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Median nerve block

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https://www.readbyqxmd.com/read/29750695/proximal-versus-distal-continuous-adductor-canal-blocks-does-varying-perineural-catheter-location-influence-analgesia-a-randomized-subject-masked-controlled-clinical-trial
#1
Jacklynn F Sztain, Bahareh Khatibi, Amanda M Monahan, Engy T Said, Wendy B Abramson, Rodney A Gabriel, John J Finneran, Richard H Bellars, Patrick L Nguyen, Scott T Ball, Francis B Gonzales, Sonya S Ahmed, Michael C Donohue, Jennifer A Padwal, Brian M Ilfeld
BACKGROUND: A continuous adductor canal block provides analgesia after surgical procedures of the knee. Recent neuroanatomic descriptions of the thigh and knee led us to speculate that local anesthetic deposited in the distal thigh close to the adductor hiatus would provide superior analgesia compared to a more proximal catheter location. We therefore tested the hypothesis that during a continuous adductor canal nerve block, postoperative analgesia would be improved by placing the perineural catheter tip 2-3 cm cephalad to where the femoral artery descends posteriorly to the adductor hiatus (distal location) compared to a more proximal location at the midpoint between the anterior superior iliac spine and the superior border of the patella (proximal location)...
May 9, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29727758/deliberate-practice-using-validated-metrics-improves-skill-acquisition-in-performance-of-ultrasound-guided-peripheral-nerve-block-in-a-simulated-setting
#2
Osman M A Ahmed, Imran Azher, Anthony G Gallagher, Dara S Breslin, Brian D O'Donnell, George D Shorten
STUDY OBJECTIVES: The aim of this study was to compare the effects of deliberate vs. self-guided practices (both using validated metrics) on the acquisition of needling skills by novice learners. DESIGN: Randomized Controlled Study. SETTING: Simulation lab, Department of Anesthesia, St.Vincent's Hospital, Dublin. SUBJECTS: Eighteen medical students. INTERVENTIONS: Students were assigned to either (i) deliberate practice (n = 10) or (ii) self-guided practice (n = 8) groups...
May 1, 2018: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/29667940/the-importance-of-the-saphenous-nerve-block-for-analgesia-following-major-ankle-surgery-a-randomized-controlled-double-blind-study
#3
Siska Bjørn, Wan Yi Wong, Jørgen Baas, Kristian K Nielsen, Jens Børglum, Rasmus Wulff Hauritz, Thomas Fichtner Bendtsen
BACKGROUND AND OBJECTIVES: Major ankle surgery causes intense postoperative pain, and whereas the importance of a sciatic nerve block is well established, the clinical significance of a supplemental saphenous nerve block has never been determined in a prospective, randomized, double-blind, placebo-controlled trial. We hypothesized that a saphenous nerve block reduces the proportion of patients experiencing significant clinical pain after major ankle surgery. METHODS: Eighteen patients were enrolled and received a popliteal sciatic nerve block...
March 26, 2018: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29629543/partial-conduction-block-as-an-early-nerve-conduction-finding-in-neurolymphomatosis
#4
Hyung Jun Park, Ha Young Shin, Se Hoon Kim, Ha Neul Jeong, Young Chul Choi, Bum Chun Suh, Kee Duk Park, Seung Min Kim
BACKGROUND AND PURPOSE: Neurolymphomatosis is a rare manifestation of hematological malignancy and is characterized by direct infiltration of the peripheral nervous system. The objective of this study was to identify the clinical and electrophysiological features of neurolymphomatosis. METHODS: We retrospectively analyzed the medical records of 13 patients with neurolymphomatosis. Seven (54%) of the patients were men, and the median age at symptom onset was 60.0 years...
January 2018: Journal of Clinical Neurology
https://www.readbyqxmd.com/read/29589414/comparison-of-axillary-nerve-block-duration-using-mepivacaine-in-non-insulin-diabetic-or-renal-insufficiency-patients-a-controlled-observational-matched-multicentre-trial
#5
Philippe Cuvillon, Melissa Casier, Christophe Demattei, Nathalie Bernard, Christophe Boisson, Nathalie Vialles, Joel Lhermite, Jacques Ripart, Xavier Capdevila
BACKGROUND: Although studies in diabetic patients demonstrated delayed recovery after long-acting local anesthetic, its effects with short-acting LA remains to be determined. Using mepivacaine, the authors evaluated the duration of axillary nerve blocks in diabetic (DP), renal failure (creatinine clearance < 30 ml.min-1) (RP) and healthy patients (HP). METHOD: We prospectively included consecutive patients aged 18-80 years, with DP (n=37), RP (n=32) and HP (n=48) scheduled for distal upper limb surgery...
March 27, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29576124/cutaneous-innervation-of-the-hand-clinical-testing-in-volunteers-shows-high-intra-and-inter-individual-variability
#6
M Keplinger, P Marhofer, B Moriggl, M Zeitlinger, S Muehleder-Matterey, D Marhofer
BACKGROUND: Many clinicians require a solid understanding of the anatomical areas supplied by specific peripheral nerves. Virtually all pertinent medical textbooks claim that the entire (palmar and dorsal) surface of the hand is supplied by three (median, radial, and ulnar) nerves and that each of these covers a well-defined area. This study was designed to evaluate the sensory-distribution pattern of peripheral nerves in the hand. METHODS: Twelve volunteers were enrolled and randomly allocated to have median, ulnar, or radial nerve blocks to each hand on three successive days...
April 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29570507/how-central-is-central-post-stroke-pain-the-role-of-afferent-input-in-post-stroke-neuropathic-pain-a-prospective-open-label-pilot-study
#7
Simon Haroutounian, Andria L Ford, Karen Frey, Lone Nikolajsen, Nanna B Finnerup, Alicia Neiner, Evan D Kharasch, Pall Karlsson, Michael M Bottros
Central post-stroke pain is a neuropathic pain disorder, the underlying mechanisms of which are not well understood. It has been suggested that stroke-associated loss of inhibitory neurons in the spinothalamic tract causes disinhibition of thalamic neurons, which autonomously generate ectopic nociceptive action potentials responsible for the pain experience. We hypothesized that central post-stroke pain is a result of misinterpretation of afferent sensory input by the sensitized neurons within the brain, rather than generated spontaneously by the damaged CNS neurons...
March 21, 2018: Pain
https://www.readbyqxmd.com/read/29570501/local-anesthetic-injection-speed-and-common-peroneal-nerve-block-duration-a-randomized-controlled-trial-in-healthy-volunteers
#8
Mikkel Herold Madsen, Claus B Christiansen, Christian Rothe, Asger M Andreasen, Lars H Lundstrøm, Kai H W Lange
BACKGROUND AND OBJECTIVES: The speed of local anesthetic (LA) injections in peripheral regional anesthesia ranges from slow continuous infusions (3-12 mL/h) to rapid manual injections (>7500 mL/h). Optimizing injection speed could augment the spread of LA toward the targeted nerves and influence nerve block characteristics. The objective of this study was to investigate whether injection speed of a single dose of LA affects peripheral nerve block duration. METHODS: After approval from the Danish Regional Scientific Ethics Committee, we enrolled 60 healthy adult volunteers...
March 22, 2018: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29559326/canadian-trends-in-carpal-tunnel-surgery
#9
Blair Peters, Jennifer L Giuffre
PURPOSE: Treatment patterns of carpal tunnel surgery by members of the American Society of Surgery of the Hand (ASSH) have recently been published. The majority of cases in this study were performed in the general operating room with intravenous (IV) sedation or a Bier block. Patients were most commonly prescribed hydrocodone for postoperative pain. The majority of carpal tunnel releases at our center are performed under local anesthesia alone, with plain acetaminophen (Tylenol) or codeine prescribed for postoperative pain...
March 17, 2018: Journal of Hand Surgery
https://www.readbyqxmd.com/read/29545039/assessment-of-discomfort-and-pain-in-patients-undergoing-fusion-magnetic-resonance-imaging-guided-vs-trus-guided-prostate-biopsy
#10
Dennis Robins, Michael Lipsky, Arindam RoyChoudry, Sven Wenske
OBJECTIVE: To investigate patient pain perception from receiving magnetic resonance imaging fusion-guided prostate biopsy (FBx) in addition to transrectal ultrasound-guided template biopsy (TBx) vs pain from standard TBx alone. MATERIALS AND METHODS: Patients undergoing FBx + TBx or TBx alone from April 2016 to February 2017 completed a validated pain survey after biopsy. Responses were graded from 0 to 10 (0: no pain or willing to return for repeat procedure; 10: excruciating pain or not willing to return for repeat procedure if necessary)...
March 12, 2018: Urology
https://www.readbyqxmd.com/read/29516161/diagnostic-characteristics-of-anterior-cutaneous-nerve-entrapment-syndrome-in-childhood
#11
Murid Siawash, Rudi Roumen, Walther Tjon A Ten, Ernst van Heurn, Marc Scheltinga
Some children suffering from chronic abdominal pain may have an abdominal wall entity such as anterior cutaneous nerve entrapment syndrome. This syndrome is largely suspected on a combination of findings at history and physical examination. The aim is to obtain clues in history and physical examinations in a selected population of children with anterior cutaneous nerve entrapment syndrome. We analyzed all children with abdominal pain visiting our hospital between January 2013 and January 2015. A total of 71 cases were identified (median age 15 years, range 8-17, 77% female)...
June 2018: European Journal of Pediatrics
https://www.readbyqxmd.com/read/29505566/blood-concentration-of-bupivacaine-and-duration-of-sensory-and-motor-block-following-ultrasound-guided-femoral-and-sciatic-nerve-blocks-in-dogs
#12
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
https://www.readbyqxmd.com/read/29498951/association-of-multimodal-pain-management-strategies-with-perioperative-outcomes-and-resource-utilization-a-population-based-study
#13
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...
May 2018: Anesthesiology
https://www.readbyqxmd.com/read/29457288/injury-to-the-perineal-branch-of-the-pudendal-nerve-in-men-outcomes-from-surgical-resection-of-the-perineal-branches
#14
Eric L Wan, A Lee Dellon
OBJECTIVE: The objective is to report the outcome of an anterior surgical approach to treat neuroma of the perineal branch of the pudendal nerve (PBPN). PATIENTS AND METHODS: An IRB-approved prospective study enrolled 14 consecutive male patients from 2011 through 2015 who had symptoms of perineal/scrotal pain. Each patient had a successful, diagnostic, pudendal nerve block. The surgical procedure was resection of the PBPN and implantation of the nerve into the obturator internus muscle...
February 2018: Microsurgery
https://www.readbyqxmd.com/read/29456706/comparison-of-single-and-triple-injection-methods-for-ultrasound-guided-interscalene-brachial-plexus-blockade
#15
Cun-Jin Wang, Ya-Li Ge, Ju Gao, Feng-Yun Long, Zhi-Hua Mi, Tian-Feng Huang, Xiang-Zhi Fang, Xiao-Ping Chen, Yu-Si Hua, Yang Zhang
Ultrasound-guided interscalene brachial plexus blockade (IBPB) has a relatively high success rate in shoulder surgery; however, whether multiple injections are superior to a single injection (SI) is currently unknown. In the present study, ultrasound-guided SI and triple-injection (TI) IBPBs were compared in a prospective randomized trial. A total of 111 patients undergoing arthroscopic shoulder surgery and presenting with an American Society of Anesthesiologists physical status grading of I-II were randomly allocated to receive IBPB with 15 ml of 1% ropivacaine as a SI or TI...
March 2018: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29444116/field-evaluation-of-the-safety-acceptability-and-feasibility-of-early-infant-male-circumcision-using-the-accucirc-device
#16
Robert C Bailey, Irene Nyaboke, Mary Ellen Mackesy-Amiti, Erick Okello, Valentine Pengo, Betha Ochomo, Mary Emmaculate Auma, Simon Were, Stella Ojuok, Evelyne Adoyo, Mildred Adhiambo, Marisa R Young, Rebeca M Plank, Fredrick O Otieno
BACKGROUND: As countries scale up adult voluntary medical male circumcision (VMMC) for HIV prevention, they are looking ahead to long term sustainable strategies, including introduction of early infant male circumcision (EIMC). Although a number of devices for EIMC are prequalified by the World Health Organization, evaluation of additional devices can provide policy-makers and clinicians the information required to make informed decisions. We undertook a field evaluation of the safety and acceptability of the AccuCirc device in Kisumu County, Kenya...
2018: PloS One
https://www.readbyqxmd.com/read/29424059/effective-dose-of-dexmedetomidine-as-an-adjuvant-sedative-to-peripheral-nerve-blockade-in-elderly-patients
#17
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
https://www.readbyqxmd.com/read/29406180/intravenous-dexamethasone-fails-to-prolong-psoas-compartment-block-when-assessed-by-objective-pinprick-sensory-testing-a-prospective-randomised-dose-dependent-placebo-controlled-equivalency-trial
#18
J D Turner, S W Dobson, R S Weller, G B Russell, D S Henshaw
BACKGROUND: Recent studies have concluded that i.v. dexamethasone can prolong the duration of peripheral nerve blockade. We hypothesized that a 4 mg dose would equally prolong the duration of psoas compartment blocks (PCBs) when compared with 8 mg, and that both doses would prolong the duration when compared with placebo. METHODS: This was a prospective, randomized, placebo-controlled, dose-dependent, equivalency trial with 115 patients undergoing total hip arthroplasty...
February 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29405670/low-concentration-distal-nerve-blocks-with-0-125-levobupivacaine-versus-systemic-analgesia-for-ambulatory-trapeziectomy-performed-under-axillary-block-a-randomized-controlled-trial
#19
Mireia Rodríguez, FJavier González, Sergi Sabaté, Mercedes García, Claudia Lamas, Adrià Font, Marisa Moreno, Ignasi Proubasta, M Àngels Gil, M Victoria Moral, Rolf Hoffmann
BACKGROUND: Trapeziectomy is one of the most painful procedures in ambulatory surgery. This prospective randomized trial aimed to compare postoperative pain control using distal peripheral nerve blocks (dPNB) with a low concentration of a long-acting local anaesthetic versus conventional systemic analgesia. METHODS: Fifty-two patients undergoing trapeziectomy were randomized to receive levobupivacaine 0.125% 5ml on radial and median nerves at the elbow (dNB group), or not to receive these blocks (control group)...
February 5, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29404987/enhanced-recovery-via-peripheral-nerve-block-for-open-hepatectomy
#20
Lucas W Thornblade, Yongwoo D Seo, Tracy Kwan, Jane H Cardoso, Eric Pan, Gregory Dembo, Raymond S W Yeung, James O Park
BACKGROUND: Enhanced recovery after surgery (ERAS) protocols are now commonplace in many fields of surgery, but only limited data exists for their use in hepatobiliary surgery. We implemented standardized ERAS protocols for all open hepatectomies and replaced thoracic epidurals with a transversus abdominis plane (TAP) block. METHODS: We performed a retrospective cohort study of all patients undergoing open hepatectomy during the 14 months before and 19 months after implementation of an ERAS protocol at our institution (January 2014-September 2016)...
February 5, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
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