saphenous nerve-dorsal root ganglion (DRG)-spinal cord preparation...
November 18, 2016: Pain
https://www.readbyqxmd.com/read/27834474/minimum-local-anaesthetic-volumes-for-a-selective-saphenous-nerve-block-a-dose-finding-study
#3
Werner Ten Hoope, Markus W Hollmann, Arthur Atchabahian, Marcel Rigaud, Gino M Kerkhoffs, Philipp Lirk, Holger M Baumann
BACKGROUND: Saphenous nerve block contributes to analgesia after knee and lower leg surgery. However, literature reports a wide range of volumes of local anaesthetic being used for this block. METHODS: A non-randomized controlled trial in a single university hospital in March 2015. Eighteen healthy volunteers (ASA 1 status, aged 27-43 years; male/female ratio 11 vs. 7) were needed to determine the minimum local anaesthetic volume (MLAV) of mepivacaine 2% using the Dixon up-and-down method to achieve a selective ultrasound-guided saphenous nerve block...
November 11, 2016: Minerva Anestesiologica
https://www.readbyqxmd.com/read/27799178/does-dexamethasone-have-a-perineural-mechanism-of-action-a-paired-blinded-randomized-controlled-study-in-healthy-volunteers
#4
P Jæger, U Grevstad, Z J Koscielniak-Nielsen, A R Sauter, J K Sørensen, J B Dahl
BACKGROUND: Dexamethasone prolongs block duration. Whether this is achieved via a peripheral or a central mechanism of action is unknown. We hypothesized that perineural dexamethasone added as an adjuvant to ropivacaine prolongs block duration compared with ropivacaine alone, by a locally mediated effect when controlled for a systemic action. METHODS: We performed a paired, blinded, randomized trial, including healthy men. All subjects received bilateral blocks of the saphenous nerve with ropivacaine 0...
November 2016: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/27792047/does-dexmedetomidine-have-a-perineural-mechanism-of-action-when-used-as-an-adjuvant-to-ropivacaine-a-paired-blinded-randomized-trial-in-healthy-volunteers
#5
Jakob H Andersen, Ulrik Grevstad, Hanna Siegel, Jørgen B Dahl, Ole Mathiesen, Pia Jæger
BACKGROUND: Dexmedetomidine used as an adjuvant to local anesthetics may prolong the duration of peripheral nerve blocks. Whether this is mediated by a perineural or systemic mechanism remains unknown. The authors hypothesized that dexmedetomidine has a peripheral mechanism of action. METHODS: The authors conducted a randomized, paired, triple-blind trial in healthy volunteers. All received bilateral saphenous nerve blocks with 20 ml ropivacaine, 0.5%, plus 1 ml dexmedetomidine, 100 µg/ml, in one thigh and 20 ml ropivacaine 0...
October 28, 2016: Anesthesiology
https://www.readbyqxmd.com/read/27687059/anesthesia-and-analgesia-methods-for-outpatient-anterior-cruciate-ligament-reconstruction
#6
L Baverel, T Cucurulo, C Lutz, Colombet, J Cournapeau, F Dalmay, N Lefevre, R Letartre, J-F Potel, X Roussignol, L Surdeau, E Servien
INTRODUCTION: More and more anterior cruciate ligament (ACL) reconstructions are being performed as outpatient surgery in France, because of economic considerations. Postoperative pain is the most common reason for delayed discharge that could require hospitalization, and the main reason for unanticipated hospital admission. The purpose of this study was to define the best anesthesia and analgesia methods for ACL reconstruction. MATERIALS AND METHODS: This was a prospective, multicenter, comparative study performed between January 2014 and April 2015...
September 26, 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/27613814/a-randomized-controlled-trial-assessing-the-effect-of-a-continuous-subcutaneous-infusion-of-local-anesthetic-following-elective-surgery-to-the-great-toe
#7
Barry Rose, Kumar Kunasingam, Tristan Barton, James Walsh, Karen Fogarty, Andrew Wines
: Local anesthetic use for wound infusions, single injection, and continuous nerve blocks for postoperative analgesia is well established. No study has investigated the effect of a continuous block of the saphenous and superficial peroneal nerves at the level of the ankle joint following first ray surgery. A double blind randomized controlled trial was designed. One hundred patients with hallux valgus and rigidus requiring surgical correction were recruited and randomized to receive a postoperative continuous infusion at the ankle of normal saline or ropivacaine for 24 hours...
September 9, 2016: Foot & Ankle Specialist
https://www.readbyqxmd.com/read/27567396/endocannabinoids-inhibit-neurogenic-inflammation-in-murine-joints-by-a-non-canonical-cannabinoid-receptor-mechanism
#8
Eugene Krustev, Milind M Muley, Jason J McDougall
Neurogenic inflammation is a local inflammatory response that is driven by the peripheral release of neuropeptides from small diameter afferents which occurs in many organs including joints. The knee joint has a rich endocannabinoid system which has been shown to decrease acute synovitis. The aim of this study was to investigate the influence of joint afferents on leukocyte-endothelial interactions within the synovial microcirculation of mice and determine the role of endocannabinoids on this inflammatory response...
August 22, 2016: Neuropeptides
https://www.readbyqxmd.com/read/27537926/effect-of-total-dose-of-lidocaine-on-duration-of-adductor-canal-block-assessed-by-different-test-methods-a-report-of-two-blinded-randomized-crossover-studies-in-healthy-volunteers
#9
Pia Jæger, Zbigniew J Koscielniak-Nielsen, Karen Lisa Hilsted, Ulrik Grevstad, Volkert Siersma, Maria Louise Fabritius, Jørgen Berg Dahl
BACKGROUND: The binary aims of this study were to investigate the effect of total dose of lidocaine on duration of an adductor canal block (ACB) and to validate different methods used to assess nerve blocks. METHODS: We performed 2 blinded, randomized, controlled crossover trials, including healthy, young men. In study 1, 14 subjects received 4 ACBs with saline and 40, 80, and 160 mg lidocaine. In study 2, 14 new subjects received 2 ACBs with 100 and 300 mg lidocaine...
October 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27349601/effects-of-dexmedetomidine-combined-with-ropivacaine-on-sciatic-and-femoral-nerve-blockade-in-dogs
#10
Thomas A Trein, Beatriz P Floriano, Juliana T Wagatsuma, Joana Z Ferreira, Guilherme L da Silva, Paulo Sp Dos Santos, Sílvia Hv Perri, Valéria Nls Oliva
OBJECTIVE: To evaluate motor and sensory blockade of combining dexmedetomidine with ropivacaine, administered perineurally or systemically, for femoral and sciatic nerve blocks in conscious dogs. STUDY DESIGN: Randomized, controlled, experimental study. ANIMALS: Seven healthy Beagle dogs, aged 3.3 ± 0.1 years and weighing 11.0 ± 2.4 kg. METHODS: Dogs were anesthetized with isoflurane on three separate occasions for unilateral femoral and sciatic nerve blocks and were administered the following treatments in random order: perineural ropivacaine 0...
June 28, 2016: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/27075893/perineural-dexamethasone-with-subsartorial-saphenous-nerve-blocks-in-acl-reconstruction
#11
Mary F Chisholm, Jennifer Cheng, Kara G Fields, Robert G Marx, Daniel B Maalouf, Gregory A Liguori, Michael A Gordon, Victor M Zayas, Jacques T Yadeau
PURPOSE: Subsartorial saphenous nerve blockade (SSNB) is an effective analgesic alternative to femoral nerve blockade after anterior cruciate ligament (ACL) reconstruction with bone-tendon-bone (BTB) autograft. It was hypothesized that dexamethasone in a SSNB will prolong analgesia, improve pain and satisfaction, and reduce postoperative opioid requirements and side effects. METHODS: One hundred ninety-five patients undergoing ACL reconstruction with BTB autograft (ages 16-65) were enrolled...
April 13, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/27016187/-ultrasound-guided-peripheral-nerve-blocks-in-anticoagulated-patients-case-series
#12
Luis Eduardo Silveira Martins, Leonardo Henrique Cunha Ferraro, Alexandre Takeda, Masashi Munechika, Maria Angela Tardelli
BACKGROUND AND OBJECTIVES: The advent of ultrasound has brought many benefits to peripheral nerve blocks. It includes both safety and effectiveness, given the possibility of visualizing the neurovascular structures and the needle during the procedure. Despite these benefits, there is no consensus in the literature on the use of this technique in anticoagulated patients or with other coagulation disorders. Moreover, peripheral blocks vary in depth, spreadability, and possibility of local compression...
March 23, 2016: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/27015545/the-nerves-of-the-adductor-canal-and-the-innervation-of-the-knee-an-anatomic-study
#13
David Burckett-St Laurant, Philip Peng, Laura Girón Arango, Ahtsham U Niazi, Vincent W S Chan, Anne Agur, Anahi Perlas
BACKGROUND AND OBJECTIVES: Adductor canal block contributes to analgesia after total knee arthroplasty. However, controversy exists regarding the target nerves and the ideal site of local anesthetic administration. The aim of this cadaveric study was to identify the trajectory of all nerves that course in the adductor canal from their origin to their termination and describe their relative contributions to the innervation of the knee joint. METHODS: After research ethics board approval, 20 cadaveric lower limbs were examined using standard dissection technique...
May 2016: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/27007076/the-risk-of-falls-after-total-knee-arthroplasty-with-the-use-of-a-femoral-nerve-block-versus-an-adductor-canal-block-a-double-blinded-randomized-controlled-study
#14
RANDOMIZED CONTROLLED TRIAL
Nabil M Elkassabany, Sean Antosh, Moustafa Ahmed, Charles Nelson, Craig Israelite, Ignacio Badiola, Lu F Cai, Rebekah Williams, Christopher Hughes, Edward R Mariano, Jiabin Liu
BACKGROUND: Adductor canal block (ACB) has emerged as an appealing alternative to femoral nerve block (FNB) that produces a predominantly sensory nerve block by anesthetizing the saphenous nerve. Studies have shown greater quadriceps strength preservation with ACB compared with FNB, but no advantage has yet been shown in terms of fall risk. The Tinetti scale is used by physical therapists to assess gait and balance, and total score can estimate a patient's fall risk. We designed this study to test the primary hypothesis that FNB results in a greater proportion of "high fall risk" patients postoperatively using the Tinetti score compared with ACB...
May 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/26897449/peripheral-nerve-blocks-in-patients-with-ehlers-danlos-syndrome-hypermobility-type-a-report-of-2-cases
#15
Michael S Patzkowski
Ehlers-Danlos syndrome is an inherited disorder of collagen production that results in multiorgan dysfunction. Patients with hypermobility type display skin hyperextensibility and joint laxity, which can result in chronic joint instability, dislocation, peripheral neuropathy, and severe musculoskeletal pain. A bleeding diathesis can be found in all subtypes of varying severity despite a normal coagulation profile. There have also been reports of resistance to local anesthetics in these patients. Several sources advise against the use of regional anesthesia in these patients citing the 2 previous features...
March 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/26875052/percutaneous-freezing-of-sensory-nerves-prior-to-total-knee-arthroplasty
#16
Vinod Dasa, Gabriel Lensing, Miles Parsons, Justin Harris, Julia Volaufova, Ryan Bliss
BACKGROUND: Total knee arthroplasty (TKA) is a common procedure resulting in significant post-operative pain. Percutaneous cryoneurolysis targeting the infrapatellar branch of the saphenous nerve and anterior femoral cutaneous nerve could relieve post-operative knee pain by temporarily blocking sensory nerve conduction. METHODS: A retrospective chart review of 100 patients who underwent TKA was conducted to assess the value of adding perioperative cryoneurolysis to a multimodal pain management program...
June 2016: Knee
https://www.readbyqxmd.com/read/26807391/postoperative-sciatic-and-femoral-or-saphenous-nerve-blockade-for-lower-extremity-surgery-in-anesthetized-adults
#17
Loreto Lollo, Sanjay Bhananker, Agnes Stogicza
BACKGROUND: Guidelines warn of increased risks of injury when placing regional nerve blocks in the anesthetized adult but complications occurred in patients that received neither sedation nor local anesthetic. This restriction of nerve block administration places vulnerable categories of patients at risk of severe opioid induced side effects. Patient and operative technical factors can preclude use of preoperative regional anesthesia. The purpose of this study was to assess complications following sciatic popliteal and femoral or saphenous nerve blockade administered to anesthetized adult patients following foot and ankle surgery...
October 2015: International Journal of Critical Illness and Injury Science
https://www.readbyqxmd.com/read/26735938/steroid-atrophy-scarring-treated-with-fat-grafting-in-a-patient-with-complex-regional-pain-syndrome-a-case-report
#18
Leah R Strickland, Sherry S Collawn
Subcutaneous atrophy is a known complication of steroid injections. Excellent results with fat grafting for the treatment of steroid atrophy have been documented. However, the benefit of treating steroid-induced subcutaneous atrophy in an extremity diagnosed with complex regional pain syndrome (CRPS) has not been described. CRPS, known formerly as reflex sympathetic dystrophy or RSD, causalgia, or reflex neurovascular dystrophy, is a severe, progressive musculoskeletal pain syndrome characterized by pain which is disproportionate to the severity of the inciting event, edema, or skin changes...
June 2016: Journal of Cosmetic and Laser Therapy: Official Publication of the European Society for Laser Dermatology
https://www.readbyqxmd.com/read/26678473/distribution-of-injectate-and-sensory-motor-blockade-after-adductor-canal-block
#19
Philippe E Gautier, Admir Hadzic, Jean-Pierre Lecoq, Jean Francois Brichant, Maxine M Kuroda, Catherine Vandepitte
BACKGROUND: The analgesic efficacy reported for the adductor canal block may be related to the spread of local anesthetic outside the adductor canal. METHODS: Fifteen patients undergoing knee surgery received ultrasound-guided injections of local anesthetic at the level of the adductor hiatus. Sensory-motor block and spread of contrast solution were assessed. RESULTS: Sensation was rated as "markedly diminished" or "absent" in the saphenous nerve distribution and "slightly diminished" in the sciatic nerve territory without motor deficits...
January 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/26121891/effect-of-ultrasound-guided-subsartorial-approach-for-saphenous-nerve-block-in-cases-with-saphenous-nerve-entrapment-in-adductor-canal-for-controlling-chronic-knee-pain
#20
Arman Taheri, Maryam Hatami, Majid Dashti, Alireza Khajehnasiri, Mahsa Ghajarzadeh
BACKGROUND: Saphenous nerve neuropathy is one of the causes of chronic pain of the knee. Blockade of saphenous nerve under sonographich guide has been used for controlling pain in recent years. The goal of this study was to evaluate the effect of saphenous nerve block for controlling pain in patients with chronic knee pain. METHOD: Thirty five patients with chronic knee pain referred to Amir Alam hospital during June 2012-June 2013 were enrolled in this study. Under sonographic approach, subsartorial blockade of saphenous nerve conducted and patients were followed up for 3 months after treatment...
February 2015: Middle East Journal of Anesthesiology
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