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https://www.readbyqxmd.com/read/29245259/efficacy-of-pudendal-nerve-block-for-alleviation-of-catheter-related-bladder-discomfort-in-male-patients-undergoing-lower-urinary-tract-surgeries-a-randomized-controlled-double-blind-trial
#1
Li Xiaoqiang, Zhang Xuerong, Liu Juan, Bechu Shelley Mathew, Yin Xiaorong, Wan Qin, Luo Lili, Zhu Yingying, Luo Jun
BACKGROUND: Catheter-related bladder discomfort (CRBD) to an indwelling urinary catheter is defined as a painful urethral discomfort, resistant to conventional opioid therapy, decreasing the quality of postoperative recovery. According to anatomy, the branches of sacral somatic nerves form the afferent nerves of the urethra and bladder triangle, which deriving from the ventral rami of the second to fourth sacral spinal nerves, innervating the urethral muscles and sphincter of the perineum and pelvic floor; as well as providing sensation to the penis and clitoris in males and females, which including the urethra and bladder triangle...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29214081/a-rare-complication-of-a-tap-block-performed-after-caesarean-delivery
#2
Osman Nawazish Salaria, Murlikrishna Kannan, Bryan Kerner, Howard Goldman
The transversus abdominis plane block is a regional anesthesia technique that has become popular. Being a relatively simple procedure, the TAP block has an excellent safety profile and major complications are rare. We present a case of transient femoral nerve palsy occurring after a TAP block with involvement of the sacral plexus for a patient who had undergone a caesarean section.
2017: Case Reports in Anesthesiology
https://www.readbyqxmd.com/read/29213283/lateral-supratrochanteric-approach-to-sciatic-and-femoral-nerve-blocks-in-children-a-feasibility-study
#3
Andrew A Albokrinov, Ulbolhan A Fesenko, Taras B Huz, Valentyna M Perova-Sharonova
Background: Sciatic and femoral nerve blocks (SNB and FNB) result in effective lower limb analgesia. Classical SNB and FNB require patient repositioning which can cause pain and discomfort. Alternative approaches to sciatic and femoral nerve blocks in supine patients can be useful. Materials and Methods: Neurostimulator-guided SNB and FNB from the lateral supratrochanteric approach were performed. Local anesthetic spread in SNB and FNB after radiographic opacification was analyzed...
2017: Anesthesiology Research and Practice
https://www.readbyqxmd.com/read/29173661/sacroiliac-joint-interventions
#4
REVIEW
David A Soto Quijano, Eduardo Otero Loperena
Sacroiliac joint (SIJ) pain is an important cause of lower back problems. Multiple SIJ injection techniques have been proposed over the years to help in the diagnosis and treatment of this condition. However, the SIJ innervation is complex and variable, and truly intra-articular injections are sometimes difficult to obtain. Different sacroiliac joint injections have shown to provide pain relief in patients suffering this ailment. Various techniques for intraarticular injections, sacral branch blocks and radiofrequency ablation, both fluoroscopy guided and ultrasound guided are discussed in this paper...
February 2018: Physical Medicine and Rehabilitation Clinics of North America
https://www.readbyqxmd.com/read/29161549/ultrasound-guided-versus-conventional-injection-for-caudal-block-in-children-a-prospective-randomized-clinical-study
#5
Ali Ahiskalioglu, Ahmet Murat Yayik, Elif Oral Ahiskalioglu, Mursel Ekinci, Birzat Emre Gölboyu, Erkan Cem Celik, Haci Ahmet Alici, Akgun Oral, Saban Oguz Demirdogen
STUDY OBJECTIVE: The aim of this study was to compare the efficacies of ultrasound guided sacral hiatus injection and conventional sacral canal injection performed for caudal block in children. DESIGN: Randomized controlled clinical trial. SETTING: Operating rooms of university hospital of Erzurum, Turkey. PATIENTS: One hundred-thirty four children, American Society of Anesthesiologists I-II, between the ages of 5 and 12, scheduled for elective phimosis and circumcision surgery...
November 18, 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28931549/sacral-neuromodulation-blocks-pudendal-inhibition-of-reflex-bladder-activity-in-cats-insight-into-the-efficacy-of-sacral-neuromodulation-in-fowler-s-syndrome
#6
Xing Li, Jamie Uy, Michelle Yu, Shun Li, Katherine Theisen, Jeffrey Browning, Bing Shen, Jicheng Wang, James R Roppolo, William C de Groat, Changfeng Tai
This study tested the hypothesis that sacral neuromodulation, i.e. electrical stimulation of afferent axons in sacral spinal root, can block pudendal afferent inhibition of the micturition reflex. In α-chloralose anesthetized cats, pudendal nerve stimulation (PNS) at 3-5 Hz was used to inhibit bladder reflex activity while the sacral S1 or S2 dorsal root was stimulated at 15-30 Hz to mimic sacral neuromodulation and to block the bladder inhibition induced by PNS. The intensity threshold (T) for PNS or S1/S2 dorsal root stimulation (DRS) to induce muscle twitch of anal sphincter or toe was determined...
September 20, 2017: American Journal of Physiology. Regulatory, Integrative and Comparative Physiology
https://www.readbyqxmd.com/read/28885726/achieving-interfragmentary-compression-without-special-drilling-technique-or-screw-design
#7
Jonathan Eastman, Bradley Deafenbaugh, Blaine Christiansen, Tanya Garcia-Nolen, Mark Lee
Traditional fracture fixation teaching suggests that fully threaded screws do not provide interfragmentary compression unless placed through a glide hole. Based on this assumption, pelvic surgeons typically use fully threaded screws in the treatment of comminuted transforaminal sacral fractures to limit iatrogenic neuroforaminal stenosis. Clinical experience with fully threaded screws suggests that interfragmentary compression actually does occur. We hypothesized that the use of a fully threaded screw does not produce any interfragmentary compression and that there is no difference in insertional torque between partially threaded and fully threaded screws...
September 8, 2017: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
https://www.readbyqxmd.com/read/28882370/caudal-epidural-anesthesia-in-mares-after-bicarbonate-addition-to-a-lidocaine-epinephrine-combination
#8
Patricia C Duarte, Cahuê F R Paz, Alvaro P L Oliveira, Thairê P Maróstica, Leticia O Cota, Rafael R Faleiros
OBJECTIVE: To investigate the nociceptive and clinical effects of buffering a lidocaine-epinephrine solution with sodium bicarbonate in caudal epidural block in mares. STUDY DESIGN: Prospective randomized controlled trial. ANIMALS: Six mixed-breed mares weighing 350-440 kg. METHODS: Each animal was administered two caudal epidural injections, 72 hours apart, using different solutions prepared immediately before injection...
January 11, 2017: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/28781205/psoas-compartment-and-sacral-plexus-block-via-electrostimulation-for-pelvic-limb-amputation-in-dogs
#9
Jonathon M Congdon, Pedro Boscan, Clara S S Goh, Marlis Rezende
OBJECTIVE: To assess the efficacy of psoas compartment and sacral plexus block for pelvic limb amputation in dogs. STUDY DESIGN: Prospective clinical study. ANIMALS: A total of 16 dogs aged 8±3 years and weighing 35±14 kg (mean±standard deviation). METHODS: Dogs were administered morphine (0.5 mg kg(-1)) and atropine (0.02 mg kg(-1)); anesthesia was induced with propofol and maintained with isoflurane. Regional blocks were performed before surgery in eight dogs with bupivacaine (2...
March 22, 2017: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/28723774/relationship-between-first-dorsal-sacral-foramen-and-lumbar-facet-joint-connecting-line-in-south-korea-populations-retrospective-study
#10
Young Deog Cha, Jae Kyu Choi, Chun Woo Yang, Hyun Kyoung Lim, Gyoung A Heo, Byung-Gun Kim
The first sacral nerve root block (S1 nerve root block) is a practical procedure for patients with radiating lower back pain. In general, S1 nerve root block is performed under x-ray fluoroscopy. It is necessary to adjust the position of the patient and angle of fluoroscopy to properly visualize the first dorsal sacral foramen (dorsal S1 foramen). The purpose of this study was to analyze the location of dorsal S1 foramen and lumbar facet joint in S1 nerve root block.A total of 388 patients undergoing x-ray fluoroscopy-guided S1 nerve root block in the prone position were examined...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28709890/a-novel-collaborative-protocol-for-successful-management-of-penile-pain-mediated-by-radiculitis-of-sacral-spinal-nerve-roots-from-tarlov-cysts
#11
Irwin Goldstein, Barry R Komisaruk, Rachel S Rubin, Sue W Goldstein, Stacy Elliott, Jennifer Kissee, Choll W Kim
INTRODUCTION: Since 14 years of age, the patient had experienced extreme penile pain within seconds of initial sexual arousal through masturbation. Penile pain was so severe that he rarely proceeded to orgasm or ejaculation. After 7 years of undergoing multiple unsuccessful treatments, he was concerned for his long-term mental health and for his future ability to have relationships. AIM: To describe a novel collaboration among specialists in sexual medicine, neurophysiology, and spine surgery that led to successful management...
September 2017: Sexual Medicine
https://www.readbyqxmd.com/read/28681191/low-back-pain-due-to-middle-cluneal-nerve-entrapment-neuropathy
#12
Kyongsong Kim, Toyohiko Isu, Juntaro Matsumoto, Kazuyoshi Yamazaki, Masanori Isobe
PURPOSE: The etiology of low back pain (LBP) is complicated and the diagnosis can be difficult. Superior cluneal nerve entrapment neuropathy (SCN-EN) is a known cause of LBP, although the middle cluneal nerve (MCN) can be implicated in the elicitation of LBP. METHODS: A 76-year-old woman with a 4-year history of severe LBP was admitted to our department in a wheelchair. She complained of bilateral LBP that was exacerbated by lumbar movement. Her pain was severe on the right side and she also suffered right leg pain and numbness...
July 5, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28676364/neurogenic-pelvic-pain
#13
REVIEW
Nicholas Elkins, Jason Hunt, Kelly M Scott
Pelvic neuralgias frequently cause severe pain and may have associated bladder, bowel, or sexual dysfunctions which also impact quality of life. This article explores the etiology, epidemiology, presentation and treatment of common causes of neurogenic pelvic pain, including neuralgia of the border nerves (ilioinguinal, iliohypogastric, and genitofemoral), pudendal neuralgia, clunealgia, sacral radiculopathies caused by Tarlov cysts, and cauda equina syndrome. Treatment of pelvic neuralgia includes conservative measures such as pelvic physical therapy, lifestyle modification, and medications with escalation to more invasive and novel treatments such as nerve blocks, radiofrequency ablation, cryoablation, neuromodulation and neurectomy/neurolysis if conservative treatments are ineffective...
August 2017: Physical Medicine and Rehabilitation Clinics of North America
https://www.readbyqxmd.com/read/28651520/surgical-anesthesia-with-a-combination-of-t12-paravertebral-block-and-lumbar-plexus-sacral-plexus-block-for-hip-replacement-in-ankylosing-spondylitis-care-compliant-4-case-reports
#14
Xijian Ke, Ji Li, Yong Liu, Xi Wu, Wei Mei
BACKGROUND: Anesthesia management for patients with severe ankylosing spondylitis scheduled for total hip arthroplasty is challenging due to a potential difficult airway and difficult neuraxial block. We report 4 cases with ankylosing spondylitis successfully managed with a combination of lumbar plexus, sacral plexus and T12 paravertebral block. CASE PRESENTATION: Four patients were scheduled for total hip arthroplasty. All of them were diagnosed as severe ankylosing spondylitis with rigidity and immobilization of cervical and lumbar spine and hip joints...
June 26, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28645869/real-time-changes-in-brain-activity-during-sacral-neuromodulation-for-overactive-bladder
#15
Bradley C Gill, Javier Pizarro-Berdichevsky, Pallab K Bhattacharyya, Thaddeus S Brink, Brian K Marks, Adrienne Quirouet, Sandip P Vasavada, Stephen E Jones, Howard B Goldman
PURPOSE: We performed functional magnetic resonance imaging to identify changes in brain activity during sacral neuromodulation in women with overactive bladder who were responsive to therapy. MATERIALS AND METHODS: Women recruited into the study had nonneurogenic refractory overactive bladder, responded to sacral neuromodulation and had had a stable program for at least 3 months with no subsequent overactive bladder treatment. Enrolled patients completed validated symptom and quality of life instruments before functional magnetic resonance imaging...
December 2017: Journal of Urology
https://www.readbyqxmd.com/read/28487040/immediate-postpartum-neurological-deficits-in-the-lower-extremity-a-prospective-observational-study
#16
A Richards, T McLaren, M J Paech, E A Nathan, E Beattie, N McDonnell
BACKGROUND: Neurological deficits noted immediately after childbirth are usually various obstetric neuropathies, but prospective studies are limited. The main study aim was to quantify and describe immediate postpartum neurological deficits of the lower extremity, including the buttocks. METHODS: A prospective observational study of postpartum women delivering in a single maternity hospital during three months of 2016. Among 1147 eligible women, 1019 were screened for symptoms of lower extremity numbness or weakness within eight to 32hours of delivery...
May 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28365529/giant-cell-tumour-of-bone-in-the-denosumab-era
#17
REVIEW
Lizz van der Heijden, P D Sander Dijkstra, Jean-Yves Blay, Hans Gelderblom
Giant cell tumour of bone (GCTB) is an intermediate locally aggressive primary bone tumour, occurring mostly at the meta-epiphysis of long bones. Overexpression of receptor activator of nuclear factor kappa-B ligand (RANKL) by mononuclear neoplastic stromal cells promotes recruitment of numerous reactive multinucleated osteoclast-like giant cells, causing lacunar bone resorption. Preferential treatment is curettage with local adjuvants such as phenol, alcohol or liquid nitrogen. The remaining cavity may be filled with bone graft or polymethylmethacrylate (PMMA) bone cement; benefits of the latter are a lower risk of recurrence, possibility of direct weight bearing and early radiographic detection of recurrences...
May 2017: European Journal of Cancer
https://www.readbyqxmd.com/read/28337460/caudal-epidural-block-an-updated-review-of-anatomy-and-techniques
#18
REVIEW
Sheng-Chin Kao, Chia-Shiang Lin
Caudal epidural block is a commonly used technique for surgical anesthesia in children and chronic pain management in adults. It is performed by inserting a needle through the sacral hiatus to gain entrance into the sacral epidural space. Using conventional blind technique, the failure rate of caudal epidural block in adults is high even in experienced hands. This high failure rate could be attributed to anatomic variations that make locating sacral hiatus difficult. With the advent of fluoroscopy and ultrasound in guiding needle placement, the success rate of caudal epidural block has been markedly improved...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28332251/measuring-the-depth-of-the-caudal-epidural-space-to-prevent-dural-sac-puncture-during-caudal-block-in-children
#19
Hyun Jeong Lee, Ji Young Min, Hyun Il Kim, Hyo-Jin Byon
BACKGROUND: Caudal blocks are performed through the sacral hiatus in order to provide pain control in children undergoing lower abdominal surgery. During the block, it is important to avoid advancing the needle beyond the sacrococcygeal ligament too much to prevent unintended dural puncture. This study used demographic data to establish simple guidelines for predicting a safe needle depth in the caudal epidural space in children. METHODS: A total of 141 children under 12 years old who had undergone lumbar-sacral magnetic resonance imaging were included...
May 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28328326/interleukin-12-and-interleukin-23-blockade-in-leukocyte-adhesion-deficiency-type-1
#20
Niki M Moutsopoulos, Christa S Zerbe, Teresa Wild, Nicolas Dutzan, Laurie Brenchley, Giovanni DiPasquale, Gulbu Uzel, Karen C Axelrod, Andrea Lisco, Lucia D Notarangelo, George Hajishengallis, Luigi D Notarangelo, Steven M Holland
A patient with leukocyte adhesion deficiency type 1 (LAD1) had severe periodontitis and an intractable, deep, nonhealing sacral wound. We had previously found a dominant interleukin-23-interleukin-17 signature at inflamed sites in humans with LAD1 and in mouse models of the disorder. Blockade of this pathway in mouse models has resulted in resolution of the immunopathologic condition. We treated our patient with ustekinumab, an antibody that binds the p40 subunit of interleukin-23 and interleukin-12 and thereby blocks the activity of these cytokines, inhibiting interleukin-23-dependent production of interleukin-17...
March 23, 2017: New England Journal of Medicine
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