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https://www.readbyqxmd.com/read/28203022/-clinical-evaluation-of-in-plane-ultrasound-guided-thoracic-paravertebral-block-using-laterally-intercostal-approach
#1
T Xu, M Li, Y Tian, J T Song, C Ni, X Y Guo
OBJECTIVE: To evaluate the feasibility and success rate of in-plane ultrasound-guided paravertebral block using laterally intercostal approach. METHODS: In the study, 27 patients undergoing elective thoracic surgery were selected to do paravertebral block preoperatively. The fifth intercostal space was scanned by ultrasound probe which was placed along the long axis of the rib and 8 cm lateral to the midline of the spine. The needle was advanced in increments aiming at the space between the internal and innermost intercostal muscles...
February 18, 2017: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/28188621/the-analgesic-efficacy-of-pre-operative-bilateral-erector-spinae-plane-esp-blocks-in-patients-having-ventral-hernia-repair
#2
K J Chin, S Adhikary, N Sarwani, M Forero
Laparoscopic ventral hernia repair is an operation associated with significant postoperative pain, and regional anaesthetic techniques are of potential benefit. The erector spinae plane (ESP) block performed at the level of the T5 transverse process has recently been described for thoracic surgery, and we hypothesised that performing the ESP block at a lower vertebral level would provide effective abdominal analgesia. We performed pre-operative bilateral ESP blocks with 20-30 ml ropivacaine 0.5% at the level of the T7 transverse process in four patients undergoing laparoscopic ventral hernia repair...
February 11, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28176603/can-axial-pain-be-helpful-to-determine-surgical-level-in-the-multilevel-cervical-radiculopathy
#3
Bo-Kyung Suh, Ki Han You, Moon Soo Park
Spine surgeons are required to differentiate symptomatic cervical disc herniation with asymptomatic radiographic herniation. Although the dermatomal sensory dysfunction of upper extremity is the most important clue, axial pain including cervicogenic headache and parascapular pain may be helpful to find surgical target level. However, there is no review article about the axial pain originated from cervical spondylotic radiculopathy and relieved by surgical decompression. The purpose is to review the literatures about the axial pain, which can be utilized in determining target level to be decompressed in the patients with cervical radiculopathy at multiple levels...
January 2017: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/28161442/transdermal-delivery-of-cimetidine-across-microneedle-treated-skin-effect-of-extent-of-drug-ionization-on-the-permeation
#4
Yang Song, Anushree Herwadkar, Meera G Patel, Ajay K Banga
The objective of this work was to optimize a gel formulation of cimetidine to maximize its transdermal delivery across microporated skin. Specifically, the effect of extent of ionization in formulation on permeation of cimetidine across microporated skin was studied. Cimetidine was formulated into a gel using propylene glycol, water and carbopol 980NF. Three strengths of gels (0.1% w/w, 0.5% w/w and 0.8% w/w) were made and Tris base was used to adjust the pH of formulations to pH 5, pH 6.8 and pH 7.5. In vitro permeation testing was performed on vertical Franz cells with dermatomed porcine ear skin...
February 1, 2017: Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/28161015/-electrophysiological-testing-in-spinal-cord-tumors
#5
REVIEW
N André-Obadia, F Mauguière
Evoked potentials (EPs) are useful to evaluate the functional impairment of motor and somatosensory pathways in spinal cord tumors. Conduction through pyramidal tracts is evaluated by motor EPs (MEPs) elicited by transcranial stimulation, magnetic for awake patients or electric in the operating room. Somatosensory EPs (SEPs) and laser EPs (LEPs) are complementary procedures to explore conduction in dorsal columns and spinothalamic tracts, respectively. MEPs as well as SEPs show conduction abnormalities in about 60% of cases with a sensitivity that increases up to 70% when both procedures are carried out...
February 1, 2017: Neuro-Chirurgie
https://www.readbyqxmd.com/read/28158158/prevention-of-post-herpetic-neuralgia-from-dream-to-reality-a-ten-step-model
#6
Mohamed Younis Makharita
Herpes zoster (HZ) is a painful, blistering skin eruption in a dermatomal distribution caused by reactivation of a latent varicella zoster virus in the dorsal root ganglia (DRG). Post-herpetic neuralgia (PHN) is the most common complication of acute herpes zoster (AHZ).Severe prodrome, greater acute pain and dermatomal injury, and the density of the eruption are the risk factors and predictors for developing PHN. PHN has a substantial effect on the quality of life; many patients develop severe physical, occupational, social, and psychosocial disabilities as a result of the unceasing pain...
February 2017: Pain Physician
https://www.readbyqxmd.com/read/28158157/successful-long-term-nerve-root-stimulation-for-chronic-neuropathic-pain-a-real-world-single-center-canadian-experience
#7
Adrian B Levine, David A Steven, Andrew G Parrent, Keith W MacDougall
BACKGROUND: Spinal cord stimulation (SCS) is a well-established treatment for chronic neuropathic pain in the lower limbs. However, some patients have pain in distributions that are difficult to target specifically and consistently with SCS. This often involves pain in the groin or upper limbs, or pain limited to a specific dermatome. We hypothesized that dorsal nerve root stimulation (DNRS) would provide similar pain relief for these patients, compared to our results using SCS. OBJECTIVES: In this study we report our experience treating patients with chronic neuropathic pain using SCS and DNRS...
February 2017: Pain Physician
https://www.readbyqxmd.com/read/28157131/zosteriform-mycosis-fungoides-a-new-clinical-presentation-with-a-dermatomal-distribution
#8
Kerri E Rieger, Jinah Kim, Youn H Kim
Classic mycosis fungoides (MF) presents with patches and plaques on the trunk and proximal extremities. However, numerous clinicopathologic variants have been described, making diagnosis challenging. Here, the authors report a 21-year-old woman with immunophenotypically and molecularly confirmed MF occurring in a dermatomal distribution. Awareness of this and other rare variants of MF is critical to avoid misdiagnosis.
December 29, 2016: American Journal of Dermatopathology
https://www.readbyqxmd.com/read/28153583/evolution-of-skin-grafting-for-treatment-of-burns-reverdin-pinch-grafting-to-tanner-mesh-grafting-and-beyond
#9
REVIEW
Mansher Singh, Kristo Nuutila, K C Collins, Anne Huang
BACKGROUND: Skin grafting is the current standard care in the treatment of full thickness burns. It was first described around 1500 BC but the vast majority of advancements have been achieved over the past 200 years. METHODS: An extensive literature review was conducted on Pubmed, Medline and Google Scholar researching the evolution of skin grafting techniques. The authors concentrated on the major landmarks of skin grafting and also provide an overview of ongoing research efforts in this field...
January 30, 2017: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/28137401/secondary-hyperalgesia-occurs-regardless-of-unilateral-or-bilateral-knee-osteoarthritis-involvement-in-individuals-with-mild-or-moderate-level
#10
Vanessa Martins Pereira Silva Moreira, Saulo Delfino Barboza, Juliana Borges Oliveira, Janser Moura Pereira, Valdeci Carlos Dionisio
BACKGROUND: Secondary hyperalgesia in individuals with less severe levels of knee osteoarthritis remains unclear. The objective of this study was to measure the pressure pain threshold of individuals with mild or moderate knee osteoarthritis and compare with no osteoarthritis. METHODS: Ten healthy controls and 30 individuals with mild or moderate knee osteoarthritis divided into two groups (unilateral and bilateral involvement) were included. Dermatomes in lumbar levels (L1, L2, L3, L4 and L5) and sacral level (S1 and S2), myotomes (vastus medialis, vastus lateralis, rectus femoris, adductor longus, tibialis anterior, peroneus longus, iliacus, quadratus lumborum, and popliteus muscles), and sclerotomes in lumbar levels (L1-L2, L2-L3, L3-L4, L4-L5 supraspinous ligaments), over the L5-S1 and S1-S2 sacral areas, pes anserinus bursae, and at the patellar tendon pressure pain threshold were assessed and compared between individuals with and without knee osteoarthritis...
January 2017: Revista Brasileira de Reumatologia
https://www.readbyqxmd.com/read/28134736/zosteriform-mycosis-fungoides-a-new-clinical-presentation-with-a-dermatomal-distribution
#11
Kerri E Rieger, Jinah Kim, Youn H Kim
Classic mycosis fungoides (MF) presents with patches and plaques on the trunk and proximal extremities. However, numerous clinicopathologic variants have been described, making diagnosis challenging. Here, the authors report a 21-year-old woman with immunophenotypically and molecularly confirmed MF occurring in a dermatomal distribution. Awareness of this and other rare variants of MF is critical to avoid misdiagnosis.
February 2017: American Journal of Dermatopathology
https://www.readbyqxmd.com/read/28119773/psoas-compartment-block-for-treatment-of-motor-weakness-and-pain-following-herpes-zoster
#12
Sae Young Kim, Dong Gyeong Kim, Yong Min Park, Young Hoon Jeon
Reactivation of the latent varicella zoster virus in the sensory ganglion causes herpes zoster (HZ). Its characteristic symptom is a painful rash in the involved dermatome. HZ-induced motor weakness is rare and is usually resolved within one year of the onset, but some patients permanently experience motor dysfunction. Epidural steroid administration, with antiviral therapy, can be effective in treating pain from HZ and preventing postherpetic neuralgia. But an epidural block is contraindicated in patients receiving thromboprophylaxis...
January 2017: Korean Journal of Pain
https://www.readbyqxmd.com/read/28119344/dermatomal-organization-of-si-leg-representation-in-humans-revising-the-somatosensory-homunculus
#13
Caroline Dietrich, Kathrin R Blume, Marcel Franz, Ralph Huonker, Maria Carl, Sandra Preißler, Gunther O Hofmann, Wolfgang H R Miltner, Thomas Weiss
Penfield and Rasmussen's homunculus is the valid map of the neural body representation of nearly each textbook of biology, physiology, and neuroscience. The somatosensory homunculus places the foot representation on the mesial surface of the postcentral gyrus followed by the representations of the lower leg and the thigh in superio-lateral direction. However, this strong homuncular organization contradicts the "dermatomal" organization of spinal nerves. We used somatosensory-evoked magnetic fields and source analysis to study the leg's neural representation in the primary somatosensory cortex (SI)...
January 23, 2017: Cerebral Cortex
https://www.readbyqxmd.com/read/28117333/usefulness-of-laser-evoked-potentials-and-quantitative-sensory-testing-in-the-diagnosis-of-neuropathic-spinal-cord-injury-pain-a-multiple-case-study
#14
G Landmann, M F Berger, L Stockinger, E Opsommer
STUDY DESIGN: A retrospective study. OBJECTIVES: The aim of this study was to investigate the contribution of laser-evoked potentials (LEPs) and quantitative sensory testing (QST) to the diagnosis of neuropathic pain in patients with spinal cord injury (SCI) and inconclusive magnetic resonance imaging (MRI) findings. SETTING: A multidisciplinary pain center. METHODS: QST (DFNS protocol) and Tm-YAG-laser stimulation of the skin were applied within the pain site corresponding with dermatomes of altered sensation...
January 24, 2017: Spinal Cord
https://www.readbyqxmd.com/read/28116506/a-randomized-controlled-trial-comparing-paravertebral-block-via-the-surgical-field-with-thoracic-epidural-block-using-ropivacaine-for-post-thoracotomy-pain-relief
#15
Takahiro Tamura, Shoichi Mori, Atsushi Mori, Masahiko Ando, Shuichi Yokota, Yasuyuki Shibata, Kimitoshi Nishiwaki
PURPOSE: We conducted a comparative study to evaluate analgesic efficacy between paravertebral block via the surgical field (PVB-sf), in which the catheter was inserted into the ventral side of the sympathetic trunk in the paravertebral space by a thoracic surgeon under thoracoscopic visualization, and epidural block (Epi) using ropivacaine for post-thoracotomy pain relief. METHODS: Lung cancer patients scheduled for lobectomy via thoracotomy were randomly allocated to receive either PVB-sf or Epi (n = 36 per group)...
January 23, 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/28106318/reduced-laser-evoked-potential-habituation-detects-abnormal-central-pain-processing-in-painful-radiculopathy-patients
#16
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
#17
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
#18
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
#19
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
#20
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
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