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Peripheral nerve blocks

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https://www.readbyqxmd.com/read/28809704/kilohertz-electrical-stimulation-nerve-conduction-block-effects-of-electrode-material
#1
Yogi A Patel, Brian S Kim, Robert J Butera
Kilohertz electrical stimulation (KES) has enabled a novel new paradigm for spinal cord and peripheral nerve stimulation to treat a variety of neurological diseases. KES can excite or inhibit nerve activity and is used in many clinical devices today. However, the impact of different electrode materials on the efficacy of KES is unknown. We investigated the effect of different electrode materials and their respective charge injection mechanisms on KES nerve block thresholds using 20 and 40 kHz current-controlled sinusoidal KES waveforms...
August 10, 2017: IEEE Transactions on Neural Systems and Rehabilitation Engineering
https://www.readbyqxmd.com/read/28798922/practical-approach-to-the-patient-with-acute-neuromuscular-weakness
#2
REVIEW
Rajeev Nayak
Acute neuromuscular paralysis (ANMP) is a clinical syndrome characterized by rapid onset muscle weakness progressing to maximum severity within several days to weeks (less than 4 wk). Bulbar and respiratory muscle weakness may or may not be present. It is a common neurological emergency which requires immediate and careful investigations to determine the etiology because accurate diagnosis has significant impact on therapy and prognosis. Respiratory failure caused by neuromuscular weakness is considered as more critical than lung disease because its development may be insidious or subtle until sudden decompensation leads to life threatening hypoxia...
July 16, 2017: World Journal of Clinical Cases
https://www.readbyqxmd.com/read/28795964/neuromuscular-monitoring-in-the-perioperative-period
#3
Glenn S Murphy
Neuromuscular monitoring devices were introduced into clinical practice in the 1970s. Qualitative neuromuscular monitors, or peripheral nerve stimulators, provide an electrical stimulus to a motor nerve and the response of corresponding muscle subjectively evaluated. A standard peripheral nerve stimulator provides several patterns of nerve stimulation, including train-of-four (TOF), double-burst, tetanic, and post-tetanic count. Qualitative (and quantitative) monitors are needed to determine onset of neuromuscular blockade, maintain the required depth of muscle relaxation during the surgical procedure, and assess an appropriate dose of reversal agent...
August 8, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28795197/ultrasound-guided-interscalene-brachial-plexus-block-in-a%C3%A2-child-with-acute-upper-respiratory-infection-a%C3%A2-case-report
#4
T Ergönenç, H Can, S Gökhan Beyaz
The brachial plexus is commonly blocked at the interscalene level for shoulder and proximal humeral surgery. There are only a few publications about the interscalene technique in pediatric patients for a peripheral nerve block. Ultrasound-guided peripheral nerve block has become increasingly more popular for pediatric patients because of high success rates and safety concerns. We used ultrasound-guided interscalene brachial plexus block in an 18-month-old child with an acute upper respiratory infection who had a supracondylar fracture of the humerus...
August 9, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28794655/p2y12-and-p2y13-receptors-involved-in-adp%C3%AE-s-induced-the-release-of-il-1%C3%AE-il-6-and-tnf-%C3%AE-from-cultured-dorsal-horn-microglia
#5
Pei-Wen Liu, Ming-Xia Yue, Rui Zhou, Juan Niu, Du-Juan Huang, Tao Xu, Pei Luo, Xiao-Hong Liu, Jun-Wei Zeng
OBJECTIVE: P2 receptors have been implicated in the release of neurotransmitter and pro-inflammatory cytokines due to their response to neuroexcitatory substances in the microglia. Dorsal horn P2Y12 and P2Y13 receptors are involved in the development of pain behavior induced by peripheral nerve injury. However, it is not known whether P2Y12 and P2Y13 receptors activation is associated with the expression and the release of interleukin-1B (IL-1β), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α) in cultured dorsal spinal cord microglia...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28780644/immunopotentiator-thymosin-alpha-1-promotes-neurogenesis-and-cognition-in-the-developing-mouse-via-a-systemic-th1-bias
#6
Ge Wang, Fen He, Yunlong Xu, Yuwei Zhang, Xiao Wang, Chunhua Zhou, Yihong Huang, Juntao Zou
In early life, the immune system plays an essential role in brain development. In our study, the immunopotentiator thymosin alpha-1 (Ta1) was peripherally administered to neonatal mice to explore whether the peripheral immunopotentiator affects neurodevelopment and cognition, and to further investigate the relevant mechanism. Compared with the control group, the Ta1 mice displayed better cognitive abilities in early life. The numbers of 5-bromodeoxyuridine (BrdU)+, nestin+, T-box transcription factor 2 (Tbr2)+, BrdU+/doublecortin (DCX)+, BrdU+/ionized calcium-binding adaptor molecule 1 (Iba1)+, and BrdU+/neuronal nuclei (NeuN)+ cells in the hippocampus were increased in the Ta1 group, accompanied by increased interleukin-4 (IL-4), interferon-gamma, brain-derived neurotrophic factor, nerve growth factor, and insulin-like growth factor-1 as well as decreased IL-6 and tumor necrosis factor-α...
August 5, 2017: Neuroscience Bulletin
https://www.readbyqxmd.com/read/28776638/a-novel-combination-of-peripheral-nerve-blocks-for-arthroscopic-shoulder-surgery
#7
D Musso, S Flohr-Madsen, K Meknas, T Wilsgaard, L M Ytrebø, Ø Klaastad
BACKGROUND: Interscalene brachial plexus block is currently the gold standard for intra- and post-operative pain management for patients undergoing arthroscopic shoulder surgery. However, it is associated with block related complications, of which effect on the phrenic nerve have been of most interest. Side effects caused by general anesthesia, when this is required, are also a concern. We hypothesized that the combination of superficial cervical plexus block, suprascapular nerve block, and infraclavicular brachial plexus block would provide a good alternative to interscalene block and general anesthesia...
August 4, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28771790/motoneuron-activity-is-required-for-enhancements-in-functional-recovery-after-peripheral-nerve-injury-in-exercised-female-mice
#8
Poonam B Jaiswal, Jack K Tung, Robert E Gross, Arthur W English
Inhibitory luminopsins (iLMO2) integrate opto- and chemo-genetic approaches and allow for cell-type specific inhibition of neuronal activity. When exposed to a Renilla luciferase substrate, Coelenterazine (CTZ), iLMO2 generates bioluminescence-mediated activation of its amino-terminal halorhodopsin, resulting in neuronal inhibition. Moderate daily exercise in the form of interval treadmill-training (IT) applied following a peripheral nerve injury results in enhanced motor axon regeneration and muscle fiber reinnervation in female mice...
August 3, 2017: Journal of Neuroscience Research
https://www.readbyqxmd.com/read/28767456/effects-of-anaesthesia-and-analgesia-on-long-term-outcome-after-total-knee-replacement-a-prospective-observational-multicentre-study
#9
Dario Bugada, Massimo Allegri, Marco Gemma, Andrea L Ambrosoli, Giuseppe Gazzerro, Fernando Chiumiento, Doriana Dongu, Fiorella Nobili, Andrea Fanelli, Paolo Ferrua, Massimo Berruto, Gianluca Cappelleri
BACKGROUND: Perioperative regional anaesthesia may protect from persistent postsurgical pain (PPSP) and improve outcome after total knee arthroplasty (TKA). OBJECTIVES: Aim of this study was to evaluate the impact of regional anaesthesia on PPSP and long-term functional outcome after TKA. DESIGN: A web-based prospective observational registry. SETTING: Five Italian Private and University Hospitals from 2012 to 2015. PATIENTS: Undergoing primary unilateral TKA, aged more than 18 years, informed consent, American Society of Anesthesiologists (ASA) physical status classes 1 to 3, no previous knee surgery...
August 1, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28763315/efficacy-and-safety-of-buprenorphine-in-peripheral-nerve-blocks-a-meta-analysis-of-randomised-controlled-trials
#10
Alexander Schnabel, Sylvia U Reichl, Peter K Zahn, Esther M Pogatzki-Zahn, Christine H Meyer-Frießem
BACKGROUND: The duration of analgesia provided by nerve blocks is limited if local anaesthetics are administered alone. Therefore, a variety of additives to local anaesthetics have been investigated to prolong postoperative analgesia following single-shot nerve blocks. OBJECTIVE(S): The aims of the current meta-analysis were to assess the efficacy and safety of the addition of perineural buprenorphine to local anaesthetic compared with local anaesthetic alone, or combined with systemic administration of buprenorphine, or other perineural opioids for peripheral nerve blocks...
September 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28760938/vasorelaxation-to-the-nitroxyl-donor-isopropylamine-nonoate-in-resistance-arteries-does-not-require-perivascular-calcitonin-gene-related-peptide
#11
Alice M H Pinkney, Hamish A L Lemmey, Kim A Dora, Christopher J Garland
Nitroxyl (HNO) donors offer considerable therapeutic potential for the treatment of hypertension-related cardiovascular disorders, particularly heart failure, as they combine an inotropic action with peripheral vasodilation. Angeli's salt is the only HNO donor whose mechanism has been studied in depth, and recently, Angeli's salt vasodilation was suggested to be indirect and caused by calcitonin gene-related peptide (CGRP) released from perivascular nerves after HNO activates TRPA1 (transient receptor potential cation channel subfamily A member 1) channels...
July 31, 2017: Hypertension
https://www.readbyqxmd.com/read/28755100/point-of-care-ultrasonography-in-canadian-anesthesiology-residency-programs-a-national-survey-of-program-directors
#12
Daniel Mok, Stephan K W Schwarz, Kevin Rondi
PURPOSE: Point-of-care ultrasonography (POCUS) is a useful tool with multiple perioperative applications relevant to the anesthesiologist. Nevertheless, the full scope of POCUS applications has yet to be formally incorporated into Canadian anesthesiology training. The purpose of this study was to determine the current state of POCUS training in Canadian anesthesiology residency programs. METHODS: We conducted a web-based survey of program directors from Royal College-accredited anesthesiology residency programs across Canada...
July 28, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28754372/endogenous-nitric-oxide-inhibits-spinal-nmda-receptor-activity-and-pain-hypersensitivity-induced-by-nerve-injury
#13
Shao-Rui Chen, Xiao-Gao Jin, Hui-Lin Pan
The role of nitric oxide (NO) in nociceptive transmission at the spinal cord level remains uncertain. Increased activity of spinal N-methyl-d-aspartate (NMDA) receptors contributes to development of chronic pain induced by peripheral nerve injury. In this study, we determined how endogenous NO affects NMDA receptor activity of spinal cord dorsal horn neurons in control and spinal nerve-ligated rats. Bath application of the NO precursor l-arginine or the NO donor S-nitroso-N-acetylpenicillamine (SNAP) significantly inhibited NMDA receptor currents of spinal dorsal horn neurons in both sham control and nerve-injured rats...
July 25, 2017: Neuropharmacology
https://www.readbyqxmd.com/read/28748102/kamishoyosan-and-shakuyakukanzoto-promote-recovery-from-paclitaxel-induced-neurite-retraction-in-pc12-cells
#14
Ken Konaka, Kota Moriyama, Takumi Sakurada, Naoto Okada, Masaki Imanishi, Yoshito Zamami, Kazuyoshi Kawazoe, Shuji Fushitani, Keisuke Ishizawa
BACKGROUND: In chemotherapy, the full round of treatment must be completed as scheduled to achieve the strongest therapeutic effect. However, peripheral neuropathy, a severe side effect of the chemotherapeutic agent paclitaxel, can force the premature discontinuation of treatment. As some kampo practitioners have suggested that it may be possible to counteract such side effects, we analyzed the effects of Kamishoyosan, Shakuyakukanzoto, and Goshajinkigan in an in vitro model of paclitaxel-induced peripheral neuropathy...
2017: Journal of Pharmaceutical Health Care and Sciences
https://www.readbyqxmd.com/read/28743796/sox2-expression-in-schwann-cells-inhibits-myelination-in-vivo-and-induces-influx-of-macrophages-to-the-nerve
#15
Sheridan L Roberts, Xin-Peng Dun, Robin D S Doddrell, Thomas Mindos, Louisa K Drake, Mark W Onaitis, Francesca Florio, Angelo Quattrini, Maurizio D'Antonio, David B Parkinson
Correct myelination is crucial for the function of the peripheral nervous system. Both positive and negative regulators within the axon and Schwann cell function to ensure the correct onset and progression of myelination during both development and following peripheral nerve injury and repair. The Sox2 transcription factor is well known for its roles in the development and maintenance of progenitor and stem cell populations, but has also been proposed in vitro as a negative regulator of myelination in Schwann cells...
July 25, 2017: Development
https://www.readbyqxmd.com/read/28731982/peripheral-oxytocin-receptors-inhibit-the-nociceptive-input-signal-to-spinal-dorsal-horn-wide-dynamic-range-neurons
#16
Abimael González-Hernández, Alfredo Manzano-García, Guadalupe Martínez-Lorenzana, Irma A Tello-García, Martha Carranza, Carlos Arámburo, Miguel Condés-Lara
Oxytocin (OT) has emerged as a mediator of endogenous analgesia in behavioral and electrophysiological experiments. In fact, OT receptors (OTRs) in the spinal dorsal horn participate in a selective inhibition of the neuronal activity mediated by Aδ and C fibers but not Aβ fibers. This study shows that OTRs are expressed in the terminal nerve endings and are able to inhibit nociceptive neuronal firing. Indeed, local peripheral OT blocked the first sensorial activity of Aδ and C fibers recorded in the spinal cord neurons...
July 19, 2017: Pain
https://www.readbyqxmd.com/read/28727704/evaluating-the-adjuvant-effect-of-dexamethasone-to-ropivacaine-in-transversus-abdominis-plane-block-for-inguinal-hernia-repair-and-spermatocelectomy-a-randomized-controlled-trial
#17
Robert Wegner, Duane Akwar, Sarah Guzman-Reyes, Greesha Pednekar, Rabail Chaudhry, Navneet Grewal, Naveen Kukreja, Omar L Mancillas, George W Williams, Omonele Nwokolo
BACKGROUND: The transversus abdominis plane (TAP) block is a relatively straightforward regional technique used for postoperative analgesia in patients undergoing abdominal surgeries. Various adjuvants have been used in past to prolong the duration of action of analgesia in peripheral nerve blocks. Several studies investigating the analgesic efficacy of dexamethasone added to local anesthetic agents, such as bupivacaine, have shown promising results. However, there are few studies comparing the efficacy of dexamethasone with ropivacaine...
July 2017: Pain Physician
https://www.readbyqxmd.com/read/28727583/serum-bupivacaine-concentration-after-periarticular-injection-with-a-mixture-of-liposomal-bupivacaine-and-bupivacaine-hcl-during-total-knee-arthroplasty
#18
Michael J Buys, Marian F Murphy, Christine M Warrick, Nathan L Pace, Jeremy M Gililland, Christopher E Pelt, Byron R Bankhead, John L Patzkowsky, Ken B Johnson
BACKGROUND AND OBJECTIVES: A relatively new technique to reduce postoperative pain for total knee arthroplasty is to inject a mixture of 266 mg of liposomal bupivacaine and 125 mg of 0.25% bupivacaine HCl with epinephrine 1:300,000 around the knee joint at the time of surgery. Currently, no publications report serum bupivacaine concentrations over time after periarticular injection of liposomal mixed with free bupivacaine. This information is important to ensure safe serum bupivacaine concentrations are maintained especially when considering supplemental or rescue peripheral nerve blocks...
July 20, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28722246/delta-9-tetrahydrocannabinol-decreases-masticatory-muscle-sensitization-in-female-rats-through-peripheral-cannabinoid-receptor-activation
#19
H Wong, S Hossain, B E Cairns
BACKGROUND: This study investigated whether intramuscular injection of delta-9-tetrahydrocannabinol (THC), by acting on peripheral cannabinoid (CB) receptors, could decrease nerve growth factor (NGF)-induced sensitization in female rat masseter muscle; a model which mimics the symptoms of myofascial temporomandibular disorders. METHODS: Immunohistochemistry was used to explore the peripheral expression of cannabinoid receptors in the masseter muscle while behavioural and electrophysiology experiments were employed to assess the functional effects of intramuscular injection of THC...
July 18, 2017: European Journal of Pain: EJP
https://www.readbyqxmd.com/read/28719457/regional-anesthesia-in-diabetic-peripheral-neuropathy
#20
Werner Ten Hoope, Marjolein Looije, Philipp Lirk
PURPOSE OF REVIEW: The aim of this review is to summarize recent relevant literature regarding regional anesthesia in the diabetic neuropathic patient and formulate recommendations for clinical practice. RECENT FINDINGS: Diabetic neuropathic nerves, but not nerves of diabetic patients per se, exhibit complex functional changes. As a result, they seem more sensitive to local anesthetics, and are more difficult to stimulate. When catheters are used postoperatively, diabetes is an independent risk factor for infection...
July 15, 2017: Current Opinion in Anaesthesiology
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