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perineural injections

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https://www.readbyqxmd.com/read/28092337/anatomical-basis-and-clinical-application-of-synovial-flaps-in-the-wrist-and-distal-forearm
#1
David L Colen, Jiun-Ting Yeh, Lawrence B Colen
Neuropathic symptoms after median nerve repair at the wrist or secondary to refractory carpal tunnel syndrome may become debilitating. These symptoms develop due to perineural adhesions, intraneural fibrosis and fixation of the nerve to the transverse carpal ligament after surgery and often require neurolysis. Interposition of vascularized soft tissue over the median nerve at the time of neurolysis prevents recurrence of such adhesions. The synovial flap, fashioned from the synovial lining of the flexor tendon sheath, is an ideal tissue for this purpose...
January 12, 2017: Plastic and Reconstructive Surgery
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
#2
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/28068408/pharmacokinetics-of-lidocaine-hydrochloride-administered-with-or-without-adrenaline-for-the-paravertebral-brachial-plexus-block-in-dogs
#3
Amélie Choquette, Eric Troncy, Martin Guillot, France Varin, Jérôme R E Del Castillo
Adrenaline is known to prolong the duration of local anesthesia but its effects on the pharmacokinetic processes of local anesthetic drugs are not fully understood. Our objective was to develop a compartmental model for quantification of adrenaline's impact on the pharmacokinetics of perineurally-injected lidocaine in the dog. Dogs were subjected to paravertebral brachial plexus block using lidocaine alone or adrenalinated lidocaine. Data was collected through a prospective, randomised, blinded crossover protocol performed over three periods...
2017: PloS One
https://www.readbyqxmd.com/read/28033159/effect-of-perineural-dexamethasone-on-the-duration-of-single-injection-saphenous-nerve-block-for-analgesia-after-major-ankle-surgery-a-randomized-controlled-study
#4
Siska Bjørn, Frank Linde, Kristian K Nielsen, Jens Børglum, Rasmus Wulff Hauritz, Thomas Fichtner Bendtsen
BACKGROUND AND OBJECTIVES: Patients undergoing major elective ankle surgery often experience pain from the saphenous nerve territory persisting beyond the duration of a single-injection saphenous nerve block. We hypothesized that perineural dexamethasone as an adjuvant for the saphenous nerve block prolongs the duration of analgesia and postpones as well as reduces opioid-requiring pain. METHODS: Forty patients were included in this prospective, randomized, controlled study...
December 29, 2016: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28017171/perineural-dexmedetomidine-effects-on-sciatic-nerve-in-rat
#5
Abdulkadir Yektaş, Murat Çabalar, Mehmet Sar, Ayşin Alagöl, Duygu Sultan Çelik, Vildan Yayla, Deniz Tolga
The present study was designed to test the hypothesis that high dose dexmedetomidine would increase the duration of antinociception to a thermal stimulus in a rat model of sciatic nerve blockade without causing nerve damage. The rats were anesthetized with isoflurane. After electromyography (EMG) recordings, right sciatic nerves were explored and perineural injections were delivered: Group D (n=7), 40μgμgkg(-1) dexmedetomidine administration, Group II (n=6), (0.2mL) saline administration, Group III (n=2), only surgically exploration of the right sciatic nevre...
January 2017: Brazilian Journal of Anesthesiology
https://www.readbyqxmd.com/read/27999499/perineural-liposomal-bupivacaine-for-postoperative-pain-control-in-patients-undergoing-upper-extremity-orthopedic-surgery-a-prospective-and-randomized-pilot-study
#6
José R Soberón, William Ericson-Neilsen, Leslie E Sisco-Wise, Mariella Gastañaduy, David E Beck
BACKGROUND: Upper extremity surgery is commonly performed in the ambulatory setting and is associated with moderate to severe postoperative pain. METHODS: Patients scheduled for upper extremity orthopedic surgery with a peripheral nerve block were randomized to receive either an ultrasound-guided single-injection supraclavicular block or ultrasound-guided median, ulnar, and radial nerve blocks (forearm blocks) performed at the level of the mid to proximal forearm with liposomal bupivacaine (Exparel) combined with a short-acting supraclavicular block...
2016: Ochsner Journal
https://www.readbyqxmd.com/read/27881053/oxytocin-provides-protection-against-diabetic-polyneuropathy-in-rats
#7
Oytun Erbas, Dilek Taşkıran, Fatih Oltulu, Altuğ Yavaşoğlu, Saylav Bora, Okan Bilge, Bilge Piri Çınar, Gönül Peker
PURPOSE: The aim of the present study is to investigate the protective effects of oxytocin (OT) on diabetic neuropathy (DNP) in rats. MATERIALS AND METHODS: Eighteen rats were used to induce diabetes using single dose streptozotocin (STZ, 60 mg/kg). Diabetic DNP was verified by electromyography (EMG) and motor function test on 21st day following STZ injection. Six rats served as naïve control group and received no drug (n = 6). Following EMG, diabetic rats were randomly divided into three groups and administered with either 1 ml/kg saline or 80 μg/kg OT or 160 μg/kg OT intraperitoneally for four weeks...
January 2017: Neurological Research
https://www.readbyqxmd.com/read/27875620/a-reliable-technique-for-us-guided-perineural-injection-in-ulnar-neuropathy-at-the-elbow
#8
Ulrike M Hamscha, Ines Tinhofer, Stefan Heber, Wolfgang Grisold, Wolfgang J Weninger, Stefan Meng
INTRODUCTION: Ulnar neuropathy at the elbow (UNE) is a common peripheral compression neuropathy and in most cases occurs at 2 sites, the retroepicondylar groove or the cubital tunnel. With regard to a potential therapeutic approach with perineural corticosteroid injection the aim of this study was to evaluate the distribution of injection fluid applied at a standard site. METHODS: We performed ultrasound-guided (US-guided) perineural injections to the ulnar nerve halfway between the olecranon and the medial epicondyle in 21 upper limbs from 11 non-embalmed cadavers...
November 22, 2016: Muscle & Nerve
https://www.readbyqxmd.com/read/27871587/peripheral-nerve-blocks-in-the-management-of-postoperative-pain-challenges-and-opportunities
#9
REVIEW
Girish Joshi, Kishor Gandhi, Nishant Shah, Jeff Gadsden, Shelby L Corman
Peripheral nerve blocks (PNBs) are increasingly used as a component of multimodal analgesia and may be administered as a single injection (sPNB) or continuous infusion via a perineural catheter (cPNB). We undertook a qualitative review focusing on sPNB and cPNB with regard to benefits, risks, and opportunities for optimizing patient care. Meta-analyses of randomized controlled trials have shown superior pain control and reductions in opioid consumption in patients receiving PNB compared with those receiving intravenous opioids in a variety of upper and lower extremity surgical procedures...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27871553/fascia-iliaca-block-associated-only-with-deep-sedation-in-high-risk-patients-taking-p2y12-receptor-inhibitors-for-intramedullary-femoral-fixation-in-intertrochanteric-hip-fracture-a-series-of-3-cases
#10
Carlos Rodrigues Almeida, Emília Milheiro Francisco, Vítor Pinho-Oliveira, José Pedro Assunção
OBJECTIVE: We present a series of 3 cases in which the impact in outcome was, first of all, related to the capacity to offer early and safer treatment to some hip fracture high-risk patients using a fascia iliaca block (FIB; ropivacaine 0,5% 20 cc and mepivacaine 1,3% 15 cc, given 30 minutes before incision) associated only with deep sedation, contributing to better practice and outcome. CASE REPORTS: All elderly patients were American Society of Anesthesiologists IV patients, under P2Y12 receptor inhibitors, suffering from an intertrochanteric fracture, and purposed for intramedullary femoral fixation (IMF)...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27816166/-perineural-dexmedetomidine-effects-on-sciatic-nerve-in-rat
#11
Abdulkadir Yektaş, Murat Çabalar, Mehmet Sar, Ayşin Alagöl, Duygu Sultan Çelik, Vildan Yayla, Deniz Tolga
The present study was designed to test the hypothesis that high dose dexmedetomidine would increase the duration of antinociception to a thermal stimulus in a rat model of sciatic nerve blockade without causing nerve damage. The rats were anesthetized with isoflurane. After electromyography (EMG) recordings, right sciatic nerves were explored and perineural injections were delivered: Group D (n=7), 40μgμgkg(-1) dexmedetomidine administration, Group II (n=6), (0.2mL) saline administration, Group III (n=2), only surgically exploration of the right sciatic nevre...
January 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/27810208/retrograde-maxillary-nerve-perineural-injection-a-tomographic-and-anatomical-evaluation-of-the-infraorbital-canal-and-evaluation-of-needle-type-and-size-in-equine-cadavers
#12
S Nannarone, G Bini, M Vuerich, L Menchetti, R Arcelli, G Angeli
The aim of this study was to investigate a new approach for equine maxillary nerve blocks, which can facilitate several orofacial surgeries. Current techniques aim at the maxillary foramen and approach via the zygomatic arch, conferring the risk of injury to several delicate structures in the target area. To investigate the feasibility of a retrograde approach from the infraorbital foramen, an anatomic study of the infraorbital canal and its surrounding structures was performed on 13 cadaveric skulls using computed tomography and anatomical dissection...
November 2016: Veterinary Journal
https://www.readbyqxmd.com/read/27749351/optimizing-pain-and-rehabilitation-after-knee-arthroplasty-a-two-center-randomized-trial
#13
Stephen Choi, Turlough O'Hare, Jeffrey Gollish, James E Paul, Hans Kreder, Kevin E Thorpe, Joel D Katz, Muhammad Mamdani, Peter Moisiuk, Colin J McCartney
BACKGROUND: This randomized trial compared (1) continuous femoral nerve block (cFNB), (2) single femoral nerve block (sFNB), and (3) local infiltration analgesia (LIA) with respect to analgesic and functional outcomes after primary tricompartmental knee arthroplasty (TKA). METHODS: One hundred twenty patients undergoing primary tricompartmental knee arthroplasty were randomly assigned to 1 of 3 interventions for postoperative analgesia: (1) cFNB-preoperative bolus of ropivacaine 0...
November 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27717401/adoptive-transfer-of-m2-macrophages-reduces-neuropathic-pain-via-opioid-peptides
#14
Maria Pannell, Dominika Labuz, Melih Ö Celik, Jacqueline Keye, Arvind Batra, Britta Siegmund, Halina Machelska
BACKGROUND: During the inflammation which occurs following nerve damage, macrophages are recruited to the site of injury. Phenotypic diversity is a hallmark of the macrophage lineage and includes pro-inflammatory M1 and anti-inflammatory M2 populations. Our aim in this study was to investigate the ability of polarized M0, M1, and M2 macrophages to secrete opioid peptides and to examine their relative contribution to the modulation of neuropathic pain. METHODS: Mouse bone marrow-derived cells were cultured as unstimulated M0 macrophages or were stimulated into an M1 phenotype using lipopolysaccharide and interferon-γ or into an M2 phenotype using interleukin-4...
October 7, 2016: Journal of Neuroinflammation
https://www.readbyqxmd.com/read/27663451/a-randomized-comparison-between-intravenous-and-perineural-dexamethasone-for-ultrasound-guided-axillary-block
#15
Julian Aliste, Prangmalee Leurcharusmee, Phatthanaphol Engsusophon, Aida Gordon, Giuliano Michelagnoli, Chonticha Sriparkdee, Worakamol Tiyaprasertkul, Dana Q Tran, Tom C R V Van Zundert, Roderick J Finlayson, De Q H Tran
BACKGROUND: This randomized double-blinded trial compared the effect of intravenous and perineural dexamethasone (8 mg) on the duration of motor block for ultrasound (US)-guided axillary brachial plexus block (AXB). METHODS: Patients undergoing upper limb surgery with US-guided AXB were randomly allocated to receive preservative-free dexamethasone (8 mg) via intravenous (n = 75) or perineural (n = 75) administration. The local anesthetic agent, 1% lidocaine -0...
2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/27650364/comparison-of-histopathological-effects-of-perineural-administration-of-bupivacaine-and-bupivacaine-dexmedetomidine-in-rat-sciatic-nerve
#16
Elham Memari, Mohammad-Ali Hosseinian, Ali Mirkheshti, Ali Arhami-Dolatabadi, Mojtaba Mirabotalebi, Mohsen Khandaghy, Yahya Daneshbod, Leila Alizadeh, Sadegh Shirian
Injection of a variety of drugs such as local anesthetics (LAs) for peripheral nerve block has been shown to cause damage to peripheral nerves. Bupivacaine is a local anesthetic widely used in surgical procedures. The aim of this study was to evaluate the neurotoxicity of LAs including Bupivacaine and dexmedetomidine (DEX)-Bupivacaine on sciatic nerve tissue at histopathological level. In addition, we investigated whether perineural administration of DEX can attenuate Bupivacaine-induced neurotoxicity. Twenty adult Sprague Dawley rats received unilateral sciatic nerve blocks with either 0...
November 2016: Experimental and Toxicologic Pathology: Official Journal of the Gesellschaft Für Toxikologische Pathologie
https://www.readbyqxmd.com/read/27618322/ct-guided-perineural-injections-for-chronic-pelvic-pain
#17
Vibhor Wadhwa, Kelly M Scott, Shai Rozen, Adam J Starr, Avneesh Chhabra
Chronic pelvic pain is a disabling condition that affects a large number of men and women. It may occur after a known inciting event, or it could be idiopathic. A common cause of pelvic pain syndrome is neuropathy of the pelvic nerves, including the femoral and genitofemoral nerves, ilioinguinal and iliohypogastric nerves, pudendal nerve, obturator nerve, lateral and posterior femoral cutaneous nerves, inferior cluneal nerves, inferior rectal nerve, sciatic nerve, superior gluteal nerve, and the spinal nerve roots...
September 2016: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/27568492/perineural-bupivacaine-injection-reduces-inguinodynia-after-inguinal-hernia-repair
#18
Joseph G Crompton, Aaron J Dawes, Graham W Donald, Masha J Livhits, Charles F Chandler
BACKGROUND: Inguinodynia, defined as pain lasting >3 months after inguinal hernia repair, remains the major complication of hernia operation. We sought to determine the effect of direct perineural infiltration on acute pain and inguinodynia after open inguinal hernia repair. METHODS: Patients who presented with an inguinal hernia at a university teaching hospital were evaluated prospectively and randomized to either (1) percutaneous ilioinguinal nerve block or (2) percutaneous ilioinguinal nerve block with additional perineural infiltration of the ilioinguinal, iliohypogastric, genitofemoral nerves...
December 2016: Surgery
https://www.readbyqxmd.com/read/27563364/lower-extremity-near-infrared-spectroscopy-after-popliteal-block-for-orthopaedic-foot-surgery
#19
Stijn Van de Velde, Alain F Kalmar, Matthias Raes, Jan Poelaert, Tom Lootens, Henk Vanoverschelde
BACKGROUND: Noninvasive measurement of cutaneous tissue oxygenation using near-infrared spectroscopy (NIRS) has become common in peri-operative care. Following institution of peripheral nerve blocks, neurovascular alterations in the blocked region have been described. OBJECTIVE: The primary aim of this study encompassed the assessment of the influence of a popliteal block on changes in regional oxygen saturation (SrO2), and the location of most prominent changes...
2016: Open Orthopaedics Journal
https://www.readbyqxmd.com/read/27559966/minimum-effective-local-anesthetic-volume-for-surgical-anesthesia-by-subparaneural-ultrasound-guided-popliteal-sciatic-nerve-block-a-prospective-dose-finding-study
#20
Seung Uk Bang, Dong Ju Kim, Jin Ho Bae, Kyudon Chung, Yeesuk Kim
Because of its rapid onset time, recent years have seen an increase in the use of ultrasound (US)-guided popliteal sciatic nerve block (PSNB) via subparaneural injection for induction of surgical anesthesia. Moreover, in below-knee surgery, combined blocks, as opposed to sciatic nerve block alone, have become more common. These combined blocks often require a large volume of local anesthetic (LA), thus increasing the risk of local-anesthetic systemic toxicity (LAST). Thus, to decrease the risk of LAST, it is important to know the minimum effective volume (MEV) required for an adequate block...
August 2016: Medicine (Baltimore)
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