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Femoral block

Marco Scardino, Tiziana D'Amato, Federica Martorelli, Giorgia Fenocchio, Vincenzo Simili, Berardo Di Matteo, Dario Bugada, Elizaveta Kon
BACKGROUND: Currently many TKA protocols rely on multimodal analgesic protocols with patient-controlled analgesia systems that administer opioids through a patient controlled IV infusion pump, in addition to concomitant peripheral nerve blocks and local anesthetics. Although effective, PCA IV opioids do not provide optimal results with fast track rehabilitation protocols. METHODS: The present is a retrospective study comparing the novel sublingual sufentanil PCA system (SSTS) to our standard of care foreseeing continuous femoral nerve block (cFNB) within a multimodal analgesic in a TKA fast-track protocol...
March 20, 2018: Journal of Experimental Orthopaedics
Ramón Cugat, Eduard Alentorn-Geli, Xavier Cuscó, Jordi Navarro, Gilbert Steinbacher, Pedro Álvarez-Díaz, Roberto Seijas, David Barastegui, Montse García-Balletbó
Posterior cruciate ligament reconstruction using the transtibial technique provides successful clinical outcomes. However, a bone-patellar tendon-bone (BTB) autograft with the transtibial technique has not been used by some surgeons because of concerns with graft passage from the tibial to the femoral tunnels (sharp turn) that can damage graft fibers. In the present surgical technique, an arthroscopic, transtibial, single-bundle technique for posterior cruciate ligament reconstruction using the BTB autograft with an easy and effective technical tip to facilitate graft passage is presented...
February 2018: Arthroscopy Techniques
Don C Beringer
No abstract text is available yet for this article.
January 2018: Clinical Orthopaedics and related Research
Stephen Yu, John Dundon, Olga Solovyova, Joseph Bosco, Richard Iorio
BACKGROUND: TKA pain management protocols vary widely with no current consensus on a standardized pain management regimen. Multimodal TKA pain management protocols aim to address pain control, facilitate functional recovery, and maintain patient satisfaction. QUESTIONS/PURPOSES: (1) Did changes to our pain management protocol, specifically adding liposomal bupivacaine, eliminating patient-controlled analgesia (PCA), and discontinuing femoral nerve blocks (FNBs), affect narcotic consumption after TKA? (2) Did these changes to our pain management protocols affect patient-reported pain scores? (3) Does the use of an immediate postoperative PCA affect rapid rehabilitation and functional recovery? (4) How did changes to our pain management regimen affect discharge disposition and pain-related Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores? METHODS: We retrospectively analyzed an institutional arthroplasty database between September 2013 and September 2015 containing 1808 patients who underwent primary TKA...
January 2018: Clinical Orthopaedics and related Research
Joseph J Kavolus, David Sia, Hollis G Potter, David E Attarian, Paul F Lachiewicz
BACKGROUND: Surgeon-performed periarticular injections and anesthesiologist-performed femoral nerve or adductor canal blocks with local anesthetic are in common use as part of multimodal pain management regimens for patients undergoing TKA. However, femoral nerve blocks risk causing quadriceps weakness and falls, and anesthesiologist-performed adductor canal blocks are costly in time and resources and may be unreliable. We investigated the feasibility of a surgeon-performed saphenous nerve ("adductor canal") block from within the knee at the time of TKA...
January 2018: Clinical Orthopaedics and related Research
Rebecca-Lea Smith, Richard Doyle
No abstract text is available yet for this article.
March 2, 2018: British Journal of Hospital Medicine
Andres Zorrilla-Vaca, Jinlei Li
INTRODUCTION: Femoral nerve block (FNB) appears to have higher postoperative analgesic benefits compared with the patient-controlled analgesia (PCA) in total knee arthroplasty (TKA). However, the role of sciatic nerve block (SNB) as a complement to FNB remains controversial. We performed a meta-analysis assessing the benefits of the SNB as a complement to FNB, as well as comparing the efficacy of single-injection versus continuous SNB in TKA. METHODS: Our group conducted a systematic literature search in PubMed, EMBASE and Google Scholar...
March 8, 2018: Journal of Anesthesia
Ke Lu, Tianshu Shi, Lan Li, Kaijia Zhang, Xiaobo Zhu, Siyu Shen, Fei Yu, Huajian Teng, Xiang Gao, Huangxian Ju, Wei Wang, Qing Jiang
Zhuangguguanjie formulation (ZG) can provide noticeable relief from joint pain in patients suffering from knee osteoarthritis (OA). However, the underlying mechanism has not been fully described. Male C57BL/6 mice were administered either ZG or normal saline (NS) following surgical destabilization of the medial meniscus (DMM). At weeks 4, 6 and 8 (post-surgery), knee joints were harvested and assessed with Safranin-O staining. Blood serum was collected and tested. In vitro analysis was carried out to evaluate the effects of ZG on the expression of the OA-related genes...
2018: American Journal of Translational Research
Qian Wen, Shimeng Zhang, Xialin Du, Ruining Wang, Yanfen Li, Honglin Liu, Shengfeng Hu, Chaoying Zhou, Xinying Zhou, Li Ma
Absence of effective therapeutic methods for avascular necrosis of femoral head (ANFH) is still perplexing the world's medical community. Bone marrow mesenchymal stem cells (BMSCs) adoptive cell therapy combined with core decompression is a promising modality, which is highly dependent on the cellular activities of BMSCs. Hepatocyte growth factor (HGF) is a survival factor for BMSCs, yet the underlying mechanism is not fully elucidated. In this study, the effects of multiplicity of infections (MOIs) of recombinant adenovirus carrying HGF gene (rAd-HGF) on human BMSC proliferation and osteogenic differentiation were systemically examined...
March 5, 2018: International Journal of Molecular Sciences
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
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
Johannes L Bron, Jeanette Verhart, Inger N Sierevelt, Dirk De Vries, Hylke J Kingma, Maarten V Rademakers
Background and purpose - The use of local infiltration anesthesia (LIA) has become one of the cornerstones of rapid recovery protocols in total knee arthroplasty patients during the past decade. In total hip arthroplasty (THR), however, the study results are more variable and LIA has therefore not yet been generally accepted. There is no consensus on which structure should be infiltrated and the cutaneous nerves are generally neglected. Hence, we hypothesized a pain-reducing effect of specifically blocking these nerves...
March 1, 2018: Acta Orthopaedica
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)
Georg Matziolis, Tanja Mueller, Frank Layher, Andreas Wagner
PURPOSE: Although the spacer block technique has been recommended for the implantation of unicompartmental knee arthroplasty (UKA), there is still a lack of data concerning the resulting component positioning. METHODS: This retrospective study included 193 consecutive patients who had undergone medial UKA using the spacer technique. On the basis of the postoperative long standing radiographs, the coronal component alignment was determined in relation to the mechanical axes and the sagittal component alignment in relation to the anatomical axes of the tibia and femur...
February 26, 2018: Archives of Orthopaedic and Trauma Surgery
Ruixue Hou, Hong Wang, Lianhua Chen, Yimin Qiu, Shitong Li
Objectives: Clinical observation, as well as randomized controlled trials, indicated an increasing rate of postoperative cognitive dysfunction (POCD) with increasing depth of general anesthesia. However, the findings are subject to bias due to varying degree of analgesia. In this trial, we compared the rate of POCD between patients receiving light versus high anesthesia while holding analgesia comparable using nerve block. Methods: Elderly patients (≧60 years) receiving elective total knee replacement were randomized to receive the surgery under general anesthesia at BIS 40-50 (LOBIS group) or BIS 55-65 (HIBIS group)...
February 2018: Brain and Behavior
Xiaona Jin, Baozhen Zhou, Dangfeng Zhang
BACKGROUND: Previous studies have suggested that tumor necrosis factor a (TNF-a), encoded by TNF gene, can increase osteoclast formation, and that specific alleles of the TNF gene are associated with postmenopausal osteoporosis susceptibility in some populations; however, the exact molecular mechanism remains unknown. AIMS: To investigate the potential association of nineteen polymorphisms of the TNF gene with postmenopausal osteoporosis and bone mineral density (BMD) traits in a sample of 1288 postmenopausal women from the Han Chinese population...
February 26, 2018: Genetic Testing and Molecular Biomarkers
M Nersesjan, D Hägi-Pedersen, J H Andersen, O Mathiesen, J B Dahl, L Broeng, K H Thybo
BACKGROUND: The lateral femoral cutaneous nerve (LFCN) block may be used for post-operative pain management in patients undergoing total hip arthroplasty. The aim of this trial was to investigate the sensory coverage of the posterior and the lateral incision lines and the involvement of the femoral nerve after an LFCN block. METHODS: The study was a randomised, blinded trial in 20 healthy volunteers. All subjects received a bilateral LFCN block randomised to 8 ml ropivacaine on the right side and 8 ml isotonic saline on the left side, or vice versa...
February 21, 2018: Acta Anaesthesiologica Scandinavica
Lu-Kai Zhang, Jian-Xiong Ma, Ming-Jie Kuang, Xin-Long Ma
BACKGROUND: Total knee arthroplasty (TKA) is accompanied by moderate-to-severe postoperative pain. Postoperative pain will hamper functional recovery and lower patients' satisfaction with surgery. Recently, periarticular local infiltration analgesia (LIA) has been widely used in TKA. However, there is no definite answer as to the efficacy and safety of LIA compared with femoral nerve block (FNB). METHOD: Randomized controlled trials about relevant studies were searched from PubMed (1996 to July 2017), Embase (1980 to July 2017), and Cochrane Library (CENTRAL, July 2017)...
January 11, 2018: Journal of Arthroplasty
Hany M El-Bassossy, Mona F Mahmoud, Basma G Eid
Despite the reported reduction in blood pressure in hypertensive patients treated with allopurinol, the mechanism of the allopurinol hypotensive effect is still unclear. In the current study, the hypotensive effect of allopurinol has been fully investigated in hypertensive rats. Hypertension was induced in rats by angiotensin II (120 ng/min/kg) infusion for two weeks. Rats were then subjected to real-time recording of blood pressure, left ventricular pressure and volume and surface ECG. After 10 min of basal recording, allopurinol was slowly injected into the femoral vein with a dose of 10 μmole/kg...
February 14, 2018: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
Hao Guo, Lei Zhao, Bodong Wang, Xia Li, Hao Bai, Haixiao Liu, Liang Yue, Wei Guo, Zhenyuan Bian, Li Gao, Dayun Feng, Yan Qu
Remote limb ischemic postconditioning (RIPoC) is a promising adjunct treatment for cerebral ischemia-reperfusion (IR) injury. However, the underlying mechanisms have not been fully elucidated yet. The present study aims to investigate potential involvement and regulatory mechanisms of autophagy in RIPoC treatment against cerebral IR injury in mice. Mice were subjected to 2 h middle cerebral artery occlusion (MCAO) then treated with vehicle, 3-methyladenine (3-MA, an autophagy inhibitor), or compound C (an AMPK inhibitor) at the onset of reperfusion...
February 13, 2018: Brain Research Bulletin
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