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Median nerve block

Yusuf A Rajabally, Fu Liong Hiew
INTRODUCTION: The most efficient method of performing electrophysiology for Guillain-Barré syndrome (GBS) is unknown. METHODS: We retrospectively analyzed electrophysiological data of 97 consecutive GBS patients from Birmingham, U.K. (2001-12) studied ≤3 weeks post-onset. RESULTS: The sensitivity of electrophysiology for each GBS subtype was dependent on the tested upper and lower limb nerves. In acute inflammatory demyelinating polyneuropathy (AIDP), abnormalities were predominant in the arms, whereas leg abnormalities predominated in axonal GBS...
October 17, 2016: Muscle & Nerve
Malte Kuniss, Harald Greiß, Dmitri Pajitnev, Ersan Akkaya, Nikolas Deubner, Andreas Hain, Lars Bodammer, Alexander Berkowitsch, Gian-Battista Chierchia, Christian W Hamm, Thomas Neumann
AIMS: Although the generation of linear lesions by ablation improves success rates in patients with persistent atrial fibrillation (AF), the procedure has been considered unsuitable for cryoablation balloon catheter technologies. We developed a technique for linear ablations, using second-generation cryoballoon technology. METHODS AND RESULTS: This was a single-arm, prospective study in 76 patients with persistent AF treated consecutively at our centre. Cryoablation was performed using a 28 mm second-generation cryoballoon...
October 12, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Wenwen Zhai, Xuedong Wang, Yulan Rong, Min Li, Hong Wang
BACKGROUND: Ultrasound guidance has reduced the amount of local anesthetics to achieve a successful block. Previous studies of the relationship between the volume or concentration of local anesthetics and the effects of the block were based on relatively high doses of local anesthetics. We tested the hypothesis that providing low dose of ropivacaine at three combinations of volumes and concentrations for ultrasound-guided interscalene brachial plexus block would produce different effects in the aspect of onset time, pain control and the incidence of side effects...
September 30, 2016: BMC Anesthesiology
Lindsay Borg, Steven K Howard, T Edward Kim, Lauren Steffel, Cynthia Shum, Edward R Mariano
BACKGROUND: Despite the benefits of continuous peripheral nerve blocks, catheter dislodgment remains a major problem, especially in the ambulatory setting. However, catheter dressing techniques to prevent such dislodgment have not been studied rigorously. We designed this simulation study to test the strength of two commercially available catheter dressings. METHODS: Using a cadaver model, we randomly assigned 20 trials to one of two dressing techniques applied to the lateral thigh: 1) clear adhesive dressing alone, or 2) clear adhesive dressing with an anchoring device...
October 2016: Korean Journal of Anesthesiology
S T Kokkalis, A F Mavrogenis, C Vottis, L Papatheodorou, P J Papagelopoulos, P N Soucacos, D G Sotereanos
Nerve wrap protectors are bioabsorbable synthetic materials made of collagen or extracellular matrix that provide a non-constricting encasement for injured peripheral nerves. They are designed to be used as an interface between the nerve and the surrounding tissue. After hydrated, they transform into a soft, pliable, nonfriable, easy to handle porous conduit. The wall of the nerve wrap has a longitudinal slit that allows to be placed around the injured nerve. Τhis article presents the surgical technique for median nerve neurolysis and nerve coverage using a collagen or an extracellular matrix nerve wrap protector in 10 patients with recurrent or persistent carpal -tunnel syndrome...
August 2016: Acta Orthopaedica Belgica
Hamid Reza Rostami, Malahat Akbarfahimi, Afsoon Hassani Mehraban, Ali Reza Akbarinia, Susan Samani
OBJECTIVE: To investigate effect of practice type during modified constraint-induced movement therapy on hand function in patients with chronic median and ulnar nerve injuries. DESIGN: A prospective, single-blinded, randomized controlled clinical trial. SETTING: Participants' private home. SUBJECTS: A convenience sample of 36 outpatient participants allocated randomly to three equal groups. INTERVENTIONS: Intervention groups underwent 3-hour intensive training of affected hand each day, 3-day a week, 4-week in association with immobilisation of healthy hand: occupation-based group practiced meaningful occupations while rote exercise-based group performed rote exercises during constraint-induced movement therapy...
September 28, 2016: Clinical Rehabilitation
Chun-Ta Huang, Seu-Hwa Chen, June-Horng Lue, Chi-Fen Chang, Wen-Hsin Wen, Yi-Ju Tsai
BACKGROUND: Mechanisms underlying neuropathic pain relief by the neurosteroid allopregnanolone remain uncertain. We investigated if allopregnanolone attenuates glial extracellular signal-regulated kinase (ERK) activation in the cuneate nucleus (CN) concomitant with neuropathic pain relief in median nerve chronic constriction injury (CCI) model rats. METHODS: We examined the time course and cellular localization of phosphorylated ERK (p-ERK) in CN after CCI. We subsequently employed microinjection of a mitogen-activated protein kinase kinase (ERK kinase) inhibitor, PD98059, to clarify the role of ERK phosphorylation in neuropathic pain development...
September 23, 2016: Anesthesiology
Madhu Nagappa, Archana B Netto, Arun B Taly, Girish Baburao Kulkarni, G S Umamaheshwara Rao, Sunder Periyavan, Shivaji Rao
BACKGROUND: Respiratory muscle paralysis is a serious complication of Guillain-Barre syndrome (GBS). Factors that govern duration and recovery from respiratory paralysis are unclear. AIM: To correlate electrophysiological parameters in critically ill GBS with duration of mechanical ventilation and outcome at discharge. MATERIALS AND METHODS: Data of a large cohort (n=93; M:F 59:34; mean age: 33.51+21.4 years) of critically-ill patients with GBS seen over one decade was retrospectively analyzed...
September 2016: Neurology India
Travis J Menge, Elizabeth B Rinker, Kang-Hsien Fan, John J Block, Donald H Lee
INTRODUCTION: Carpal tunnel steroid injections (CTIs) have the potential risk of damaging underlying critical structures, including the median nerve (MN), radial artery (RA), and ulnar neurovascular bundle (UB). The purpose of this study was to analyze the safety of a volar radial (VR) and volar ulnar (VU) CTI, using standardized anatomical "safe zones." MATERIALS AND METHODS: This study was performed on 87 cadaveric arms using a percentage of the total wrist width as a guide for placement of a VR (30 and 33% of total wrist width) and VU (60 and 66% of total wrist width) injection...
April 2016: Journal of Hand and Microsurgery
C He, Y J Yang, C Zhang, H R Dong
OBJECTIVE: To Verify the value of the ratio of sensory nerves conductive velocity along palm-median finger /wrist-palm minus 1 for diagnosis of the mild-moderate carpal tunnel syndrome(CTS). METHODS: The different value between 1 and the ratio of sensory nerves conductive velocity along palm-median finger/wrist-palm was defined as index-CTS which was used to assess the severity of CTS.The index-CTS of 100 palms from healthy controls and 58 palms from mild-moderate CTS patients were calculated and compared...
August 16, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Shubhangi Arora, Anjolie Chhabra, Rajeshwari Subramaniam, Mahesh K Arora, Mahesh C Misra, Virender K Bansal
BACKGROUND: Pain after laparoscopic inguinal hernia surgery can be moderate to severe, interfering with return to normal activity. The study aimed to assess the efficacy of bilateral ultrasound-guided (USG) transversus abdominis plane (TAP) block for relieving acute pain after laparoscopic hernia repair as T10-L1 nerve endings are anesthetized with this block. METHODS: Seventy-one American Society of Anesthesiologists I to II patients, aged 18 to 65 years, undergoing unilateral/bilateral laparoscopic hernia repair were randomized to port site infiltration (control, 36) and TAP block groups (35)...
September 2016: Journal of Clinical Anesthesia
Nahel N Saied, Rajnish K Gupta, Lina Saffour, Mohammad A Helwani
OBJECTIVE: The primary aim of this study is to determine the effect of adding dexamethasone, clonidine or both with and without epinephrine to ropivacaine and bupivacaine brachial plexus blocks. DESIGN: Observational study of prospectively collected data SETTING: Single academic outpatient surgery center METHODS: We evaluated 5,515 patient entries who received brachial plexus block (BPB). Multiple, rescue, unsuccessful, and distal nerve blocks of the upper extremity were excluded...
August 22, 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
S Kulhari, N Bharti, I Bala, S Arora, G Singh
BACKGROUND: Pectoral nerve (PecS) block is a recently introduced technique for providing surgical anaesthesia and postoperative analgesia during breast surgery. The present study was planned to compare the efficacy and safety of ultrasound-guided PecS II block with thoracic paravertebral block (TPVB) for postoperative analgesia after modified radical mastectomy. METHODS: Forty adult female patients undergoing radical mastectomy were randomly allocated into two groups...
September 2016: British Journal of Anaesthesia
José R Soberón, Joseph W Crookshank, Bobby D Nossaman, Clint E Elliott, Leslie E Sisco-Wise, Scott F Duncan
PURPOSE: Limited data exist regarding the role of perineural blockade of the distal median, ulnar, and radial nerves as a primary anesthetic in patients undergoing hand surgery. We conducted a prospective and randomized pilot study to compare these techniques to brachial plexus blocks as a primary anesthetic in this patient population. METHODS: Sixty patients scheduled for hand surgery were randomized to receive either an ultrasound-guided supraclavicular, infraclavicular, or axillary nerve block (brachial plexus blocks) or ultrasound-guided median, ulnar, and radial nerve blocks performed at the level of the mid to proximal forearm (forearm blocks)...
October 2016: Journal of Hand Surgery
Gabriel J Rendón, Lina Echeverri, Francisco Echeverri, Carlos Millán Sanz-Lomana, Pedro T Ramirez, Rene Pareja
OBJECTIVE: The goal of our study was to report on the feasibility of outpatient laparoscopic radical hysterectomy in patients with early-stage cervical cancer. METHODS: We included all patients who underwent a laparoscopic radical hysterectomy at the Instituto de Cancerología - Las Americas in Medellin, Colombia, between January 2013 and July 2015. The control group was a similar cohort of patients who were admitted after their surgery. RESULTS: Seventy-six patients were included [outpatient (31) and admitted (45)]...
August 9, 2016: Gynecologic Oncology
Horst Claassen, Oliver Schmitt, Andreas Wree, Marko Schulze
INTRODUCTION: Variations in the brachial plexus are the rule rather than the exception. This fact is of special interest for the anesthetist when planning axillary block of brachial plexus. MATERIAL AND METHODS: 167 cadaver arms were evaluated for variations in brachial plexus, with focus on the cords of the plexus, the loop of the median nerve, and the course of the median, musculocutaneous, ulnar, axillary and radial nerves. In addition, concomitant arterial variations were recorded...
August 6, 2016: Annals of Anatomy, Anatomischer Anzeiger: Official Organ of the Anatomische Gesellschaft
George Paraskevas, Konstantinos Koutsouflianiotis, Kalliopi Iliou, Theodosios Bitsis, Panagiotis Kitsoulis
A double upper subscapular nerve on the right side was detected in a male cadaver, with the proximal one arising from the suprascapular nerve and the distal one from the posterior division of the upper trunk of the brachial plexus. Both of them penetrated and supplied the uppermost portion of the right subscapularis muscle. That anatomic variation was associated with a median nerve formed by two lateral roots. The origin and pattern of the upper subscapular nerve displays high variability, however the presented combination of the variable origin of a double upper subscapular nerve has rarely been described in the literature...
June 2016: Journal of Clinical and Diagnostic Research: JCDR
M A Dickson, M R Mahoney, W D Tap, S P D'Angelo, M L Keohan, B A Van Tine, M Agulnik, L E Horvath, J S Nair, G K Schwartz
BACKGROUND: Aurora kinase A (AURKA) is commonly overexpressed in sarcoma. The inhibition of AURKA by shRNA or by a specific AURKA inhibitor blocks in vitro proliferation of multiple sarcoma subtypes. MLN8237 (alisertib) is a novel oral adenosine triphosphate-competitive AURKA inhibitor. PATIENTS AND METHODS: This Cancer Therapy Evaluation Program-sponsored phase II study of alisertib was conducted through the Alliance for Clinical Trials in Oncology (A091102). Patients were enrolled into histology-defined cohorts: (i) liposarcoma, (ii) leiomyosarcoma, (iii) undifferentiated sarcoma, (iv) malignant peripheral nerve sheath tumor, or (v) other...
October 2016: Annals of Oncology: Official Journal of the European Society for Medical Oncology
Hannah E Visser, Kathryn A Diehl, Richard D Whitley, Kathern E Myrna
OBJECTIVE: To compare Schirmer tear test I (STTI) values collected in normal horses with and without an auriculopalpebral nerve block. PROCEDURE: Schirmer tear test I values were measured in 20 clinically normal horses (38 eyes) with a median age of 12 years. The order of eyes tested was randomized. Within 24-48 h, at the same time of day, tear measurements were collected again after administration of an auriculopalpebral nerve block. Each block was performed a minimum of 5 min prior to each STT I...
August 8, 2016: Veterinary Ophthalmology
Nilgun Kavrut Ozturk, Elif Dogan Baki, Ali Sait Kavakli, Ayca Sultan Sahin, Raif Umut Ayoglu, Arzu Karaveli, Mustafa Emmiler, Kerem Inanoglu, Bilge Karsli
Background. Parasternal block and transcutaneous electrical nerve stimulation (TENS) have been demonstrated to produce effective analgesia and reduce postoperative opioid requirements in patients undergoing cardiac surgery. Objectives. To compare the effectiveness of TENS and parasternal block on early postoperative pain after cardiac surgery. Methods. One hundred twenty patients undergoing cardiac surgery were enrolled in the present randomized, controlled prospective study. Patients were assigned to three treatment groups: parasternal block, intermittent TENS application, or a control group...
2016: Pain Research & Management: the Journal of the Canadian Pain Society
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