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Peripheral nerve surgery

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https://www.readbyqxmd.com/read/29036889/single-administration-of-melatonin-modulates-the-nitroxidergic-system-at-the-peripheral-level-and-reduces-thermal-nociceptive-hypersensitivity-in-neuropathic-rats
#1
Elisa Borsani, Barbara Buffoli, Veronica Bonazza, Russel J Reiter, Rita Rezzani, Luigi F Rodella
Neuropathic pain is a severe condition with unsatisfactory treatments. Melatonin, an indolamine, seems to be a promising molecule suitable for this purpose due to its well-known anti-inflammatory, analgesic, and antioxidant effects, as well as its modulation of the nitroxidergic system. Nevertheless, the data on its mechanism of action and potentialities are currently insufficient in this pathology, especially at the peripheral level. Thus, this work evaluated the effect of a single administration of melatonin in an established mononeuropathy pain model that monitors the behaviour and the changes in the nitroxidergic system in dorsal root ganglia and skin, which are affected by nervous impairment...
October 14, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/29029335/cortical-reorganization-in-dual-innervation-by-single-peripheral-nerve
#2
Mou-Xiong Zheng, Yun-Dong Shen, Xu-Yun Hua, Ao-Lin Hou, Yi Zhu, Wen-Dong Xu
BACKGROUND: Functional recovery after peripheral nerve injury and repair is related with cortical reorganization. However, the mechanism of innervating dual targets by 1 donor nerve is largely unknown. OBJECTIVE: To investigate the cortical reorganization when the phrenic nerve simultaneously innervates the diaphragm and biceps. METHODS: Total brachial plexus (C5-T1) injury rats were repaired by phrenic nerve-musculocutaneous nerve transfer with end-to-side (n = 15) or end-to-end (n = 15) neurorrhaphy...
September 21, 2017: Neurosurgery
https://www.readbyqxmd.com/read/29026822/intraoperative-nerve-stimulation-during-brachial-plexus-surgery-comparison-between-a-totally-disposable-nerve-stimulator-and-nerve-stimulator-normally-used-for-nerve-blocks
#3
Ahmed Thallaj, Wadha M Alotaibi, Tariq AlZahrani, Abdulaziz S Abaalkhail, Amel A F El-Sayed, Mohammad M Al-Qattan
BACKGROUND: Intraoperative nerve stimulation is done routinely in brachial plexus and peripheral nerve surgery as well as in selective neurectomy in spastic patients. OBJECTIVE: The current study compares the use of 2 different devices for nerve stimulation: a totally disposable nerve stimulator and a nerve stimulator used for nerve blocks by anesthetists. METHODS: A retrospective study of 60 patients who underwent brachial plexus surgery: In 30 patients, we used the totally disposable nerve stimulator (group 1) and in another 30 patients, we used the anesthesia device (group 2)...
August 2017: Plastic Surgery
https://www.readbyqxmd.com/read/29026761/postherpetic-neuralgia-diabetic-neuropathy-and-trigeminal-neuralgia-chronic-peripheral-neuropathic-pain-in-58-480-rural-italian-primary-care-patients
#4
Nicola Buono, Hans Thulesius, Ferdinando Petrazzuoli, Elena Castelli, Marco Cambielli
INTRODUCTION: Chronic peripheral neuropathic pain (CPNP) is a condition due to peripheral nervous system diseases or injury, but its prevalence is unknown in Italian primary care. AIM: The aim of this study is to assess the prevalence of CPNP in a rural primary care area in Northern Italy. MATERIALS AND METHODS: A multicenter audit study was carried out in a rural area in Northern Italy with 113 participating general practitioners (GPs) seeing 58,480 patients >18 years during 3 months...
January 2017: Journal of Family Medicine and Primary Care
https://www.readbyqxmd.com/read/28991122/peripheral-nerve-blocks-for-hip-fractures-a-cochrane-review
#5
Joanne Guay, Martyn J Parker, Richard Griffiths, Sandra L Kopp
BACKGROUND: This review focuses on the use of peripheral nerve blocks as preoperative analgesia, as postoperative analgesia, or as a supplement to general anesthesia for hip fracture surgery and tries to determine if they offer any benefit in terms of pain on movement at 30 minutes after block placement, acute confusional state, myocardial infarction/ischemia, pneumonia, mortality, time to first mobilization, and cost of analgesic. METHODS: Trials were identified by computerized searches of Cochrane Central Register of Controlled Trials (2016, Issue 8), MEDLINE (Ovid SP, 1966 to 2016 August week 1), Embase (Ovid SP, 1988 to 2016 August week 1), and the Cumulative Index to Nursing and Allied Health Literature (EBSCO, 1982 to 2016 August week 1), trials registers, and reference lists of relevant articles...
October 4, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28987316/bypass-for-symptomatic-in-stent-carotid-restenosis
#6
Francesco Stilo, Pasqualino Sirignano, Nunzio Montelione, Wassim Mansour, Laura Capoccia, Vincenzo Catanese, Francesco Spinelli, Francesco Speziale
BACKGROUND: To evaluate early and long-term outcomes of symptomatic patients treated for in-stent carotid restenosis (ISR) with carotid bypass (CB). METHODS: Data were retrospectively collected from a prospectively compiled database on patients treated with CB in two high-volume Italian centers between 2008 and 2016, for symptomatic high-grade ISR after CAS. After carotid endarterectomy and stent removal, a greater saphenous vein (GSV) was preferentially employed as the graft; when the GSV was not accessible, a 6mm polytetrafluoroethylene (PTFE) graft was implanted...
September 20, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28974982/current-concept-in-adult-peripheral-nerve-and-brachial-plexus-surgery
#7
REVIEW
Lukas Rasulic
Peripheral nerve injuries and brachial plexus injuries are relatively frequent. Significance of these injuries lies in the fact that the majority of patients with these types of injuries constitute working population. Since these injuries may create disability, they present substantial socioeconomic problem nowadays. This article will present current state-of-the-art achievements of minimal invasive brachial plexus and peripheral nerve surgery. It is considered that the age of the patient, the mechanism of the injury, and the associated vascular and soft-tissue injuries are factors that primarily influence the extent of recovery of the injured nerve...
January 2017: Journal of Brachial Plexus and Peripheral Nerve Injury
https://www.readbyqxmd.com/read/28973650/bupivacaine-field-block-with-clonidine-for-postoperative-pain-control-in-posterior-spine-approaches-a-randomized-double-blind-trial
#8
Joe Abdel Hay, Sandra Kobaiter-Maarrawi, Patrick Tabet, Ronald Moussa, Tony Rizk, Georges Nohra, Nabil Okais, Elie Samaha, Jospeh Maarrawi
BACKGROUND: The synergistic effect of clonidine with bupivacaine, well established in peripheral nerve blocks, remains controversial in local field block for postoperative analgesia. OBJECTIVE: To investigate the potential analgesic benefit of adding clonidine to bupivacaine during preincisional field block in posterior approaches for spine surgeries. METHODS: Two hundred twenty-five patients were enrolled in this study and underwent lumbar spinal fusion (n = 80), lumbar laminectomy (n = 25), lumbar microdiscectomy (n = 94), or cervical laminectomy (n = 26)...
July 21, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28968538/local-infiltration-of-the-surgical-wound-with-levobupivacaine-ibuprofen-and-epinephrine-in-postoperative-pain-an-experimental-study
#9
Prashant S Korat, Pankaj P Kapupara
The body areas from where sutures are removed later, where wound healing is delayed. Epidural analgesia is the most effective method but could not be used for postoperative pain. Peripheral nerve blockers also provided excellent analgesia but are not effective in postoperative pain. Infiltration of the surgical wound with local anesthetics is decreased postoperative pain by inhibiting transmission of noxious impulses at the site. The objective of the study was to explore the effect of the local infiltration of the surgical wounds with low-dose of levobupivacaine, ibuprofen, and epinephrine over the sutured muscle wound in postoperative pain...
September 29, 2017: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
https://www.readbyqxmd.com/read/28968230/comparative-evaluation-of-the-electrophysiological-functional-and-ultrastructural-effects-of-alpha-lipoic-acid-and-cyanocobalamin-administration-in-a-rat-model-of-sciatic-nerve-injury
#10
Bahriye Horasanli, Askin Esen Hasturk, Murat Arikan, Guray Togral, Fatma Helvacioglu, Atilla Dagdeviren, Senem Mut, Ferhat Harman, Guldeniz Argun
BACKGROUND: Vitamin B12 and alpha lipoic acid (ALA) are known to promote functional and morphological recovery after peripheral nerve injury. OBJECTIVE: To compare the regenerative and neuroprotective effects of vitamin B12 and ALA treatment after sciatic nerve injury. METHODS: A total of 40 rats were randomly assigned to control (sciatic nerve exposure without injury or anastomosis), sham (sciatic nerve injury and epineural anastomosis were performed but no treatment was administered), PS (isotonic saline was administered for 12 weeks after surgery), ALA (2 mg/kg ALA was administered for 12 weeks after surgery), and vitamin B12 groups (2 mg/kg cyanocobalamin was administered for 12 weeks after surgery)...
September 22, 2017: Journal of Back and Musculoskeletal Rehabilitation
https://www.readbyqxmd.com/read/28964926/managing-postoperative-pain-after-minimally-invasive-gynecologic-surgery-in-the-era-of-the-opioid-epidemic
#11
REVIEW
Marron Wong, Stephanie Morris, Karen Wang, Khara Simpson
In this review, we examine the evidence behind non-opioid medication alternatives, peripheral nerve blocks, surgical techniques, and postoperative recovery protocols that can help minimize and effectively treat postoperative pain after minimally invasive gynecologic surgery (MIGS). Due to the depth and heterogeneity of the data, a narrative review was performed of reported interventions. A comprehensive review was performed of Pubmed, EMBASE, and the Cochrane Database with a focus on randomized controlled trials (RCT)...
September 27, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28944869/promoting-potential-of-adipose-derived-stem-cells-on-peripheral-nerve-regeneration
#12
Jiayan Guo, Shu Guo, Yuxin Wang, Yanqiu Yu
The ultimate goal of treating peripheral nerve defects is reconstructing continuity of the nerve stumps to regain nerve conduction and functional recovery. Clinically, autologous nerve grafts and Schwann cell (SC) therapy have limitations, such as the need for secondary surgery, sacrifice of another nerve and donor site complication. Adipose derived stem cells (ADSCs) may promise to be ideal alternative cells of SCs. To explore the potential of ADSCs promoting peripheral nerve regeneration, the present study investigated the influences of ADSCs on proliferation and neurotrophic function of SCs using co‑culture model in vitro...
September 21, 2017: Molecular Medicine Reports
https://www.readbyqxmd.com/read/28938298/safety-and-efficacy-of-epidural-analgesia
#13
Elke M E Bos, Markus W Hollmann, Philipp Lirk
PURPOSE OF REVIEW: Epidural analgesia remains a widely used analgesic technique. This article aims to assess the safety of epidural analgesia by balancing efficacy and complications, of epidural analgesia for acute, labor and chronic pain. RECENT FINDINGS: Main indications for epidural analgesia include major open abdominal surgery, thoracotomy and labor analgesia. Past and current literature show that epidural analgesia leads to statistically significant, but possibly clinically less meaningful, reductions in pain scores compared with intravenous analgesia...
September 21, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28928555/continuous-femoral-nerve-blockade-versus-epidural-analgesia-for-postoperative-pain-relief-in-knee-surgeries-a-randomized-controlled-study
#14
Suma Vishwanatha, Sandhya Kalappa
BACKGROUND: Peripheral neural blockade provides effective analgesia with potentially less side effects than an epidural blockade. The present study was undertaken to compare continuous femoral nerve blockade (CFNB) with continuous epidural analgesia (CEA) for postoperative pain control in knee surgeries. MATERIALS AND METHODS: The patients belonging to the American Society of Anesthesiologists Class I and II scheduled for various knee surgeries under spinal anesthesia were enrolled in this study...
July 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28927209/intraoperative-imaging-in-traumatic-peripheral-nerve-lesions-correlating-histologic-cross-sections-with-high-resolution-ultrasound
#15
S Shelby Burks, Iahn Cajigas, Jean Jose, Allan D Levi
BACKGROUND: Intraoperative ultrasound (US) has been used as a guide during surgery to better identify deep neuroanatomical structures. OBJECTIVE: To correlate histologic cross-sections from nerve samples taken at the time of surgery with axial, high-resolution US images at similar locations and validate this important tool for intraoperative guidance in nerve surgery. METHODS: Three subjects undergoing nerve repair procedures after traumatic nerve injuries were enrolled prospectively...
April 1, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28926683/salvage-rates-and-prognostic-factors-after-relapse-in-children-and-adolescents-with-malignant-peripheral-nerve-sheath-tumors
#16
Luca Bergamaschi, Gianni Bisogno, Carla Manzitti, Paolo D'Angelo, Giuseppe Maria Milano, Angela Scagnellato, Mirko Cappelletti, Stefano Chiaravalli, Patrizia Dall'Igna, Rita Alaggio, Antonio Ruggiero, Martina Di Martino, Maria Carmen Affinita, Marta Pierobon, Alberto Garaventa, Michela Casanova, Andrea Ferrari
BACKGROUND: Malignant peripheral nerve sheath tumor (MPNST) is one of the most common nonrhabdomyosarcoma soft tissue sarcomas encountered in pediatric age, and it is generally characterized by poor outcome, particularly for relapsing patients. MATERIALS AND METHODS: This study considered 73 patients <21 years of age with relapsing MPNST observed among 120 patients enrolled in Italian pediatric protocols from 1979 to 2004. With the aim of possibly establishing a risk-adapted stratification, patients' outcome was examined using univariate and multivariate analysis based on clinical features at onset, first-line treatments, clinical findings at the time of first relapse, and second-line treatments...
September 19, 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/28924675/malignant-triton-tumor-grand-round-presentation-of-a-rare-aggressive-case-thoracolumbar-spine-tumor
#17
Soufiane Ghailane, Sandra Fauquier, Sébastien Lepreux, Jean-Charles Le Huec
INTRODUCTION: We report a rare and aggressive case of malignant triton tumor (MTT) at the thoracolumbar junction with foraminal extension mistreated as schwannoma. MATERIALS AND METHODS: A 70-year-old man with a 2-year history of lower back pain and left L4 radiculopathy with no history of neurofibromatosis. RESULTS: Pre-operative MRI suggested a typical schwannoma. Upon complete marginal resection, histological findings revealed a MTT. The patient presented with a local and regional recurrence and died 10 months after surgery...
September 18, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28922231/use-of-regional-anesthesia-for-outpatient-surgery-within-the-united-states-a-prevalence-study-using-a-nationwide-database
#18
Rodney A Gabriel, Brian M Ilfeld
BACKGROUND: Regional anesthesia is of benefit for outpatient surgery given its demonstrated improvement in analgesia and decrease in complications, resulting in shorter average recovery room times and lower hospital readmission rates. Unfortunately, there are few epidemiological studies outlining the overall utilization of peripheral nerve blocks (PNBs) in this setting. Therefore, the primary objective of this study was to report the overall utilization of several types of PNBs among all candidate cases in the outpatient setting within the United States...
September 14, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28919502/comparison-of-the-memory-foam-pad-versus-the-bean-bag-with-shoulder-braces-in-preventing-patient-displacement-during-gynecologic-laparoscopic-surgery
#19
Sara Farag, Leigh Rosen, Charles Ascher-Walsh
STUDY OBJECTIVE: The primary aim was to compare the amount of patient displacement when a memory foam pad is used versus a bean bag with shoulder braces. The secondary aim was to evaluate for post-operative extremity symptoms including pain, numbness, and weakness. DESIGN: Prospective randomized pilot study. DESIGN: Classification: Canadian Task Force Class I SETTING: Single academic institution PATIENTS: Women ≥ 18 years of age undergoing laparoscopic or robotic gynecologic surgery INTERVENTIONS: Patients were randomized to be positioned on the memory foam pad (Group A) or the bean bag with shoulder braces (Group B) pre-operatively...
September 15, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28914740/the-role-of-precisely-matching-fascicles-in-the-quick-recovery-of-nerve-function-in-long-peripheral-nerve-defects
#20
Liwei Yan, Zhi Yao, Tao Lin, Qingtang Zhu, Jian Qi, Liqiang Gu, Jintao Fang, Xiang Zhou, Xiaolin Liu
Peripheral nerve injury therapy in the clinic remains less than satisfactory. The gold standard of treatment for long peripheral nerve defects is autologous nerve grafts; however, numerous clinical complications are associated with this treatment. As tissue engineering has developed, tissue-engineered nerve grafts (TENGs) have shown potential applications as alternatives to autologous nerve grafts. To verify the important role of the biomimetic pathway of fascicle design in TENGs, we designed an animal model to study the role of the precise matching of fascicles in the effectiveness of nerve function recovery...
October 18, 2017: Neuroreport
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