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Peripheral nerve blocks

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https://www.readbyqxmd.com/read/28106354/adding-dexmedetomidine-to-ropivacaine-for-femoral-nerve-block-inhibit-local-inflammatory-response
#1
Jing Li, Hanghui Wang, Buhuai Dong, Jianbing Ma, Xucai Wu
BACKGROUND: Peripheral nerve block has an anti-inflammatory effect that is confirmed in animal studies, while inconclusive in human studies. Dexmedetomidine (DEX), a highly selective α2-adenoceptor agonist, has a potent anti-inflammatory effect. The aim of this study was to evaluate the effect of DEX added to ropivacaine for femoral nerve block (FNB) on local inflammatory response after total knee arthroplasty (TKA). METHODS: Sixty patients scheduled for TKA were randomized into two equal groups in a prospective randomized study...
January 20, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28100520/evidence-basis-for-using-perineural-dexmedetomidine-to-enhance-the-quality-of-brachial-plexus-nerve-blocks-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#2
L Vorobeichik, R Brull, F W Abdallah
BACKGROUND: Dexmedetomidine has been proposed as a perineural local anaesthetic (LA) adjunct to prolong peripheral nerve block duration; however, results from our previous meta-analysis in the setting of brachial plexus block (BPB) did not support its use. Many additional randomized trials have since been published. We thus conducted an updated meta-analysis. METHODS: Randomized trials investigating the addition of dexmedetomidine to LA compared with LA alone (Control) in BPB for upper extremity surgery were sought...
February 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28098683/threading-the-needle-with-peripheral-nerve-blocks-achieving-analgesia-avoiding-neurological-injury
#3
(no author information available yet)
No abstract text is available yet for this article.
February 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28092318/opening-injection-pressure-is-higher-in-intraneural-compared-with-perineural-injections-during-simulated-nerve-blocks-of-the-lower-limb-in-fresh-human-cadavers
#4
Kris Vermeylen, Marlies Hermans, Filiep Soetens, Evie Vereecke, Thorsten Steinfeldt, Gerbrand Groen, Admir Hadzic, Marc Van de Velde
BACKGROUND AND OBJECTIVES: Needle-induced nerve trauma and intraneural injection can lead to neurologic injury during peripheral nerve blocks. In this study, we assessed the utility of opening injection pressure (OIP), time to OIP, and rate of rise to OIP in detecting needle-nerve contact and intraneural injection. METHODS: Five common ultrasound-guided blocks of the femoral, saphenous, subgluteal sciatic, tibial, and common peroneal nerves were simulated in 10 fresh cadavers...
January 13, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28090631/operating-unit-time-use-is-associated-with-anaesthesia-type-in-below-knee-surgery-in-adults
#5
T J Lohela, R P Chase, T A Hiekkanen, V K Kontinen, M J Hynynen
BACKGROUND: Peripheral nerve blocks could reduce the operating unit and theatre time spent on high-risk patients who are particularly vulnerable to complications of general anaesthesia or have medications that prevent application of central neuraxial blocks. METHODS: Medical record data of 617 and 254 elderly adults undergoing below-knee surgery in Jorvi and Meilahti hospitals (Helsinki University Hospital) between January 2010 and December 2012 were used to investigate the influence of anaesthetic technique on operating theatre times and on operating unit times using flexible parametric survival models...
January 16, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28086940/ultrasound-guided-percutaneous-peripheral-nerve-stimulation-for-analgesia-following-total-knee-arthroplasty-a-prospective-feasibility-study
#6
Brian M Ilfeld, Christopher A Gilmore, Stuart A Grant, Michael P Bolognesi, Daniel J Del Gaizo, Amorn Wongsarnpigoon, Joseph W Boggs
BACKGROUND: Peripheral nerve stimulation has been used for decades to treat chronic pain but has not been used for postoperative analgesia due to multiple limitations, beginning with invasive electrode placement. With the development of small-diameter/gauge leads enabling percutaneous insertion, ultrasound guidance for accurate introduction, and stimulators small enough to be adhered to the skin, neurostimulation may now be provided in a similar manner to continuous peripheral nerve blocks...
January 13, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/28079735/incidence-of-local-anesthetic-systemic-toxicity-in-orthopedic-patients-receiving-peripheral-nerve-blocks
#7
Eva E Mörwald, Nicole Zubizarreta, Crispiana Cozowicz, Jashvant Poeran, Stavros G Memtsoudis
BACKGROUND AND OBJECTIVES: Peripheral nerve blocks are increasingly used. However, despite low complication rates, concerns regarding local anesthetic systemic toxicity remain. Although recent studies suggest that this severe complication has decreased considerably, there is a paucity of data about it on a national level. We sought to elucidate the incidence of local anesthetic systemic toxicity on a national level and therefore provide guidance toward the need for preparedness in daily anesthetic practice...
January 9, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28075022/the-mechanistic-basis-for-photobiomodulation-therapy-of-neuropathic-pain-by-near-infrared-laser-light
#8
Vanessa Milanesi Holanda, Maria Cristina Chavantes, Xingjia Wu, Juanita J Anders
BACKGROUND AND OBJECTIVE: Various irradiances have been reported to be beneficial for the treatment of neuropathic pain with near infrared light. However, the mechanistic basis for the beneficial outcomes may vary based on the level of irradiance or fluence rate used. Using in vivo and in vitro experimental models, this study determined the mechanistic basis of photobiomodulation therapy (PBMT) for the treatment of neuropathic pain using a high irradiance. STUDY DESIGN/MATERIALS AND METHODS: In vitro experiments: Cultured, rat DRG were randomly assigned to control or laser treatment (LT) groups with different irradiation times (2, 5, 30, 60, or 120 seconds)...
January 11, 2017: Lasers in Surgery and Medicine
https://www.readbyqxmd.com/read/28073836/ionotropic-glutamate-receptors-activate-cell-signaling-in-response-to-glutamate-in-schwann-cells
#9
Wendy M Campana, Elisabetta Mantuano, Pardis Azmoon, Kenneth Henry, Michael A Banki, John H Kim, Donald P Pizzo, Steven L Gonias
In the peripheral nervous system, Schwann cells (SCs) demonstrate surveillance activity, detecting injury and undergoing trans-differentiation to support repair. SC receptors that detect peripheral nervous system injury remain incompletely understood. We used RT-PCR to profile ionotropic glutamate receptor expression in cultured SCs. We identified subunits required for assembly of N-methyl-d-aspartic acid (NMDA) receptors (NMDA-R), α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptors, and kainate receptors...
January 10, 2017: FASEB Journal: Official Publication of the Federation of American Societies for Experimental Biology
https://www.readbyqxmd.com/read/28073317/activation-of-kcnq-channels-suppresses-spontaneous-activity-in-drg-neurons-and-reduces-chronic-pain-after-spinal-cord-injury
#10
Zizhen Wu, Lin Li, Fuhua Xie, Junhui Du, Yan Zuo, Jeffrey A Frost, Susan M Carlton, Edgar T Walters, Qing Yang
A majority of people who have sustained spinal cord injury (SCI) experience chronic pain after injury, and this pain is highly resistant to available treatments. Contusive SCI in rats at T10 results in hyperexcitability of primary sensory neurons, which contributes to chronic pain. KCNQ channels are widely expressed in nociceptive dorsal root ganglion (DRG) neurons, are important for controlling their excitability, and their activation has proven effective in reducing pain in peripheral nerve injury and inflammation models...
January 10, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/28072807/occipital-nerve-stimulation-for-refractory-chronic-migraine-results-of-a-long-term-prospective-study
#11
Dolores Rodrigo, Pilar Acin, Pedro Bermejo
BACKGROUND: Refractory chronic migraine affects approximately 4% of the population worldwide and results in severe pain, lifestyle limitations, and decreased quality of life. Occipital nerve stimulation (ONS) refers to the electric stimulation of the distal branches of greater and lesser occipital nerves; the surgical technique has previously been described and has demonstrated efficacy in the treatment of a wide variety of headache disorders. OBJECTIVES: The aim of this study is to evaluate the long-term efficacy and tolerability of ONS for medically intractable chronic migraine...
January 2017: Pain Physician
https://www.readbyqxmd.com/read/28067709/factors-associated-with-risk-of-neurologic-complications-after-peripheral-nerve-blocks-a-systematic-review
#12
Rakesh V Sondekoppam, Ban C H Tsui
The onset of neurologic complications after regional anesthesia is a complex process and may result from an interaction of host, agent, and environmental risk factors. The purpose of this systematic review was examine the qualitative evidence relating to various risk factors implicated in neurologic dysfunction after peripheral nerve block (PNB). The MEDLINE, OVID, and EMBASE databases were primary sources for literature. Cochrane, LILACS, DARE, IndMed, ERIC, NHS, and HTA via Centre for Reviews and Dissemination (CRD; York University) databases were searched for additional unique results...
February 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28060787/peripheral-nerve-blocks-for-surgery-about-the-knee
#13
Richard Howell, Brenton Hill, Christopher Hoffman, Erin Treacy, Mary K Mulcahey
No abstract text is available yet for this article.
December 6, 2016: JBJS Reviews
https://www.readbyqxmd.com/read/28059804/bupivacaine-increases-the-rate-of%C3%A2-motoneuron-death-following-peripheral%C3%A2-nerve-injury
#14
Susanna C Byram, Scott W Byram, Nicholas M Miller, Keith N Fargo
BACKGROUND: Appropriate management of pain after an injury or surgical procedure has been shown to improve patient outcomes. While infrequent, nerve damage resulting from regional anesthesia can be devastating, however the mechanism remains unknown. Local anesthetics are neurotoxic yet are frequently applied to sites where peripheral nerves are regenerating. Therefore, understanding their effects on injured and growing neurons may have important implications for clinical practice. OBJECTIVE: The purpose of this study was to determine if local anesthetics exacerbate the rate of motoneuron death following axotomy...
January 4, 2017: Restorative Neurology and Neuroscience
https://www.readbyqxmd.com/read/28057459/parabrachial-pituitary-adenylate-cyclase-activating-polypeptide-activation-of-amygdala-endosomal-extracellular-signal-regulated-kinase-signaling-regulates-the-emotional-component-of-pain
#15
Galen Missig, Linda Mei, Margaret A Vizzard, Karen M Braas, James A Waschek, Kerry J Ressler, Sayamwong E Hammack, Victor May
BACKGROUND: Chronic pain and stress-related psychopathologies, such as depression and anxiety-associated abnormalities, are mutually reinforcing; however, the neuronal circuits and mechanisms that underlie this reinforcement are still not well understood. Pituitary adenylate cyclase activating polypeptide (PACAP; Adcyap1) and its cognate PAC1 receptor (Adcyap1r1) are expressed in peripheral nociceptive pathways, participate in anxiety-related responses and have been have been linked to posttraumatic stress disorder and other mental health afflictions...
August 29, 2016: Biological Psychiatry
https://www.readbyqxmd.com/read/28053042/induction-of-migraine-like-photophobic-behavior-in-mice-by-both-peripheral-and-central-cgrp-mechanisms
#16
Bianca N Mason, Eric A Kaiser, Adisa Kuburas, Maria-Cristina M Loomis, John A Latham, Leon F Garcia-Martinez, Andrew F Russo
: The neuropeptide calcitonin gene-related peptide (CGRP) is a key player in migraine. Although migraine can be treated using CGRP antagonists that act peripherally, the relevant sites of CGRP action remain unknown. To address the role of CGRP both within and outside the CNS, we used CGRP-induced light-aversive behavior in mice as a measure of migraine-associated photophobia. Peripheral (intraperitoneal) injection of CGRP resulted in light-aversive behavior in wild-type CD1 mice similar to aversion seen previously after central (intracerebroventricular) injection...
January 4, 2017: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
https://www.readbyqxmd.com/read/28049434/why-does-a-cooled-object-feel-heavier-psychophysical-investigations-into-the-weber-s-phenomenon
#17
James S Dunn, David A Mahns, Saad S Nagi
BACKGROUND: It has long been known that a concomitantly cooled stimulus is perceived as heavier than the same object at a neutral temperature-termed Weber's Phenomenon (WP). In the current study, we re-examined this phenomenon using well-controlled force and temperature stimuli to explore the complex interplay between thermal and tactile systems, and the peripheral substrates contributing to these interactions. A feedback-controlled apparatus was constructed using a mechanical stimulator attached to a 5- × 5-mm thermode...
January 3, 2017: BMC Neuroscience
https://www.readbyqxmd.com/read/28040578/analgesia-after-acl-reconstruction-hamstring-donor-site-injection-versus-intra-articular-local-anaesthetic-injection
#18
Bertrand Sonnery-Cottet, Adnan Saithna, Abdul Azeem, Eric Choudja, Jean Baptiste Pic, Julien Cabaton, Mathieu Thaunat
BACKGROUND: The purpose of this study was to compare hamstring donor-site injection versus intra-articular injection of a local anaesthetic for analgesia after anterior cruciate ligament (ACL) reconstruction. HYPOTHESIS: The two methods provide similar pain relief. MATERIAL AND METHODS: 158 consecutive patients undergoing ACL hamstring tendon graft reconstruction (semi-tendinosus/gracilis [STG] or four-stranded semi-tendinosus [ST4]) during two periods in 2015 were included...
December 28, 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28039061/primary-angle-closure-glaucoma-what-we-know-and-what-we-don-t-know
#19
REVIEW
Xinghuai Sun, Yi Dai, Yuhong Chen, Dao-Yi Yu, Stephen J Cringle, Junyi Chen, Xiangmei Kong, Xiaolei Wang, Chunhui Jiang
Primary angle-closure glaucoma (PACG) is a common cause of blindness. Angle closure is a fundamental pathologic process in PAGC. With the development of imaging devices for the anterior segment of the eye, a better understanding of the pathogenesis of angle closure has been reached. Aside from pupillary block and plateau iris, multiple-mechanisms are more common contributors for closure of the angle such as choroidal thickness and uveal expansion, which may be responsible for the presenting features of PACG...
December 28, 2016: Progress in Retinal and Eye Research
https://www.readbyqxmd.com/read/28033291/adductor-canal-block-versus-femoral-nerve-block-combined-with-sciatic-nerve-block-as-an-anesthetic-technique-for-hindfoot-and-ankle-surgery-a-prospective-randomized-noninferiority-trial
#20
Han Bum Joe, Ho Sik Choo, Ji Sang Yoon, Sang Eon Oh, Jae Ho Cho, Young Uk Park
BACKGROUND: A femoral nerve block (FNB) in combination with a sciatic nerve block (SNB) is commonly used for anesthesia and analgesia in patients undergoing hindfoot and ankle surgery. The effects of FNB on motor function, related fall risk, and rehabilitation are controversial. An adductor canal block (ACB) potentially spares motor fibers in the femoral nerve, but the comparative effect on hindfoot and ankle surgeries between the 2 approaches is not yet well defined. We hypothesized that compared to FNB, ACB would cause less weakness in the quadriceps and produce similar pain scores during and after the operation...
December 2016: Medicine (Baltimore)
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