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Saphenous nerve

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https://www.readbyqxmd.com/read/27922951/anatomic-and-ultrasonographic-evaluation-of-the-knee-sensory-innervation-a-cadaveric-study-to-determine-anatomic-targets-in-the-treatment-of-chronic-knee-pain
#1
Jorge M Orduña Valls, Ricardo Vallejo, Pablo López Pais, Eliezer Soto, Daniel Torres Rodríguez, David L Cedeño, Carlos Tornero Tornero, Maximino Quintáns Rodríguez, Aurora Baluja González, Julián Álvarez Escudero
BACKGROUND AND OBJECTIVES: Osteoarthrosis is a main cause of knee pain in the elderly. Pain associated with this condition is often refractory to conservative treatment. Total knee replacement may be the best option for severe pathologies; however, the occurrence of a chronic pain state after knee replacement has been well documented in the literature. The previous descriptions of the genicular nerves have been considered somewhat inaccurate. This innervation is complex and exhibits significant interindividual variability...
December 5, 2016: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/27902645/effect-of-nerve-stimulation-use-on-the-success-rate-of-ultrasound-guided-subsartorial-saphenous-nerve-block-a-randomized-controlled-trial
#2
Shaylyn H Montgomery, Colleen M Shamji, Grace S Yi, Cynthia H Yarnold, Stephen J Head, Scott C Bell, Stephan K W Schwarz
BACKGROUND AND OBJECTIVES: Ultrasound-guided subsartorial saphenous nerve block is commonly used to provide complete surgical anesthesia of the foot and ankle in combination with a popliteal sciatic nerve block. However, in part owing to its small caliber and absence of a prominent vascular landmark in the subsartorial plane distal to the adductor canal, the saphenous nerve is more difficult to reliably block than the sciatic nerve in the popliteal fossa. Although the saphenous nerve is a sensory nerve only, neurostimulation can be used to elicit a "tapping" sensation on the anteromedial aspect of the lower leg extending toward the medial malleolus...
November 29, 2016: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/27900340/retropatellar-accessory-portals-for-improved-access-to-the-patella-anatomic-description-and-evaluation-of-safety
#3
Jason L Koh, Anthony L Logli
BACKGROUND: Standard knee arthroscopy portals are frequently used to address retropatellar chondral pathology. Alternative portals may offer a safe and simple substitute, particularly when reaching the base of deep lesions is required. PURPOSE: To describe and assess the safety of accessory retropatellar portals. STUDY DESIGN: Descriptive laboratory study. METHODS: An anatomic study was performed on 10 fresh-frozen cadaveric knees...
November 2016: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/27898492/growth-hormone-regulates-the-sensitization-of-developing-peripheral-nociceptors-during-cutaneous-inflammation
#4
Xiaohua Liu, Kathryn J Green, Zachary K Ford, Luis F Queme, Peilin Lu, Jessica L Ross, Frank B Lee, Aaron T Shank, Renita C Hudgins, Michael P Jankowski
Cutaneous inflammation alters the function of primary afferents and gene expression in the affected dorsal root ganglia (DRGs). However specific mechanisms of injury-induced peripheral afferent sensitization and behavioral hypersensitivity during development are not fully understood. Recent studies in children suggest a potential role for growth hormone (GH) in pain modulation. GH modulates homeostasis and tissue repair after injury, but how GH effects nociception in neonates is not known. To determine if GH played a role in modulating sensory neuron function and hyper-responsiveness during skin inflammation in young mice, we examined behavioral hypersensitivity and the response properties of cutaneous afferents using an ex vivo hairy skin-saphenous nerve-dorsal root ganglion (DRG)-spinal cord preparation...
November 18, 2016: Pain
https://www.readbyqxmd.com/read/27898181/endovenous-ablation-therapy-laser-or-radiofrequency-or-foam-sclerotherapy-versus-conventional-surgical-repair-for-short-saphenous-varicose-veins
#5
REVIEW
Sharath Chandra Vikram Paravastu, Margaret Horne, P Dominic F Dodd
BACKGROUND: Short (or small) saphenous vein (SSV) varices occur as a result of an incompetent sapheno-popliteal junction, where the SSV joins the popliteal vein, resulting in reflux in the SSV; they account for about 15% of varicose veins. Untreated varicose veins may sometimes lead to ulceration of the leg, which is difficult to manage. Traditionally, treatment was restricted to surgery or conservative management. Since the 1990s, however, a number of minimally invasive techniques have been developed; these do not normally require a general anaesthetic, are day-case procedures with a quicker return to normal activities and avoid the risk of wound infection which may occur following surgery...
November 29, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27878340/anatomical-risk-evaluation-of-iatrogenic-injury-to-the-infrapatellar-branch-of-the-saphenous-nerve-during-medial-meniscus-arthroscopic-surgery
#6
Guillaume Koch, Agathe Kling, Nitin Ramamurthy, Faramarz Edalat, Roberto Luigi Cazzato, Jean-Luc Kahn, Julien Garnon, Philippe Clavert
PURPOSE: To determine the relationship of the medial meniscus with the infrapatellar branches of the saphenous nerve, the primary goal is to define and characterize different risk areas for these nerves during medial meniscus surgery. METHODS: After dissecting 20 embalmed cadaver knees, we defined 7 readily identifiable anatomical landmarks. For each knee, we recorded 2 morphological criteria and 16 measurements. RESULTS: The most common anatomical course is a main trunk that is 8 mm anterior to the tuberculum adductorium and 60 mm posterior to the midpoint of the medial patellar margin...
November 22, 2016: Surgical and Radiologic Anatomy: SRA
https://www.readbyqxmd.com/read/27870646/ultrasound-guided-electrodes-for-conduction-studies-of-the-saphenous-nerve
#7
M E Evangelopoulos, S Humpert, K M Rösler
INTRODUCTION: Saphenous nerve conduction studies are difficult, since the nerve is hard to localize and evoked responses are small. Ultrasound imaging may assist in the accurate localization and optimal positioning of surface (SE) and needle electrodes (NE). METHODS: The study population included 39 subjects and was divided into 2 groups. Group A consisted of 20 healthy subjects, while group B of 19 patients with polyneuropathies. Orthodromic conduction was measured by distal supramaximal nerve stimulation...
November 16, 2016: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
https://www.readbyqxmd.com/read/27846646/the-variable-emergence-of-the-infrapatellar-branch-of-the-saphenous-nerve
#8
Brandon Michael Henry, Krzysztof A Tomaszewski, Przemysław A Pękala, Piravin Kumar Ramakrishnan, Dominik Taterra, Karolina Saganiak, Ewa Mizia, Jerzy A Walocha
The infrapatellar branch of the saphenous nerve (IPBSN) is a cutaneous nerve of the lower limb, which arises distal to the adductor canal. High variability in the emergence, course, branching, termination, and morphometrics of the IPBSN poses an increased risk of injury to the nerve during surgical interventions on the anteromedial aspect of the knee. The aim of this study was to describe the anatomical characteristics of the IPBSN. This study utilized cadaveric (n = 100) and ultrasonography (n = 30) assessments, and meta-analysis...
November 15, 2016: Journal of Knee Surgery
https://www.readbyqxmd.com/read/27834474/minimum-local-anaesthetic-volumes-for-a-selective-saphenous-nerve-block-a-dose-finding-study
#9
Werner Ten Hoope, Markus W Hollmann, Arthur Atchabahian, Marcel Rigaud, Gino M Kerkhoffs, Philipp Lirk, Holger M Baumann
BACKGROUND: Saphenous nerve block contributes to analgesia after knee and lower leg surgery. However, literature reports a wide range of volumes of local anaesthetic being used for this block. METHODS: A non-randomized controlled trial in a single university hospital in March 2015. Eighteen healthy volunteers (ASA 1 status, aged 27-43 years; male/female ratio 11 vs. 7) were needed to determine the minimum local anaesthetic volume (MLAV) of mepivacaine 2% using the Dixon up-and-down method to achieve a selective ultrasound-guided saphenous nerve block...
November 11, 2016: Minerva Anestesiologica
https://www.readbyqxmd.com/read/27833497/peroneal-nerve-palsy-after-compression-stockings-application
#10
Jun Hyun Kim, Won Il Kim, Ji Yeon Kim, Won Joo Choe
Peroneal nerve palsy can be caused by various etiology. We report unilateral peroneal nerve palsy after compression stockings application. A 64-year-old man underwent off-pump coronary bypass graft. Surgeon did not use saphenous vein for the bypass graft. Sedation was stopped after 3 h postoperative. After 16 h, for prophylaxis of deep vein thrombosis, knee-high elastic stocking was applied. After 1 h, he took off right stocking because of numbness but left stocking was kept. After 24 h postoperative, (8 h after stocking application) patient complained suddenly left foot drop...
October 2016: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/27830881/transtendinous-course-of-the-infrapatellar-branch-of-saphenous-nerve-a-contribution-to-the-etiology-of-entrapment-neuropathy-and-modification-of-the-existing-classification
#11
Konstantinos Natsis, Georgios Konstantinidis, Georgios Geropoulos, Trifon Totlis, Nikolaos Lazaridis, Thomas Tegos
BACKGROUND: The course of the infrapatellar branch of saphenous nerve (IPBSN) in relation to the Sartorius muscle has been classified into presartorial, transsartorial and retrosartorial types. Mechanical compression of the IPBSN within the sartorius tendon has been surgically recognized as a cause of entrapment neuropathy. Purpose of the present study was to differentiate the IPBSNs penetrating the sartorius tendon from those penetrating the sartorius muscle, from an anatomical and clinical point of views and thus modifying the existing classification...
November 10, 2016: Folia Morphologica (Warsz)
https://www.readbyqxmd.com/read/27799178/does-dexamethasone-have-a-perineural-mechanism-of-action-a-paired-blinded-randomized-controlled-study-in-healthy-volunteers
#12
P Jæger, U Grevstad, Z J Koscielniak-Nielsen, A R Sauter, J K Sørensen, J B Dahl
BACKGROUND: Dexamethasone prolongs block duration. Whether this is achieved via a peripheral or a central mechanism of action is unknown. We hypothesized that perineural dexamethasone added as an adjuvant to ropivacaine prolongs block duration compared with ropivacaine alone, by a locally mediated effect when controlled for a systemic action. METHODS: We performed a paired, blinded, randomized trial, including healthy men. All subjects received bilateral blocks of the saphenous nerve with ropivacaine 0...
November 2016: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/27792047/does-dexmedetomidine-have-a-perineural-mechanism-of-action-when-used-as-an-adjuvant-to-ropivacaine-a-paired-blinded-randomized-trial-in-healthy-volunteers
#13
Jakob H Andersen, Ulrik Grevstad, Hanna Siegel, Jørgen B Dahl, Ole Mathiesen, Pia Jæger
BACKGROUND: Dexmedetomidine used as an adjuvant to local anesthetics may prolong the duration of peripheral nerve blocks. Whether this is mediated by a perineural or systemic mechanism remains unknown. The authors hypothesized that dexmedetomidine has a peripheral mechanism of action. METHODS: The authors conducted a randomized, paired, triple-blind trial in healthy volunteers. All received bilateral saphenous nerve blocks with 20 ml ropivacaine, 0.5%, plus 1 ml dexmedetomidine, 100 µg/ml, in one thigh and 20 ml ropivacaine 0...
October 28, 2016: Anesthesiology
https://www.readbyqxmd.com/read/27773371/circular-frame-fixation-for-calcaneal-fractures-risks-injury-to-the-medial-neurovascular-structures-a-cadaveric-description
#14
Tom Esparon, Callum M Thomson, Paul M Rea, Bilal Jamal
AIM: There is a risk of iatrogenic injury to the soft tissues of the calcaneus and this study assesses the risk of injury to these structures in circular frame calcaneal fracture fixation. MATERIALS AND METHODS: After olive tip wires were inserted, an L-shaped incision on the lateral and medial aspects of 5 formalin fixed cadaveric feet was performed to expose the underlying soft tissues. The calcaneus was divided into zones corresponding to high, medium and low risk using a grading system...
December 2016: Injury
https://www.readbyqxmd.com/read/27709038/bicruciate-knee-ligament-reconstruction-using-4-all-anterior-arthroscopic-portals
#15
Robert Petretta, Vipul Mandalia
The use of an accessory posteromedial portal for posterior cruciate ligament reconstruction in bicruciate knee ligament reconstruction has often been described. However, the use of a posteromedial portal can be time consuming and has some inherent risks including injury to the saphenous vein or nerve. We describe our bicruciate knee ligament reconstruction using 4 exclusively anterior portals including a high anteromedial, high anterolateral, low anteromedial, and low anterolateral portals. Arthroscopy is performed using a combination of 30° and 70° arthroscopes...
August 2016: Arthroscopy Techniques
https://www.readbyqxmd.com/read/27688037/hydrodisplacement-of-sural-nerve-for-safety-and-efficacy-of-endovenous-thermal-ablation-for-small-saphenous-vein-incompetence
#16
Omar Rodriguez-Acevedo, Kristen E Elstner, Kui Martinic, Aaron Zea, Jenny Diaz, Rodrigo T Martins, Fernando Arduini, Alexandra Hodgkinson, Nabeel Ibrahim
BACKGROUND: Endovenous radio frequency ablation for small saphenous vein incompetence by and large appears to be superior and safer than conventional open surgery. Small saphenous vein ablation from approximately mid-calf to the point proximally where the small saphenous vein dives into the popliteal fossa is considered to be safe, as the sural nerve is in most cases separated from this segment of the small saphenous vein by the deep fascia. The outcome of the distal incompetent small saphenous vein remains unclear...
September 29, 2016: Phlebology
https://www.readbyqxmd.com/read/27687059/anesthesia-and-analgesia-methods-for-outpatient-anterior-cruciate-ligament-reconstruction
#17
L Baverel, T Cucurulo, C Lutz, Colombet, J Cournapeau, F Dalmay, N Lefevre, R Letartre, J-F Potel, X Roussignol, L Surdeau, E Servien
INTRODUCTION: More and more anterior cruciate ligament (ACL) reconstructions are being performed as outpatient surgery in France, because of economic considerations. Postoperative pain is the most common reason for delayed discharge that could require hospitalization, and the main reason for unanticipated hospital admission. The purpose of this study was to define the best anesthesia and analgesia methods for ACL reconstruction. MATERIALS AND METHODS: This was a prospective, multicenter, comparative study performed between January 2014 and April 2015...
September 26, 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
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/27616424/the-control-of-alternative-splicing-by-srsf1-in-myelinated-afferents-contributes-to-the-development-of-neuropathic-pain
#19
Richard P Hulse, Robert A R Drake, David O Bates, Lucy F Donaldson
Neuropathic pain results from neuroplasticity in nociceptive neuronal networks. Here we demonstrate that control of alternative pre-mRNA splicing, through the splice factor serine-arginine splice factor 1 (SRSF1), is integral to the processing of nociceptive information in the spinal cord. Neuropathic pain develops following a partial saphenous nerve ligation injury, at which time SRSF1 is activated in damaged myelinated primary afferent neurons, with minimal found in small diameter (IB4 positive) dorsal root ganglia neurons...
December 2016: Neurobiology of Disease
https://www.readbyqxmd.com/read/27613814/a-randomized-controlled-trial-assessing-the-effect-of-a-continuous-subcutaneous-infusion-of-local-anesthetic-following-elective-surgery-to-the-great-toe
#20
Barry Rose, Kumar Kunasingam, Tristan Barton, James Walsh, Karen Fogarty, Andrew Wines
: Local anesthetic use for wound infusions, single injection, and continuous nerve blocks for postoperative analgesia is well established. No study has investigated the effect of a continuous block of the saphenous and superficial peroneal nerves at the level of the ankle joint following first ray surgery. A double blind randomized controlled trial was designed. One hundred patients with hallux valgus and rigidus requiring surgical correction were recruited and randomized to receive a postoperative continuous infusion at the ankle of normal saline or ropivacaine for 24 hours...
September 9, 2016: Foot & Ankle Specialist
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