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Anesthetic nerve injury

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https://www.readbyqxmd.com/read/28436683/dexmedetomidine-protects-pc12-cells-from-lidocaine-induced-cytotoxicity-through-downregulation-of-col3a1-mediated-by-mir-let-7b
#1
Qiong Wang, Yingjun She, Xiaobao Bi, Baisong Zhao, Xiangcai Ruan, Yonghong Tan
Safety concerns of some local anesthetics, such as lidocaine, have been raised in recent years due to potential neurological impairment. Dexmedetomidine may protect humans from neurotoxicity, and miR-let-7b is activated by nerve injury; however, the roles of miR-let-7b and its target gene in lidocaine-induced cytotoxicity are not well known. Through bioinformatics and a luciferase reporter assay, COL3A1 was suggested as a direct target gene of miR-let-7b. Here, we confirmed by measuring mRNA and protein levels that miR-let-7b was downregulated and COL3A1 was upregulated in lidocaine-treated cells, an observation that was reversed by dexmedetomidine...
April 24, 2017: DNA and Cell Biology
https://www.readbyqxmd.com/read/28435323/ambulatory-thyroidectomy-an-anesthesiologist-s-perspective
#2
REVIEW
Benjamin Murray, Sankalap Tandon, Ged Dempsey
Thyroidectomy has been performed on an inpatient basis because of concerns regarding postoperative complications. These include cervical hematoma, bilateral recurrent laryngeal nerve injury and symptomatic hypocalcemia. We have reviewed the current available evidence and aimed to collate published data to generate incidence of the important complications. We performed a literature search of Medline, EMBASE and the Cochrane database of randomized trials. One hundred sixty papers were included. Twenty-one papers fulfilled inclusion criteria...
2017: Local and Regional Anesthesia
https://www.readbyqxmd.com/read/28413272/an-analysis-of-perioperative-adverse-neurological-events-associated-with-anesthetic-management-at-a-tertiary-care-center-of-a-developing-country
#3
Fauzia Anis Khan, Sobia Khan, Gauhar Afshan
BACKGROUND AND AIMS: Existing literature on neurological complications related to anesthesia is reported from affluent countries but the trends may vary in less affluent countries. MATERIAL AND METHODS: The objective was to find the associated factors contributing to neurological adverse events occurring within 48 h of anesthesia and surgery. The existing departmental morbidity and mortality database was reviewed from 1992 to 2012 for major adverse neurological events...
January 2017: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/28403100/delayed-bilateral-vocal-cord-paresis-after-a-continuous-interscalene-brachial-plexus-block-and-endotracheal-intubation-a-lesson-why-we-should-use-low-concentrated-local-anesthetics-for-continuous-blocks
#4
Hee-Sun Park, Ha-Jung Kim, Young-Jin Ro, Hong-Seuk Yang, Won-Uk Koh
RATIONALE: Recurrent laryngeal nerve block is an uncommon complication that can occur after an interscalene brachial plexus block (ISB), which may lead to vocal cord palsy or paresis. However, if the recurrent laryngeal nerve is blocked in patients with a preexisting contralateral vocal cord palsy following neck surgery, this may lead to devastating acute respiratory failure. Thus, ISB is contraindicated in patients with contralateral vocal cord lesion. To the best of our knowledge, there are no reports of bilateral vocal cord paresis, which occurred after a continuous ISB and endotracheal intubation in a patient with no history of vocal cord injury or surgery of the neck...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28390647/brain-derived-neurotrophic-factor-in-the-mesolimbic-reward-circuitry-mediates-nociception-in-chronic-neuropathic-pain
#5
Hongxing Zhang, Yi-Ling Qian, Chen Li, Di Liu, Lei Wang, Xiao-Yi Wang, Mei-Jun Liu, He Liu, Song Zhang, Xiao-Yun Guo, Jun-Xia Yang, Hai-Lei Ding, Ja Wook Koo, Ezekiell Mouzon, Karl Deisseroth, Eric J Nestler, Venetia Zachariou, Ming-Hu Han, Jun-Li Cao
BACKGROUND: The mesolimbic reward system plays a critical role in modulating nociception; however, its underlying molecular, cellular, and neural circuitry mechanisms remain unknown. METHODS: Chronic constrictive injury (CCI) of the sciatic nerve was used to model neuropathic pain. Projection-specific in vitro recordings in mouse brain slices and in vivo recordings from anesthetized animals were used to measure firing of dopaminergic neurons in the ventral tegmental area (VTA)...
March 1, 2017: Biological Psychiatry
https://www.readbyqxmd.com/read/28335745/ipsilateral-and-contralateral-sensory-changes-in-healthy-subjects-after-experimentally-induced-concomitant-sensitization-and-hypoesthesia
#6
Elena K Enax-Krumova, Stephanie Pohl, Andrea Westermann, Christoph Maier
BACKGROUND: In unilateral neuropathic pain. e.g. after peripheral nerve injury, both positive and negative sensory signs occur often, accompanied by minor but equally directed contralateral sensory changes. To mimic this feature, we experimentally aimed to induce concomitant c-fibre sensitization and block in healthy subjects and analyzed the bilateral sensory changes by quantitative sensory testing (QST) using the protocol of the German Research Network on Neuropathic Pain. METHODS: Twenty eight healthy subjects were firstly randomized in 2 groups to receive either topical capsaicin (0...
March 23, 2017: BMC Neurology
https://www.readbyqxmd.com/read/28299217/management-of-retained-genital-piercings-a-case-report-and-review
#7
Laura J Moulton, Amelia M Jernigan
The prevalence of genital piercing among women is increasing. As the popularity increases, the number of complications from infection, injury, and retained jewelry is likely to rise. Techniques to remove embedded jewelry are not well described in the literature. The purpose of this report was to describe a case of a patient with a retained clitoral glans piercing, discuss a simple technique for outpatient removal, and review current evidence regarding associated risks of clitoral piercings. A 24-year-old female presented to the emergency department with an embedded clitoral glans piercing...
2017: Case Reports in Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28291541/evidence-for-a-novel-neurohumoral-antinociceptive-mechanism-mediated-by-peripheral-capsaicin-sensitive-nociceptors-in-conscious-rats
#8
Gábor Pethő, Kata Bölcskei, Réka Füredi, Bálint Botz, Teréz Bagoly, Erika Pintér, János Szolcsányi
Stimulation of capsaicin-sensitive peripheral sensory nerve terminals induces remote anti-inflammatory effects throughout the body of anesthetized rats and guinea-pigs mediated by somatostatin. As somatostatin has also antinociceptive effects, the study aimed at investigating whether similar remote antinociceptive effects can be demonstrated in awake animals. In conscious rats, nociceptive nerve endings of the right hind paw decentralized by cutting the sciatic and saphenous nerves 18h before were chemically stimulated, and drop of the noxious heat threshold (heat hyperalgesia) induced by prior (18h before) plantar incision was measured on the contralateral, left hind paw using an increasing-temperature water bath...
February 10, 2017: Neuropeptides
https://www.readbyqxmd.com/read/28255948/what-adverse-events-and-injuries-are-cited-in-anesthesia-malpractice-claims-for-nonspine-orthopaedic-surgery
#9
Christopher D Kent, Linda S Stephens, Karen L Posner, Karen B Domino
BACKGROUND: Malpractice claims that arise during the perioperative care of patients receiving orthopaedic procedures will frequently involve both orthopaedic surgeons and anesthesiologists. The Anesthesia Closed Claims database contains anesthesia malpractice claim data that can be used to investigate patient safety events arising during the care of orthopaedic patients and can provide insight into the medicolegal liability shared by the two specialties. QUESTIONS/PURPOSES: (1) How do orthopaedic anesthetic malpractice claims differ from other anesthesia claims with regard to patient and case characteristics, common events and injuries, and liability profile? (2) What are the characteristics of patients who had neuraxial hematomas after spinal and epidural anesthesia for orthopaedic procedures? (3) What are the characteristics of patients who had orthopaedic anesthesia malpractice claims for central ischemic neurologic injury occurring during shoulder surgery in the beach chair position? (4) What are the characteristics of patients who had malpractice claims for respiratory depression and respiratory arrests in the postoperative period? METHODS: The Anesthesia Closed Claims Project database was the source of data for this study...
March 2, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28253180/nerve-damage-in-dentistry
#10
M Anthony Pogrel
Many forms of dental treatment have the potential to cause injury to the oral branches of the trigeminal nerve, including local anesthetic injections, root canal therapy, implant insertion, bone grafting, and dentoalveolar surgery. Based on the records of a referral center with more than 30 years' experience in managing 3200 of these injuries, this article reviews etiology and prevention; suggests criteria for referral of patients; and discusses treatment for the various types of injury and the results of such treatment...
March 2017: General Dentistry
https://www.readbyqxmd.com/read/28251323/bilateral-position-related-ulnar-neuropathy-at-elbow-in-pediatric-population-and-review-of-the-literature
#11
REVIEW
Mariana Balikova, Marta Neklanova, Igor Sulla, Martin Hönig, Jan Halek, Vladimir Mihal, Vladimir Balik
Perioperative ulnar neuropathies attributed to inappropriate arm positioning and padding during surgical procedures are commonly found in adults. However, their extremely rare incidence in the pediatric population may cause absent awareness of the risk of nerve injury in anesthetized pediatric patients. Furthermore, young patients respond to conservative treatment of neuropathy less favorably than adults and their response also depends on the pathomechanism of the ulnar nerve injury. A surgeon's or anesthetist's failure to recognize all of these specifics in children may result in substantial morbidity of young patients leading to lawsuits...
March 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28246415/suspected-bilateral-phrenic-nerve-damage-following-a-mediastinal-mass-removal-in-a-17-week-old-pug
#12
Mathieu Raillard, Pamela J Murison, Ivan P Doran
The anesthetic management of a pediatric pug for removal of a mediastinal mass is described. During recovery from anesthesia, the dog's respiratory pattern was compatible with bilateral diaphragmatic paralysis. Incidence, complications, possible treatments of phrenic nerve injury, problems of long-term mechanical ventilation, and alternative case management are discussed.
March 2017: Canadian Veterinary Journal. la Revue Vétérinaire Canadienne
https://www.readbyqxmd.com/read/28223038/nanoconjugate-bound-adenosine-a1-receptor-antagonist-enhances-recovery-of-breathing-following-acute-cervical-spinal-cord-injury
#13
Zeljka Minic, Sharowyn Wilson, Fangchao Liu, Abdulghani Sankari, Guangzhao Mao, Harry Goshgarian
Respiratory complications in patients with spinal cord injury (SCI) are common and can have a negative impact on the quality of patients' lives. Previously, we found that intradiaphragmatic administration of the nanoconjugate-bound A1 adenosine receptor antagonist, 1,3-dipropyl-8-cyclopentylxanthine (DPCPX) induced recovery of diaphragm function following SCI in rats. When administered immediately following the injury, recovery was observed as early as 3days following SCI and it persisted until the end of the study, 28days after the drug delivery...
February 20, 2017: Experimental Neurology
https://www.readbyqxmd.com/read/28217061/sequestrated-caudal-catheter-in-a-child-an-anesthetic-nightmare-and-surgical-dilemma
#14
Chong Soon Eu, Shyamala V Kumar, Saedah Ali, Shamsul Kamalrujan Hassan
The usage of epidural infusion for intraoperative and postoperative pain relief is widely used in certain pediatric anesthetic practice because of the effectiveness and advantages. However, there is drawback for these techniques due to its potential complications such as inadvertent intrathecal placement, local anesthetic toxicity, catheter migration, infection, and breakage of epidural catheter. Though occur infrequently, epidural catheters have been known to snap during insertion or removal. The retained catheter tip may lead to multiple complications, including nerve injury, infection, and even catheter migration...
January 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/28186626/ultrasound-guided-dorsal-penile-nerve-block-performed-in-a-case-of-zipper-entrapment-injury
#15
Gabriel Rose, Vincent Costa, Aaran Drake, Sebastian D Siadecki, Turandot Saul
Injury to the penis resulting from zipper entrapment is a painful condition that presents a unique anesthetic challenge to the emergency physician and may even require procedural sedation for removal. In this case report, we describe successful removal of zipper entrapment from the penis of a 34-year-old patient after the application of an ultrasound-guided dorsal penile nerve block. We discuss the anatomy, sonographic features, and steps required for the nerve block procedure. © 2017 Wiley Periodicals, Inc...
February 10, 2017: Journal of Clinical Ultrasound: JCU
https://www.readbyqxmd.com/read/28126454/ultrasound-guided-retroclavicular-approach-infraclavicular-brachial-plexus-block-for-upper-extremity-emergency-procedures
#16
Josh Luftig, Daniel Mantuani, Andrew A Herring, Arun Nagdev
The America Society of Anesthesiology guidelines recommend multimodal analgesia that combines regional anesthetic techniques with pharmacotherapy to improve peri-procedural pain management and reduce opioid related complications. Commonly performed emergency procedures of the upper extremity such as fracture and dislocation reduction, wound debridement, and abscess incision and drainage are ideal candidates for ultrasound-guided (USG) regional anesthesia of the brachial plexus. However, adoption of regional anesthesia by emergency practitioners has been limited by concerns for potential complications and perceived technical difficulty...
January 15, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28079731/midterm-radiographic-and-functional-outcomes-of-the-anterior-subcutaneous-internal-pelvic-fixator-infix-for-pelvic-ring-injuries
#17
Rahul Vaidya, Adam Jonathan Martin, Matthew Roth, Frederick Tonnos, Bryant Oliphant, Jon Carlson
OBJECTIVE: To describe our experience using the anterior internal pelvic fixator (INFIX) for treating pelvic ring injuries. DESIGN: Case Series. SETTING: Level 1 Trauma Center. PATIENTS: Eighty-three patients with pelvic ring injuries were treated with INFIX. Follow-up average was 35 months (range 12-80.33). INTERVENTION: Surgical treatment of pelvic ring injuries included reduction, appropriate posterior fixation, and INFIX placement...
May 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28068994/spatiotemporal-changes-of-optical-signals-in-the-somatosensory-cortex-of-neuropathic-rats-after-electroacupuncture-stimulation
#18
Myeounghoon Cha, Younbyoung Chae, Sun Joon Bai, Bae Hwan Lee
BACKGROUND: Peripheral nerve injury causes physiological changes in primary afferent neurons. Neuropathic pain associated with peripheral nerve injuries may reflect changes in the excitability of the nervous system, including the spinothalamic tract. Current alternative medical research indicates that acupuncture stimulation has analgesic effects in various pain symptoms. However, activation changes in the somatosensory cortex of the brain by acupuncture stimulation remain poorly understood...
January 10, 2017: BMC Complementary and Alternative Medicine
https://www.readbyqxmd.com/read/28059804/bupivacaine-increases-the-rate-of%C3%A2-motoneuron-death-following-peripheral%C3%A2-nerve-injury
#19
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/28041753/modified-reversed-superficial-peroneal-artery-flap-in-the-reconstruction-of-ankle-and-foot-defects-following-severe-burns-or-trauma
#20
Shi-Ji Li, Hao Cheng, Xu Fang, Jian-Yang Xu, Fei Wang, Sheng Liu, Xu-Lin Chen, Xiong-Wen Lv
OBJECTIVE: Challenges persist in the reconstruction of the ankle and the foot with exposed tendons, joints, and bones as a result of severe burns and trauma. In flap elevation involving the sensitive superficial nerve, the local nerve was always sacrificed to obtain an anesthetic donor site; however, such a procedure introduced the possibility of painful neuromas. In this study, we present a desired clinical application of a modified reversed superficial peroneal artery flap, in which the superficial peroneal nerve is preserved...
December 29, 2016: Burns: Journal of the International Society for Burn Injuries
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