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https://www.readbyqxmd.com/read/29905630/ultrasound-guided-percutaneous-peripheral-nerve-stimulation-neuromodulation-of-the-sciatic-nerve-for-postoperative-analgesia-following-ambulatory-foot-surgery-a-proof-of-concept-study
#1
Brian M Ilfeld, Rodney A Gabriel, Engy T Said, Amanda M Monahan, Jacklynn F Sztain, Wendy B Abramson, Bahareh Khatibi, John J Finneran, Pia T Jaeger, Alexandra K Schwartz, Sonya S Ahmed
BACKGROUND AND OBJECTIVES: Percutaneous peripheral nerve stimulation (PNS) is an analgesic modality involving the insertion of a lead through an introducing needle followed by the delivery of electric current. This modality has been reported to treat chronic pain as well as postoperative pain the day following knee surgery. However, it remains unknown if this analgesic technique may be used in ambulatory subjects following foot procedures beginning within the recovery room immediately following surgery, and with only short series of patients reported to date, the only available data are derived from strictly observational studies...
June 13, 2018: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29864042/comparison-of-the-efficacy-of-different-analgesia-treatments-for-total-knee-arthroplasty-a-network-meta-analysis
#2
Peilong Dong, Xiaobo Tang, Rongrong Cheng, Jian Wang
BACKGROUND AND AIM: The severe pain after total knee arthroplasty (TKA) brings many patients more suffering, longer hospital stay and higher expenses. This study was designed to assess the relative efficacy of several clinical treatments for postoperative analgesia of TKA through network meta-analysis (NMA) based on multiple published randomized controlled trials. METHODS: Embase and PubMed were utilized to conduct this network meta-analysis from inception until 2016...
June 2, 2018: Clinical Journal of Pain
https://www.readbyqxmd.com/read/29858517/the-ability-of-a-real-time-injection-pressure-monitoring-system-to-discriminate-between-perineural-and-intraneural-injection-of-the-sciatic-nerve-in-fresh-cadavers
#3
A Saporito, C Quadri, X Capdevila
Injection pressure monitoring provides valuable information to prevent intraneural injections and possibly consequent nerve damage during peripheral nerve block. However, the measurement of injection pressure along the injection line is inaccurate as it is influenced by several variables. The aim of this study was to test a new system for precise injection pressure monitoring at the needle tip in a cadaveric model. The system consists of a miniaturised pressure sensor embedded within the needle shaft that is connected via an optical fibre to an external control unit...
June 2, 2018: Anaesthesia
https://www.readbyqxmd.com/read/29858510/comparison-of-peripheral-nerve-blockade-characteristics-between-non-diabetic-patients-and-patients-suffering-from-diabetic-neuropathy-a-prospective-cohort-study
#4
M Baeriswyl, P Taffé, K R Kirkham, I Bathory, V Rancati, X Crevoisier, S Cherix, E Albrecht
Animal data have demonstrated increased block duration after local anaesthetic injections in diabetic rat models. Whether the same is true in humans is currently undefined. We, therefore, undertook this prospective cohort study to test the hypothesis that type-2 diabetic patients suffering from diabetic peripheral neuropathy would have increased block duration after ultrasound-guided popliteal sciatic nerve block when compared with patients without neuropathy. Thirty-three type-2 diabetic patients with neuropathy and 23 non-diabetic control patients, scheduled for fore-foot surgery, were included prospectively...
June 2, 2018: Anaesthesia
https://www.readbyqxmd.com/read/29797704/the-analgesic-effect-of-a-popliteal-plexus-blockade-after-total-knee-arthroplasty-a-feasibility-study
#5
C Runge, S Bjørn, J M Jensen, N D Nielsen, M Vase, C Holm, T F Bendtsen
INTRODUCTION: An obturator nerve block (ONB) and a femoral triangle block (FTB) provide effective analgesia after total knee arthroplasty (TKA) without impeding the ambulation, although the ONB produces motor blockade of the hip adductor muscles. The popliteal plexus (PP) in the popliteal fossa is formed by contribution from the tibial nerve and the posterior obturator nerve, innervating intraarticular genicular structures and the posterior capsule of the knee. We hypothesised that a popliteal plexus block (PPB) as a supplement to an FTB would reduce pain after TKA without anaesthetising motor branches from the sciatic nerve in the popliteal fossa...
May 24, 2018: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29794563/ultrasound-guided-single-injection-versus-continuous-sciatic-nerve-blockade-on-pain-management-and-mobilisation-after-total-knee-arthroplasty-cosinus-trial-a-randomised-triple-blinded-controlled-trial
#6
Thomas Wiesmann, Ivo Hüttemann, Nora Schilke, Thomas Heyse, Turgay Efe, Daphne Eschbach, Hinnerk Wulf, Thorsten Steinfeldt, Carsten Feldmann
BACKGROUND: Combining continuous femoral nerve blockade with single injection sciatic nerve blockade is standard peripheral nerve block practice for total knee arthroplasty (TKA) during the first 24 postoperative hours. OBJECTIVES: To assess the analgesic benefits and mobilisation capability of continuous sciatic blockade in conjunction with continuous femoral nerve blockade for 72 h after arthroplasty. DESIGN: Randomised, triple-blinded controlled trial...
May 21, 2018: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29794280/repetitive-nerve-block-for-neuropathic-pain-management-a-case-report
#7
Zoher Naja, Ahmad Salah Naja, Omar Rajab, Anas Mugharbil, Abdul Rahman Shatila, Janah Al Hassan
Schwannoma is a common neoplasm in the peripheral and central nervous systems. Sciatic nerve schwanommas are rare. We report the case of a 50-year-old woman who was referred for treatment of persistent neuropathic pain in the left lower limb after resection of a schwannoma on the left S1 nerve root. The patient's history goes back when she was 27 years old and started to have electric-like pain in her lower left limb upon intercourse. Examination revealed a left ovarian cyst which was surgically removed. Her pain persisted despite taking nonsteroidal anti inflammatory drugs (NSAIDs)...
January 26, 2018: Scandinavian Journal of Pain
https://www.readbyqxmd.com/read/29782398/benefit-and-harm-of-adding-epinephrine-to-a-local-anesthetic-for-neuraxial-and-locoregional-anesthesia-a-meta-analysis-of-randomized-controlled-trials-with-trial-sequential-analyses
#8
Clément Tschopp, Martin R Tramèr, Alexis Schneider, Maroun Zaarour, Nadia Elia
BACKGROUND: This systematic review examines the benefit and harm of adding epinephrine to local anesthetics for epidural, intrathecal, or locoregional anesthesia. METHODS: We searched electronic databases to October 2017 for randomized trials comparing any local anesthetic regimen combined with epinephrine, with the same local anesthetic regimen without epinephrine, reporting on duration of analgesia, time to 2 segments regression, or any adverse effects. Trial quality was assessed using the Cochrane risk of bias tool and a random-effects model was used...
May 17, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29777135/n-methyl-d-aspartate-receptor-subtype-2b-antagonist-ro-25-6981-attenuates-neuropathic-pain-by-inhibiting-postsynaptic-density-95-expression
#9
Ling-Er Huang, Shao-Hui Guo, Lalita Thitiseranee, Yan Yang, Yan-Feng Zhou, Yong-Xing Yao
Postsynaptic density-95 (PSD-95) is a synaptic scaffolding protein that plays a crucial role in the development of neuropathic pain. However, the underlying mechanism remains unclear. To address the role of PSD-95 in N-methyl-D-aspartate receptor subtype 2B (NR2B) -mediated chronic pain, we investigated the relationship between PSD-95 activation and NR2B function in the spinal cord, by using a rat model of sciatic nerve chronic constriction injury (CCI). We demonstrate that the expression levels of total PSD-95 and cAMP response element binding protein (CREB), as well as phosphorylated NR2B, PSD-95, and CREB, in the spinal dorsal horn, and the interaction of NR2B with PSD-95 were increased in the CCI animals...
May 18, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29762181/intraneural-ultrasound-guided-sciatic-nerve-block-minimum-effective-volume-and-electrophysiologic-effects
#10
Gianluca Cappelleri, Andrea Luigi Ambrosoli, Marco Gemma, Valeria Libera Eva Cedrati, Federico Bizzarri, Giorgio Francesco Danelli
BACKGROUND: Both extra- and intraneural sciatic injection resulted in significant axonal nerve damage. This study aimed to establish the minimum effective volume of intraneural ropivacaine 1% for complete sensory-motor sciatic nerve block in 90% of patients, and related electrophysiologic variations. METHODS: Forty-seven consecutive American Society of Anesthesiologists physical status I-II patients received an ultrasound-guided popliteal intraneural nerve block following the up-and-down biased coin design...
May 15, 2018: Anesthesiology
https://www.readbyqxmd.com/read/29756651/optical-signature-of-nerve-tissue-exploratory-ex-vivo-study-comparing-optical-histological-and-molecular-characteristics-of-different-adipose-and-nerve-tissues
#11
Andrea J R Balthasar, Torre M Bydlon, Hans Ippel, Marjolein van der Voort, Benno H W Hendriks, Gerald W Lucassen, Geert-Jan van Geffen, Maarten van Kleef, Paul van Dijk, Arno Lataster
BACKGROUND: During several anesthesiological procedures, needles are inserted through the skin of a patient to target nerves. In most cases, the needle traverses several tissues-skin, subcutaneous adipose tissue, muscles, nerves, and blood vessels-to reach the target nerve. A clear identification of the target nerve can improve the success of the nerve block and reduce the rate of complications. This may be accomplished with diffuse reflectance spectroscopy (DRS) which can provide a quantitative measure of the tissue composition...
May 14, 2018: Lasers in Surgery and Medicine
https://www.readbyqxmd.com/read/29736614/mir-183-5p-alleviates-chronic-constriction-injury-induced-neuropathic-pain-through-inhibition-of-trek-1
#12
Dan-Ni Shi, Yi-Tao Yuan, Dan Ye, Lu-Mei Kang, Jing Wen, Hong-Ping Chen
MicroRNAs have been implicated in nerve injury and neuropathic pain. In the previous study we had shown that miR-96 can attenuate neuropathic pain through inhibition of Nav1.3. In this study, we investigated the role of miR-183, a same cluster member of microRNA with miR-96, in neuropathic pain and its potential mechanisms. We found that the expression level of miR-183-5p in dorsal root ganglion was decreased with the development of neuropathic pain induced by chronic constriction sciatic nerve injury (CCI)...
May 7, 2018: Neurochemical Research
https://www.readbyqxmd.com/read/29728269/mechanics-of-anesthetic-needle-penetration-into-human-sciatic-nerve
#13
Joseph E Pichamuthu, Spandan Maiti, Maria G Gan, Nicole M Verdecchia, Steven L Orebaugh, David A Vorp
Nerve blocks are frequently performed by anesthesiologists to control pain. For sciatic nerve blocks, the optimal placement of the needle tip between its paraneural sheath and epineurial covering is challenging, even under ultrasound guidance, and frequently results in nerve puncture. We performed needle penetration tests on cadaveric isolated paraneural sheath (IPS), isolated nerve (IN), and the nerve with overlying paraneural sheath (NPS), and quantified puncture force requirement and fracture toughness of these specimens to assess their role in determining the clinical risk of nerve puncture...
June 6, 2018: Journal of Biomechanics
https://www.readbyqxmd.com/read/29690884/capsaicin-enriched-diet-ameliorates-autoimmune-neuritis-in-rats
#14
Jeremias Motte, Björn Ambrosius, Thomas Grüter, Hussein Bachir, Melissa Sgodzai, Xiomara Pedreiturria, Kalliopi Pitarokoili, Ralf Gold
BACKGROUND: Autoimmune neuropathies are common PNS disorders and effective treatment is challenging. Environmental influence and dietary components are known to affect the course of autoimmune diseases. Capsaicin as pungent component of chili-peppers is common in human nutrition. An influence of capsaicin on autoimmune diseases has been postulated. METHODS: We tested capsaicin in the animal model of experimental autoimmune neuritis (EAN) in Lewis rat. Rats were immunized with P2-peptide and were treated with capsaicin in different preventive settings...
April 24, 2018: Journal of Neuroinflammation
https://www.readbyqxmd.com/read/29667940/the-importance-of-the-saphenous-nerve-block-for-analgesia-following-major-ankle-surgery-a-randomized-controlled-double-blind-study
#15
Siska Bjørn, Wan Yi Wong, Jørgen Baas, Kristian K Nielsen, Jens Børglum, Rasmus Wulff Hauritz, Thomas Fichtner Bendtsen
BACKGROUND AND OBJECTIVES: Major ankle surgery causes intense postoperative pain, and whereas the importance of a sciatic nerve block is well established, the clinical significance of a supplemental saphenous nerve block has never been determined in a prospective, randomized, double-blind, placebo-controlled trial. We hypothesized that a saphenous nerve block reduces the proportion of patients experiencing significant clinical pain after major ankle surgery. METHODS: Eighteen patients were enrolled and received a popliteal sciatic nerve block...
March 26, 2018: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29657246/effects-of-three-forms-of-local-anesthesia-on-perioperative-fentanyl-induced-hyperalgesia
#16
Lu Chang, Fang Ye, Quehua Luo, Zewen Wang, Yimin Wang, Zhengyuan Xia, Haihua Shu
Both local infiltration analgesia (LIA) and nerve block are common analgesic modalities for pain relief after surgery. The aim of the current study was to investigate the effects of those two modalities on pain behavior and the expression of pro-inflammatory cytokines such as interleukin (IL)-1β and IL-6 and tumor necrosis factor-α (TNF-α) in the spinal cord and dorsal root ganglion (DRG) in a rat model of perioperative fentanyl induced hyperalgesia. Rats were injected with fentanyl (60 μg/kg) 4 times and received a plantar incision after the second injection or they received pre-incision LIA and sciatic nerve block (SNB) or post-incision LIA with levobupivacaine (0...
May 13, 2018: Bioscience Trends
https://www.readbyqxmd.com/read/29620988/a-simple-guide-to-regional-anaesthesia
#17
E M Valsamis, S Wade, C Thornhill, C Carey, D Ricketts
Regional anaesthesia is widely used in modern anaesthetic practice for perioperative and postoperative analgesia. In the operating theatre, regional anaesthesia is used both on its own and in combination with other techniques (general anaesthesia and sedation). Regional anaesthesia is now a core skill set in anaesthetic training. This article provides a basic outline of regional anaesthesia for surgeons and other non-anaesthetic staff working with anaesthetists, reviewing preparation, consent, basic and specialist equipment, central neuraxial blocks (spinal, epidural and caudal), trunk blocks, upper limb blocks (interscalene, supraclavicular, infraclavicular and axillary) and lower limb blocks (femoral, fascia iliaca, sciatic, popliteal and ankle)...
April 2, 2018: British Journal of Hospital Medicine
https://www.readbyqxmd.com/read/29601408/microanatomical-nerve-architecture-of-6-mammalian-species-is-trans-species-translational-anatomic-extrapolation-valid
#18
Anna Server, Miguel A Reina, André P Boezaart, Alberto Prats-Galino, Marielle Esteves Coelho, Xavier Sala-Blanch
BACKGROUND AND OBJECTIVES: Various animal models have historically been used to study iatrogenic nerve injury during performance of conduction nerve blocks. Our aims were to compare the microstructures of nerves in commonly used species to those of humans and to explore the validity of the extrapolating these findings to humans. METHODS: High-resolution, light-microscopic images were obtained from cross sections of sciatic nerves at their bifurcation from fresh rat, rabbit, pig, sheep, dog, and human cadavers...
March 29, 2018: Regional Anesthesia and Pain Medicine
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
#19
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/29546785/targeting-macrophage-and-microglia-activation-with-colony-stimulating-factor-1-receptor-inhibitor-is-an-effective-strategy-to-treat-injury-triggered-neuropathic-pain
#20
SeungHwan Lee, Xiang Qun Shi, Anni Fan, Brian West, Ji Zhang
Introduction Neuropathic pain is a debilitating condition. The importance of neuroimmune interactions in neuropathic pain has been evidenced by the involvement of different immune cells in peripheral and central sensitization of pathological pain. Macrophages and microglia are the most abundant immune cells activated in injured nerves and spinal cord, respectively. Several lines of evidence showed that macrophage/microglia survival, activation, proliferation, and differentiation require the involvement of macrophage-colony stimulating factor...
January 2018: Molecular Pain
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