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perineural injections

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https://www.readbyqxmd.com/read/29756696/preliminary-experience-with-epidural-and-perineural-catheter-localization-with-pulsed-wave-doppler-ultrasonography
#1
Hesham Elsharkawy, Theresa Barnes, Rovnat Babazade, Maria Huarte, Wael Ali Sakr Esa, Brian M Ilfeld
BACKGROUND: Various methods for peripheral nerve and epidural catheter location assessment exist, with varying degrees of ease of use, utility, and accuracy. Pulsed wave Doppler (PWD) evaluates the presence of fluid flow and is possible modality to assess the location of a percutaneously inserted perineural catheter. METHODS: A retrospective chart review was conducted in which PWD ultrasonography was used to confirm the position of nerve catheters for regional anesthesia...
May 11, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29750695/proximal-versus-distal-continuous-adductor-canal-blocks-does-varying-perineural-catheter-location-influence-analgesia-a-randomized-subject-masked-controlled-clinical-trial
#2
Jacklynn F Sztain, Bahareh Khatibi, Amanda M Monahan, Engy T Said, Wendy B Abramson, Rodney A Gabriel, John J Finneran, Richard H Bellars, Patrick L Nguyen, Scott T Ball, Francis B Gonzales, Sonya S Ahmed, Michael C Donohue, Jennifer A Padwal, Brian M Ilfeld
BACKGROUND: A continuous adductor canal block provides analgesia after surgical procedures of the knee. Recent neuroanatomic descriptions of the thigh and knee led us to speculate that local anesthetic deposited in the distal thigh close to the adductor hiatus would provide superior analgesia compared to a more proximal catheter location. We therefore tested the hypothesis that during a continuous adductor canal nerve block, postoperative analgesia would be improved by placing the perineural catheter tip 2-3 cm cephalad to where the femoral artery descends posteriorly to the adductor hiatus (distal location) compared to a more proximal location at the midpoint between the anterior superior iliac spine and the superior border of the patella (proximal location)...
May 9, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29733315/an-in-vivo-murine-sciatic-nerve-model-of-perineural-invasion
#3
Sylvie Deborde, Yasong Yu, Andrea Marcadis, Chun-Hao Chen, Ning Fan, Richard L Bakst, Richard J Wong
Cancer cells invade nerves through a process termed perineural invasion (PNI), in which cancer cells proliferate and migrate in the nerve microenvironment. This type of invasion is exhibited by a variety of cancer types, and very frequently is found in pancreatic cancer. The microscopic size of nerve fibers within mouse pancreas renders the study of PNI difficult in orthotopic murine models. Here, we describe a heterotopic in vivo model of PNI, where we inject syngeneic pancreatic cancer cell line Panc02-H7 into the murine sciatic nerve...
April 23, 2018: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/29727344/targeted-ultrasound-guided-perineural-hydrodissection-of-the-sciatic-nerve-for-the-treatment-of-piriformis-syndrome
#4
Christopher J Burke, William R Walter, Ronald S Adler
Piriformis syndrome is a common cause of lumbar, gluteal, and thigh pain, frequently associated with sciatic nerve symptoms. Potential etiologies include muscle injury or chronic muscle stretching associated with gait disturbances. There is a common pathological end pathway involving hypertrophy, spasm, contracture, inflammation, and scarring of the piriformis muscle, leading to impingement of the sciatic nerve. Ultrasound-guided piriformis injections are frequently used in the treatment of these pain syndromes, with most of the published literature describing injection of the muscle...
May 1, 2018: Ultrasound Quarterly
https://www.readbyqxmd.com/read/29664183/posterior-tibial-perforators-relationship-with-superficial-nerves-and-veins-a-cadaver-study
#5
Antonio Bulla, Alberto Bolletta, Luca Fiorot, Matteo Maffei, Pasquale Bandiera, Vincent Casoli, Andrea Montella, Gian Vittorio Campus
BACKGROUND: Most authors have evaluated the location of lower leg arterial perforators, but little is still known about the relationship between the arterial network and great saphenous vein (GSV) and saphenous nerve (SN). The aim of this study is to evaluate the relationship between the arterial network of the posterior tibial artery perforators, the cutaneous nerves, and the superficial venous system in the lower one third of the leg. METHODS: Eighteen lower limbs from cadavers were used for this study...
April 17, 2018: Microsurgery
https://www.readbyqxmd.com/read/29576126/investigation-into-the-visual-perceptive-ability-of-anaesthetists-during-ultrasound-guided-interscalene-and-femoral-blocks-conducted-on-soft-embalmed-cadavers-a-randomised-single-blind-study
#6
A Mustafa, J Seeley, S Munirama, M Columb, M McKendrick, A Schwab, G Corner, R Eisma, G Mcleod
BACKGROUND: Errors may occur during regional anaesthesia whilst searching for nerves, needle tips, and test doses. Poor visual search impacts on decision making, clinical intervention, and patient safety. METHODS: We conducted a randomised single-blind study in a single university hospital. Twenty trainees and two consultants examined the paired B-mode and fused B-mode and elastography video recordings of 24 interscalene and 24 femoral blocks conducted on two soft embalmed cadavers...
April 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29554009/case-report-acanthamoeba-keratitis-management-in-a-first-trimester-pregnant-patient
#7
Francisco de Borja Domínguez-Serrano, Manuel Caro-Magdaleno, Rafael Perea-Pérez, Enrique Rodríguez-de-la-Rúa, Jesús Montero-Iruzubieta
SIGNIFICANCE: Lacrimal punctal plugs may prevent the teratogenicity of the treatment used in infectious keratitis. Its use should be strongly considered in these cases. PURPOSE: We present the case of a 7-week pregnant patient with Acanthamoeba keratitis. CASE REPORT: The patient was a contact lens user with photophobia, redness, and intense pain in the right eye that started 2 weeks earlier. Corrected visual acuity was 20/63 (0.5 logMAR)...
April 2018: Optometry and Vision Science: Official Publication of the American Academy of Optometry
https://www.readbyqxmd.com/read/29393751/endoscopic-anterior-transmaxillary-transalisphenoid-approach-to-meckel-s-cave-and-the-middle-cranial-fossa-an-anatomical-study-and-clinical-application
#8
Huy Q Truong, Xicai Sun, Emrah Celtikci, Hamid Borghei-Razavi, Eric W Wang, Carl H Snyderman, Paul A Gardner, Juan C Fernandez-Miranda
OBJECTIVE Multiple approaches have been designed to reach the medial middle fossa (for lesions in Meckel's cave, in particular), but an anterior approach through the greater wing of the sphenoid (transalisphenoid) has not been explored. In this study, the authors sought to assess the feasibility of and define the anatomical landmarks for an endoscopic anterior transmaxillary transalisphenoid (EATT) approach to Meckel's cave and the middle cranial fossa. METHODS Endoscopic dissection was performed on 5 cadaver heads injected intravascularly with colored silicone bilaterally to develop the approach and define surgical landmarks...
February 2, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29338149/injection-pressure-mapping-of-intraneural-vs-perineural-injections-further-lessons-from-cadaveric-studies
#9
Andrzej Krol, Arber Vala, Leonidas Phylactides, Matthew Szarko, Miguel A Reina, Jose de Andrés
BACKGROUND: The aim of the study was to investigate the difference between intraneural and perineural injection pressures in human cadavers. Targeted nerves included the cervical roots, the supraclavicular and infraclavicular brachial plexus, the sciatic-subgluteal nerve and the common peroneal and tibial nerves. METHODS: Ten readings were obtained for each nerve location. 1mL of 0.9% NaCl was injected over ten seconds - deliberately slower than in clinical practice to eliminate the risk of aberrant readings relating to the speed of injection...
January 16, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29249272/successful-spinal-anaesthesia-in-a-patient-with-a-tarlov-cyst
#10
N Pfund, A Oh, A Cyna
Perineural (Tarlov) cysts are cerebrospinal fluid-containing perineural sacs that are usually located in the sacral spine. While often asymptomatic, they can cause progressive neurological symptoms including pain, paraesthesia and weakness. We present a case of a 24-year-old patient who had uneventful spinal anaesthesia at the L3-4 level for an elective caesarean section. Prior to her procedure, she had reported a two-year history of intermittent back pain and lower-limb paraesthesia, secondary to an S1 segment perineural cyst...
December 14, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/29226148/transition-from-deep-regional-blocks-toward-deep-nerve-hydrodissection-in-the-upper-body-and-torso-method-description-and-results-from-a-retrospective-chart-review-of-the-analgesic-effect-of-5-dextrose-water-as-the-primary-hydrodissection-injectate-to-enhance
#11
Stanley K H Lam, Kenneth Dean Reeves, An-Lin Cheng
Deep nerve hydrodissection uses fluid injection under pressure to purposely separate nerves from areas of suspected fascial compression, which are increasingly viewed as potential perpetuating factors in recalcitrant neuropathic pain/complex regional pain. The usage of 5% dextrose water (D5W) as a primary injectate for hydrodissection, with or without low dose anesthetic, could limit anesthetic-related toxicity. An analgesic effect of 5% dextrose water (D5W) upon perineural injection in patients with chronic neuropathic pain has recently been described...
2017: BioMed Research International
https://www.readbyqxmd.com/read/29196315/phosphorylated-ccaat-enhancer-binding-protein-%C3%AE-contributes-to-rat-hiv-related-neuropathic-pain-in-vitro-and-in-vivo-studies
#12
Hyun Yi, Shue Liu, Yuta Kashiwagi, Daigo Ikegami, Wan Huang, Hirotsugu Kanda, Takafumi Iida, Ching-Hang Liu, Keiya Takahashi, David A Lubarsky, Shuanglin Hao
Chronic pain is increasingly recognized as an important comorbidity of HIV-infected patients, however, the exact molecular mechanisms of HIV-related pain are still elusive. CCAAT/enhancer binding proteins (C/EBPs) are expressed in various tissues, including the CNS. C/EBPβ, one of the C/EBPs, is involved in the progression of HIV/AIDS, but the exact role of C/EBPβ and its upstream factors are not clear in HIV pain state. Here, we used a neuropathic pain model of perineural HIV envelope glycoprotein gp120 application onto the rat sciatic nerve to test the role of phosphorylated C/EBPβ (pC/EBPβ) and its upstream pathway in the spinal cord dorsal horn (SCDH)...
January 17, 2018: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
https://www.readbyqxmd.com/read/29173667/ultrasound-guided-interventions-of-the-cervical-spine-and-nerves
#13
REVIEW
Ke-Vin Chang, Wei-Ting Wu, Levent Özçakar
High-resolution ultrasound (US) enables prompt depiction of muscles, tendons, ligaments, and peripheral nerves. It seems to be the best imaging modality for guiding perineural injections. The most complicated neurovascular network of the musculoskeletal system surrounds the cervical spine; so injection to that region is never an easy task. This article elaborates the regional anatomy and the use of US scanning and guidance for cervical interventions; for example, cervical root, superficial cervical plexus, stellate ganglion, cervical medial branch, greater occipital nerve, and third occipital nerve...
February 2018: Physical Medicine and Rehabilitation Clinics of North America
https://www.readbyqxmd.com/read/29171437/mir-30c-promotes-schwann-cell-remyelination-following-peripheral-nerve-injury
#14
Sheng Yi, Qi-Hui Wang, Li-Li Zhao, Jing Qin, Ya-Xian Wang, Bin Yu, Song-Lin Zhou
Differential expression of miRNAs occurs in injured proximal nerve stumps and includes miRNAs that are firstly down-regulated and then gradually up-regulated following nerve injury. These miRNAs might be related to a Schwann cell phenotypic switch. miR-30c, as a member of this group, was further investigated in the current study. Sprague-Dawley rats underwent sciatic nerve transection and proximal nerve stumps were collected at 1, 4, 7, 14, 21, and 28 days post injury for analysis. Following sciatic nerve injury, miR-30c was down-regulated, reaching a minimum on day 4, and was then upregulated to normal levels...
October 2017: Neural Regeneration Research
https://www.readbyqxmd.com/read/29166638/predictors-of-surgical-outcomes-of-traumatic-peripheral-nerve-injuries-in-children-an-institutional-experience
#15
Bhagavatula Indira Devi, Subhas K Konar, Dhananjaya I Bhat, Dhaval P Shukla, R Bharath, M S Gopalakrishnan
AIM: This study was undertaken to address the epidemiological characteristics, operative details, and surgical outcome of peripheral nerve injuries in children treated in a tertiary hospital in India (NIMHANS, Bangalore). MATERIALS AND METHODS: This is a retrospective study of epidemiology, operative findings, and surgical outcomes over the period of 2000-2016. Our series includes 102 children with peripheral nerve injuries of various causes. RESULTS: Intramuscular injections were the most common cause (52...
2018: Pediatric Neurosurgery
https://www.readbyqxmd.com/read/29026354/novel-regional-techniques-for-total-knee-arthroplasty-promote-reduced-hospital-length-of-stay-an-analysis-of-106-patients
#16
Salman Thobhani, Lauren Scalercio, Clint E Elliott, Bobby D Nossaman, Leslie C Thomas, Dane Yuratich, Kim Bland, Kristie Osteen, Matthew E Patterson
BACKGROUND: Novel regional techniques, including the adductor canal block (ACB) and the local anesthetic infiltration between the popliteal artery and capsule of the knee (IPACK) block, provide an alternative approach for controlling pain following total knee arthroplasty (TKA). This study compared 3 regional techniques (femoral nerve catheter [FNC] block alone, FNC block with IPACK, and ACB with IPACK) on pain scores, opioid consumption, performance during physical therapy, and hospital length of stay in patients undergoing TKA...
2017: Ochsner Journal
https://www.readbyqxmd.com/read/28952392/ultrasound-guided-hydroneurolysis-of-the-median-nerve-for-recurrent-carpal-tunnel-syndrome
#17
Scott M Fried, Levon N Nazarian
BACKGROUND: Recurrent carpal tunnel syndrome is often associated with perineural scarring around the median nerve. Surgical options include relatively invasive procedures, such as fat pad grafting, ligament reconstruction, muscle transfer, and nerve wraps. All have limited success because of the possibility of repeated recurrent scarring postoperatively. METHODS: We discuss a technique involving injection with external hydroneurolysis of the median nerve under ultrasound guidance for recurrent carpal tunnel...
September 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28886259/addition-of-dexmedetomidine-to-qx-314-enhances-the-onset-and-duration-of-sciatic-nerve-block-in-rats
#18
Wenling Zhao, Qinqin Yin, Jin Liu, Wensheng Zhang, Linghui Yang
An experimental set-up was designed to observe whether adding dexmedetomidine to QX-314 would enhance the onset and duration of sensory and motor function in a rat sciatic nerve block model. Fifty-six Sprague-Dawley rats received unilateral sciatic nerve blocks with 0.2 mL of 35 mmol/L QX-314 alone, dexmedetomidine (5.3 μmol/L (1 μg/kg), 26.4 μmol/L (5 μg/kg), 52.8 μmol/L (10 μg/kg)) alone, or a combination of the two. Thermal nociception and motor function were assessed by an investigator blinded to the drug treatment, and sciatic nerves and perineural tissues were harvested at 14 days after injection...
April 2018: Canadian Journal of Physiology and Pharmacology
https://www.readbyqxmd.com/read/28858839/axonal-excitability-and-conduction-alterations-caused-by-levobupivacaine-in-rat
#19
Seçkin Tuncer, Tülay Tuncer Peker, İlksen Burat, Erhan Kiziltan, Barkin İlhan, Nizamettin Dalkiliç
In this study, effects of the long-acting amide-type local anesthetic levobupivacaine on axonal conduction and excitability parameters of the rat sciatic nerve were thoroughly examined both in vitro and in vivo. In order to deduce its effects on isolated nerve conduction, compound nerve action potential (CNAP) recordings were performed using the suction method over sciatic nerves of Wistar rats before and after administration of 0.05 % (1.7 mmol L-1) levobupivacaine. Levobupivacaine caused complete CNAP area and amplitude depression by blocking conduction in a time-dependent manner...
September 1, 2017: Acta Pharmaceutica
https://www.readbyqxmd.com/read/28854551/efficacy-of-perineural-vs-systemic-dexamethasone-to-prolong-analgesia-after-peripheral-nerve-block-a-systematic-review-and-meta-analysis
#20
M Baeriswyl, K R Kirkham, A Jacot-Guillarmod, E Albrecht
Perineural dexamethasone has gained popularity in regional anaesthesia to prolong the duration of analgesia, but its advantage over systemic administration is disputed. The objective of this meta-analysis was to compare the analgesic efficacy of both routes of administration during peripheral nerve block. The methodology followed the PRISMA statement guidelines. The primary outcome was the duration of analgesia analysed according to the type of local anaesthetic administered (bupivacaine or ropivacaine). Secondary outcomes included cumulative opioid consumption in morphine i...
August 1, 2017: British Journal of Anaesthesia
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