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Regional nerve block

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https://www.readbyqxmd.com/read/28079754/ultrasound-guided-needle-technique-accuracy-prospective-comparison-of-passive-magnetic-tracking-versus-unassisted-echogenic-needle-localization
#1
Angela N Johnson, Jeffery S Peiffer, Nahi Halmann, Luke Delaney, Cindy A Owen, Jeff Hersh
BACKGROUND AND OBJECTIVES: Ultrasound-guided regional anesthesia facilitates an approach to sensitive targets such as nerve clusters without contact or inadvertent puncture. We compared accuracy of needle placement with a novel passive magnetic ultrasound needle guidance technology (NGT) versus conventional ultrasound (CU) with echogenic needles. METHODS: Sixteen anesthesiologists and 19 residents performed a series of 16 needle insertion tasks each, 8 using NGT (n = 280) and 8 using CU (n = 280), in high-fidelity porcine phantoms...
January 11, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28079735/incidence-of-local-anesthetic-systemic-toxicity-in-orthopedic-patients-receiving-peripheral-nerve-blocks
#2
Eva E Mörwald, Nicole Zubizarreta, Crispiana Cozowicz, Jashvant Poeran, Stavros G Memtsoudis
BACKGROUND AND OBJECTIVES: Peripheral nerve blocks are increasingly used. However, despite low complication rates, concerns regarding local anesthetic systemic toxicity remain. Although recent studies suggest that this severe complication has decreased considerably, there is a paucity of data about it on a national level. We sought to elucidate the incidence of local anesthetic systemic toxicity on a national level and therefore provide guidance toward the need for preparedness in daily anesthetic practice...
January 9, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28067709/factors-associated-with-risk-of-neurologic-complications-after-peripheral-nerve-blocks-a-systematic-review
#3
Rakesh V Sondekoppam, Ban C H Tsui
The onset of neurologic complications after regional anesthesia is a complex process and may result from an interaction of host, agent, and environmental risk factors. The purpose of this systematic review was examine the qualitative evidence relating to various risk factors implicated in neurologic dysfunction after peripheral nerve block (PNB). The MEDLINE, OVID, and EMBASE databases were primary sources for literature. Cochrane, LILACS, DARE, IndMed, ERIC, NHS, and HTA via Centre for Reviews and Dissemination (CRD; York University) databases were searched for additional unique results...
February 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28067703/anesthesia-for-ambulatory-pediatric-surgery-in-sub-saharan-africa-a-pilot-study-in-burkina-faso
#4
Yvette B Kabré, Idriss S S Traoré, Flavien A R Kaboré, Bertille Ki, Alain I Traoré, Isso Ouédraogo, Emile Bandré, Albert Wandaogo, Nazinigouba Ouédraogo
BACKGROUND: Long surgical wait times and limited hospital capacity are common obstacles to surgical care in many countries in Sub-Saharan Africa (SSA). Introducing ambulatory surgery might contribute to a solution to these problems. The purpose of this study was to evaluate the safety and feasibility of introducing ambulatory surgery into a pediatric hospital in SSA. METHODS: This is a cross-sectional descriptive study that took place over 6 months. It includes all patients assigned to undergo ambulatory surgery in the Pediatric University Hospital in Ouagadougou, Burkina Faso...
February 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28059804/bupivacaine-increases-the-rate-of%C3%A2-motoneuron-death-following-peripheral%C3%A2-nerve-injury
#5
Susanna C Byram, Scott W Byram, Nicholas M Miller, Keith N Fargo
BACKGROUND: Appropriate management of pain after an injury or surgical procedure has been shown to improve patient outcomes. While infrequent, nerve damage resulting from regional anesthesia can be devastating, however the mechanism remains unknown. Local anesthetics are neurotoxic yet are frequently applied to sites where peripheral nerves are regenerating. Therefore, understanding their effects on injured and growing neurons may have important implications for clinical practice. OBJECTIVE: The purpose of this study was to determine if local anesthetics exacerbate the rate of motoneuron death following axotomy...
January 4, 2017: Restorative Neurology and Neuroscience
https://www.readbyqxmd.com/read/28059686/the-role-of-spinal-thrombin-through-protease-activated-receptor-1-in-hyperalgesia-after-neural-injury
#6
Jenell R Smith, Beth A Winkelstein
OBJECTIVE Painful neuropathic injuries induce blood-spinal cord barrier (BSCB) breakdown, allowing pro-inflammatory serum molecules to cross the BSCB, which contributes to nociception. The goal of these studies was to determine whether the blood-borne serine protease thrombin also crosses a permeable BSCB, contributing to nociception through its activation of protease-activated receptor-1 (PAR1). METHODS A 15-minute C-7 nerve root compression, which induces BSCB breakdown and painful behaviors by Day 1, was administered in the rat (n = 10); sham operation (n = 11) and a 3-minute compression (n = 10) that does not induce sensitivity were administered as controls...
January 6, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28035645/reflex-arc-of-the-teeth-clenching-induced-pressor-response-in-rats
#7
Ichiro Shoji, Takehito Kemuriyama, Megumi Tandai-Hiruma, Satoshi Maruyama, Akimasa Tashiro, Hidetaka Yokoe, Yasuhiro Nishida
Although "teeth clenching" induces pressor response, the reflex tracts of the response are unknown. In this study, dantrolene administration inhibited teeth clenching generated by electrical stimulation of the masseter muscles and completely abolished the pressor response. In addition, trigeminal ganglion block or hexamethonium administration completely abolished the pressor response. Local anesthesia of molar regions significantly reduced the pressor response to 27 ± 10%. Gadolinium (mechanoreceptor blocker of group III muscle afferents) entrapment in masticatory muscles also significantly reduced the pressor response to 62 ± 7%...
December 29, 2016: Journal of Physiological Sciences: JPS
https://www.readbyqxmd.com/read/28025820/adductor-canal-blocks-changing-practice-patterns-and-associated-quality-profile
#8
M M Masaracchia, M D Herrick, M J Barrington, P R Hartmann, B D Sites
BACKGROUND: Femoral nerve blocks have been the gold standard approach for post-operative analgesia following total knee arthroplasty; however, the adductor canal block has recently gained popularity due to less block-induced motor weakness. The primary aim of this time-series analysis was to identify whether regional anesthesia practice changes have occurred for total knee arthroplasty. Our secondary aim was to assess for possible associated changes in safety and quality. METHODS: Using a 20-member clinical registry, we examined the practice patterns and safety around the performance of adductor canal blocks for all total knee arthroplasties between 18 July 2011 to 9 October 2015...
December 26, 2016: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28018749/focused-training-for-humanitarian-responders-in-regional-anesthesia-techniques-for-a-planned-randomized-controlled-trial-in-a-disaster-setting
#9
Adam R Aluisio, Carrei Teicher, Tess Wiskel, Allysia Guy, Adam Levine
BACKGROUND: Lower extremity trauma during earthquakes accounts for the largest burden of geophysical disaster-related injuries. Insufficient pain management is common in disaster settings, and regional anesthesia (RA) has the potential to reduce pain in injured patients beyond current standards. To date, no prospective research has evaluated the use of RA in a disaster setting. This cross-sectional study assesses knowledge translation and skill acquisition outcomes for lower extremity RA performed with and without ultrasound guidance among a cohort of Médecins Sans Frontières (MSF) volunteers who will function as proceduralists in a planned randomized controlled trial evaluating the efficacy of RA for pain management in an earthquake setting...
November 16, 2016: PLoS Currents
https://www.readbyqxmd.com/read/28018501/regional-anesthesia-with-dexmedetomidine-infusion-a-feasible-method-for-the-awake-test-during-carotid-endarterectomy
#10
Jonggeun Lee, Up Huh, Seunghwan Song, Sung Woon Chung, Sang Min Sung, Han Jin Cho
Background: Carotid endarterectomy (CEA) is the standard treatment modality for the prevention of stroke in patients with carotid stenosis. This study reports our experiences during CEA with routine awake tests under regional anesthesia (RA) combined with light sedation by dexmedetomidine infusion. Materials and Methods: We retrospectively reviewed 23 patients who had undergone CEA between April 2013 and June 2015. All patients underwent the awake test during CEA with cervical plexus block and light sedation by continuous dexmedetomidine infusion...
2016: Annals of Vascular Diseases
https://www.readbyqxmd.com/read/28017173/femoral-nerve-block-versus-intravenous-fentanyl-in-adult-patients-with-hip-fractures-a-systematic-review
#11
Flávia Vieira Guimarães Hartmann, Maria Rita Carvalho Garbi Novaes, Marta Rodrigues de Carvalho
BACKGROUND: Hip fractures configure an important public health issue and are associated with high mortality taxes and lose of functionality. Hip fractures refer to a fracture occurring between the edge of the femoral head and 5cm below the lesser trochanter. They are common in orthopedic emergencies. The number of proximal femoral fractures is likely to increase as the population ages. The average cost of care during the initial hospitalization for hip fracture can be estimated about US$ 7,000 per patient...
January 2017: Brazilian Journal of Anesthesiology
https://www.readbyqxmd.com/read/28009677/effectiveness-of-temporary-deafferentation-of-the-arm-on-somatosensory-and-motor-functions-following-stroke-a-systematic-review
#12
Emmanuelle Opsommer, Camille Zwissig, Natalya Korogod, Thomas Weiss
BACKGROUND: After stroke, regaining functional use of the upper limb can be challenging. Temporary deafferentation (TD) is a novel approach used in neurorehabilitation to voluntarily reduce the somatosensory input in a body part by temporary anesthesia; which has been shown to improve sensorimotor functions in the affected limb. OBJECTIVES: The primary objective of this systematic review was to present the best available evidence related to the effects of TD of the affected arm on the recovery of motor function and activity of the upper limb (arm and hand) following stroke...
December 2016: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/28009637/novel-needle-guide-reduces-time-to-perform-ultrasound-guided-femoral-nerve-catheter-placement-a-randomised-controlled-trial
#13
Alparslan Turan, Rovnat Babazade, Hesham Elsharkawy, Wael Ali Sakr Esa, Kamal Maheshwari, Ehab Farag, Nicole M Zimmerman, Loran Mounir Soliman, Daniel I Sessler
BACKGROUND: Ultrasound-guided nerve blocks have become the standard when performing regional nerve blocks in anaesthesia. Infiniti Plus (CIVCO Medical Solutions, Kalona, Iowa, USA) is a needle guide that has been recently developed to help clinicians in performing ultrasound-guided nerve blocks. OBJECTIVES: We tested the hypothesis that femoral nerve catheter placement carried out with the Infiniti Plus needle guide will be quicker to perform than without the Infiniti Plus...
December 22, 2016: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/27999501/axillary-block-induced-chemical-sympathectomy-in-the-setting-of-digital-ischemia
#14
José R Soberón, T Michael Truxillo, Christin C Gethers, Taylor A Smith, William E Davis
BACKGROUND: Digital ischemia is associated with several rheumatologic disorders and is often difficult to treat. Symptoms and sequelae can include pain, disability, need for amputation, and poor quality of life. METHODS: Patients diagnosed with digital ischemia were referred for an ultrasound-guided axillary nerve block using liposomal bupivacaine (Exparel, Pacira Pharmaceuticals). The primary outcome measure was radial and ulnar artery diameter preprocedure and postprocedure...
2016: Ochsner Journal
https://www.readbyqxmd.com/read/27990435/low-volume-brachial-plexus-block-providing-surgical-anesthesia-for-distal-arm-surgery-comparing-supraclavicular-infraclavicular-and-axillary-approach-a-randomized-observer-blind-trial
#15
Mojgan Vazin, Kenneth Jensen, Danja L Kristensen, Mathias Hjort, Katrine Tanggaard, Manoj K Karmakar, Thomas F Bendtsen, Jens Børglum
Background. Distal arm surgery is widely performed under regional anesthesia with brachial plexus block. The preponderance of evidence for the efficacy relies upon injection of local anesthetic in excess of 30 mL. We aimed to compare three different ultrasound-guided brachial plexus block techniques restricting the total volume to 20 mL. Methods. 120 patients were prospectively randomized to ultrasound-guided brachial plexus block with 20 mL ropivacaine 0.75% at either the supraclavicular, infraclavicular, or axillary level...
2016: BioMed Research International
https://www.readbyqxmd.com/read/27982684/nesfatin-1-influences-the-excitability-of-gastric-distension-responsive-neurons-in-the-ventromedial-hypothalamic-nucleus-of-rats
#16
Hongzhen Feng, Qiaoling Wang, Feifei Guo, Xiaohua Han, Mingjie Pang, Xiangrong Sun, Yanling Gong, Luo Xu
The present study investigated the effects of nesfatin-1 on gastric distension (GD)- responsive neurons via an interaction with corticotropin-releasing factor (CRF) receptor signaling in the ventromedial hypothalamic nucleus (VMH), and the potential regulation of these effects by hippocampal projections to VMH. Extracellular single-unit discharges were recorded in VHM following administration of nesfatin-1. The projection of nerve fibers and expression of nesfatin-1 were assessed by retrograde tracing and fluoro-immunohistochemical staining, respectively...
December 16, 2016: Physiological Research
https://www.readbyqxmd.com/read/27939017/regional-analgesia-in-postsurgical-critically-ill-patients
#17
S Moliner Velázquez, R Rubio Haro, C De Andrés Serrano, J De Andrés Ibáñez
Regional analgesia intrinsically, based on its physiological effects, is routinely used for the perioperative treatment of pain associated with surgical procedures. However, in other areas such as the non-surgical treatment of acute pain for patients in a critical condition, it has not been subjected to specific prospective studies. If we confine ourselves to the physiological effects of the nerve block, in a situation of stress, the indications for regional anaesthesia in this group of patients extend to the management of a wide variety of medical as well as postsurgical conditions, of trauma patients and of other painful procedures performed in the patient's bed...
December 7, 2016: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/27913981/the-challenges-of-anaesthesia-and-pain-relief-in-hip-fracture-care
#18
Rachel Cowan, Jun Hao Lim, Terence Ong, Ashok Kumar, Opinder Sahota
The care of the older person with hip fracture is complicated by their comorbid condition, limited physiological reserve, cognitive impairment and frailty. Two aspects of hip fracture management that have received considerable attention are how best to manage the pain associated with it and the ideal mode of anaesthesia. Existing literature has reported on the suboptimal treatment of pain in this orthogeriatric cohort. With recent advancements in medical care, a number of options have emerged as alternatives to conservative systemic analgesia...
December 3, 2016: Drugs & Aging
https://www.readbyqxmd.com/read/27904211/post-operative-pain-management-in-shoulder-surgery-suprascapular-and-axillary-nerve-block-by-arthroscope-assisted-catheter-placement
#19
H Çağdaş Basat, D Hakan Uçar, Mehmet Armangil, Berk Güçlü, Mehmet Demirtaş
BACKGROUND: Postoperative pain management is the part of shoulder surgery to improve patient satisfaction, start rehabilitation process rapidly and decrease for hospital stay. Various treatment modalities have been used for pain management, but they have some limitations, side effects and risks. Throughout intraoperative and postoperative period, nerve blocks have been used more popularly than others because of efficacy. For the regional nerve block, local anesthetic should be infiltrated close to the nerve for maximum effect...
November 2016: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/27897312/the-feasibility-of-micro-ultrasound-as-a-tool-to-image-peripheral-nerves
#20
A Chandra, R Eisma, P Felts, S Munirama, G A Corner, C E M Demore, G McLeod
Despite widespread use of ultrasound imaging to guide needle placement, the incidence of transient and permanent nerve damage as a complication of regional anaesthesia has not changed over the last decade. In view of the controversy surrounding intraneural injection there is a need to understand the structural changes caused by subepineural and subperineural needle penetration. Clinical ultrasound machines do not provide adequate anatomical resolution, and anaesthetists have difficulty judging the precise location of the needle tip relative to the epineurium...
November 29, 2016: Anaesthesia
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