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Truncal Block

J Rahiri, J Tuhoe, D Svirskis, N J Lightfoot, P B Lirk, A G Hill
Background.: Safe and efficacious modalities of perioperative analgesia are essential for enhanced recovery after surgery. Truncal nerve blocks are one potential adjunct for analgesia of the abdominal wall, and in recent years their popularity has increased. Transversus abdominis plane block (TAPB) and rectus sheath block (RSB) have been shown to reduce morphine consumption and improve pain relief after abdominal surgery. These blocks typically require large volumes of local anaesthetic (LA)...
April 1, 2017: British Journal of Anaesthesia
Hyejin Cho, William G Kaelin
Inactivation of the von Hippel-Lindau tumor-suppressor protein (pVHL) is the signature "truncal" event in clear cell renal cell carcinoma, which is the most common form of kidney cancer. pVHL is part of a ubiquitin ligase the targets the α subunit of the hypoxia-inducible factor (HIF) transcription factor for destruction when oxygen is available. Preclinical studies strongly suggest that deregulation of HIF, and particularly HIF2, drives pVHL-defective renal carcinogenesis. Although HIF2α was classically considered undruggable, structural and chemical work by Rick Bruick and Kevin Gardner at University of Texas Southwestern laid the foundation for the development of small molecule direct HIF2α antagonists (PT2385 and the related tool compound PT2399) by Peloton Therapeutics that block the dimerization of HIF2α with its partner protein ARNT1...
December 8, 2016: Cold Spring Harbor Symposia on Quantitative Biology
Arunangshu Chakraborty, Rakhi Khemka, Taniya Datta
The practice of regional anaesthesia is rapidly changing with the introduction of ultrasound into the working domain of the anaesthesiologist. New techniques are being pioneered. Among the recent techniques, notable are the truncal blocks, for example, the transversus abdominis plane block, rectus sheath block, hernia block and quadratus lumborum block in the abdomen and the pectoral nerves (Pecs) block 1 and 2, serratus anterior plane block and intercostal nerve block. This narrative review covers the brief anatomical discourse along with technical description of the ultrasound-guided truncal blocks...
October 2016: Indian Journal of Anaesthesia
Kariem El-Boghdadly, Herman Sehmbi, Vincent W S Chan
No abstract text is available yet for this article.
September 2016: Regional Anesthesia and Pain Medicine
Takeshi Murouchi, Michiaki Yamakage
PURPOSE: Retrolaminar block (RLB) is a thoracic truncal block that can produce analgesia for the thoracic and abdominal wall. However, the characteristics of RLB are not well known. The aim of this study was to determine analgesic efficacy by measuring postoperative consume of patient-controlled analgesia (PCA), additional nonsteroidal antiinflammatory drug (NSAID) rescue, and opioid rescue. Our secondary analysis included assessment of the chronological change in arterial levobupivacaine concentrations after the block...
December 2016: Journal of Anesthesia
Ramon Go, Yolanda Y Huang, Paul D Weyker, Christopher Aj Webb
As the American healthcare system continues to evolve and reimbursement becomes tied to value-based incentive programs, perioperative pain management will become increasingly important. Regional anesthetic techniques are only one component of a successful multimodal pain regimen. In recent years, the use of peripheral and paraneuraxial blocks to provide chest wall and abdominal analgesia has gained popularity. When used within a multimodal regimen, truncal blocks may provide similar analgesia when compared with other regional anesthetic techniques...
October 2016: Pain Management
Matthew Abrahams, Ryan Derby, Jean-Louis Horn
UNLABELLED: We summarized the evidence for ultrasound (US) guidance for truncal blocks in 2010 by performing a systematic literature review and rating the strength of evidence for each block using a system developed by the United States Agency for Health Care Policy and Research. Since then, numerous studies of US guidance for truncal blocks have been published. In addition, 3 novel US-guided blocks have been described since our last review. To provide updated recommendations, we performed another systematic search of the literature to identify studies pertaining to US guidance for the following blocks: paravertebral, intercostal, transversus abdominis plane, rectus sheath, ilioinguinal/iliohypogastric, as well as the Pecs, quadratus lumborum, and transversalis fascia blocks...
March 2016: Regional Anesthesia and Pain Medicine
Takeshi Murouchi, Soshi Iwasaki, Michiaki Yamakage
BACKGROUND AND OBJECTIVES: The quadratus lumborum block (QLB) is an abdominal truncal block, similar to transversus abdominis plane block (TAPB). However, the characteristics of QLB with regard to its duration and safety are not well known. The primary aim of this study was to determine the block duration and the cutaneous sensory block area. Our secondary analysis included assessment of the chronological change in arterial local anesthetic concentrations after QLB. METHODS: This study included 11 patients scheduled for laparoscopic ovarian surgery under general anesthesia...
March 2016: Regional Anesthesia and Pain Medicine
Kirstin Aschbacher, Sarah Kornfeld, Martin Picard, Eli Puterman, Peter J Havel, Kimber Stanhope, Robert H Lustig, Elissa Epel
BACKGROUND: In preclinical studies, the combination of chronic stress and a high sugar/fat diet is a more potent driver of visceral adiposity than diet alone, a process mediated by peripheral neuropeptide Y (NPY). METHODS: In a human model of chronic stress, we investigated whether the synergistic combination of highly palatable foods (HPF; high sugar/fat) and stress was associated with elevated metabolic risk. Using a case-control design, we compared 33 post-menopausal caregivers (the chronic stress group) to 28 age-matched low-stress control women on reported HPF consumption (modified Block Food Frequency Questionnaire), waistline circumference, truncal fat ultrasound, and insulin sensitivity using a 3-h oral glucose tolerance test...
August 2014: Psychoneuroendocrinology
Masato Kitayama, Morito Wada, Hiroshi Hashimoto, Tsuyoshi Kudo, Norikazu Takada, Kazuyoshi Hirota
We evaluated the pharmacokinetics of ropivacaine following rectus sheath block (RSB) and transversus abdominis plane (TAP) block with or without epinephrine. A total of 26 adult patients undergoing lower abdominal surgery with RSB (=RSB trial) and another 26 adult patients undergoing open prostatectomy with TAP block (=TAP trial) were enrolled. Patients were randomly assigned to receive either a mixture of 0.75 % ropivacaine 13.2 mL with 1 % plain lidocaine 6.8 mL (TAP-E(-) and RSB-E(-) groups) or a mixture of 0...
August 2014: Journal of Anesthesia
Claudia Pföhler, Eva Janssen, Arno Buecker, Thomas Vogt, Cornelia S L Müller
Abstract The β-blocker propranolol has become a valuable and effective drug for the treatment of infantile hemangiomas. Its therapeutic action probably results from vasoconstriction, blocking of angiogenesis through effects on vascular endothelial growth factor and induction of apoptosis. It is reasonable to suggest that propranolol can also be used effectively in the treatment of other vascular abnormalities. This case report describes propranolol treatment of vascular malformations such as Klippel-Trénaunay syndrome or Parkes-Weber syndrome in adults...
February 2015: Journal of Dermatological Treatment
Jodi-Ann Oliver, Lori-Ann Oliver
PURPOSE OF REVIEW: To discuss and compare the more commonly used truncal blocks with neuraxial techniques in children undergoing a variety of thoracic, abdominal and urological procedures. RECENT FINDINGS: Owing to the advent of ultrasonography and its increasing use in regional anesthesia, there has been a renewed interest in implementing these techniques in children for intraoperative and postoperative pain management. SUMMARY: The use of regional anesthesia particularly with ultrasound guidance is an integral part of pain management during the intraoperative and postoperative period in children who undergo surgery...
December 2013: Current Opinion in Anaesthesiology
Margaret Lashof-Sullivan, Andrew Shoffstall, Erin Lavik
Excessive bleeding and the resulting complications are a leading killer of young people globally. There are many successful methods to halt bleeding in the extremities, including compression, tourniquets, and dressings. However, current treatments for internal hemorrhage (including from head or truncal injuries), termed non-compressible bleeding, are inadequate. For these non-compressible injuries, blood transfusions are the current treatment standard. However, they must be refrigerated, may potentially transfer disease, and are of limited supply...
November 21, 2013: Nanoscale
Stan L Block
No abstract text is available yet for this article.
August 2013: Pediatric Annals
Kil Hwan Kim, Ye Seob Jee
Gastrojejunocolic fistula is a rare condition after gastrojejunostomy. It is severe complications of gastrojejunostomy, which results an inadequate resection or incomplete vagotomy during peptic ulcer surgery. The symptoms are diarrhea, upper abdominal pain, bleeding, vomiting and weight loss. A 55-year-old man with chronic diarrhea and weight loss for 6 months visited Dankook University Hospital. The patient had received a truncal vagotomy and gastrojejunostomy for duodenal ulcer obstruction 15 years previously...
April 2013: Journal of the Korean Surgical Society
Bassam R Ali, Jennifer L Silhavy, Matthew J Gleeson, Joseph G Gleeson, Lihadh Al-Gazali
BACKGROUND: Dysequilibrium syndrome is a genetically heterogeneous condition that combines autosomal recessive, nonprogressive cerebellar ataxia with mental retardation. The condition has been classified into cerebellar ataxia, mental retardation and disequilibrium syndrome types 1 (CAMRQ1), 2 (CAMRQ2) and 3 (CAMRQ3) and attributed to mutations in VLDLR, CA8 and WDR81 genes, respectively. Quadrupedal locomotion in this syndrome has been reported in association with mutations in all three genes...
September 14, 2012: BMC Medical Genetics
Tomoe Nakamura, Noriko Morimoto, Fumiyuki Goto, Yoko Shioda, Hideki Hoshino, Masaya Kubota, Hidenobu Taiji
Langerhans cell histiocytosis (LCH) is a very rare disease in which granulation tissue forms in various organs and the central nervous system (CNS) due to monoclonal proliferation of Langerhans cells. Some patients develop ataxia, tremor, or neurodegenerative abnormalities (such as personality changes and mental deterioration) several years after the onset as the late effects of LCH. We report a case of a 4-year-old boy with LCH, showing speech disorder, truncal ataxia and a wide-based gait with abnormal findings of central nervous system in CT and MRI image...
December 2012: Auris, Nasus, Larynx
Nikhil Singh, Chinmay M Trivedi, MinMin Lu, Shannon E Mullican, Mitchell A Lazar, Jonathan A Epstein
RATIONALE: The development of the cardiac outflow tract (OFT) and great vessels is a complex process that involves coordinated regulation of multiple progenitor cell populations. Among these populations, neural crest cells make important contributions to OFT formation and aortic arch remodeling. Although numerous signaling pathways, including Notch, have been implicated in this process, the role of epigenetics in OFT development remains largely unexplored. OBJECTIVE: Because histone deacetylases (Hdacs) play important roles in the epigenetic regulation of mammalian development, we have investigated the function of Hdac3, a class I Hdac, during cardiac neural crest development in mouse...
November 11, 2011: Circulation Research
Peter N van Harten, Diederik E Tenback
Tardive dyskinesia (TD) is a common and potentially irreversible side effect of dopamine blocking agents, most often antipsychotics. It is often socially and sometimes also physically disabling. The clinical picture can be divided into orofacial, limb-truncal, and respiratory dyskinesia. The clinical options to prevent or mitigate TD include psychoeducation, systematic screening, and evaluation of the need for antipsychotics and/or dosages, managementof known risk factors, and switching to an antipsychotic with a lower risk of TD...
2011: International Review of Neurobiology
Mohamed Bilal Delvi
Ultrasound has added a feather in the cap of the anesthesiologists as real-time nerve localization and drug deposition around the nerve structure under real-time guidance is now a reality, as the saying "seeing is believing" has been proven true with the advent of ultrasound in anesthesia. Pediatric patients are a unique group regarding their anatomical and physiological features in comparison with adults; regional blocks in adults with the anatomical landmark and surface marking are almost uniform across the adult population...
April 2011: Saudi Journal of Anaesthesia
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