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Adductor nerve block

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https://www.readbyqxmd.com/read/29233569/continuous-adductor-canal-blocks-provide-superior-ambulation-and-pain-control-compared-to-epidural-analgesia-for-primary-knee-arthroplasty-a-randomized-controlled-trial
#1
Erdan Kayupov, Kamil Okroj, Adam C Young, Mario Moric, Timothy J Luchetti, Gilat Zisman, Asokumar Buvanendran, Tad L Gerlinger, Craig J Della Valle
BACKGROUND: Adductor canal blocks (ACBs) are an alternative to femoral nerve blocks that minimize lower extremity weakness. However, it is unclear whether this block will provide analgesia that is equivalent to techniques, such as epidural analgesia. The purpose of this randomized controlled trial was to compare continuous ACBs with epidural analgesia for primary total knee arthroplasty. METHODS: Following institutional review board approval, 145 patients were randomized to 1 of 3 groups: combined spinal-epidural (CSE), spinal + continuous ACB (CACB), or general + CACB...
November 13, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29219188/toxicity-trial-of-canine-posterior-cricoarytenoid-intramuscular-vincristine-injections
#2
Randal C Paniello, Neel K Bhatt, Rebecca Chernock
OBJECTIVES/HYPOTHESIS: In animal studies, intramuscular vincristine injections have been shown to block reinnervation of the denervated target muscle. This application could be used selectively to influence recovery patterns following injury of recurrent laryngeal nerves (RLNs). However, vincristine is currently Food and Drug Administration approved only for intravenous use. A formal toxicity trial of intramuscular injections was performed. STUDY DESIGN: Animal study...
December 8, 2017: Laryngoscope
https://www.readbyqxmd.com/read/29204497/decreased-risk-of-knee-buckling-with-adductor-canal-block-versus-femoral-nerve-block-in-total-knee-arthroplasty-a-retrospective-cohort-study
#3
Ryan R Thacher, Thomas R Hickernell, Matthew J Grosso, Roshan Shah, Herbert J Cooper, Robert Maniker, Anthony Robin Brown, Jeffrey Geller
Background: Femoral nerve (FNB) and adductor canal blocks (ACB) are used in the setting of total knee arthroplasty (TKA), but neither has been demonstrated to be clearly superior. Although dynamometer studies have shown ACBs spare perioperative quadriceps function when compared to FNBs, ACBs have been widely adopted in orthopaedic surgery without significant evidence that they decrease the risk of perioperative falls. Methods: All patients who received single-shot FNB (129 patients) or ACB (150 patients) at our institution for unilateral primary TKA from April 2014 to September 2015 were retrospectively reviewed for perioperative falls or near-falls during physical therapy and inpatient care...
December 2017: Arthroplasty Today
https://www.readbyqxmd.com/read/29178460/the-adequate-rocuronium-dose-required-for-complete-block-of-the-adductor-muscles-of-the-thigh
#4
M Fujimoto, K Kawano, T Yamamoto
BACKGROUND: Rocuronium can prevent the obturator jerk during transurethral resection of bladder tumors. We investigated the adequate rocuronium dose required for complete block of the thigh adductor muscles, and its correlation with individual responses of the adductor pollicis muscle to rocuronium. METHODS: Eleven patients scheduled for transurethral resection of bladder tumors under general anesthesia were investigated. After general anesthesia induction, neuromuscular monitoring of the adductor pollicis muscle and ultrasonography-guided stimulation of the obturator nerve was commenced...
November 26, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29172388/does-combination-therapy-of-popliteal-sciatic-nerve-block-and-adductor-canal-block-effectively-control-early-postoperative-pain-after-total-knee-arthroplasty
#5
Jin-Hyeok Seo, Seung-Suk Seo, Do-Hun Kim, Byung-Yoon Park, Chan-Ho Park, Ok-Gul Kim
Purpose: We compared adductor canal block (ACB) alone and a combination of ACB and sciatic nerve block (SNB) to control early postoperative pain after total knee arthroplasty. Materials and Methods: One hundred patients received continuous ACB alone (group A), and another 100 patients received continuous ACB and single popliteal SNB (group B). Pain was evaluated at rest and 45° knee flexion using the numeric rating scale (NRS). The number of times the patient pressed the intravenous patient-controlled analgesia (PCA) button, total PCA volume infused, and the total dosage of additional analgesics were evaluated...
December 1, 2017: Knee Surgery & related Research
https://www.readbyqxmd.com/read/29152521/isokinetic-strength-deficit-6-months-after-adductor-canal-blockade-for-anterior-cruciate-ligament-reconstruction
#6
James E Christensen, Natalie E Taylor, Scott J Hetzel, John A Shepler, Tamara A Scerpella
Background: Recent evidence shows a delayed return to sport in children and delayed quadriceps recovery in both adults and children who have undergone anterior cruciate ligament (ACL) reconstruction with concomitant femoral nerve blockade (FNB) compared with those who had no blockade. We evaluated the use of adductor canal blockade (ACB), as an alternative to FNB, at the time of ACL reconstruction. Hypothesis: Patients who receive ACB will have greater isokinetic strength at 6 months postoperative compared with patients who receive FNB at the time of ACL reconstruction...
November 2017: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/29064877/evidence-basis-for-regional-anesthesia-in-ambulatory-arthroscopic-knee-surgery-and-anterior-cruciate-ligament-reconstruction-part-ii-adductor-canal-nerve-block-a-systematic-review-and-meta-analysis
#7
Herman Sehmbi, Richard Brull, Ushma Jitendra Shah, Kariem El-Boghdadly, David Nguyen, Girish P Joshi, Faraj W Abdallah
BACKGROUND: Adductor canal block (ACB) has emerged as an effective analgesic regional technique for major knee surgeries in the last decade. Its motor-sparing properties make it particularly attractive for ambulatory knee surgery, but evidence supporting its use in ambulatory arthroscopic knee surgery is conflicting. This systematic review and meta-analysis evaluates the analgesic effects of ACB for ambulatory arthroscopic knee surgeries. METHODS: We conducted a comprehensive search of electronic databases for randomized controlled trials examining the analgesic effects of ACB compared to control or any other analgesic modality...
October 19, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29043004/efficacy-of-perineural-dexamethasone-with-ropivacaine-in-adductor-canal-block-for-post-operative-analgesia-in-patients-undergoing-total-knee-arthroplasty-a-randomized-controlled-trial
#8
Cun-Jin Wang, Feng-Yun Long, Liu-Qing Yang, You-Jing Shen, Fang Guo, Tian-Feng Huang, Ju Gao
Adductor canal block (ACB) is an effective analgesic alternative to femoral nerve block after total knee arthroplasty (TKA). The aim of the present study was to investigate whether addition of dexamethasone to ropivacaine for ACB is able to prolong analgesia and reduce pain. Study participants were randomized into groups receiving ACB with either 0.5% ropivacaine + normal saline (control group; n=93) or 0.5% ropivacaine + 8 mg dexamethasone (dexamethasone group; n=93). All patients were subjected to identical peri-operative management...
October 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29026354/novel-regional-techniques-for-total-knee-arthroplasty-promote-reduced-hospital-length-of-stay-an-analysis-of-106-patients
#9
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/28953616/effects-of-methylprednisolone-on-the-duration-of-rocuronium-induced-neuromuscular-block-a-randomized-double-blind-trial
#10
RANDOMIZED CONTROLLED TRIAL
Weilian Geng, Yuyan Nie, Shaoqiang Huang
BACKGROUND: We aim to investigate whether intraoperative use of methylprednisolone could affect the duration of rocuronium-induced neuromuscular blockade. METHODS: A double blind, randomized, placebo-controlled trial was conducted. A total of 136 patients underwent gynecologic laparoscopic surgery were randomly divided into 3 groups: pregroup, receiving intravenous injection of methylprednisolone (40 mg) 30 minutes before induction of anesthesia; postgroup, receiving intravenous injection of methylprednisolone (40 mg) immediately after induction of anesthesia and intubation; and control group, receiving intravenous injection of normal saline...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28937534/the-spread-of-ultrasound-guided-injectate-from-the-adductor-canal-to-the-genicular-branch-of-the-posterior-obturator-nerve-and-the-popliteal-plexus-a-cadaveric-study
#11
Charlotte Runge, Bernhard Moriggl, Jens Børglum, Thomas Fichtner Bendtsen
BACKGROUND AND OBJECTIVES: The popliteal nerve plexus contributes to afferent knee-pain conduction. It is mainly formed by genicular branches from the posterior obturator and the tibial nerves, innervating the intra-articular and posterior knee region. A subinguinal obturator nerve block alleviates pain after total knee arthroplasty. Reduced hip adductor motor function could be avoided by a posterior obturator nerve block inside the popliteal fossa.The aim of this study was to evaluate the spread of dye after a distal adductor canal (AC) injection to the popliteal fossa and coloring of the popliteal plexus and the genicular branch of the posterior obturator nerve by dissection...
November 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28880902/clonidine-used-as-a-perineural-adjuvant-to-ropivacaine-does-not-prolong-the-duration-of-sensory-block-when-controlling-for-systemic-effects-a-paired-blinded-randomized-trial-in-healthy-volunteers
#12
RANDOMIZED CONTROLLED TRIAL
Jakob Hessel Andersen, Pia Jaeger, Tobias Laier Sonne, Jørgen Berg Dahl, Ole Mathiesen, Ulrik Grevstad
BACKGROUND: Clonidine used as an adjuvant to ropivacaine have been shown to prolong the duration of peripheral nerve blocks. The mechanism of action remains unclear. We hypothesized, that clonidine used as an adjuvant to ropivacaine extends the duration of an adductor canal block (ACB) by a peripheral mechanism, compared to ropivacaine alone when controlling for systemic effects. METHODS: We conducted a paired, blinded, randomized trial in healthy volunteers. Participants received bilateral ACBs containing 20 ml ropivacaine 0...
2017: PloS One
https://www.readbyqxmd.com/read/28868169/relieving-pain-after-arthroscopic-knee-surgery-ultrasound-guided-femoral-nerve-block-or-adductor-canal-block
#13
Poupak Rahimzadeh, Hamid Reza Faiz, Farnad Imani, Geoffrey Grant Hobika, Armaghan Abbasi, Nader D Nader
OBJECTIVE: To compare the analgesic effects of femoral nerve block (FNB) and adductor canal block (ACB) after arthroscopic knee surgery. METHODS: This was a prospective randomised clinical trial that enrolled 92 patients undergoing arthroscopic knee surgery. Ultrasound-guided FNB or ACB was performed immediately after surgery for pain relief. Visual analogue scale (VAS) scores and modified sedation-agitation scale (SAS) were recorded and analysed immediately following block and at 3, 6, 12 and 24 hours...
August 2017: Turkish Journal of Anaesthesiology and Reanimation
https://www.readbyqxmd.com/read/28861197/comparison-of-the-effect-of-continuous-femoral-nerve-block-and-adductor-canal-block-after-primary-total-knee-arthroplasty
#14
Seung Suk Seo, Ok Gul Kim, Jin Hyeok Seo, Do Hoon Kim, Youn Gu Kim, Beyoung Yun Park
BACKGROUND: This study aimed to compare the effects of femoral nerve block and adductor canal block on postoperative pain, quadriceps strength, and walking ability after primary total knee arthroplasty. METHODS: Between November 2014 and February 2015, 60 patients underwent primary total knee arthroplasty. Thirty patients received femoral nerve block and the other 30 received adductor canal block for postoperative pain control. Before spinal anesthesia, the patients received nerve block via a catheter (20 mL 0...
September 2017: Clinics in Orthopedic Surgery
https://www.readbyqxmd.com/read/28799964/the-effect-of-adductor-canal-block-on-knee-extensor-muscle-strength-6-weeks-after-total-knee-arthroplasty-a-randomized-controlled-trial
#15
Nicolas Rousseau-Saine, Stephan R Williams, François Girard, Luc J Hébert, Florian Robin, Luc Duchesne, Frédéric Lavoie, Monique Ruel
BACKGROUND: Total knee arthroplasty (TKA) reduces knee extensor muscle strength (KES) in the operated limb for several months after the surgery. Immediately after TKA, compared to either inguinal femoral nerve block or placebo, adductor canal block (ACB) better preserves KES. Whether this short-term increase in KES is maintained several weeks after surgery remains unknown. We hypothesized that 48 hours of continuous ACB immediately after TKA would improve KES 6 weeks after TKA, compared to placebo...
August 9, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28795964/neuromuscular-monitoring-in-the-perioperative-period
#16
Glenn S Murphy
Neuromuscular monitoring devices were introduced into clinical practice in the 1970s. Qualitative neuromuscular monitors, or peripheral nerve stimulators, provide an electrical stimulus to a motor nerve and the response of corresponding muscle subjectively evaluated. A standard peripheral nerve stimulator provides several patterns of nerve stimulation, including train-of-four (TOF), double-burst, tetanic, and post-tetanic count. Qualitative (and quantitative) monitors are needed to determine onset of neuromuscular blockade, maintain the required depth of muscle relaxation during the surgical procedure, and assess an appropriate dose of reversal agent...
August 8, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28763413/ultrasound-guided-motor-sparing-knee-blocks-for-postoperative-analgesia-following-total-knee-arthroplasty-a-randomized-blinded-study
#17
RANDOMIZED CONTROLLED TRIAL
Olawale A Sogbein, Rakesh V Sondekoppam, Dianne Bryant, David F Johnston, Edward M Vasarhelyi, Steven MacDonald, Brent Lanting, Sugantha Ganapathy, James L Howard
BACKGROUND: Pain following total knee arthroplasty (TKA) is often severe and can inhibit rehabilitation. Motor-sparing analgesic techniques such as periarticular infiltrations and adductor canal blocks have been popularized for knee analgesia since they preserve motor strength and permit early mobilization. Our primary objective was to compare the duration of analgesia from motor-sparing blocks with that of a standard periarticular infiltration. We used the time to first rescue analgesia as the end point...
August 2, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28757853/ultrasound-guided-adductor-and-sciatic-nerve-block-two-in-one-approach-at-mid-thigh-level
#18
Amarjeet Kumar, Chandni Sinha, Ajeet Kumar, Poonam Kumari
No abstract text is available yet for this article.
July 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/28663632/obturator-nerve-block-in-transurethral-resection-of-bladder-tumor-a-comparison-of-ultrasound-guided-technique-versus-ultrasound-with-nerve-stimulation-technique
#19
Nida Farooq Shah, Khalid Parvez Sofi, Showkat Hussain Nengroo
BACKGROUND: Obturator nerve (ON) stimulation during transurethral resection of lateral and posterolateral bladder wall tumor under spinal anesthesia may lead to obturator reflex, adductor contraction, and leg jerking with complications such as bleeding, bladder perforation, or incomplete tumor resection. Our study was carried out to obtain successful block of ON using ultrasound (US)-guided technique with or without nerve stimulation in patients undergoing transurethral resection of bladder tumor (TURBT) under spinal anesthesia...
April 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28617716/hybrid-blocks-for-total-knee-arthroplasty-a-technical-description
#20
David F Johnston, Rakesh V Sondekoppam, Vishal Uppal, James L Howard, Sugantha Ganapathy
This narrative review article aims to examine current evidence of knee innervation in order to develop a technique of targeting pure sensory innervation of the knee joint without compromising motor function. A literature review of knee innervation was performed to gain an anatomic understanding of terminal sensory branches of the relevant target nerves (femoral, obturator, sciatic, and lateral femoral cutaneous). Pure sensory block of the knee joint is challenging due to important contributions from the muscular innervation close to the joint and the variability of nerves afferents contained within and around the adductor canal...
June 14, 2017: Clinical Journal of Pain
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