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Anesthetic injury to peroneal nerve

F Curt Nuño, S López Álvarez, J Juncal Díaz, A Domínguez Chaos, F Llorca González, A Pensado Castiñeiras
We introduce a case report of a woman that was operated of foot surgery under locoregional anesthesia with an echo-guided peripheral sciatic-popliteal nerve block. As post operatory complication a peroneal nerve injury was noticed. We revised differential diagnosis of peripheral nerve block and therapeutic strategy we should take. In our case the finding was a high degree axonotmesis secondary to extrinsic compressure due to pneumatic tourniquet placed in the ankle used during surgery. There was no relationship with the anesthetic technique...
February 2015: Revista Española de Anestesiología y Reanimación
Irina Kirillova-Woytke, Ralf Baron, Wilfrid Jänig
Cutaneous (CVC) and muscle (MVC) vasoconstrictor neurons exhibit typical reflex patterns to physiological stimulation of somatic and visceral afferent neurons. Here we tested the hypothesis that CVC neurons are inhibited by stimulation of cutaneous nociceptors but not of muscle nociceptors and that MVC neurons are inhibited by stimulation of muscle nociceptors but not of cutaneous nociceptors. Activity in the vasoconstrictor neurons was recorded from postganglionic axons isolated from the sural nerve or the lateral gastrocnemius-soleus nerve in anesthetized rats...
May 2014: Journal of Neurophysiology
Scott J Thompson, Magali Millecamps, Antonio Aliaga, David A Seminowicz, Lucie A Low, Barry J Bedell, Laura S Stone, Petra Schweinhardt, M Catherine Bushnell
Persistent pain is a central characteristic of neuropathic pain conditions in humans. Knowing whether rodent models of neuropathic pain produce persistent pain is therefore crucial to their translational applicability. We investigated the spared nerve injury (SNI) model of neuropathic pain and the formalin pain model in rats using positron emission tomography (PET) with the metabolic tracer [18F]fluorodeoxyglucose (FDG) to determine if there is ongoing brain activity suggestive of persistent pain. For the formalin model, under brief anesthesia we injected one hindpaw with 5% formalin and the FDG tracer into a tail vein...
May 1, 2014: NeuroImage
Juanita J Anders, Helina Moges, Xingjia Wu, Isaac D Erbele, Stephanie L Alberico, Edward K Saidu, Jason T Smith, Brian A Pryor
BACKGROUND AND OBJECTIVE: Repair of peripheral nerve injuries remains a major challenge in restorative medicine. Effective therapies that can be used in conjunction with surgical nerve repair to improve nerve regeneration and functional recovery are being actively investigated. It has been demonstrated by a number of peer reviewed publications that photobiomodulation (PBM) supports nerve regeneration, reinnervation of the denervated muscle, and functional recovery after peripheral nerve injury...
January 2014: Lasers in Surgery and Medicine
Tessa Watt, Arun R Hariharan, David W Brzezinski, Michelle S Caird, John L Zeller
PURPOSE: Given the severity and incidence of injury to the common fibular (peroneal) nerve (CFN), there is a need to further clarify its anatomical location and branching patterns. This project attempts to consolidate current anatomical understanding of this nerve and provide physicians with reproducible measurements regarding the CFN and its branches. METHODS: Dissections were performed on 50 specimens (28 cadavers), both fresh and preserved. The CFN was dissected from its emergence from the fibular tunnel to its anterior tibial recurrent nerve (ATRN), superficial fibular nerve (SFN), and deep fibular nerve (DFN) branches...
October 2014: Surgical and Radiologic Anatomy: SRA
J Douglas Jaffe, Daryl S Henshaw, Pamela C Nagle
(CRPS) describes a constellation of symptoms including pain, trophic changes, hyperesthesia, allodynia, and dysregulation of local blood flow often following trauma. It is often confined to the extremities. Treatment of this disorder consists of a variety of modalities including systemic pharmacotherapy, local anesthetic injections or infusions, psychological nonpharmacotherapy, physical rehabilitation, and surgical intervention. Chronic pain not related to CRPS can also be treated with similar interventions...
September 2013: Pain Practice: the Official Journal of World Institute of Pain
Sanjay K Sinha, Jonathan H Abrams, Sivasenthil Arumugam, John D'Alessio, David G Freitas, John T Barnett, Robert S Weller
BACKGROUND: Sciatic nerve block when combined with femoral nerve block for total knee arthroplasty may provide superior analgesia but can produce footdrop, which may mask surgically induced peroneal nerve injury. In this prospective, randomized, observer-blinded study, we evaluated whether performing a selective tibial nerve block in the popliteal fossa would avoid complete peroneal motor block. METHODS: Eighty patients scheduled for primary total knee arthroplasty were randomized to receive either a tibial nerve block in the popliteal fossa or a sciatic nerve block proximal to its bifurcation in combination with femoral nerve block as part of a multimodal analgesia regimen...
July 2012: Anesthesia and Analgesia
V Hajek, C Dussart, F Klack, A Lamy, J-Y Martinez, P Lainé, L Mazurier, L Guilloton, A Drouet
BACKGROUND: Continuous peripheral nerve block (CPNB), in particular at the popliteal fossa, is widely used in orthopedic surgery, allowing good postoperative analgesia. Possible neuropathic complications, however, remain poorly known. OBJECTIVE: To review the characteristics of peripheral neuropathy (PN) after sciatic CPNB at the popliteal fossa, estimating prevalence, severity, evolution and possible risk factors, especially those relating to the procedure. METHODS: Retrospective study of PN associated with popliteal fossa CPNB for hallux valgus surgery, between November 1st, 2005 and November 1st, 2009...
May 2012: Orthopaedics & Traumatology, Surgery & Research: OTSR
Didier Morau, Frank Levy, Sophie Bringuier, Philippe Biboulet, Olivier Choquet, Michèle Kassim, Nathalie Bernard, Xavier Capdevila
BACKGROUND: The ideal spread of local anesthetic (LA) solution around the sciatic nerve during a popliteal block remains unclear. We tested the hypothesis that a circumferential spread of LA and/or intraneural injection could lead to rapid surgical block. METHODS: Patients (n = 100) scheduled for foot or ankle surgery underwent popliteal sciatic nerve block using nerve stimulation according to Borgeat's technique and injection of ropivacaine (0.5 mL/kg). Sensory and motor blockades were assessed on the tibial nerve (TN) and common peroneal nerve (CPN) at 5, 15, and 30 mins after completion of the block and in the recovery room...
November 2010: Regional Anesthesia and Pain Medicine
J J Brightwell, B K Taylor
Current theories of neuropathic hypersensitivity include an imbalance of supraspinal inhibition and facilitation. Our overall hypothesis is that the locus coeruleus (LC), classically interpreted as a source of pain inhibition, may paradoxically result in facilitation after tibial and common peroneal nerve transection (spared sural nerve injury--SNI). We first tested the hypothesis that non-noxious tactile hind paw stimulation of the spared sural innervation territory increases neuronal activity in the LC in male rats...
April 21, 2009: Neuroscience
A Lee Dellon
BACKGROUND: Partial joint denervation is the concept of preservation of joint function and relief of joint pain by interrupting neural pathways that transmit the pain message from the joint to the brain. Partial denervation of painful wrist, elbow, and shoulder joints was described in part I. Application of these principles to the knee and ankle is described in part II. METHODS: Cadaveric anatomical studies identified innervation of the knee and the ankle (sinus tarsi) to provide a guide to nerve blocks and surgical intervention...
January 2009: Plastic and Reconstructive Surgery
Yutaka Kano, Kazumi Masuda, Hirotaka Furukawa, Mizuki Sudo, Kazuyuki Mito, Kazuyoshi Sakamoto
This study examined the effects of a different number of eccentric contractions (ECs) on histological characteristics, surface electromyogram (EMG) parameters (integral EMG, iEMG; muscle fiber conduction velocity, MFCV; and action potential waveform), and isometric peak torque using the rat EC model. Male Wistar rats (n = 40) were anesthetized, and ECs were initiated in the tibialis anterior muscle via electrical stimulation while the muscle was being stretched by electromotor. The rats were grouped according to the number of ECs (EC1, EC5, EC10, EC20, EC30, EC40, and EC100)...
October 2008: Journal of Physiological Sciences: JPS
Murat Acar, Ahmet Karacalar, Mustafa Ayyildiz, Bunyami Unal, Sinan Canan, Erdal Agar, Suleyman Kaplan
Aside from anatomical repairs, the reestablishment of sensory and motor innervations for proper functional recovery is one of the fundamental objectives of reconstructive surgery. The heterotopic transfer of autologous tissues is likely to result in a size discrepancy between the donor and recipient nerves, which will have a negative influence on regeneration. Twenty Wistar albino female rats were used in a study that was divided into two main groups: tibial-peroneal (TP) and peroneal-tibial repair (PT). Both types of nerves were exposed on the hind legs with the nerves cut on the right side, while the proximal stump of the tibial nerve and distal stump of the peroneal nerve were sutured to each other...
March 10, 2008: Brain Research
Y Maeda, P W Wacnik, K A Sluka
Spinal cord stimulation (SCS) is an established treatment for neuropathic pain. However, SCS is not effective for all the patients and the mechanisms underlying the reduction in pain by SCS are not clearly understood. To elucidate the mechanisms of pain relief by SCS, we utilized the spared nerve injury model. Sprague-Dawley rats were anesthetized, the tibial and common peroneal nerves were tightly ligated, and an epidural SCS lead implanted in the upper lumbar spinal cord. SCS was delivered daily at one of 4 different frequencies (4Hz, 60Hz, 100Hz, and 250Hz) at approximately 85% of motor threshold 2 weeks after nerve injury for 4 days...
August 15, 2008: Pain
Yeong-Ray Wen, Marc R Suter, Yasuhiko Kawasaki, Jin Huang, Marie Pertin, Tatsuro Kohno, Charles B Berde, Isabelle Decosterd, Ru-Rong Ji
BACKGROUND: Current evidence indicates that p38 mitogen-activated protein kinase activation in spinal microglia contributes to the development of neuropathic pain. However, how nerve injury activates p38 in spinal microglia is incompletely unknown. Nerve injury-induced ectopic spontaneous activity is essential for the generation of neuropathic pain. The authors examined whether peripheral neural activity is necessary for p38 activation in spinal microglia. METHODS: To examine whether spinal microglia activation depends on peripheral activity in the rat spared nerve injury (SNI) model, the authors blocked conduction in the sciatic nerve before or 2 days after SNI...
August 2007: Anesthesiology
Osei B Ansah, Hugo Leite-Almeida, Hong Wei, Antti Pertovaara
Earlier studies indicate that striatal dopamine D(2) receptors are involved in pain regulation in non-neuropathic conditions. We assessed whether striatal dopamine D(2) receptors contribute to pain regulation also in neuropathic conditions. The spared nerve injury model of neuropathy was induced by unilateral ligation of the tibial and common peroneal nerves in the rat. In awake nerve-injured animals, pain-related withdrawal responses to calibrated monofilaments or noxious heating were attenuated following striatal administration of a dopamine D(2) receptor agonist quinpirole...
June 2007: Experimental Neurology
J G Kennedy, J B Brunner, W H Bohne, C W Hodgkins, D B Baxter
Persistent recalcitrant dorsolateral foot pain after ankle sprain cannot always be explained by known anatomic nerve pathways. To determine whether an impingement of a lateral branch of the deep peroneal nerve might be responsible for atypical pain, we conducted a cadaveric anatomic study to identify the anatomy and course of the nerve. Furthermore, using this information, we conducted a clinical study to determine if targeted treatment to a lateral branch of the deep peroneal nerve would resolve these symptoms...
June 2007: Clinical Orthopaedics and related Research
Terese T Horlocker, James R Hebl, Bhargavi Gali, Christopher J Jankowski, Christopher M Burkle, Daniel J Berry, Fernando A Zepeda, Susanna R Stevens, Darrell R Schroeder
Nerve injury after prolonged tourniquet inflation results from the combined effects of ischemia and mechanical trauma. Tourniquet release, allowing a reperfusion interval of 10-30 min followed by re-inflation, has been recommended to extend the duration of total tourniquet time. However, this practice has not been confirmed clinically. We retrospectively reviewed the medical records of 1001 patients undergoing 1166 primary or revision knee replacements with tourniquet time more than 120 min during a 5-yr interval...
March 2006: Anesthesia and Analgesia
Lara M Rasmussen, Alan J Lipowitz, Lynelle F Graham
OBJECTIVE: To determine whether bupivacaine peripheral nerve block of the saphenous, tibial and common peroneal nerves proximal to the femoro-tibial joint reduces peri-operative pain following extracapsular surgical stabilization of cranial cruciate ligament rupture in the nonchondrodystrophoid dog. ANIMALS: Forty-one dogs with naturally acquired femoro-tibial joint instability. Study design Randomized, controlled, clinical trial. METHODS: Dogs diagnosed with suspected cranial cruciate ligament injury based on physical and radiographic evidence were randomly assigned to treatment (bupivacaine) or control (saline) nerve blocks before femoro-tibial joint surgery...
January 2006: Veterinary Anaesthesia and Analgesia
Joseph W Boggs, Brian J Wenzel, Kenneth J Gustafson, Warren M Grill
Reflexes mediated by urethral sensory pathways are integral to urinary function. This study investigated the changes in bladder pressure and urethral sphincter activity resulting from electrical stimulation of afferents in the deep perineal nerve (DP), which innervates the urethra and surrounding muscles, before and after acute spinal cord transection (SCT) in cats anesthetized with alpha-chloralose monitored by blood pressure and heart rate. DP stimulation elicited bladder contractions before and after SCT but only if the bladder contained a sufficient volume of fluid (78% of the volume needed to cause distention-evoked reflex contractions)...
May 2005: Journal of Neurophysiology
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