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Peripheral nerve blockade

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https://www.readbyqxmd.com/read/28094765/selective-antagonism-of-muscarinic-receptors-is-neuroprotective-in-peripheral-neuropathy
#1
Nigel A Calcutt, Darrell R Smith, Katie Frizzi, Mohammad Golam Sabbir, Subir K Roy Chowdhury, Teresa Mixcoatl-Zecuatl, Ali Saleh, Nabeel Muttalib, Randy Van der Ploeg, Joseline Ochoa, Allison Gopaul, Lori Tessler, Jürgen Wess, Corinne G Jolivalt, Paul Fernyhough
Sensory neurons have the capacity to produce, release, and respond to acetylcholine (ACh), but the functional role of cholinergic systems in adult mammalian peripheral sensory nerves has not been established. Here, we have reported that neurite outgrowth from adult sensory neurons that were maintained under subsaturating neurotrophic factor conditions operates under cholinergic constraint that is mediated by muscarinic receptor-dependent regulation of mitochondrial function via AMPK. Sensory neurons from mice lacking the muscarinic ACh type 1 receptor (M1R) exhibited enhanced neurite outgrowth, confirming the role of M1R in tonic suppression of axonal plasticity...
January 17, 2017: Journal of Clinical Investigation
https://www.readbyqxmd.com/read/28091556/vegf-b-promotes-recovery-of-corneal-innervations-and-trophic-functions-in-diabetic-mice
#2
Guohu Di, Xiaowen Zhao, Xia Qi, Songmei Zhang, Lu Feng, Weiyun Shi, Qingjun Zhou
Vascular endothelial growth factor (VEGF)-B possesses the capacity of promoting injured peripheral nerve regeneration and restore their sensory and trophic functions. However, the contribution and mechanism of VEGF-B in diabetic peripheral neuropathy remains unclear. In the present study, we investigated the expression and role of VEGF-B in diabetic corneal neuropathy by using type 1 diabetic mice and cultured trigeminal ganglion (TG) neurons. Hyperglycemia attenuated the endogenous expression of VEGF-B in regenerated diabetic corneal epithelium, but not that of VEGF receptors in diabetic TG neurons and axons...
January 16, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28087135/surgical-site-infection-related-to-use-of-elastomeric-pumps-in-pectus-excavatum-repair-lessons-learned-from-root-cause-analysis
#3
Nadja Apelt, Joshua Schaffzin, Christina Bates, Rebeccah L Brown, Marc Mecoli, Senthilkumar Sadhasivam, Victor Garcia
BACKGROUND: Pectus excavatum repair (PEX) is among the most painful thoracic procedures performed. Continuous peripheral nerve blockade (CPNB) is known to be efficacious in optimizing pain control while limiting narcotic use in adult thoracic procedures. It was introduced in May 2015 as a bridge to oral pain control in children undergoing PEX. Consequently, the surgical site infection (SSI) rate increased from 2.7% to 27.7%. METHODS: SSI surveillance followed national guidelines...
January 6, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27992665/naloxone-antagonises-soman-induced-central-respiratory-depression-in-rats
#4
Ranko Škrbić, Miloš P Stojiljković, Slavko S Ćetković, Silva Dobrić, Dejan Jeremić, Maja Vulović
The influence of naloxone on respiration impaired by the highly toxic organophosphate nerve agent soman in anaesthetized rats was investigated. Soman, administered in a dose that was ineffective in blocking the electrically induced contractions of the phrenic nerve-diaphragm preparation in situ, induced a complete block of the spontaneous respiratory movements of the diaphragm, indicating the domination of central over the peripheral effects. Naloxone dose-dependently antagonised the soman-induced respiratory blockade...
December 19, 2016: Basic & Clinical Pharmacology & Toxicology
https://www.readbyqxmd.com/read/27977461/peripheral-nerve-blockade-for-primary-total-knee-arthroplasty-a-population-based-cohort-study-of-outcomes-and-resource-utilization
#5
Daniel I McIsaac, Colin J L McCartney, Carl van Walraven
BACKGROUND: Although peripheral nerve blocks decrease pain after total knee arthroplasty, the population-level impact of nerve blocks on arthroplasty resource utilization is unknown. METHODS: We conducted a population-based cohort study using linked administrative data from Ontario, Canada. We identified all adults having their first primary knee arthroplasty between 2002 and 2013. Using propensity scores to adjust for measureable confounders, we matched nerve block patients to a patient who did not receive a block...
February 2017: Anesthesiology
https://www.readbyqxmd.com/read/27955918/dexmedetomidine-added-to-local-anesthetic-mixture-of-lidocaine-and-ropivacaine-enhances-onset-and-prolongs-duration-of-a-popliteal-approach-to-sciatic-nerve-blockade
#6
Xiawei Hu, Jinlei Li, Riyong Zhou, Quanguang Wang, Fangfang Xia, Thomas Halaszynski, Xuzhong Xu
PURPOSE: A literature review of multiple clinical studies on mixing additives to improve pharmacologic limitation of local anesthetics during peripheral nerve blockade revealed inconsistency in success rates and various adverse effects. Animal research on dexmedetomidine as an adjuvant on the other hand has promising results, with evidence of minimum unwanted results. This randomized, double-blinded, contrastable observational study examined the efficacy of adding dexmedetomidine to a mixture of lidocaine plus ropivacaine during popliteal sciatic nerve blockade (PSNB)...
December 9, 2016: Clinical Therapeutics
https://www.readbyqxmd.com/read/27943522/no-benefit-of-ultrasound-guided-transversus-abdominis-plane-tap-blocks-over-local-anaesthetic-wound-infiltration-in-elective-laparoscopic-colonic-surgery-results-of-a-double-blind-randomised-controlled-trial
#7
A Rashid, K J Gorissen, F Ris, M P Gosselink, J R Shorthouse, A D Smith, J J Pandit, I Lindsey, N Crabtree
AIM: Advances in laparoscopic techniques combined with enhanced recovery pathways have led to faster recuperation and discharge after colorectal surgery. Peripheral nerve blockade using Transversus Abdominis Plane (TAP) blocks reduce opioid requirements and provide better analgesia than inactive controls for laparoscopic colectomies. This double-blind randomized study was performed comparing TAP blocks using Bupivacaine to standardised wound infiltration with local anaesthetic (LA). METHODS: 71 Patients were randomised between either TAP-block or wound infiltration...
December 10, 2016: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/27920573/femoral-nerve-blockade-using-various-concentrations-of-local-anesthetic-for-knee-arthroscopy-in-the-pediatric-population
#8
Giorgio Veneziano, Jennifer Tripi, Dmitry Tumin, Mumin Hakim, David Martin, Ralph Beltran, Kevin Klingele, Tarun Bhalla, Joseph D Tobias
BACKGROUND: Femoral nerve blockade (FNB) provides effective postoperative analgesia in children undergoing arthroscopic knee surgery as evidenced by their opioid-sparing effects and decreased postoperative pain scores. Increasing the local anesthetic concentration in peripheral nerve blockade for adults undergoing orthopedic surgery has been shown to be beneficial, increasing block success rate, and providing a longer duration of analgesia. The effect of increasing the concentration of local anesthetic in extremity blocks in children remains largely unexplored...
2016: Journal of Pain Research
https://www.readbyqxmd.com/read/27904260/sonographic-identification-of-peripheral-nerves-in-the-forearm
#9
Saundra A Jackson, Charlotte Derr, Anthony De Lucia, Marvin Harris, Zuheily Closser, Branko Miladinovic, Rahul Mhaskar, Theresa Jorgensen, Lori Green
BACKGROUND: With the growing utilization of ultrasonography in emergency medicine combined with the concern over adequate pain management in the emergency department (ED), ultrasound guidance for peripheral nerve blockade in ED is an area of increasing interest. The medical literature has multiple reports supporting the use of ultrasound guidance in peripheral nerve blocks. However, to perform a peripheral nerve block, one must first be able to reliably identify the specific nerve before the procedure...
October 2016: Journal of Emergencies, Trauma, and Shock
https://www.readbyqxmd.com/read/27871587/peripheral-nerve-blocks-in-the-management-of-postoperative-pain-challenges-and-opportunities
#10
REVIEW
Girish Joshi, Kishor Gandhi, Nishant Shah, Jeff Gadsden, Shelby L Corman
Peripheral nerve blocks (PNBs) are increasingly used as a component of multimodal analgesia and may be administered as a single injection (sPNB) or continuous infusion via a perineural catheter (cPNB). We undertook a qualitative review focusing on sPNB and cPNB with regard to benefits, risks, and opportunities for optimizing patient care. Meta-analyses of randomized controlled trials have shown superior pain control and reductions in opioid consumption in patients receiving PNB compared with those receiving intravenous opioids in a variety of upper and lower extremity surgical procedures...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27828793/comparison-of-supraclavicular-and-infraclavicular-brachial-plexus-block-a-systemic-review-of-randomized-controlled-trials
#11
Sun-Kyung Park, Su-Young Lee, Won Ho Kim, Han-Seul Park, Young-Jin Lim, Jae-Hyon Bahk
BACKGROUND: Supraclavicular (SC) and infraclavicular (IC) brachial plexus block (BPB) are commonly used for upper extremity surgery. Recent clinical studies have compared the effect of SC- and IC-BPB, but there have been controversies over spread of sensory blockade in each of the 4 peripheral nerve branches of brachial plexus. METHODS: This study included a systemic review, using the Medline and EMBASE database from their inceptions through March 2016. Randomized controlled trials (RCTs) comparing SC- and IC-BPB were included...
February 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27810215/development-of-a-peripheral-nerve-stimulator-guided-technique-for-equine-pudendal-nerve-blockade
#12
K Gallacher, L C Santos, L Campoy, A J Bezuidenhout, R O Gilbert
The aim of this study was to develop and evaluate a procedure for equine pudendal nerve block using a peripheral nerve locator. In the first experiment, six ponies were used to determine the relationship between elicited muscle contractions (anal, perineal or both) and nerves serving the perineal region (pudendal, caudorectal and perineal nerves) when methylene blue dye was injected using the electrolocation technique. This experiment showed that the pudendal nerve was approached effectively when both anal and perineal twitch were elicited during electrolocation...
November 2016: Veterinary Journal
https://www.readbyqxmd.com/read/27755068/clinical-practice-guidelines-for-sustained-neuromuscular-blockade-in-the-adult-critically-ill-patient
#13
Michael J Murray, Heidi DeBlock, Brian Erstad, Anthony Gray, Judi Jacobi, Che Jordan, William McGee, Claire McManus, Maureen Meade, Sean Nix, Andrew Patterson, M Karen Sands, Richard Pino, Ann Tescher, Richard Arbour, Bram Rochwerg, Catherine Friederich Murray, Sangeeta Mehta
OBJECTIVE: To update the 2002 version of "Clinical practice guidelines for sustained neuromuscular blockade in the adult critically ill patient." DESIGN: A Task Force comprising 17 members of the Society of Critical Medicine with particular expertise in the use of neuromuscular-blocking agents; a Grading of Recommendations Assessment, Development, and Evaluation expert; and a medical writer met via teleconference and three face-to-face meetings and communicated via e-mail to examine the evidence and develop these practice guidelines...
November 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27753708/perioperative-nerve-injury-after-peripheral-nerve-block-in-patients-with-previous-systemic-chemotherapy
#14
Arnoley S Abcejo, Hans P Sviggum, Michelle L Mauermann, James R Hebl, Carlos B Mantilla, Andrew C Hanson, Yi Lin, Adam K Jacob
BACKGROUND AND OBJECTIVES: There are multiple risk factors for developing perioperative nerve injury (PNI). Perioperative nerve injury after peripheral nerve blockade (PNB) is rare. Exposure to systemic chemotherapy may cause peripheral neuropathy, but its role as a risk factor for PNI after PNB is unknown. The objective of this retrospective study was to determine the incidence of PNI in patients undergoing PNB as part of extremity surgery after prior exposure to systemic chemotherapy...
November 2016: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/27746528/lower-limb-surgeries-under-combined-femoral-and-sciatic-nerve-block
#15
Lipsy Bansal, Joginder Pal Attri, Pawan Verma
INTRODUCTION: Peripheral nerve blocks are gaining popularity for many infraumblical surgeries with the development of new techniques such as ultrasound and peripheral nerve stimulator. It provides stable hemodynamic, better, and prolonged postoperative analgesia. This study was carried out to see the effectiveness of combined femoral and sciatic nerve block with ropivacaine alone and by adding fentanyl. MATERIALS AND METHODS: The study was carried out on 100 patients scheduled for lower limb surgeries and were randomly divided into two groups of 50 each...
September 2016: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/27730452/emerging-targets-for-the-management-of-osteoarthritis-pain
#16
Anne-Marie Malfait, Richard J Miller
Worldwide, osteoarthritis (OA) is one of the leading causes of chronic pain, for which adequate relief is not available. Ongoing peripheral input from the affected joint is a major factor in OA-associated pain. Therefore, this review focuses predominantly on peripheral targets emerging in the preclinical and clinical arena. Nerve growth factor is the most advanced of these targets, and its blockade has shown tremendous promise in clinical trials in knee OA. A number of different types of ion channels, including voltage-gated sodium channels and calcium channels, transient receptor potential channels, and acid-sensing ion channels, are important for neuronal excitability and play a role in pain genesis...
October 12, 2016: Current Osteoporosis Reports
https://www.readbyqxmd.com/read/27716431/tor1a-mice-develop-dystonia-like-movements-via-a-striatal-dopaminergic-dysregulation-triggered-by-peripheral-nerve-injury
#17
Chi Wang Ip, Ioannis U Isaias, Burak B Kusche-Tekin, Dennis Klein, Janos Groh, Aet O'Leary, Susanne Knorr, Takahiro Higuchi, James B Koprich, Jonathan M Brotchie, Klaus V Toyka, Andreas Reif, Jens Volkmann
Isolated generalized dystonia is a central motor network disorder characterized by twisted movements or postures. The most frequent genetic cause is a GAG deletion in the Tor1a (DYT1) gene encoding torsinA with a reduced penetrance of 30-40 % suggesting additional genetic or environmental modifiers. Development of dystonia-like movements after a standardized peripheral nerve crush lesion in wild type (wt) and Tor1a+/- mice, that express 50 % torsinA only, was assessed by scoring of hindlimb movements during tail suspension, by rotarod testing and by computer-assisted gait analysis...
October 3, 2016: Acta Neuropathologica Communications
https://www.readbyqxmd.com/read/27651153/lysophosphatidic-acid-provides-a-missing-link-between-osteoarthritis-and-joint-neuropathic-pain
#18
J J McDougall, S Albacete, N Schuelert, P G Mitchell, C Lin, J L Oskins, H H Bui, M G Chambers
OBJECTIVE: Emerging evidence suggests that osteoarthritis (OA) has a neuropathic component; however, the identity of the molecules responsible for this peripheral neuropathy is unknown. The aim of this study was to determine the contribution of the bioactive lipid lysophosphatidic acid (LPA) to joint neuropathy and pain. DESIGN: Male Lewis rats received an intra-articular injection of 50 μg of LPA into the knee and allowed to recover for up to 21 days. Saphenous nerve myelination was assessed by g-ratio calculation from electron micrographs and afferent nerve damage visualised by activation transcription factor-3 (ATF-3) expression...
September 17, 2016: Osteoarthritis and Cartilage
https://www.readbyqxmd.com/read/27592218/meta-analysis-of-epidural-analgesia-versus-peripheral-nerve-blockade-after-total-knee-joint-replacement
#19
REVIEW
Adam Daniel Gerrard, Ben Brooks, Peter Asaad, Shahab Hajibandeh, Shahin Hajibandeh
BACKGROUND: Postoperative pain after major knee surgery can be severe. Our aim was to compare the outcomes of epidural analgesia and peripheral nerve blockade (PNB) in patients undergoing total knee joint replacement (TKR). Moreover, we aimed to compare outcomes of adductor canal block (ACB) with those of femoral nerve block (FNB) after TKR. METHODS: We conducted a systematic search of electronic information sources, including MEDLINE; EMBASE; CINAHL; and the Cochrane Central Register of Controlled Trials (CENTRAL)...
September 3, 2016: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/27588404/characterizing-the-immune-microenvironment-of-malignant-peripheral-nerve-sheath-tumor-by-pd-l1-expression-and-presence-of-cd8-tumor-infiltrating-lymphocytes
#20
Elizabeth Shurell, Arun S Singh, Joseph G Crompton, Sarah Jensen, Yunfeng Li, Sarah Dry, Scott Nelson, Bartosz Chmielowski, Nicholas Bernthal, Noah Federman, Paul Tumeh, Fritz C Eilber
BACKGROUND: Malignant peripheral nerve sheath tumor (MPNST) is an aggressive sarcoma with few treatment options. Tumor immune state has not been characterized in MPNST, and is important in determining response to immune checkpoint blockade. Our aim was to evaluate the expression of programmed death-ligand 1 (PD-L1), programmed cell death protein 1 (PD-1), and presence of CD8+ tumor infiltrating lymphocytes (TILs) in MPNST, and correlate these findings with clinical behavior and outcome...
September 27, 2016: Oncotarget
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