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https://www.readbyqxmd.com/read/29717288/effects-of-adding-intrathecal-dexmedetomidine-to-hyperbaric-bupivacaine-for-saddle-spinal-block-in-adults-undergoing-peri-anal-surgeries
#1
Binod Gautam, Sushila Moktan Lama, Mona Sharma
BACKGROUND: Saddle spinal block is the first choice anesthetic technique for adults undergoing peri-anal surgeries. It prevents unnecessary high levels of analgesia and sympathetic block. However, it may not provide prolonged analgesia. This study aims to investigate analgesic effects of dexmedetomidine when added to hyperbaric bupivacaine in saddle spinal block. METHODS: Fifty otherwise healthy adults scheduled for uncomplicated peri-anal surgery were randomly allocated into two equal groups in this double-blinded study...
March 13, 2018: Journal of Nepal Health Research Council
https://www.readbyqxmd.com/read/29708263/parameters-and-functional-analysis-of-the-deep-epaxial-muscles-in-the-thoracic-lumbar-and-sacral-regions-of-the-equine-spine
#2
J A García Liñeiro, G H Graziotti, J M Rodríguez Menéndez, C M Ríos, N O Affricano, C L Victorica
The epaxial muscles produce intervertebral rotation in the transverse, vertical and axial axes. These muscles also counteract the movements induced by gravitational and inertial forces and movements produced by antagonistic muscles and the intrinsic muscles of the pelvic limb. Their fascicles are innervated by the dorsal branch of the spinal nerve, which corresponds to the metamere of its cranial insertion in the spinous process. The structure allows the function of the muscles to be predicted: those with long and parallel fibres have a shortening function, whereas the muscles with short and oblique fibres have an antigravity action...
April 30, 2018: Journal of Anatomy
https://www.readbyqxmd.com/read/29704223/low-thoracic-erector-spinae-plane-block-for-perioperative-analgesia-in-lumbosacral-spine-surgery-a-case-series
#3
Josh P Melvin, Rudolph J Schrot, George M Chu, Ki Jinn Chin
PURPOSE: Severe postoperative pain following spine surgery is a significant cause of morbidity, extended length of facility stay, and marked opioid usage. The erector spinae plane (ESP) block anesthetizes the dorsal rami of spinal nerves that innervate the paraspinal muscles and bony vertebra. We describe the use of low thoracic ESP blocks as part of multimodal analgesia in lumbosacral spine surgery. CLINICAL FEATURES: We performed bilateral ESP blocks at the T10 or T12 level in six cases of lumbosacral spine surgery: three lumbar decompressions, two sacral laminoplasties, and one coccygectomy...
April 27, 2018: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/29556817/a-review-of-current-treatment-options-for-coccygodynia
#4
REVIEW
Yasmin Elkhashab, Andrew Ng
PURPOSE OF REVIEW: Coccygodynia is pain within the coccyx area. The diagnosis is made clinically with symptoms of pain in the coccyx region and worsening pain in sitting position. The initial treatment is conservative therapy. For patients who do not respond to conservative therapies, there are further interventions available. This includes local injection of local anesthetics and steroids, neurolysis of sacral nerve roots, caudal epidural block, pulse radiofrequency (PRF), intra-rectal massage and manipulation, ganglion impar block, levator ani massage and stretching, coccyx manipulation, and coccygectomy...
March 19, 2018: Current Pain and Headache Reports
https://www.readbyqxmd.com/read/29510099/effects-of-sex-and-prenatal-androgen-manipulations-on-onuf-s-nucleus-of-rhesus-macaques
#5
Nancy G Forger, Elara Ruszkowski, Andrew Jacobs, Kim Wallen
The role of gonadal steroids in sexual differentiation of the central nervous system (CNS) is well established in rodents, but no study to date has manipulated androgens prenatally and examined their effects on any CNS structure in a primate. Onuf's nucleus is a column of motoneurons in the sacral spinal cord that innervates the striated perineal muscles. This cell group is larger in males than in females of many species, due to androgens acting during a sensitive perinatal period. Here, we examined Onuf's nucleus in 21 adult rhesus monkeys, including control males and females, as well as males whose mothers had been treated with an anti-androgen or testosterone during gestation...
April 2018: Hormones and Behavior
https://www.readbyqxmd.com/read/29372428/cryosurgery-in-the-excision-of-a-giant-local-recurrent-sacral-chordoma-a-case-report-and-literature-review
#6
Valerio Pipola, Marco Girolami, Riccardo Ghermandi, Giuseppe Tedesco, Gisberto Evangelisti, Alessandro Gasbarrini
PURPOSE: Chordoma is a low-grade malignant tumor with recurrence and metastasis tendency that originates from embryonic notochordal remnants. The sacrococcygeal region is the most commonly involved site. The aim of this paper is to report the results of the use of cryosurgery in the excision of a giant recurrent sacral chordoma and review of pertinent literature. METHODS: A 64 years old female patient with a locally recurrent sacral chordoma came to our attention after ten interventions performed at another institute...
January 25, 2018: European Spine Journal
https://www.readbyqxmd.com/read/29357336/the-termination-level-of-the-dural-sac-relevant-to-caudal-epidural-block-in-lumbosacral-transitional-vertebrae-a-comparison-between-sacralization-and-lumbarization-groups
#7
Ji Young Jeon, Yu Mi Jeong, Sheen-Woo Lee, Jeong Ho Kim, Hye-Young Choi, Yong Ahn
BACKGROUND: Lumbosacral transitional vertebrae (LSTV) are a relatively common variant and have been considered as one of the reasons for back pain. It is not unusual for clinicians to encounter patients with LSTV who require caudal epidural block (CEB) for pain management. OBJECTIVE: We investigated the termination level of the dural sac (DS) and anatomical features of the lumbosacral region relevant to CEB in patients with LSTV and compared these findings between sacralization and lumbarization groups...
January 2018: Pain Physician
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
#8
RANDOMIZED CONTROLLED TRIAL
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
#9
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
#10
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
#11
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
#12
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...
February 2018: 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
#13
Xing Li, Jamie Uy, Michelle Yu, Shun Li, Katherine Theisen, Jeffery 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...
January 1, 2018: 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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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