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Saphenous block

Amanda J Kennedy, Peiran Yang, Cai Read, Rhoda E Kuc, Lucy Yang, Emily J A Taylor, Colin W Taylor, Janet J Maguire, Anthony P Davenport
BACKGROUND: Circulating levels of chemerin are significantly higher in hypertensive patients and positively correlate with blood pressure. Chemerin activates chemokine-like receptor 1 (CMKLR1 or ChemR23) and is proposed to activate the "orphan" G-protein-coupled receptor 1 (GPR1), which has been linked with hypertension. Our aim was to localize chemerin, CMKLR1, and GPR1 in the human vasculature and determine whether 1 or both of these receptors mediate vasoconstriction. METHODS AND RESULTS: Using immunohistochemistry and molecular biology in conduit arteries and veins and resistance vessels, we localized chemerin to endothelium, smooth muscle, and adventitia and found that CMKLR1 and GPR1 were widely expressed in smooth muscle...
October 14, 2016: Journal of the American Heart Association
L Baverel, T Cucurulo, C Lutz, Colombet, J Cournapeau, F Dalmay, N Lefevre, R Letartre, J-F Potel, X Roussignol, L Surdeau, E Servien
INTRODUCTION: More and more anterior cruciate ligament (ACL) reconstructions are being performed as outpatient surgery in France, because of economic considerations. Postoperative pain is the most common reason for delayed discharge that could require hospitalization, and the main reason for unanticipated hospital admission. The purpose of this study was to define the best anesthesia and analgesia methods for ACL reconstruction. MATERIALS AND METHODS: This was a prospective, multicenter, comparative study performed between January 2014 and April 2015...
September 26, 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
Barry Rose, Kumar Kunasingam, Tristan Barton, James Walsh, Karen Fogarty, Andrew Wines
: Local anesthetic use for wound infusions, single injection, and continuous nerve blocks for postoperative analgesia is well established. No study has investigated the effect of a continuous block of the saphenous and superficial peroneal nerves at the level of the ankle joint following first ray surgery. A double blind randomized controlled trial was designed. One hundred patients with hallux valgus and rigidus requiring surgical correction were recruited and randomized to receive a postoperative continuous infusion at the ankle of normal saline or ropivacaine for 24 hours...
September 9, 2016: Foot & Ankle Specialist
Eugene Krustev, Milind M Muley, Jason J McDougall
Neurogenic inflammation is a local inflammatory response that is driven by the peripheral release of neuropeptides from small diameter afferents which occurs in many organs including joints. The knee joint has a rich endocannabinoid system which has been shown to decrease acute synovitis. The aim of this study was to investigate the influence of joint afferents on leukocyte-endothelial interactions within the synovial microcirculation of mice and determine the role of endocannabinoids on this inflammatory response...
August 22, 2016: Neuropeptides
Pia Jæger, Zbigniew J Koscielniak-Nielsen, Karen Lisa Hilsted, Ulrik Grevstad, Volkert Siersma, Maria Louise Fabritius, Jørgen Berg Dahl
BACKGROUND: The binary aims of this study were to investigate the effect of total dose of lidocaine on duration of an adductor canal block (ACB) and to validate different methods used to assess nerve blocks. METHODS: We performed 2 blinded, randomized, controlled crossover trials, including healthy, young men. In study 1, 14 subjects received 4 ACBs with saline and 40, 80, and 160 mg lidocaine. In study 2, 14 new subjects received 2 ACBs with 100 and 300 mg lidocaine...
October 2016: Anesthesia and Analgesia
Barbara A Danek, Aris Karatasakis, Aya J Alame, Phuong-Khanh J Nguyen-Trong, Judit Karacsonyi, Bavana Rangan, Michele Roesle, Amy Atwell, Erica Resendes, Jose Roberto Martinez-Parachini, Rahel Iwnetu, Pratik Kalsaria, Furqan Siddiqui, James E Muller, Subhash Banerjee, Emmanouil Brilakis
OBJECTIVES: We sought to examine near-infrared spectroscopy (NIRS) imaging findings of aortocoronary saphenous vein grafts (SVGs). BACKGROUND: SVGs are prone to develop atherosclerosis similar to native coronary arteries. They have received little study using NIRS. METHODS: We examined the clinical characteristics and imaging findings from 43 patients who underwent NIRS imaging of 45 SVGs at our institution between 2009 and 2016. RESULTS: The mean patient age was 67 ± 7 years and 98% were men, with high prevalence of diabetes mellitus (56%), hypertension (95%), and dyslipidemia (95%)...
August 18, 2016: Catheterization and Cardiovascular Interventions
Thomas A Trein, Beatriz P Floriano, Juliana T Wagatsuma, Joana Z Ferreira, Guilherme L da Silva, Paulo Sp Dos Santos, Sílvia Hv Perri, Valéria Nls Oliva
OBJECTIVE: To evaluate motor and sensory blockade of combining dexmedetomidine with ropivacaine, administered perineurally or systemically, for femoral and sciatic nerve blocks in conscious dogs. STUDY DESIGN: Randomized, controlled, experimental study. ANIMALS: Seven healthy Beagle dogs, aged 3.3 ± 0.1 years and weighing 11.0 ± 2.4 kg. METHODS: Dogs were anesthetized with isoflurane on three separate occasions for unilateral femoral and sciatic nerve blocks and were administered the following treatments in random order: perineural ropivacaine 0...
June 28, 2016: Veterinary Anaesthesia and Analgesia
José Antonio López-Ruiz, Luis Tallón-Aguilar, Beatriz Marenco-de la Cuadra, José López-Pérez, Fernando Oliva-Mompeán, Javier Padillo-Ruiz
BACKGROUND: Large vessel sarcomas are rare tumours. Leiomyosarcoma of the inferior vena cava is the most common. About 300 cases have been reported in the literature. They tend to be large, and not develop metastasis. The prognosis of these tumours is poor. CLINICAL CASE: An 81 year-old woman who complained of pain in the right flank, with no other symptoms. Abdominal computed tomography showed a large retroperitoneal mass, which affected the inferior vena cava, with signs of thrombosis inside...
June 15, 2016: Cirugia y Cirujanos
Kyle M Hocking, Gowthami Putumbaka, Eric S Wise, Joyce Cheung-Flynn, Colleen M Brophy, Padmini Komalavilas
OBJECTIVE: Papaverine is used to prevent vasospasm in human saphenous veins (HSV) during vein graft preparation prior to implantation as a bypass conduit. Papaverine is a nonspecific inhibitor of phosphodiesterases, leading to increases in both intracellular cGMP and cAMP. We hypothesized that papaverine reduces force by decreasing intracellular calcium concentrations ([Ca2+]i) and myosin light chain phosphorylation, and increasing actin depolymerization via regulation of actin regulatory protein phosphorylation...
2016: PloS One
Mary F Chisholm, Jennifer Cheng, Kara G Fields, Robert G Marx, Daniel B Maalouf, Gregory A Liguori, Michael A Gordon, Victor M Zayas, Jacques T Yadeau
PURPOSE: Subsartorial saphenous nerve blockade (SSNB) is an effective analgesic alternative to femoral nerve blockade after anterior cruciate ligament (ACL) reconstruction with bone-tendon-bone (BTB) autograft. It was hypothesized that dexamethasone in a SSNB will prolong analgesia, improve pain and satisfaction, and reduce postoperative opioid requirements and side effects. METHODS: One hundred ninety-five patients undergoing ACL reconstruction with BTB autograft (ages 16-65) were enrolled...
April 13, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Jennifer E McCallum, Amanda E Mackenzie, Nina Divorty, Carolyn Clarke, Christian Delles, Graeme Milligan, Stuart A Nicklin
Vascular smooth muscle cell (VSMC) migration and proliferation is central to neointima formation in vein graft failure following coronary artery bypass. However, there are currently no pharmacological interventions that prevent vein graft failure through intimal occlusion. It is hence a therapeutic target. Here, we investigated the contribution of GPR35 to human VSMC and endothelial cell (EC) migration, using a scratch-wound assay, and also the contribution to proliferation, using MTS and BrdU assays, in in vitro models using recently characterized human GPR35 ortholog-selective small-molecule agonists and antagonists...
2015: Journal of Vascular Research
Luis Eduardo Silveira Martins, Leonardo Henrique Cunha Ferraro, Alexandre Takeda, Masashi Munechika, Maria Angela Tardelli
BACKGROUND AND OBJECTIVES: The advent of ultrasound has brought many benefits to peripheral nerve blocks. It includes both safety and effectiveness, given the possibility of visualizing the neurovascular structures and the needle during the procedure. Despite these benefits, there is no consensus in the literature on the use of this technique in anticoagulated patients or with other coagulation disorders. Moreover, peripheral blocks vary in depth, spreadability, and possibility of local compression...
March 22, 2016: Revista Brasileira de Anestesiologia
David Burckett-St Laurant, Philip Peng, Laura Girón Arango, Ahtsham U Niazi, Vincent W S Chan, Anne Agur, Anahi Perlas
BACKGROUND AND OBJECTIVES: Adductor canal block contributes to analgesia after total knee arthroplasty. However, controversy exists regarding the target nerves and the ideal site of local anesthetic administration. The aim of this cadaveric study was to identify the trajectory of all nerves that course in the adductor canal from their origin to their termination and describe their relative contributions to the innervation of the knee joint. METHODS: After research ethics board approval, 20 cadaveric lower limbs were examined using standard dissection technique...
May 2016: Regional Anesthesia and Pain Medicine
Nabil M Elkassabany, Sean Antosh, Moustafa Ahmed, Charles Nelson, Craig Israelite, Ignacio Badiola, Lu F Cai, Rebekah Williams, Christopher Hughes, Edward R Mariano, Jiabin Liu
BACKGROUND: Adductor canal block (ACB) has emerged as an appealing alternative to femoral nerve block (FNB) that produces a predominantly sensory nerve block by anesthetizing the saphenous nerve. Studies have shown greater quadriceps strength preservation with ACB compared with FNB, but no advantage has yet been shown in terms of fall risk. The Tinetti scale is used by physical therapists to assess gait and balance, and total score can estimate a patient's fall risk. We designed this study to test the primary hypothesis that FNB results in a greater proportion of "high fall risk" patients postoperatively using the Tinetti score compared with ACB...
May 2016: Anesthesia and Analgesia
Michael S Patzkowski
Ehlers-Danlos syndrome is an inherited disorder of collagen production that results in multiorgan dysfunction. Patients with hypermobility type display skin hyperextensibility and joint laxity, which can result in chronic joint instability, dislocation, peripheral neuropathy, and severe musculoskeletal pain. A bleeding diathesis can be found in all subtypes of varying severity despite a normal coagulation profile. There have also been reports of resistance to local anesthetics in these patients. Several sources advise against the use of regional anesthesia in these patients citing the 2 previous features...
March 2016: Journal of Clinical Anesthesia
Vinod Dasa, Gabriel Lensing, Miles Parsons, Justin Harris, Julia Volaufova, Ryan Bliss
BACKGROUND: Total knee arthroplasty (TKA) is a common procedure resulting in significant post-operative pain. Percutaneous cryoneurolysis targeting the infrapatellar branch of the saphenous nerve and anterior femoral cutaneous nerve could relieve post-operative knee pain by temporarily blocking sensory nerve conduction. METHODS: A retrospective chart review of 100 patients who underwent TKA was conducted to assess the value of adding perioperative cryoneurolysis to a multimodal pain management program...
June 2016: Knee
Loreto Lollo, Sanjay Bhananker, Agnes Stogicza
BACKGROUND: Guidelines warn of increased risks of injury when placing regional nerve blocks in the anesthetized adult but complications occurred in patients that received neither sedation nor local anesthetic. This restriction of nerve block administration places vulnerable categories of patients at risk of severe opioid induced side effects. Patient and operative technical factors can preclude use of preoperative regional anesthesia. The purpose of this study was to assess complications following sciatic popliteal and femoral or saphenous nerve blockade administered to anesthetized adult patients following foot and ankle surgery...
October 2015: International Journal of Critical Illness and Injury Science
Leah R Strickland, Sherry S Collawn
Subcutaneous atrophy is a known complication of steroid injections. Excellent results with fat grafting for the treatment of steroid atrophy have been documented. However, the benefit of treating steroid-induced subcutaneous atrophy in an extremity diagnosed with complex regional pain syndrome (CRPS) has not been described. CRPS, known formerly as reflex sympathetic dystrophy or RSD, causalgia, or reflex neurovascular dystrophy, is a severe, progressive musculoskeletal pain syndrome characterized by pain which is disproportionate to the severity of the inciting event, edema, or skin changes...
June 2016: Journal of Cosmetic and Laser Therapy: Official Publication of the European Society for Laser Dermatology
Philippe E Gautier, Admir Hadzic, Jean-Pierre Lecoq, Jean Francois Brichant, Maxine M Kuroda, Catherine Vandepitte
BACKGROUND: The analgesic efficacy reported for the adductor canal block may be related to the spread of local anesthetic outside the adductor canal. METHODS: Fifteen patients undergoing knee surgery received ultrasound-guided injections of local anesthetic at the level of the adductor hiatus. Sensory-motor block and spread of contrast solution were assessed. RESULTS: Sensation was rated as "markedly diminished" or "absent" in the saphenous nerve distribution and "slightly diminished" in the sciatic nerve territory without motor deficits...
January 2016: Anesthesia and Analgesia
Ni Chen, Meiping Ren, Rong Li, Xin Deng, Yongjie Li, Kai Yan, Lamei Xiao, Yan Yang, Liqun Wang, Mao Luo, William P Fay, Jianbo Wu
BACKGROUND: An increased incidence of venous thromboembolism (VTE) is associated with anti-vascular endothelial growth factor (VEGF) treatment in cancer. However, the mechanism underlying this effect remains elusive. In this study, we examined the effect of bevacizumab, a humanized monoclonal antibody against VEGF-A, on VTE in a murine xenograft A549 cell tumor model. METHODS: Inferior vena cava stenosis model and FeCl3-induced saphenous vein thrombosis model were performed in a mouse xenograft models of human lung adenocarcinoma...
2015: Molecular Cancer
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