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Femoral block

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https://www.readbyqxmd.com/read/28092318/opening-injection-pressure-is-higher-in-intraneural-compared-with-perineural-injections-during-simulated-nerve-blocks-of-the-lower-limb-in-fresh-human-cadavers
#1
Kris Vermeylen, Marlies Hermans, Filiep Soetens, Evie Vereecke, Thorsten Steinfeldt, Gerbrand Groen, Admir Hadzic, Marc Van de Velde
BACKGROUND AND OBJECTIVES: Needle-induced nerve trauma and intraneural injection can lead to neurologic injury during peripheral nerve blocks. In this study, we assessed the utility of opening injection pressure (OIP), time to OIP, and rate of rise to OIP in detecting needle-nerve contact and intraneural injection. METHODS: Five common ultrasound-guided blocks of the femoral, saphenous, subgluteal sciatic, tibial, and common peroneal nerves were simulated in 10 fresh cadavers...
January 13, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28086940/ultrasound-guided-percutaneous-peripheral-nerve-stimulation-for-analgesia-following-total-knee-arthroplasty-a-prospective-feasibility-study
#2
Brian M Ilfeld, Christopher A Gilmore, Stuart A Grant, Michael P Bolognesi, Daniel J Del Gaizo, Amorn Wongsarnpigoon, Joseph W Boggs
BACKGROUND: Peripheral nerve stimulation has been used for decades to treat chronic pain but has not been used for postoperative analgesia due to multiple limitations, beginning with invasive electrode placement. With the development of small-diameter/gauge leads enabling percutaneous insertion, ultrasound guidance for accurate introduction, and stimulators small enough to be adhered to the skin, neurostimulation may now be provided in a similar manner to continuous peripheral nerve blocks...
January 13, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/28079176/adductor-canal-block-versus-femoral-nerve-block-for-total-knee-arthroplasty-a-meta-analysis-of-randomized-controlled-trials
#3
Duan Wang, Yang Yang, Qi Li, Shen-Li Tang, Wei-Nan Zeng, Jin Xu, Tian-Hang Xie, Fu-Xing Pei, Liu Yang, Ling-Li Li, Zong-Ke Zhou
Femoral nerve blocks (FNB) can provide effective pain relief but result in quadriceps weakness with increased risk of falls following total knee arthroplasty (TKA). Adductor canal block (ACB) is a relatively new alternative providing pure sensory blockade with minimal effect on quadriceps strength. The meta-analysis was designed to evaluate whether ACB exhibited better outcomes with respect to quadriceps strength, pain control, ambulation ability, and complications. PubMed, Embase, Web of Science, Wan Fang, China National Knowledge Internet (CNKI) and the Cochrane Database were searched for RCTs comparing ACB with FNB after TKAs...
January 12, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28061515/spacer-based-gap-balancing-in-total-knee-arthroplasty-clinical-success-with-a-reproducible-technique
#4
Frédéric Lavoie
Purpose Proper coronal and transverse ligament balancing is an important aspect of total knee arthroplasty (TKA) and has an impact on postoperative outcome. Many variations of the gap balancing technique were described to address this challenge, most of them using various tensioning devices, but none for which the use is widespread. The aim of this paper is to describe a gap technique variant for TKA using spacer blocks and report the clinical results for a cohort of patients on which it was used. Methods A total of 114 TKAs were performed in 101 patients using a standardized surgical technique that integrates ligament balancing with sizing and positioning of the femoral component...
January 6, 2017: Journal of Knee Surgery
https://www.readbyqxmd.com/read/28050474/technique-efficiency-and-safety-of-different-nerve-blocks-for-analgesia-in-laser-ablation-and-sclerotherapy-for-lower-limb-superficial-venous-insufficiency-a-multicentre-experience
#5
Krishna Prasad Premnath Bellam, Binu Joy, Abhilash Sandhyala, Kiran Naiknaware, Brijesh Ray, Vijayakumar
INTRODUCTION: Laser ablation and sclerotherapy, as minimally invasive alternatives to surgery for varicose veins, have good efficacy, safety and cosmetic result. Some form of anaesthesia is generally used for pain control. AIM: To describe the technique and evaluate the efficacy and safety of femoral, saphenous and sciatic nerve blocks in isolation or in combination for analgesia during laser ablation and sclerotherapy for lower limb varicose veins. MATERIALS AND METHODS: In this prospective observational study, over a period of 33 months, in 856 limbs of 681 patients with varicose veins, ultrasound guided femoral, saphenous and sciatic nerve blocks for analgesia were performed in 769, 808 and 52 instances respectively; following which, endovenous laser ablation, sclerotherapy or combination of both were carried out using standard practice...
November 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28043809/physical-training-associated-with-enalapril-but-not-to-losartan-results-in-better-cardiovascular-autonomic-effects
#6
Karina Delgado Maida, Ada Clarice Gastaldi, Tabata de Paula Facioli, João Eduardo de Araújo, Hugo Celso Dutra de Souza
BACKGROUND: We investigated the cardiovascular autonomic effects of physical training associated with Enalapril or Losartan pharmacological treatments in spontaneously hypertensive rats (SHR). METHODS: SHRs, 18weeks of age (N=48) was assigned to either sedentary (N=24) and trained (N=24; aerobic training by swimming for 10wk). Each group was subdivided in 3 subgroups (N=8) vehicle (control); Enalapril (10mg·kg(-1)·d(-1)); and Losartan (5mg·kg(-1)·d(-1)). All animals received a 10-week treatment in drinking water...
December 24, 2016: Autonomic Neuroscience: Basic & Clinical
https://www.readbyqxmd.com/read/28035016/esmolol-infusion-versus-propranolol-infusion-effects-on-heart-rate-and-blood-pressure-in-healthy-volunteers
#7
Matthew D Muller, Tariq Ali Ahmad, Alvaro F Vargas Pelaez, David N Proctor, Anthony S Bonavia, J Carter Luck, Stephan R Maman, Amanda J Ross, Urs A Leuenberger, Patrick M McQuillan
Despite its widespread clinical use, the β1 adrenergic receptor antagonist esmolol hydrochloride is not commonly used in human physiology research and the effective dose (compared to the nonselective β-blocker propranolol) is unclear. In four separate studies, we used cycle ergometry exercise and infusions of isoproterenol and epinephrine to test the heart rate (HR)- lowering effect of esmolol compared to propranolol and saline in healthy humans. In Cohort 1, both esmolol (ΔHR: 57 ± 6) and propranolol (ΔHR: 56 ± 7) attenuated exercise tachycardia compared to saline (ΔHR: 88 ± 17)...
December 29, 2016: Journal of Applied Physiology
https://www.readbyqxmd.com/read/28033291/adductor-canal-block-versus-femoral-nerve-block-combined-with-sciatic-nerve-block-as-an-anesthetic-technique-for-hindfoot-and-ankle-surgery-a-prospective-randomized-noninferiority-trial
#8
Han Bum Joe, Ho Sik Choo, Ji Sang Yoon, Sang Eon Oh, Jae Ho Cho, Young Uk Park
BACKGROUND: A femoral nerve block (FNB) in combination with a sciatic nerve block (SNB) is commonly used for anesthesia and analgesia in patients undergoing hindfoot and ankle surgery. The effects of FNB on motor function, related fall risk, and rehabilitation are controversial. An adductor canal block (ACB) potentially spares motor fibers in the femoral nerve, but the comparative effect on hindfoot and ankle surgeries between the 2 approaches is not yet well defined. We hypothesized that compared to FNB, ACB would cause less weakness in the quadriceps and produce similar pain scores during and after the operation...
December 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28029532/role-of-periarticular-liposomal-bupivacaine-infiltration-in-patients-undergoing-total-knee-arthroplasty-a-meta-analysis-of-comparative-trials
#9
Preet Mohinder Singh, Anuradha Borle, Anjan Trikha, Lia Michos, Ashish Sinha, Basavana Goudra
BACKGROUND: Over last 2 years, many trials have evaluated newly approved liposomal bupivacaine for periarticular infiltration in total knee arthroplasty (TKA) with mixed results. Our meta-analysis attempts to consolidate the results and make evidence-based conclusions. METHODS: Trails comparing periarticular infiltration of liposomal bupivacaine to conventional analgesic regimens for total knee arthroplasty published till June 2016 were searched in medical database...
October 8, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28027249/neurectomy-for-the-treatment-of-chronic-postoperative-pain-after-surgery-of-the-trunk
#10
Purushottam Nagarkar, Smita Ramanadham, Khalil Chamseddin, Avneesh Chhabra, Shai M Rozen
BACKGROUND: Incidence of chronic postoperative neurogenic pain after open and laparoscopic trunk operations is reported between 1 and 20 percent, rendering a large population in the United States and worldwide. One possible treatment is selective surgical neurectomy. METHODS: All patients who underwent neurectomy for chronic trunk or groin postoperative neurogenic pain were identified. Based on individual history and examination, patients underwent neurectomies of the ilioinguinal, iliohypogastric, genitofemoral, lateral-femoral cutaneous, or intercostal nerves...
January 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28025820/adductor-canal-blocks-changing-practice-patterns-and-associated-quality-profile
#11
M M Masaracchia, M D Herrick, M J Barrington, P R Hartmann, B D Sites
BACKGROUND: Femoral nerve blocks have been the gold standard approach for post-operative analgesia following total knee arthroplasty; however, the adductor canal block has recently gained popularity due to less block-induced motor weakness. The primary aim of this time-series analysis was to identify whether regional anesthesia practice changes have occurred for total knee arthroplasty. Our secondary aim was to assess for possible associated changes in safety and quality. METHODS: Using a 20-member clinical registry, we examined the practice patterns and safety around the performance of adductor canal blocks for all total knee arthroplasties between 18 July 2011 to 9 October 2015...
December 26, 2016: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28018749/focused-training-for-humanitarian-responders-in-regional-anesthesia-techniques-for-a-planned-randomized-controlled-trial-in-a-disaster-setting
#12
Adam R Aluisio, Carrei Teicher, Tess Wiskel, Allysia Guy, Adam Levine
BACKGROUND: Lower extremity trauma during earthquakes accounts for the largest burden of geophysical disaster-related injuries. Insufficient pain management is common in disaster settings, and regional anesthesia (RA) has the potential to reduce pain in injured patients beyond current standards. To date, no prospective research has evaluated the use of RA in a disaster setting. This cross-sectional study assesses knowledge translation and skill acquisition outcomes for lower extremity RA performed with and without ultrasound guidance among a cohort of Médecins Sans Frontières (MSF) volunteers who will function as proceduralists in a planned randomized controlled trial evaluating the efficacy of RA for pain management in an earthquake setting...
November 16, 2016: PLoS Currents
https://www.readbyqxmd.com/read/28017173/femoral-nerve-block-versus-intravenous-fentanyl-in-adult-patients-with-hip-fractures-a-systematic-review
#13
Flávia Vieira Guimarães Hartmann, Maria Rita Carvalho Garbi Novaes, Marta Rodrigues de Carvalho
BACKGROUND: Hip fractures configure an important public health issue and are associated with high mortality taxes and lose of functionality. Hip fractures refer to a fracture occurring between the edge of the femoral head and 5cm below the lesser trochanter. They are common in orthopedic emergencies. The number of proximal femoral fractures is likely to increase as the population ages. The average cost of care during the initial hospitalization for hip fracture can be estimated about US$ 7,000 per patient...
January 2017: Brazilian Journal of Anesthesiology
https://www.readbyqxmd.com/read/28017161/ultrasound-guided-peripheral-nerve-blocks-in-anticoagulated-patients-case-series
#14
Luis Eduardo Silveira Martins, Leonardo Henrique Cunha Ferraro, Alexandre Takeda, Masashi Munechika, Maria Angela Tardelli
BACKGROUND AND OBJECTIVES: The advent of ultrasound has brought many benefits to peripheral nerve blocks. It includes both safety and effectiveness, given the possibility of visualizing the neurovascular structures and the needle during the procedure. Despite these benefits, there is no consensus in the literature on the use of this technique in anticoagulated patients or with other coagulation disorders. Moreover, peripheral blocks vary in depth, spreadability, and possibility of local compression...
January 2017: Brazilian Journal of Anesthesiology
https://www.readbyqxmd.com/read/28009637/novel-needle-guide-reduces-time-to-perform-ultrasound-guided-femoral-nerve-catheter-placement-a-randomised-controlled-trial
#15
Alparslan Turan, Rovnat Babazade, Hesham Elsharkawy, Wael Ali Sakr Esa, Kamal Maheshwari, Ehab Farag, Nicole M Zimmerman, Loran Mounir Soliman, Daniel I Sessler
BACKGROUND: Ultrasound-guided nerve blocks have become the standard when performing regional nerve blocks in anaesthesia. Infiniti Plus (CIVCO Medical Solutions, Kalona, Iowa, USA) is a needle guide that has been recently developed to help clinicians in performing ultrasound-guided nerve blocks. OBJECTIVES: We tested the hypothesis that femoral nerve catheter placement carried out with the Infiniti Plus needle guide will be quicker to perform than without the Infiniti Plus...
December 22, 2016: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28005125/the-role-of-liposomal-bupivacaine-in-value-based-care
#16
Richard Iorio
Multimodal pain control strategies are crucial in reducing opioid use and delivering effective pain management to facilitate improved surgical outcomes. The utility of liposomal bupivacaine in enabling effective pain control in multimodal strategies has been demonstrated in several studies, but others have found the value of liposomal bupivacaine in such approaches to be insignificant. At New York University Langone Medical Center, liposomal bupivacaine injection and femoral nerve block were compared in their delivery of efficacious and cost-effective multimodal analgesia among patients undergoing total joint arthroplasty (TJA)...
November 2016: American Journal of Orthopedics
https://www.readbyqxmd.com/read/28005122/opioid-sparing-pain-control-in-outpatient-total-joint-arthroplasty
#17
John W Barrington
Postoperative pain management is vital to promoting recovery and improving clinical outcomes. Although improved understanding of pain pathways has led to the development of varied approaches for controlling pain after surgery, some approaches are associated with potentially harmful side effects. Several lines of evidence have demonstrated that opioid analgesics can have unwanted adverse effects on patients having surgery. Similarly, risks associated with femoral nerve blocks have outweighed the benefits. Liposomal bupivacaine has shown efficacy in reducing the need for opioid analgesics and nerve blocks...
November 2016: American Journal of Orthopedics
https://www.readbyqxmd.com/read/28002228/defining-the-location-of-the-adductor-canal-using-ultrasound
#18
Wan Yi Wong, Siska Bjørn, Jennie Maria Christin Strid, Jens Børglum, Thomas Fichtner Bendtsen
BACKGROUND AND OBJECTIVES: The precise location of the adductor canal remains controversial among anesthesiologists. In numerous studies of the analgesic effect of the so-called adductor canal block for total knee arthroplasty, the needle insertion point has been the midpoint of the thigh, determined as the midpoint between the anterior superior iliac spine and base of patella. "Adductor canal block" may be a misnomer for an approach that is actually an injection into the femoral triangle, a "femoral triangle block...
December 19, 2016: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/27999958/use-of-patient-specific-cutting-blocks-reduces-blood-loss-after-total-knee-arthroplasty
#19
Vicente J León, María A Lengua, Víctor Calvo, Alonso J Lisón
Total knee arthroplasty (TKA) is associated with substantial blood loss. Sources of bleeding are the femoral and tibial intramedullary canals, which are violated during implantation using standard instrumentation. Patient-specific instrumentation (PSI) and computer-assisted surgery (CAS) do not require violation of the intramedullary canals. Therefore, we sought to assess the impact of these methods on blood loss and transfusion requirement. A retrospective cohort study was conducted in a series of 107 consecutive primary TKAs...
December 20, 2016: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/27994198/osteoprotegerin-polymorphisms-are-associated-with-alcohol-induced-osteonecrosis-of-femoral-head-in-chinese-han-population-from-henan-province
#20
Yizhou Li, Yongchang Guo, Quanjian Wang, Yongri Ouyang, Yuju Cao, Tianbo Jin, Jianzhong Wang
Alcohol-induced osteonecrosis of femoral head (ONFH) is one of the most important pathogenesis of nontraumatic ONFH. However, its pathogenesis mechanism is still unknown. Osteoprotegerin (OPG) has been implicated in multiple functions including blocking osteoclast maturation, controlling vascular calcifications, promoting tumour growth and metastasis. This study is focussed on OPG gene polymorphisms associated with alcohol-induced ONFH. A total of 509 participants (209 patients and 300 normal individuals) were recruited, and we selected 13 single-nucleotide polymorphisms (SNPs) to evaluate the association between genetic susceptibility variants and alcohol-induced ONFH by using the χ(2) test and genetic model analysis...
December 2016: Journal of Genetics
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