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https://www.readbyqxmd.com/read/28106318/reduced-laser-evoked-potential-habituation-detects-abnormal-central-pain-processing-in-painful-radiculopathy-patients
#1
P Hüllemann, C von der Brelie, G Manthey, J Düsterhöft, A K Helmers, M Synowitz, R Baron
BACKGROUND: Repetitive painful laser stimuli lead to physiological laser-evoked potential (LEP) habituation, measurable by a decrement of the N2/P2 amplitude. The time course of LEP-habituation is reduced in the capsaicin model for peripheral and central sensitization and in patients with migraine and fibromyalgia. In the present investigation, we aimed to assess the time course of LEP-habituation in a neuropathic pain syndrome, i.e. painful radiculopathy. METHODS: At the side of radiating pain, four blocks of 25 painful laser stimuli each were applied to the ventral thigh at the L3 dermatome in 27 patients with painful radiculopathy...
January 20, 2017: European Journal of Pain: EJP
https://www.readbyqxmd.com/read/28098413/dermatomal-spread-following-posterior-transversus-abdominis-plane-block-in-pediatric-patients-our-initial-experience
#2
Maria A Hernandez, Tricia Vecchione, Karen Boretsky
INTRODUCTION: Several techniques for the transversus abdominis plane (TAP) block have been described. The extent of sensory changes using an ultrasound-guided posterior TAP block (pTAP) remains unclear in pediatric patients. The primary aim of this study was to report the extent of sensory changes achieved with pTAP; specifically the highest thoracic dermatome anesthetized. Secondary outcomes were pain scores (PS), opioid consumption, and complications. METHODS: We retrospectively reviewed the medical records of patients less than 21 years of age undergoing abdominal surgery with a unilateral or bilateral pTAP(s) for postoperative analgesia...
January 18, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28091815/quantitative-validation-of-sensory-mapping-in-persistent-postherniorrhaphy-inguinal-pain-patients-undergoing-triple-neurectomy
#3
M F Bjurström, R Álvarez, A L Nicol, R Olmstead, P K Amid, D C Chen
PURPOSE: Neurectomy of the inguinal nerves may be considered for selected refractory cases of chronic postherniorrhaphy inguinal pain (CPIP). There is to date a paucity of easily applicable clinical tools to identify neuropathic pain and examine the neurosensory effects of remedial surgery. The present quantitative sensory testing (QST) pilot study evaluates a sensory mapping technique. METHODS: Longitudinal (preoperative, immediate postoperative, and late postoperative) dermatomal sensory mapping and a comprehensive QST protocol were conducted in CPIP patients with unilateral, predominantly neuropathic inguinodynia presenting for triple neurectomy (n = 13)...
January 13, 2017: Hernia: the Journal of Hernias and Abdominal Wall Surgery
https://www.readbyqxmd.com/read/28074426/use-of-colour-doppler-and-m-mode-ultrasonography-to-confirm-the-location-of-an-epidural-catheter-a-retrospective-case-series
#4
Hesham Elsharkawy, Abraham Sonny, Srinivasa Raghavan Govindarajan, Vincent Chan
PURPOSE: Epidural anesthesia and analgesia has a reported failure rate ranging from 13% to 32%. We describe a technique using colour Doppler and M-mode ultrasonography to determine the position of the epidural catheter after placement in adults. METHODS: This retrospective review included 37 adult patients who received postoperative epidural analgesia and underwent technically difficult epidural catheter placement. The demographic characteristics, type of surgery, use of ultrasonography, method of insertion, intervertebral level, and success of epidural localization using colour Doppler were noted for each patient...
January 10, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28072800/modified-percutaneous-lumbar-foraminoplasty-and-percutaneous-endoscopic-lumbar-discectomy-instrument-design-technique-notes-and-5-years-follow-up
#5
Zhen-Zhou Li, Shu-Xun Hou, Wei-Lin Shang, Ke-Ran Song, Hong-Liang Zhao
BACKGROUND: Conventional percutaneous endoscopic lumbar discectomy (PELD) with an "inside-outside" technique has 4.3% - 10.3% surgical failure rate, especially in central herniated discs (HDs), migrated HDs, and axillary type HDs. PELD with foraminoplasty has been used for complex HDs. Percutaneous lumbar foraminoplasty (PLF), which is performed with a trephine or bone reamer introduced over a guidewire without a protective working cannula in the original Tessys technique, can quickly cut the hypertrophied bony structure under fluoroscopic guidance, and risk injury to the exiting and traversing nerve roots...
January 2017: Pain Physician
https://www.readbyqxmd.com/read/28071597/three-dimensional-printing-of-a-microneedle-array-on-personalized-curved-surfaces-for-dual-pronged-treatment-of-trigger-finger
#6
Seng Han Lim, Jian Yao Ng, Lifeng Kang
The hand function of patients who suffer from trigger finger can be impaired by the use of traditional splints. There is also a risk of systemic side effects with oral non-steroidal anti-inflammatory drugs (NSAIDs) used for pain relief. Microneedle-assisted transdermal drug delivery offers an attractive alternative for local delivery of NSAIDs. However, traditional microneedle arrays fabricated on flat surfaces are unable to deliver drugs effectively across the undulating skin surface of affected finger(s)...
January 10, 2017: Biofabrication
https://www.readbyqxmd.com/read/28062367/methods-to-simulate-rubbing-of-topical-formulation-for-in-vitro-skin-permeation-studies
#7
Hiep X Nguyen, Ashana Puri, Ajay K Banga
Rubbing a topical formulation on skin is generally assumed to enhance drug penetration. The aim of this study was to demonstrate different techniques such as using glass rod, rheometer, and gloved finger for rubbing a 2% salicylic acid gel on skin and investigate their effect on in vitro permeation of salicylic acid through dermatomed porcine ear skin. The studies included evaluation of the gel's rheological properties, gel distribution on skin surface, in vitro permeability, drug distribution in skin, skin extraction recovery, and mass balance...
January 3, 2017: International Journal of Pharmaceutics
https://www.readbyqxmd.com/read/28036319/quadratus-lumborum-block-as-an-alternative-to-lumbar-plexus-block-for-hip-surgery-a-report-of-2-cases
#8
Luca La Colla, Bruce Ben-David, Rita Merman
Quadratus lumborum (QL) block was first described several years ago, but few articles have been published regarding this technique, for the most part case series involving abdominal surgery. We report 2 cases of prolonged, extensive block of thoracic and lumbar dermatomes after QL block in patients undergoing different hip surgery procedures for whom QL block was used in place of lumbar plexus block. Further prospective studies comparing these 2 techniques are necessary to better characterize the role of QL block in hip surgery...
January 1, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28017162/quadratus-lumborum-block-in-chronic-pain-after-abdominal-hernia-repair-case-report
#9
Rita Carvalho, Elena Segura, Maria do Céu Loureiro, José Pedro Assunção
BACKGROUND AND OBJECTIVES: The quadratus lumborum blockade was described by R. Blanco in its two approaches (I and II). The local anesthetic deposition in this location can provide blockade to T6-L1 dermatomes. We performed this fascia blockade guided by ultrasound for treating a chronic neuropathic pain in the abdominal wall. CASE REPORT: Male patient, 61 years old, 83kg, with a history of thrombocytopenia due to alcoholic cirrhosis, among others; had chronic pain in the abdominal wall after multiple abdominal hernia repairs in the last year and a half, with poor response to treatment with neuromodulators and opioids...
January 2017: Brazilian Journal of Anesthesiology
https://www.readbyqxmd.com/read/27990397/unilateral-zosteriform-lichen-planus-involving-multiple-noncontiguous-dermatomes-with-oral-involvement
#10
Nidhi Jivani, Rahulkrishna S Kota, Pragya A Nair
No abstract text is available yet for this article.
November 2016: Indian Dermatology Online Journal
https://www.readbyqxmd.com/read/27938930/clinical-characteristics-and-outcomes-in-a-population-with-disseminated-herpes-zoster-a-retrospective-cohort-study
#11
M L Bollea-Garlatti, L A Bollea-Garlatti, A S Vacas, A C Torre, A M Kowalczuk, R L Galimberti, B L Ferreyro
INTRODUCTION: Shingles is the cutaneous expression of the reactivation of latent varicella zoster virus infection in sensory ganglia. It presents as vesicles in the corresponding dermatome. The condition is called disseminated herpes zoster (DHZ) when more than 2 contiguous dermatomes are affected, more than 20 vesicles are observed outside the initial dermatome, or involvement is systemic. DHZ is rare and most frequently occurs in immunocompromised patients. OBJECTIVES: To describe the epidemiology, predisposing factors, clinical presentation, laboratory findings, and clinical course of patients with DHZ, and to compare the findings in immunocompromised and immunocompetent patients...
December 6, 2016: Actas Dermo-sifiliográficas
https://www.readbyqxmd.com/read/27935990/hyperalgesia-and-persistent-pain-after-breast-cancer-surgery-a-prospective-randomized-controlled-trial-with-perioperative-cox-2-inhibition
#12
Noud van Helmond, Monique A Steegers, Gertie P Filippini-de Moor, Kris C Vissers, Oliver H Wilder-Smith
BACKGROUND: Persistent pain is a challenging clinical problem after breast cancer treatment. After surgery, inflammatory pain and nociceptive input from nerve injury induce central sensitization which may play a role in the genesis of persistent pain. Using quantitative sensory testing, we tested the hypothesis that adding COX-2 inhibition to standard treatment reduces hyperalgesia after breast cancer surgery. A secondary hypothesis was that patients developing persistent pain would exhibit more postoperative hyperalgesia...
2016: PloS One
https://www.readbyqxmd.com/read/27932746/-distribution-of-pain-and-numbness-in-patients-with-cervical-spine-disorders
#13
Keita Kuraishi, Masaki Mizuno, Yasuyuki Umeda, Tomoki Ishigaki, Ryuta Yasuda, Takanori Sano, Masato Shiba, Fumihiro Kawakita, Yoshinari Nakatsuka, Kazuhiro Furukawa, Satoru Tanioka, Masanori Tsuji, Masayuki Kitagami, Seiji Hatazaki, Hidenori Suzuki
PURPOSE: To elucidate the distribution of improved pain and numbness after cervical decompression surgery in patients with cervical spine disorders. METHODS: This study included 4 men and 5 women aged 45 to 71 years(mean 58 years)presenting with radiculopathy and 50 men and 17 women aged 35 to 88 years(mean 66 years)presenting with myelopathy. RESULTS: All 9 patients with radiculopathy presented with neck pain, and 3 presented with cervical angina...
December 2016: No Shinkei Geka. Neurological Surgery
https://www.readbyqxmd.com/read/27917700/posterior-reversible-encephalopathy-syndrome-following-elevated-mean-arterial-pressures-for-cervical-spinal-cord-injury
#14
Jeffrey H Zimering, Addisu Mesfin
BACKGROUND: Increasing the mean arterial pressure (MAP) is an accepted treatment modality to minimize the risk for irreversible neurologic damage secondary to spinal cord ischemia. Posterior reversible encephalopathy syndrome (PRES) is a rare complication occurring after transplantation surgery, in persons having an autoimmune disorder or after abrupt increases in blood pressure of various etiologies. STUDY DESIGN: Case report. METHODS: Retrospective evaluation of medical records...
December 5, 2016: Journal of Spinal Cord Medicine
https://www.readbyqxmd.com/read/27904277/herpes-zoster-duplex-unilateralis-two-cases-and-brief-literature-review
#15
Jee Hee Son, Bo Young Chung, Hye One Kim, Hee Jin Cho, Chun Wook Park
Cases involving dermatomal herpes zoster in two or more locations are rare, especially in immunocompetent patients. When two noncontiguous dermatomes are involved, if affected unilaterally, it is called herpes zoster duplex unilateralis; if bilaterally, bilateralis. Here, we report two cases of herpes zoster duplex unilateralis. A 66-year-old man presented with painful erythematous grouped vesicles on his left scalp, forehead, trunk, and back (left [Lt.] V1, Lt. T8). Histologic findings were consistent with herpetic infection...
December 2016: Annals of Dermatology
https://www.readbyqxmd.com/read/27904265/a-study-of-intravenous-administration-of-vitamin-c-in-the-treatment-of-acute-herpetic-pain-and-postherpetic-neuralgia
#16
Min Sung Kim, Dong Jin Kim, Chan Ho Na, Bong Seok Shin
BACKGROUND: Although there are several available management strategies for treatment of both acute pain of herpes zoster (HZ) and postherpetic neuralgia (PHN), it is difficult to treat them adequately. OBJECTIVE: The aim of this study was to evaluate the efficacy of intravenously administrated vitamin C on acute pain and its preventive effects on PHN in patients with HZ. METHODS: Between September 2011 and May 2013 eighty-seven patients who were admitted for HZ were assessed according to age, sex, underlying diseases, duration of pain and skin lesion, dermatomal distribution, and PHN...
December 2016: Annals of Dermatology
https://www.readbyqxmd.com/read/27903340/-the-clinical-application-of-lumbar-plexus-the-first-posterior-sacral-foramina-block-for-hip-arthroplasty-in-elderly-patients
#17
J Li, X J Ke, Y Liu, K Chen, M B Chen, W Mei
Objective: To evaluate the clinical efficacy of lumbar plexus-the first posterior sacral foramina block as an anesthesia technique for hip arthroplasty in elderly patients. Methods: Forty-four patients, aged 60-91 years, weighing 37-100 kg, American Society of Anesthesiologists (ASA) Ⅰ-Ⅲ, underwent elective hip arthroplasty in Tongji Hospital from February 2015 to January 2016.All patients received lumbar plexus and the first posterior sacral foramina block.The first posterior sacral foramina puncture point of 23 cases were located by traditional positioning method, the others were orientated via ultrasonic method...
November 22, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/27900771/laparoscopic-guided-psoas-blockade-as-a-novel-analgesic-method-during-inguinal-herniorrhaphy-a-clinical-trial
#18
T F Tammam, A F Salama
BACKGROUND: Under laparoscopic guidance, block of ilioinguinal, iliohypogastric, and genitofemoral nerves can be possible with anesthetic injection in the plane between psoas major and the fasciae covering its anterior aspects [laparoscopic-assisted psoas (LAP) blockade]. This observer-blinded trial aimed to compare the opioid-sparing effect of LAP block with transversus abdominis plane (TAP) block after laparoscopic inguinal herniorrhaphy. METHODS: Forty-five male patients were randomly assigned to receive LAP block, group LAP (n = 23), or ultrasound-guided TAP block, group TAP (n = 22)...
February 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/27897183/sensory-thresholds-at-different-sites-of-the-foot-a-valuable-reference-for-neurologic-examinations
#19
J-W Zhang, Q Wang, X-F Wang, M-M Gao, X-P Yun, H-F Wu, Y Hong
STUDY DESIGN: Prospective healthy volunteer study for sensory thresholds. OBJECTIVES: The aim of this study was to test sensory thresholds at different sites of the foot to provide a reference for diagnosis and neurologic classification. SETTING: A university hospital for the research and clinical practice of rehabilitation. METHODS: Thirty healthy volunteers were recruited, and quantitative sensory testing was performed on three sites of the foot (medial malleolus (for the L4 dermatome), dorsum of the foot at the third metatarsal phalangeal joint (for the L5 dermatome) and lateral heel (for the S1 dermatome))...
November 29, 2016: Spinal Cord
https://www.readbyqxmd.com/read/27896665/ultrasound-guided-thoracic-paravertebral-block-by-the-paralaminar-in-plane-approach-using-a-microconvex-array-transducer-methodological-utility-based-on-anatomical-structures
#20
Yasuko Taketa, Taro Fujitani, Yumi Irisawa, Satoko Sudo, Kazushi Takaishi
OBJECTIVE: We evaluated the analgesic feasibility of paralaminar in-plane (PL) approach for ultrasound-guided thoracic paravertebral block (USG-TPVB). As the needle trajectory was expected to be closely affected by the distance from the skin to the lamina-transverse process junction (LTPJ), we examined the correlativity between them on computed tomography (CT) or ultrasonography. METHODS: Thirty-two patients undergoing thoracotomy were recruited. We measured the distances between the skin and LTPJ using preoperative CT (S-L) and procedural ultrasonography (US-L)...
November 28, 2016: Journal of Anesthesia
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