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Median nerve block

Dennis Robins, Michael Lipsky, Arindam RoyChoudry, Sven Wenske
OBJECTIVE: To investigate patient pain perception from receiving MRI fusion guided prostate biopsy (FBx) in addition to transrectal ultrasound guided template biopsy (TBx) versus pain from standard TBx alone. MATERIALS AND METHODS: Patients undergoing FBx+TBx or TBx alone from April 2016 through February 2017 completed a validated pain survey after biopsy. Responses were graded from 0-10 (0: no pain/willing to return for repeat procedure; 10: excruciating pain/not willing to return for repeat procedure if necessary)...
March 12, 2018: Urology
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)...
March 7, 2018: European Journal of Pediatrics
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
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
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
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
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
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
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
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
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
Giorgio Veneziano, David P Martin, Ralph Beltran, NʼDiris Barry, Dmitry Tumin, Candice Burrier, Kevin Klingele, Tarun Bhalla, Joseph D Tobias
BACKGROUND AND OBJECTIVES: Perineural dexamethasone has been demonstrated to extend postsurgical analgesia after peripheral nerve blockade in adults. The mechanism of action of dexamethasone as a regional anesthetic adjuvant is unclear as intravenous dexamethasone has been shown to have similar analgesic efficacy as perineural dexamethasone. The efficacy of perineural dexamethasone has not been previously explored in the pediatric population. METHODS: After obtaining informed consent, children (aged 10-18 years) presenting for arthroscopic knee surgery with a femoral nerve block were randomized to 1 of 3 groups: ropivacaine 0...
January 26, 2018: Regional Anesthesia and Pain Medicine
Reuben J Miller, Andrew J Cameron, Julian Dimech, Robert J Orec, Nicholas J Lightfoot
BACKGROUND AND OBJECTIVES: The primary aim of this study was to examine the pharmacokinetics of ropivacaine in patients undergoing elective total knee arthroplasty with local infiltration analgesia as the primary analgesic method. We also sought to determine the incidence of biochemical toxicity through measurement of plasma ropivacaine concentrations over the first 24 hours postoperatively. METHODS: This was a prospective, observational study of 15 patients undergoing elective total knee arthroplasty...
January 24, 2018: Regional Anesthesia and Pain Medicine
Alicia Skelding, Alexander Valverde, Melissa Sinclair, Jeffrey Thomason, Noel Moens
OBJECTIVES: To describe the ventral spinal nerve rami contribution to the formation of the brachial plexus (BP), and to compare ease of performing and nerve staining between three blind techniques for BP blockade in dogs. STUDY DESIGN: Prospective, randomized, blind study. ANIMALS: A total of 18 dog cadavers weighing 28.2 ± 9.7 kg (mean ± standard deviation). METHODS: Dogs were randomly assigned to two of three BP treatments: traditional approach (TA), perpendicular approach (PA), and axillary approach (AA)...
December 12, 2017: Veterinary Anaesthesia and Analgesia
Karen Boretsky, Maria A Hernandez, Elizabeth Eastburn, Cornelius Sullivan
BACKGROUND: The clinical reliability and reproducibility of ultrasound-guided lumbar plexus blocks is not established in pediatric populations. We present the results of a combined nerve stimulation ultrasound-guided lumbar plexus block using the vertebral body, transverse process, and psoas muscle as landmarks on a transverse lumbar paravertebral sonogram with mid-axillary transducer placement, "shamrock method," in children and adolescents. AIMS: Our primary objective was to determine the rate of achieving sensory changes in the lumbar plexus distribution...
January 23, 2018: Paediatric Anaesthesia
Lindsey B Armstrong, Pradeep Dinakar, David P Mooney
INTRODUCTION: Anterior cutaneous nerve entrapment syndrome (ACNES) is an underrecognized etiology of chronic abdominal pain that causes great morbidity to those affected. We sought to determine the outcome of neurectomy for ACNES in children. METHODS: Demographic and clinical data on children who underwent neurectomy for ACNES by a single surgeon from 10/2011 to 01/2017 were reviewed. RESULTS: Twenty-six patients underwent neurectomy for ACNES...
December 8, 2017: Journal of Pediatric Surgery
Yoshinori Kamiya, Miki Hasegawa, Takayuki Yoshida, Misako Takamatsu, Yu Koyama
BACKGROUND: In recent years, thoracic wall nerve blocks, such as the pectoral nerve (PECS) block and the serratus plane block have become popular for peri-operative pain control in patients undergoing breast cancer surgery. The effect of PECS block on quality of recovery (QoR) after breast cancer surgery has not been evaluated. OBJECTIVES: To evaluate the ability of PECS block to decrease postoperative pain and anaesthesia and analgesia requirements and to improve postoperative QoR in patients undergoing breast cancer surgery...
March 2018: European Journal of Anaesthesiology
Wei Liu, Jianxia Liu, Xingqin Tan, Shouyong Wang
BACKGROUND AND AIM: Trigger thumb is a common hand disability in children and is primarily treated with open surgery. A conscious median nerve block can usually meet the requirements for trigger thumb-releasing surgery in adults; however, its effectiveness in children requires further clarification. The present study aims to demonstrate whether ultrasound-guided lower forearm median nerve blockade is a viable option for children undergoing open surgery for trigger thumb. METHODS: A prospective randomized study was designed to compare median nerve blocks guided by ultrasonography with those guided by anatomic landmarks...
February 2018: Paediatric Anaesthesia
Alberto Prats-Galino, Martin Čapek, Miguel A Reina, Erika Cvetko, Barbora Radochova, R Shane Tubbs, Marija Damjanovska, Tatjana Stopar Pintarič
The general microscopic characteristics of nerves are described in several textbooks of histology, but the specific microanatomies of most nerves that can be blocked by anesthesiologists are usually less well known. Our objective was to evaluate the 3D reconstruction of nerve fascicles from optical projection tomography images (OPT) and the ability to undertake an internal navigation exploring the morphology in detail, more specifically the fascicular interconnections. Median and lingual nerve samples were obtained from five euthanized piglets...
December 2, 2017: Clinical Anatomy
Tomislav Kifer, Zrinjka Mišak, Oleg Jadrešin, Iva Hojsak
OBJECTIVE: Anterior cutaneous nerve entrapment syndrome (ACNES) is often an overlooked cause of abdominal pain. Data for pediatric patients, especially regarding the treatment modalities are scarce. The aim of this study is to present a treatment modality of ACNES with combined local subfascial anesthetic and corticosteroid injection in a prospectively collected cohort of pediatric patients. METHODS: This was a prospective observational long-term study, which included pediatric patients who were diagnosed with ACNES in a tertiary care pediatric center and followed up for at least 12 months (median 1...
November 17, 2017: Clinical Journal of Pain
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