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Peripheral nerve blocks

SeungHwan Lee, Xiang Qun Shi, Anni Fan, Brian West, Ji Zhang
Introduction Neuropathic pain is a debilitating condition. The importance of neuroimmune interactions in neuropathic pain has been evidenced by the involvement of different immune cells in peripheral and central sensitization of pathological pain. Macrophages and microglia are the most abundant immune cells activated in injured nerves and spinal cord, respectively. Several lines of evidence showed that macrophage/microglia survival, activation, proliferation, and differentiation require the involvement of macrophage-colony stimulating factor...
January 2018: Molecular Pain
Peter Bond, David B Parkinson
The use of electron microscopy allows analysis of the microarchitecture of peripheral nerves both during development and in the processes of nerve regeneration and repair.We describe a novel method for the rapid analysis and quantification of myelin in peripheral nerve using a low vacuum scanning electron microscopy protocol. For this methodology, excised nerves are prepared for traditional transmission electron microscopy (TEM) imaging, but at the stage where semi-thin sections would be taken, the resin block is instead imaged at low vacuum in the scanning electron microscope (SEM) using the backscattered electron signal...
2018: Methods in Molecular Biology
Rodrigo López-Leal, Paula Diaz, Felipe A Court
Sensory neurons from dorsal root ganglion efficiently regenerate after peripheral nerve injuries. These neurons are widely used as a model system to study degenerative mechanisms of the soma and axons, as well as regenerative axonal growth in the peripheral nervous system. This chapter describes techniques associated to the study of axonal degeneration and regeneration using explant cultures of dorsal root ganglion sensory neurons in vitro in the presence or absence of Schwann cells. Schwann cells are extremely important due to their involvement in tissue clearance during axonal degeneration as well as their known pro-regenerative effect during regeneration in the peripheral nervous system...
2018: Methods in Molecular Biology
Bin Mei, Gaige Meng, Guanghong Xu, Xinqi Cheng, Shishou Chen, Ye Zhang, Ming Zhang, Xuesheng Liu, Erwei Gu
BACKGROUND: Peripheral nerve block is a preferable method for elderly patients receiving hip arthroplasty. Sedation with dexmedetomidine may reduce postoperative delirium. The aim of this study was to investigate whether intraoperative sedation with dexmedetomidine, as a supplementary to peripheral nerve block for elderly patients receiving total hip arthroplasty, can decrease the prevalence of postoperative delirium. METHODS: A prospective, randomized controlled study was conducted with patients 65 years of age or older who underwent total hip arthroplasty between June 2016 and June 2017...
March 9, 2018: Clinical Journal of Pain
Bo Hu, Megan Mccollum, Vignesh Ravi, Sezgi Arpag, Daniel Moiseev, Ryan Castoro, Bret C Mobley, Bryan W Burnette, Carly Siskind, John W Day, Robin Yawn, Shawna Feely, Yuebing Li, Qing Yan, Michael E Shy, Jun Li
OBJECTIVE: Charcot-Marie-Tooth type 4J (CMT4J) is a rare autosomal recessive neuropathy caused by mutations in FIG4 that result in loss of FIG4 protein. This study investigates the natural history and mechanisms of segmental demyelination in CMT4J. METHODS: Over the past 9 years, we have enrolled and studied a cohort of 12 CMT4J patients, including 6 novel FIG4 mutations. We evaluated these patients and related mouse models using morphological, electrophysiological and biochemical approaches...
March 8, 2018: Annals of Neurology
Michéal O Cathasaigh, Matt R Read, Aylin Atilla, Teresa Schiller, Grace P S Kwong
Peripheral nerve blocks are becoming increasingly popular for perioperative use as anesthetics and analgesics in small animals. This prospective study was performed to investigate the duration of motor and sensory blockade following use of bupivacaine for ultrasound-guided femoral and sciatic nerve blocks in dogs and to measure the plasma concentrations of bupivacaine that result from these procedures. Six dogs were anesthetized twice using a randomized cross-over design. At the first anesthetic, dogs were assigned to receive either an ultrasound-guided femoral nerve block or sciatic nerve block with 0...
2018: PloS One
Kamiar Ghoseiri, Mostafa Allami, Mohammad Reza Soroush, Mohammad Yusuf Rastkhadiv
The prevalence of limb amputation is increasing globally as a devastating experience that can physically and psychologically affect the lifestyle of a person. The residual limb pain and phantom limb pain are common disabling sequelae after amputation surgery. Assistive devices/technologies can be used to relieve pain in people with amputation. The existing assistive devices/technologies for pain management in people with amputation include electrical nerve block devices/technologies, TENS units, elastomeric pumps and catheters, residual limb covers, laser systems, myoelectric prostheses and virtual reality systems, etc...
January 23, 2018: Military Medical Research
Rein Ketelaars, Joram T Stollman, Evelien van Eeten, Ties Eikendal, Jörgen Bruhn, Geert-Jan van Geffen
BACKGROUND: The treatment of acute pain in the emergency department is not always optimal. Peripheral nerve blocks using "blind" or nerve stimulator techniques have substantial disadvantages. Ultrasound-guided regional anesthesia may provide quick, safe, and effective pain relief in patients with proximal femoral fractures with severe pain. However, no evidence exists on emergency physician-performed ultrasound-guided regional anesthesia in these patients in Dutch emergency departments...
March 2, 2018: International Journal of Emergency Medicine
Stavros G Memtsoudis, Jashvant Poeran, Nicole Zubizarreta, Crispiana Cozowicz, Eva E Mörwald, Edward R Mariano, Madhu Mazumdar
BACKGROUND: Multimodal analgesia is increasingly considered routine practice in joint arthroplasties, but supportive large-scale data are scarce. The authors aimed to determine how the number and type of analgesic modes is associated with reduced opioid prescription, complications, and resource utilization. METHODS: Total hip/knee arthroplasties (N = 512,393 and N = 1,028,069, respectively) from the Premier Perspective database (2006 to 2016) were included. Analgesic modes considered were opioids, peripheral nerve blocks, acetaminophen, steroids, gabapentin/pregabalin, nonsteroidal antiinflammatory drugs, cyclooxygenase-2 inhibitors, or ketamine...
March 2, 2018: Anesthesiology
Jan Vollert, Walter Magerl, Ralf Baron, Andreas Binder, Elena K Enax-Krumova, Gerd Geisslinger, Janne Gierthmühlen, Florian Henrich, Philipp Hüllemann, Thomas Klein, Jörn Lötsch, Christoph Maier, Bruno Oertel, Sigrid Schuh-Hofer, Thomas R Tölle, Rolf-Detlef Treede
As an indirect approach to relate previously identified sensory phenotypes of patients suffering from peripheral neuropathic pain to underlying mechanisms, we used a published sorting algorithm to estimate the prevalence of denervation, peripheral and central sensitization in 657 healthy subjects undergoing experimental models of nerve block (compression block, topical lidocaine), primary (sunburn, topical capsaicin), or secondary hyperalgesia (intradermal capsaicin, electrical high-frequency stimulation), and in 902 patients suffering from neuropathic pain...
February 24, 2018: Pain
Jonathan Chica, Isaac Yepes, S Shelby Burks, Ricardo Komotar, Roger Carrillo
Intracranial malignant peripheral nerve sheath tumors (MPNSTs) are an extremely rare entity with only a handful of cases reported in the literature. MPNSTs typically occur in the extremities and the trunk. The treatment algorithm includes, when possible, gross-total resection as these tumors are extremely aggressive. When these tumors occur intracranially, they are termed malignant intracerebral nerve sheath tumors. The diagnosis hinges on immunohistochemistry and pathological features and often the diagnosis can be delayed for this reason...
January 2018: Asian Journal of Neurosurgery
Christopher Wahal, Amanda Kumar, Srinivas Pyati
Advances in ultrasound guided regional anaesthesia and introduction of newer long acting local anaesthetics have given clinicians an opportunity to apply novel approaches to block peripheral nerves with ease. Consequently, improvements in outcomes such as quality of analgesia, early rehabilitation and patient satisfaction have been observed. In this article we will review some of the newer regional anaesthetic techniques, long acting local anaesthetics and adjuvants, and discuss evidence for key outcomes such as cancer recurrence and safety with ultrasound guidance...
February 2018: Indian Journal of Anaesthesia
Myong-Hwan Karm, Sohee Lee, Syn-Hae Yoon, Sukyung Lee, Wonuk Koh
RATIONALE: Although lower-extremity surgeries are mainly performed under general or central neuraxial anesthesia, ultrasound-guided peripheral nerve block (PNB) can be a good alternative, especially for patients who require continuous anticoagulation treatment and present with poor cardiovascular conditions. PATIENTS CONCERNS: The patient required continuous anticoagulation treatment due to the high risk of thromboembolism and poor cardiovascular conditions. DIAGNOSES: The patient required lower-extremity amputation due to atherosclerotic and thromboembolic obstruction...
March 2018: Medicine (Baltimore)
Niloy Bhadra, Tina L Vrabec, Narendra Bhadra, Kevin L Kilgore
Introduction: Electrical nerve block uses electrical waveforms to block action potential propagation. Materials & Methods: Two key features that distinguish electrical nerve block from other nonelectrical means of nerve block: block occurs instantly, typically within 1 s; and block is fully and rapidly reversible (within seconds). Results: Approaches for achieving electrical nerve block are reviewed, including kilohertz frequency alternating current and charge-balanced polarizing current...
January 2018: Bioelectron Med (Lond)
Osman Özgür Yalın, Derya Uludüz, Aynur Özge
Short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT) is a rare, primary headache syndrome, which is classified as a subtype of trigeminal autonomic cephalalgias. Although SUNCT is usually refractory to treatment, several antiepileptic drugs have recently shown promising results for its treatment. However, there is a lack of evidence regarding the course of SUNCT during pregnancy and the available treatment options. Here, we present a 30-week pregnant female with SUNCT who was successfully treated with infra- and supraorbital nerve blocks...
January 2018: Aǧrı: Ağrı (Algoloji) Derneği'nin Yayın Organıdır, the Journal of the Turkish Society of Algology
Alexander D Cohen, Mark C Kendall
No abstract text is available yet for this article.
February 13, 2018: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
Sumit Bhattacharya, Laura García-Posadas, Robin R Hodges, Helen P Makarenkova, Sharmila Masli, Darlene A Dartt
The purpose of this study is to determine neural, vascular, protein secretion, and cellular signaling changes with disease progression in lacrimal glands of the thrombospondin-1 -/- (TSP-1 -/- ) mouse model of dry eye compared to C57BL/6 wild-type (WT) mice. Neural innervation was reduced in TSP-1 -/- lacrimal glands compared to WT controls, whereas the number of blood vessels was increased. Intracellular Ca 2+ stores and the amount of lysosomes, mitochondria, and secretory granules, but not the endoplasmic reticulum, were reduced in TSP-1 -/- compared to WT acini at 12 weeks of age...
February 14, 2018: Mucosal Immunology
José Johann Chidiac, Ammar Kassab, Khaldoun Rifai, Nayef E Saadé, Elie D Al Chaer
INTRODUCTION: Intact neural supply is necessary for tooth eruption. Sympathetic denervation accelerates or decelerates the eruption rate depending on the tooth condition (intact or injured). The aim of this study is to reexamine the role of the sympathetic innervation, through the observation of the effects of pre or post ganglionic chemical sympathectomy on the eruption of intact rat incisors. MATERIALS AND METHODS: Different groups of rats were subjected to either ganglionic or peripheral chemical sympathectomy and the observed effects on incisor eruption were compared to those made on intact/sham groups or on rats subjected to inferior alveolar nerve (IAN) lesion...
February 7, 2018: Archives of Oral Biology
Xuelian He, Liguo Zhang, Luis F Queme, Xuezhao Liu, Andrew Lu, Ronald R Waclaw, Xinran Dong, Wenhao Zhou, Grahame Kidd, Sung-Ok Yoon, Andres Buonanno, Joshua B Rubin, Mei Xin, Klaus-Armin Nave, Bruce D Trapp, Michael P Jankowski, Q Richard Lu
Deficits in Schwann cell-mediated remyelination impair functional restoration after nerve damage, contributing to peripheral neuropathies. The mechanisms mediating block of remyelination remain elusive. Here, through small-molecule screening focusing on epigenetic modulators, we identified histone deacetylase 3 (HDAC3; a histone-modifying enzyme) as a potent inhibitor of peripheral myelinogenesis. Inhibition of HDAC3 enhanced myelin growth and regeneration and improved functional recovery after peripheral nerve injury in mice...
February 12, 2018: Nature Medicine
C Wang, H Zhang, Q Fu
BACKGROUND: The median effective dose (ED50 ) of sedative dexmedetomidine adjuvant to peripheral nerve block (PNB) has not yet been verified in elderly patients. This study assessed the ED50 of intravenous dexmedetomidine for sedation in elderly patients who were undergoing total knee arthroplasty (TKA) with PNB. METHODS: Forty-two patients aged 65-85 years were included and stratified into two groups according to age: young-old group (aged 65-74 years) and middle-old group (aged 75-85 years)...
February 9, 2018: Acta Anaesthesiologica Scandinavica
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