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Peripheral nerve surgery

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https://www.readbyqxmd.com/read/28430692/lack-of-association-between-the-use-of-nerve-blockade-and-the-risk-of-postoperative-chronic-opioid-use-among-patients-undergoing-total-knee-arthroplasty-evidence-from-the-marketscan-database
#1
Eric C Sun, Brian T Bateman, Stavros G Memtsoudis, Mark D Neuman, Edward R Mariano, Laurence C Baker
BACKGROUND: Total knee arthroplasty (TKA) is associated with high rates of prolonged opioid use after surgery (10%-34%). By decreasing opioid use in the immediate postoperative period, perioperative nerve blockade has been hypothesized to decrease the risk of persistent opioid use. METHODS: Using health care utilization data, we constructed a sample of 120,080 patients undergoing TKA between 2002 and 2012 and used billing data to identify the utilization of peripheral or neuraxial blockade...
April 19, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28413272/an-analysis-of-perioperative-adverse-neurological-events-associated-with-anesthetic-management-at-a-tertiary-care-center-of-a-developing-country
#2
Fauzia Anis Khan, Sobia Khan, Gauhar Afshan
BACKGROUND AND AIMS: Existing literature on neurological complications related to anesthesia is reported from affluent countries but the trends may vary in less affluent countries. MATERIAL AND METHODS: The objective was to find the associated factors contributing to neurological adverse events occurring within 48 h of anesthesia and surgery. The existing departmental morbidity and mortality database was reviewed from 1992 to 2012 for major adverse neurological events...
January 2017: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/28409885/long-term-results-of-the-transmanubrial-osteomuscular-sparing-approach-for-pediatric-tumors
#3
Aziz El Madi, Sabine Irtan, Frédérique Sauvat, Michel Zérah, Gudrun Schleiermacher, Louise Galmiche-Roland, Véronique Minard-Colin, Hervé Brisse, Sabine Sarnacki
BACKGROUND: The complete and safe resection of pediatric cervicothoracic tumors, mostly represented by neurogenic tumors, remains a surgical challenge because of the complex anatomy of this region. The transmanubrial osteomuscular-sparing approach (TOSA) is an alternative to isolated or combined cervical and thoracic approaches enabling the control of supra-aortic vessels and nerves through the thoracic inlet. METHODS: We retrospectively reviewed the tumor characteristics, completeness of resection, morbidity, and long-term outcome of patients with cervicothoracic tumors removed by TOSA between 2000 and 2012 in our institution...
April 14, 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/28405007/rapid-and-accurate-peripheral-nerve-imaging-by-multipoint-raman-spectroscopy
#4
Yasuaki Kumamoto, Yoshinori Harada, Hideo Tanaka, Tetsuro Takamatsu
Raman spectroscopy allows label-free, minimally invasive, and accurate detection of peripheral nerves. However, the conventional Raman imaging technique is time-consuming when measuring a large area of a sample. Establishing a method for rapidly acquiring spatial distribution of a bundle of peripheral nerve fibers is an essential step for Raman spectroscopy towards application in clinical surgery. Here we present a multipoint Raman spectroscopic technique for rapid peripheral nerve imaging. In only 5 seconds, spectra at 32 points situated on ex vivo rat peripheral nerve bundles and adjoining connective tissues were acquired...
April 12, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28401914/a-3d-engineered-porous-conduit-for-peripheral-nerve-repair
#5
Jie Tao, Yu Hu, Shujuan Wang, Jiumeng Zhang, Xuan Liu, Zhiyuan Gou, Hao Cheng, Qianqi Liu, Qianqian Zhang, Shenglan You, Maling Gou
End-to-end neurorrhaphy is the most commonly used method for treating peripheral nerve injury. However, only 50% of patients can regain useful function after treating with neurorrhaphy. Here, we constructed a 3D-engineered porous conduit to promote the function recovery of the transected peripheral nerve after neurorrhaphy. The conduit that consisted of a gelatin cryogel was prepared by molding with 3D-printed moulds. Due to its porous structure and excellent mechanical properties, this conduit could be collapsed by the mechanical force and resumed its original shape after absorption of normal saline...
April 12, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28398932/brachial-arterial-pressure-monitoring-during-cardiac-surgery-rarely-causes-complications
#6
Asha Singh, Bobby Bahadorani, Brett J Wakefield, Natalya Makarova, Priya A Kumar, Michael Zhen-Yu Tong, Daniel I Sessler, Andra E Duncan
BACKGROUND: Brachial arterial catheters better estimate aortic pressure than radial arterial catheters but are used infrequently because complications in a major artery without collateral flow are potentially serious. However, the extent to which brachial artery cannulation promotes complications remains unknown. The authors thus evaluated a large cohort of cardiac surgical patients to estimate the incidence of related serious complications. METHODS: The institutional Society of Thoracic Surgeons Adult Cardiac Surgery Database and Perioperative Health Documentation System Registry of the Cleveland Clinic were used to identify patients who had brachial artery cannulation between 2007 and 2015...
April 10, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28391532/outcome-of-a-graduated-minimally-invasive-facial-reanimation-in-patients-with-facial-paralysis
#7
Laura C Holtmann, Anja Eckstein, Kerstin Stähr, Minzhi Xing, Stephan Lang, Stefan Mattheis
Peripheral paralysis of the facial nerve is the most frequent of all cranial nerve disorders. Despite advances in facial surgery, the functional and aesthetic reconstruction of a paralyzed face remains a challenge. Graduated minimally invasive facial reanimation is based on a modular principle. According to the patients' needs, precondition, and expectations, the following modules can be performed: temporalis muscle transposition and facelift, nasal valve suspension, endoscopic brow lift, and eyelid reconstruction...
April 8, 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28390879/peripheral-nerve-injury-impairs-the-ability-to-maintain-behavioural-flexibility-following-acute-stress-in-the-rat
#8
David Mor, Michael D Kendig, James W M Kang, Gizem Gemikonakli, Paul J Austin, Eszter Kalman, Laura H Corbit
Chronic neuropathic pain often leads to impaired cognition and reduced behavioural flexibility. This study used a rat model to investigate if a peripheral nerve injury, with or without an additional acute psychological stress, alters behavioural flexibility and goal directed behaviour as measured by sensitivity to devaluation. Neuropathic pain was induced by a chronic constriction injury (CCI) of the sciatic nerve. CCI, sham-injury and naïve rats were trained to press two levers for two rewards. In outcome devaluation tests, one of the rewards was devalued by pre-feeding it to satiety, immediately prior to an extinction test measuring responding on the two levers...
April 5, 2017: Behavioural Brain Research
https://www.readbyqxmd.com/read/28387892/anesthesia-and-analgesia-in-breast-surgery-the-benefits-of-peripheral-nerve-block
#9
L Calì Cassi, F Biffoli, D Francesconi, G Petrella, O Buonomo
Breast surgery is frequently associated with postoperative pain, nausea and vomiting, that result in increased patient's suffering, prolongation of hospital stays and related costs. Thoracic paravertebral nerve block (TPVB) is a viable option to the classic multimodal analgesia in breast surgery as it enhances surgical anesthesia and postoperative analgesia. In this review, we report the results of a number of studies on the role of TPVB in breast surgery. This technique is associated with a superior control of the pain, a reduction in opioids consumption after surgery, a decrease in postoperative nausea and vomiting, and an overall decrease in length of hospital stay...
March 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28387148/malignant-triton-tumor-malignant-peripheral-nerve-sheath-tumor-with-rhabdomyoblastic-differentiation-occurring-in-a-vascularized-free-flap-reconstruction-graft
#10
Roopa Ram, Jerad Gardner, Sindhura Alapati, Kedar Jambhekar, Tarun Pandey, Corey Montgomery, Richard Nicholas
Malignant peripheral nerve sheath tumor (MPNST) is a rare form of sarcoma arising from Schwann cells or pluripotent cells of the neural crest. Malignant triton tumor (MTT) is a subtype of MPNST with a component of malignant rhabdomyoblasts in addition to malignant Schwann cells. MPNST and MTT are both aggressive malignancies that most commonly arise from large deep neurofibromas in patients with neurofibromatosis type 1 (NF-1). However, sporadic non-NF-1 cases of MTT have also been reported in the literature...
April 1, 2017: International Journal of Surgical Pathology
https://www.readbyqxmd.com/read/28384950/familial-schwannomatosis-a-diagnostic-challenge
#11
Sameer Ajit Mansukhani, Rajendra Prasad R Butala, Sunil H Shetty, Ravindra G Khedekar
Schwannomatosis is a disease characterized by the development of multiple benign tumours originating from Schwann cells. Schwannomatosis is a member of the family of diseases known as Neurofibromatosis (NF). Patients with Schwannomatosis develop multiple Schwannomas on cranial, spinal and peripheral nerves. We report a rare case of a 60-year-old female who presented with a painful swelling on the ulnar aspect of her distal forearm. She underwent an excisional biopsy for it; which was suggestive of a Schwannoma...
February 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28383293/peripheral-nerve-block-as-a-supplement-to-light-or-deep-general-anesthesia-in-elderly-patients-receiving-total-hip-arthroplasty-a-prospective-randomized-study
#12
Bin Mei, Hanning Zha, Xiaolong Lu, Xinqi Cheng, Shishou Cheng, Xuesheng Liu, Yuanhai Li, Erwei Gu
BACKGROUND: Peripheral nerve block combined with general anesthesia is a preferable anesthesia method for elderly patients receiving hip arthroplasty. The depth of sedation may influence patient recovery. Therefore, we aimed to investigate the influence of peripheral nerve blockade and different intraoperative sedation levels on the short-term recovery of elderly patients receiving total hip arthroplasty. METHODS: Patients aged 65 years and older undergoing total hip arthroplasty were randomized into three groups: a general anesthesia without lumbosacral plexus block group, and two general anesthesia plus lumbosacral plexus block groups, each with a different level of sedation (light or deep)...
April 5, 2017: Clinical Journal of Pain
https://www.readbyqxmd.com/read/28377693/inhibition-of-mammalian-target-of-rapamycin-mtor-signaling-in-the-insular-cortex-alleviates-neuropathic-pain-after-peripheral-nerve-injury
#13
Minjee Kwon, Jeongsoo Han, Un Jeng Kim, Myeounghoon Cha, Sun Woo Um, Sun Joon Bai, Seong-Karp Hong, Bae Hwan Lee
Injury of peripheral nerves can trigger neuropathic pain, producing allodynia and hyperalgesia via peripheral and central sensitization. Recent studies have focused on the role of the insular cortex (IC) in neuropathic pain. Because the IC is thought to store pain-related memories, translational regulation in this structure may reveal novel targets for controlling chronic pain. Signaling via mammalian target of rapamycin (mTOR), which is known to control mRNA translation and influence synaptic plasticity, has been studied at the spinal level in neuropathic pain, but its role in the IC under these conditions remains elusive...
2017: Frontiers in Molecular Neuroscience
https://www.readbyqxmd.com/read/28367345/pure-testicular-seminoma-relapsing-late-with-somatic-type-malignancy
#14
Klaus-Peter Dieckmann, Petra Anheuser, Ralf Gehrckens, Waldemar Wilczak, Guido Sauter, Doris Höflmayer
Background. Somatic type malignancy (STM) occurs in 2% of all germ cell tumours (GCTs). The prognosis is unfavourable and the origin is poorly understood. Pathogenetic hypotheses involve direct transformation of teratoma, origin from totipotent cancer cells, or derivation from yolk sac tumour elements. Case Presentation. A 31-year-old patient was cured from testicular seminoma clinical stage IIc by orchiectomy and cisplatin-based chemotherapy. Nine years later, he experienced a late relapse with a mass sized 5 × 6 cm located at the former metastatic site...
2017: Case Reports in Oncological Medicine
https://www.readbyqxmd.com/read/28362032/randomized-comparative-study-of-the-effectiveness-of-three-different-techniques-of-interscalene-brachial-plexus-block-using-0-5-ropivacaine-for-shoulder-arthroscopy
#15
Michał Kolny, Michał J Stasiowski, Marek Zuber, Radosław Marciniak, Ewa Chabierska, Aleksandra Pluta, Przemysław Jałowiecki, Tomasz Byrczek
BACKGROUND: Interscalene brachial plexus block is an effective regional anesthesia technique for shoulder surgeries. The superiority of the popular ultrasound-guided blocks over peripheral nerve stimulator-confirmed blocks remains unclear. In this study the efficacy of these different block techniques was compared. METHODS: This prospective, randomized, clinical study included 109 patients (ASA grades I-III) who receive 20 mL 0.5% ropivacaine with ultrasound-guided blocks (U group), peripheral nerve stimulator-confirmed blocks (N group), or ultrasound-guided and peripheral nerve stimulator-confirmed blocks (dual guidance; NU group) for elective shoulder arthroscopy...
2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/28360533/effects-of-decompression-on-behavioral-electrophysiologic-and-histomorphologic-recovery-in-a-chronic-sciatic-nerve-compression-model-of-streptozotocin-induced-diabetic-rats
#16
Ping-Hui Wang, Cheng-Chang Yang, Wei-Ren Su, Po-Ting Wu, Shun-Chien Cheng, I-Ming Jou
PURPOSE: To determine susceptibility to decompression surgery in diabetic and nondiabetic peripheral neuropathy using a chronic compression neuropathy model. MATERIALS AND METHODS: Twenty-four streptozotocin-induced diabetic rats were randomly divided into three groups: group I, chronic compression of the left sciatic nerve for 4 weeks with decompression; group II, similar without decompression; and group III, sham exposing the sciatic nerve only. The other 24 nondiabetic rats were assigned to groups IV-VI, which received compression-decompression, compression, and the sham operation, respectively...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28352311/control-released-basic-fibroblast-growth-factor-loaded-poly-lactic-co-glycolic-acid-microspheres-promote-sciatic-nerve-regeneration-in-rats
#17
Hai-Bo Si, Yi Zeng, Yan-Rong Lu, Jing-Qiu Cheng, Bin Shen
Although peripheral nerve injury may result in a loss of function in innervated areas, the most effective method for nerve regeneration remains to be determined. The aim of the present study was to investigate the effect of control-released basic fibroblast growth factor (bFGF)-loaded poly-lactic-co-glycolic acid (PLGA) microspheres on sciatic nerve regeneration following injury in rats. bFGF-PLGA microspheres were prepared and their characteristics were evaluated. The sciatic nerve was segmentally resected to create a 10 mm defect in 36 Sprague Dawley (SD) rats and, following the anastomosis of the nerve ends with a silicone tube, bFGF-PLGA microspheres, free bFGF or PBS were injected into the tube (n=12 in each group)...
February 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28352201/tibial-nerve-stimulation-with-a-miniature-wireless-stimulator-in-chronic-peripheral-neuropathic-pain
#18
Paweł Sokal, Marek Harat, Piotr Zieliński, Sara Kierońska
Peripheral neuropathic pain (PNP) and complex regional pain syndrome (CRPS) can be effectively treated with peripheral nerve stimulation. In this clinical trial report, effectiveness of novel, miniature, wirelessly controlled microstimulator of tibial nerve in PNP and CRPS was evaluated. In this pilot study the average preoperative visual analog scale (VAS) score in six patients was 7.5, with 1, 3 and 6 months: 2.6 (p=0.03), 1.6 (p=0.03), and 1.3 (p=0.02), respectively. The mean average score in the six patients a week preceding the baseline visit was 7...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28349408/cancer-of-the-peripheral-nerve-in-neurofibromatosis-type-1
#19
REVIEW
Verena Staedtke, Ren-Yuan Bai, Jaishri O'Neill Blakeley
The RASopathy neurofibromatosis 1 is an autosomal dominant hereditary cancer syndrome that represents a major risk for the development of malignancies, particularly malignant peripheral nerve sheath tumors (MPNSTs). MPNSTs are unique sarcomas that originate from the peripheral nerve and represent the only primary cancer of the peripheral nervous system. To date, surgery is the only treatment modality proven to have survival benefit for MPNSTs and even when maximal surgery is feasible, these tumors are rarely curable, despite the use of chemotherapy and radiation...
March 27, 2017: Neurotherapeutics: the Journal of the American Society for Experimental NeuroTherapeutics
https://www.readbyqxmd.com/read/28338524/chronic-boutonniere-deformities-supple-or-stiff-a-new-surgical-technique-with-early-mobilization-in-11-cases
#20
Elodie Dubois, Frederic Teboul, Thomas Bihel, Jean-N Goubier
Injuries to the central slip of the extensor mechanism can lead to a Boutonniere deformity with important functional consequences. We report a series of 11 patients treated by lengthening-dorsalizing the lateral bands and tightening the central slip with early mobilization. The average age of the patients was 42 years (14;52). The extension defect of the proximal interphalangeal (PIP) joint was 64 degrees (80;55) and the hyperextension of the distal interphalangeal joint was 10 degrees (15;5). The surgery was performed with peripheral nerve block (sensitive), allowing dynamic adjustment of the tendinous sutures...
March 23, 2017: Techniques in Hand & Upper Extremity Surgery
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