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https://www.readbyqxmd.com/read/28938298/safety-and-efficacy-of-epidural-analgesia
#1
Elke M E Bos, Markus W Hollmann, Philipp Lirk
PURPOSE OF REVIEW: Epidural analgesia remains a widely used analgesic technique. This article aims to assess the safety of epidural analgesia by balancing efficacy and complications, of epidural analgesia for acute, labor and chronic pain. RECENT FINDINGS: Main indications for epidural analgesia include major open abdominal surgery, thoracotomy and labor analgesia. Past and current literature show that epidural analgesia leads to statistically significant, but possibly clinically less meaningful, reductions in pain scores compared with intravenous analgesia...
September 21, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28928578/comparison-of-spinal-anesthesia-and-paravertebral-block-in-inguinal-hernia-repair
#2
Ranjana Khetarpal, Veena Chatrath, Arminder Kaur, Reeta Jassi, Renu Verma
CONTEXT: Inguinal hernia repair (IHR) is a common surgical procedure which can be performed under general, regional, or peripheral nerve block anesthesia. AIM: The aim of our study was to compare the efficacy of paravertebral block (PVB) with spinal anesthesia (SA) for IHR with respect to postoperative analgesia, ambulation, and adverse effects. SETTINGS AND DESIGN: This was a prospective, single-blind randomized controlled trial. MATERIALS AND METHODS: Sixty American Society of Anesthesiologists Class I-II patients of 20-60 years scheduled for IHR were randomized by a computer-generated list into two groups of thirty each, to receive either PVB (Group PVB: at T12-L2 levels, 10 ml of 0...
July 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28926447/effect-of-peripheral-nerve-block-on-length-of-stay-after-total-knee-arthroplasty
#3
Jung-Won Hwang, Young-Tae Jeon
No abstract text is available yet for this article.
October 2017: Anesthesiology
https://www.readbyqxmd.com/read/28922231/use-of-regional-anesthesia-for-outpatient-surgery-within-the-united-states-a-prevalence-study-using-a-nationwide-database
#4
Rodney A Gabriel, Brian M Ilfeld
BACKGROUND: Regional anesthesia is of benefit for outpatient surgery given its demonstrated improvement in analgesia and decrease in complications, resulting in shorter average recovery room times and lower hospital readmission rates. Unfortunately, there are few epidemiological studies outlining the overall utilization of peripheral nerve blocks (PNBs) in this setting. Therefore, the primary objective of this study was to report the overall utilization of several types of PNBs among all candidate cases in the outpatient setting within the United States...
September 14, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28921418/coping-with-phantom-limb-pain
#5
Damien P Kuffler
Phantom limb pain is a chronic neuropathic pain that develops in 45-85% of patients who undergo major amputations of the upper and lower extremities and appears predominantly during two time frames following an amputation: the first month and later about 1 year. Although in most patients the frequency and intensity of pain diminish over time, severe pain persists in about 5-10%. It has been proposed that factors in both the peripheral and central nervous systems play major roles in triggering the development and maintenance of pain associated with extremity amputations...
September 18, 2017: Molecular Neurobiology
https://www.readbyqxmd.com/read/28915149/bulleyaconitine-a-preferably-reduces-tetrodotoxin-sensitive-sodium-current-in-uninjured-dorsal-root-ganglion-neurons-of-neuropathic-rats-probably-via-inhibition-of-protein-kinase-c
#6
Man-Xiu Xie, Rui-Ping Pang, Jie Yang, Kai-Feng Shen, Jing Xu, Xiong-Xiong Zhong, Shao-Kun Wang, Xiao-Long Zhang, Yan-Qing Liu, Xian-Guo Liu
Oral Bulleyaconitine A (BLA) is effective for treating neuropathic pain in human patients, but the underlying mechanism is poorly understood. Here, we tested whether BLA blocked voltage-gated sodium channels (VGSCs) in dorsal root ganglion (DRG) neurons. Compelling evidence shows that voltage-gated sodium channels are upregulated in uninjured DRG neurons but downregulated in injured ones following peripheral nerve injury. We found that BLA preferably inhibited Na currents in uninjured DRG neurons in neuropathic rats...
July 17, 2017: Pain
https://www.readbyqxmd.com/read/28913901/real-time-continuous-monitoring-of-injection-pressure-at-the-needle-tip-for-peripheral-nerve-blocks-description-of-a-new-method
#7
C Quadri, A Saporito, X Capdevila
The measurement of injection pressure during the performance of peripheral nerve blocks can be pivotal to detect intraneural placement of the needle tip and thus avoid intrafascicular injection. However, injection pressure can only be measured along the injection line (tubing), which is influenced by several factors. The primary aim of this feasibility study was to describe and validate the principle of a novel nerve-block needle conceived for real-time continuous monitoring of injection pressures at the needle tip...
September 14, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28912683/nano-scale-biophysical-and-structural-investigations-on-intact-and-neuropathic-nerve-fibers-by-simultaneous-combination-of-atomic-force-and-confocal-microscopy
#8
Gonzalo Rosso, Ivan Liashkovich, Peter Young, Victor Shahin
The links between neuropathies of the peripheral nervous system (PNS), including Charcot-Marie-Tooth1A and hereditary neuropathy with liability to pressure palsies, and impaired biomechanical and structural integrity of PNS nerves remain poorly understood despite the medical urgency. Here, we present a protocol describing simultaneous structural and biomechanical integrity investigations on isolated nerve fibers, the building blocks of nerves. Nerve fibers are prepared from nerves harvested from wild-type and exemplary PNS neuropathy mouse models...
2017: Frontiers in Molecular Neuroscience
https://www.readbyqxmd.com/read/28905370/neuromodulation-and-devices-in-trigeminal-neuralgia
#9
Kevin Weber
PREMISE: Trigeminal neuralgia is a severe facial pain disorder that has been studied for decades. Classical trigeminal neuralgia (CTN) is either idiopathic or caused by neurovascular compression. The related painful trigeminal neuropathies are often secondary to other causes, such as multiple sclerosis or trauma. PROBLEM: Therapies for trigeminal neuralgia and neuropathy have often been pharmacologic or surgical. Pharmacologic therapies are not effective in some cases and often cause side effects, some substantial...
September 14, 2017: Headache
https://www.readbyqxmd.com/read/28904214/after-nerve-injury-lineage-tracing-shows-that-myelin-and-remak-schwann-cells-elongate-extensively-and-branch-to-form-repair-schwann-cells-which-shorten-radically-on-remyelination
#10
Jose A Gomez-Sanchez, Kjara S Pilch, Milou van der Lans, Shaline V Fazal, Cristina Benito, Laura J Wagstaff, Rhona Mirsky, Kristjan R Jessen
There is consensus that, distal to peripheral nerve injury, myelin and Remak cells reorganize to form cellular columns, Bungner's bands, which are indispensable for regeneration. However, knowledge of the structure of these regeneration tracks has not advanced for decades and the structure of the cells that form them, denervated or repair Schwann cells, remains obscure. Furthermore, the origin of these cells from myelin and Remak cells and their ability to give rise to myelin cells after regeneration has not been demonstrated directly, although these conversions are believed to be central to nerve repair...
September 13, 2017: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
https://www.readbyqxmd.com/read/28898989/role-of-histone-h3k27-trimethylation-loss-as-a-marker-for-malignant-peripheral-nerve-sheath-tumor-in-fine-needle-aspiration-and-small-biopsy-specimens
#11
Jeffrey K Mito, Xiaohua Qian, Leona A Doyle, Jason L Hornick, Vickie Y Jo
Objectives: Accurate diagnosis of malignant peripheral nerve sheath tumor (MPNST) is often challenging on fine-needle aspiration (FNA) or core needle biopsy. Recurrent mutations in EED and SUZ12, which encode subunits of polycomb repressive complex 2 (PRC2), have been identified in 70% to 92% of MPNSTs; PRC2 inactivation leads to loss of trimethylation of lysine 27 of histone H3 (H3K27me3). We evaluated the utility of H3K27me3 immunohistochemistry for distinguishing MPNST from its cytomorphologic mimics...
August 1, 2017: American Journal of Clinical Pathology
https://www.readbyqxmd.com/read/28885454/attenuation-of-early-phase-inflammation-by-cannabidiol-prevents-pain-and-nerve-damage-in-rat-osteoarthritis
#12
Holly T Philpott, Melissa O'Brien, Jason J McDougall
Osteoarthritis (OA) is a multifactorial joint disease, which includes joint degeneration, intermittent inflammation, and peripheral neuropathy. Cannabidiol (CBD) is a non-euphoria producing constituent of cannabis that has the potential to relieve pain. The aim of this study was to determine if CBD is anti-nociceptive in OA, and whether inhibition of inflammation by CBD could prevent the development of OA pain and joint neuropathy. OA was induced in male Wistar rats (150-175g) by intra-articular injection of sodium monoiodoacetate (MIA; 3mg)...
September 1, 2017: Pain
https://www.readbyqxmd.com/read/28880902/clonidine-used-as-a-perineural-adjuvant-to-ropivacaine-does-not-prolong-the-duration-of-sensory-block-when-controlling-for-systemic-effects-a-paired-blinded-randomized-trial-in-healthy-volunteers
#13
Jakob Hessel Andersen, Pia Jaeger, Tobias Laier Sonne, Jørgen Berg Dahl, Ole Mathiesen, Ulrik Grevstad
BACKGROUND: Clonidine used as an adjuvant to ropivacaine have been shown to prolong the duration of peripheral nerve blocks. The mechanism of action remains unclear. We hypothesized, that clonidine used as an adjuvant to ropivacaine extends the duration of an adductor canal block (ACB) by a peripheral mechanism, compared to ropivacaine alone when controlling for systemic effects. METHODS: We conducted a paired, blinded, randomized trial in healthy volunteers. Participants received bilateral ACBs containing 20 ml ropivacaine 0...
2017: PloS One
https://www.readbyqxmd.com/read/28870310/peripheral-nerve-blocks-in-foot-and-ankle-surgery
#14
REVIEW
Tyler W Fraser, Jesse F Doty
Postoperative pain is one of the most important factors in regard to patient outcomes. It has been linked with patient satisfaction, length of stay, and overall hospital costs. Peripheral nerve blocks have provided a safe, effective method to control early postoperative pain when symptoms are most severe. Peripheral nerve blocks, whether used intraoperatively or postoperatively, provide an alternative or adjunct to conventional pain management methods for patients who may not tolerate heavy narcotics or general anesthesia, in particular the elderly and those with cardiopulmonary disease...
October 2017: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/28870302/perioperative-pain-management-in-hip-and-knee-arthroplasty
#15
REVIEW
Christian J Gaffney, Christopher E Pelt, Jeremy M Gililland, Christopher L Peters
Total hip and knee arthroplasty is associated with significant perioperative pain, which can adversely affect recovery by increasing risk of complications, length of stay, and cost. Historically, opioids were the mainstay of perioperative pain control. However, opioids are associated with significant downsides. Preemptive use of a multimodal pain management approach has become the standard of care to manage pain after hip and knee arthroplasty. Multimodal pain management uses oral medicines, peripheral nerve blocks, intra-articular injections, and other tools to reduce the need for opioids...
October 2017: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/28866348/the-effect-of-intra-articular-cocktail-versus-femoral-nerve-block-for-patients-undergoing-hip-arthroscopy
#16
Sean Childs, Sonia Pyne, Kiritpaul Nandra, Wajeeh Bakhsh, S Atif Mustafa, Brian D Giordano
PURPOSE: To compare clinical efficacy and complication rate as measured by postoperative falls and development of peripheral neuritis between intra-articular blockade and femoral nerve block in patients undergoing arthroscopic hip surgery. METHODS: An institutional review board approved retrospective review was conducted on a consecutive series of patients who underwent elective arthroscopic hip surgery by a single surgeon, between November 2013 and April 2015. Subjects were stratified into 2 groups: patients who received a preoperative femoral nerve block for perioperative pain control, and patients who received an intra-articular "cocktail" injection postoperatively...
August 30, 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/28862159/temporary-persistence-of-conduction-block-after-prolonged-kilohertz-frequency-alternating-current-khfac-on-rat-sciatic-nerve
#17
Narendra Bhadra, Emily Foldes, Tina Vrabec, Kevin L Kilgore, Niloy Bhadra
Application of Kilohertz Frequency Alternating Current (KHFAC) waveforms can result in nerve conduction block that is induced in less than a second. Conduction recovers within seconds when KHFAC is applied for about 5 - 10 minutes. This study investigated the effect of repeated and prolonged application of KHFAC on rat Sciatic nerve with bipolar platinum electrodes. Approach: Varying durations of KHFAC at signal amplitudes for conduction block with intervals of no stimulus were studied. Nerve conduction was monitored by recording peak Gastrocnemius muscle force utilizing stimulation electrodes proximal (PS) and distal (DS) to a blocking electrode...
September 1, 2017: Journal of Neural Engineering
https://www.readbyqxmd.com/read/28861197/comparison-of-the-effect-of-continuous-femoral-nerve-block-and-adductor-canal-block-after-primary-total-knee-arthroplasty
#18
Seung Suk Seo, Ok Gul Kim, Jin Hyeok Seo, Do Hoon Kim, Youn Gu Kim, Beyoung Yun Park
BACKGROUND: This study aimed to compare the effects of femoral nerve block and adductor canal block on postoperative pain, quadriceps strength, and walking ability after primary total knee arthroplasty. METHODS: Between November 2014 and February 2015, 60 patients underwent primary total knee arthroplasty. Thirty patients received femoral nerve block and the other 30 received adductor canal block for postoperative pain control. Before spinal anesthesia, the patients received nerve block via a catheter (20 mL 0...
September 2017: Clinics in Orthopedic Surgery
https://www.readbyqxmd.com/read/28861040/a-case-of-acoustic-shock-with-post-trauma-trigeminal-autonomic-activation
#19
Alain Londero, Nicolas Charpentier, Damien Ponsot, Philippe Fournier, Laurent Pezard, Arnaud J Noreña
This study reports the case of an acoustic shock injury (ASI), which did not result in a significant hearing loss, but was followed by manifold chronic symptoms both within (tinnitus, otalgia, tingling in the ear, tension in the ear, and red tympanum) and outside the ears (blocked nose, pain in the neck/temporal region). We suggest that these symptoms may result from a loop involving injury to middle ear muscles, peripheral inflammatory processes, activation and sensitization of the trigeminal nerve, the autonomic nervous system, and central feedbacks...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28860790/evaluation-of-pain-during-endovenous-laser-ablation-of-the-great-saphenous-vein-with-ultrasound-guided-femoral-nerve-block
#20
Abdullah M Al Wahbi
BACKGROUND: Endoluminal laser ablation is now considered the method of choice for treating greater saphenous vein insufficiency. General anesthesia and peripheral nerve blocks with sedation have the risk of post-procedural delay in discharge and prolonged immobilization with the risk of deep vein thrombosis. The main pain experienced by patients during the procedure is during the laser ablation and the multiple needle punctures given along and around the great saphenous vein. The aim of our study was to evaluate the safety and efficacy of blocking the femoral nerve only under ultrasound-guidance without sedation, to reduce or prevent pain during injectable tumescent anesthesia in endovenous laser ablation of the greater saphenous vein...
2017: Vascular Health and Risk Management
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