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Sample records for alveolar nerve block

  1. Effect of Preoperative Pain on Inferior Alveolar Nerve Block.

    Science.gov (United States)

    Aggarwal, Vivek; Singla, Mamta; Subbiya, Arunajatesan; Vivekanandhan, Paramasivam; Sharma, Vikram; Sharma, Ritu; Prakash, Venkatachalam; Geethapriya, Nagarajan

    2015-01-01

    The present study tested the hypothesis that the amount and severity of preoperative pain will affect the anesthetic efficacy of inferior alveolar nerve block (IANB) in patients with symptomatic irreversible pulpitis. One-hundred seventy-seven adult volunteer subjects, actively experiencing pain in a mandibular molar, participated in this prospective double-blind study carried out at 2 different centers. The patients were classified into 3 groups on the basis of severity of preoperative pain: mild, 1-54 mm on the Heft-Parker visual analog scale (HP VAS); moderate, 55-114 mm; and severe, greater than 114 mm. After IANB with 1.8 mL of 2% lidocaine, endodontic access preparation was initiated. Pain during treatment was recorded using the HP VAS. The primary outcome measure was the ability to undertake pulp access and canal instrumentation with no or mild pain. The success rates were statistically analyzed by multiple logistic regression test. There was a significant difference between the mild and severe preoperative pain group (P = .03). There was a positive correlation between the values of preoperative and intraoperative pain (r = .2 and .4 at 2 centers). The amount of preoperative pain can affect the anesthetic success rates of IANB in patients with symptomatic irreversible pulpitis. PMID:26650491

  2. Teaching alternatives to the standard inferior alveolar nerve block in dental education: outcomes in clinical practice.

    Science.gov (United States)

    Johnson, Thomas M; Badovinac, Rachel; Shaefer, Jeffry

    2007-09-01

    Surveys were sent to Harvard School of Dental Medicine students and graduates from the classes of 2000 through 2006 to determine their current primary means of achieving mandibular anesthesia. Orthodontists and orthodontic residents were excluded. All subjects received clinical training in the conventional inferior alveolar nerve block and two alternative techniques (the Akinosi mandibular block and the Gow-Gates mandibular block) during their predoctoral dental education. This study tests the hypothesis that students and graduates who received training in the conventional inferior alveolar nerve block, the Akinosi mandibular block, and the Gow-Gates mandibular block will report more frequent current utilization of alternatives to the conventional inferior alveolar nerve block than clinicians trained in the conventional technique only. At the 95 percent confidence level, we estimated that between 3.7 percent and 16.1 percent (mean=8.5 percent) of clinicians trained in using the Gow-Gates technique use this injection technique primarily, and between 35.4 percent and 56.3 percent (mean=47.5 percent) of those trained in the Gow-Gates method never use this technique. At the same confidence level, between 0.0 percent and 3.8 percent (mean=0.0 percent) of clinicians trained in using the Akinosi technique use this injection clinical technique primarily, and between 62.2 percent and 81.1 percent (mean=72.3 percent) of those trained in the Akinosi method never use this technique. No control group that was completely untrained in the Gow-Gates or Akinosi techniques was available for comparison. However, we presume that zero percent of clinicians who have not been trained in a given technique will use the technique in clinical practice. The confidence interval for the Gow-Gates method excludes this value, while the confidence interval for the Akinosi technique includes zero percent. We conclude that, in the study population, formal clinical training in the Gow-Gates and

  3. Efficacy and complications associated with a modified inferior alveolar nerve block technique. A randomized, triple-blind clinical trial

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    Montserrat-Bosch, Marta; Nogueira-Magalhães, Pedro; Arnabat-Dominguez, Josep; Valmaseda-Castellón, Eduard; Gay-Escoda, Cosme

    2014-01-01

    Objectives: To compare the efficacy and complication rates of two different techniques for inferior alveolar nerve blocks (IANB). Study Design: A randomized, triple-blind clinical trial comprising 109 patients who required lower third molar removal was performed. In the control group, all patients received an IANB using the conventional Halsted technique, whereas in the experimental group, a modified technique using a more inferior injection point was performed. Results: A total of 100 patients were randomized. The modified technique group showed a significantly higher onset time in the lower lip and chin area, and was frequently associated to a lingual electric discharge sensation. Three failures were recorded, 2 of them in the experimental group. No relevant local or systemic complications were registered. Conclusions: Both IANB techniques used in this trial are suitable for lower third molar removal. However, performing an inferior alveolar nerve block in a more inferior position (modified technique) extends the onset time, does not seem to reduce the risk of intravascular injections and might increase the risk of lingual nerve injuries. Key words:Dental anesthesia, inferior alveolar nerve block, lidocaine, third molar, intravascular injection. PMID:24608204

  4. Effect of Oral Premedication on the Efficacy of Inferior Alveolar Nerve Block in Patients with Symptomatic Irreversible Pulpitis: A Prospective, Double-Blind, Randomized Controlled Clinical Trial

    Science.gov (United States)

    Saha, Suparna Ganguly; Dubey, Sandeep; Kala, Shubham; Misuriya, Abhinav; Kataria, Devendra

    2016-01-01

    Introduction It is generally accepted that achieving complete anaesthesia with an Inferior Alveolar Nerve Block (IANB) in mandibular molars with symptomatic irreversible pulpitis is more challenging than for other teeth. Therefore, administration of Non-Steroidal Anti-Inflammatory Agents (NSAIDs) 1 hour prior to anaesthetic administration has been proposed as a means to increase the efficacy of the IANB in such patients. Aim The purpose of this prospective, double-blind, randomized clinical trial was to determine the effect of administration of oral premedication with ketorolac (KETO) and diclofenac potassium (DP) on the efficacy of IANB in patients with irreversible pulpitis. Materials and Methods One hundred and fifty patients with irreversible pulpitis were evaluated preoperatively for pain using Heft Parker visual analogue scale, after which they were randomly divided into three groups. The subjects received identical tablets of ketorolac, diclofenac pottasium or cellulose powder (placebo), 1 hour prior to administration of IANB with 2% lidocaine containing 1:200 000 epinephrine. Lip numbness as well as positive and negative responses to cold test were ascertained. Additionally pain score of each patient was recorded during cavity preparation and root canal instrumentation. Success was defined as the absence of pain or mild pain based on the visual analog scale readings. The data was analysed using One-Way Anova, Post-Hoc Tukey pair wise, Paired T – Test and chi-square test. Trial Registery Number is 4722/2015 for this clinical trial study. Results There were no significant differences with respect to age (p =0.098), gender (p = 0.801) and pre-VAS score (DP-KETO p=0.645, PLAC-KETO p =0.964, PLAC-DP p = 0.801) between the three groups. All patients had subjective lip anaesthesia with the IAN blocks. Patients of all the three groups reported a significant decrease in active pain after local anaesthesia (p< 0.05). The post injection VAS Score was least in group

  5. Effect of preoperative medications on the efficacy of inferior alveolar nerve block in patients with irreversible pulpitis: A placebo-controlled clinical study

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    Amit Jena

    2013-01-01

    Full Text Available Background: The purpose of this prospective, randomized, double-blind, placebo-controlled study was to compare the effect of the administration of preoperative ibuprofen, ketorolac, combination of etodolac with paracetamol and combination of aceclofenac with paracetamol versus placebo for the potential increased effectiveness of the inferior alveolar nerve block [IANB] anesthesia. Materials and Methods: A total of 100 endodontic emergency patients in moderate to severe pain diagnosed with irreversible pulpitis of a mandibular posterior tooth randomly received, in a double-blind manner, either a drug or placebo 30 minutes before the administration of a conventional IANB. Cold testing was done before administration of anesthesia to determine level of pain using Heft-Parker Visual Analogue Scale (VAS score. Success was defined as no pain or pain (VAS on access or initial instrumentation. Results: Overall success was 54% for all the groups. Success was highest (70% for the ketorolac group, 55% for both ibuprofen group and combination of aceclofenac with paracetamol group, 50% for combination of etodolac with paracetamol group, and 40% for the placebo group. Conclusions: Under the conditions of this study, the use of preoperative medication did improve the anesthetic efficacy of IANB for the treatment of teeth diagnosed with irreversible pulpitis but not significantly.

  6. Lateralization Technique and Inferior Alveolar Nerve Transposition

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    Angélica Castro Pimentel

    2016-01-01

    Full Text Available Bone resorption of the posterior mandible can result in diminished bone edge and, therefore, the installation of implants in these regions becomes a challenge, especially in the presence of the mandibular canal and its contents, the inferior alveolar nerve. Several treatment alternatives are suggested: the use of short implants, guided bone regeneration, appositional bone grafting, distraction osteogenesis, inclined implants tangential to the mandibular canal, and the lateralization of the inferior alveolar nerve. The aim was to elucidate the success rate of implants in the lateralization technique and in inferior alveolar nerve transposition and to determine the most effective sensory test. We conclude that the success rate is linked to the possibility of installing implants with long bicortical anchor which favors primary stability and biomechanics.

  7. Lateralization Technique and Inferior Alveolar Nerve Transposition

    Science.gov (United States)

    Sanches, Marco Antonio; Ramalho, Gabriel Cardoso; Manzi, Marcello Roberto

    2016-01-01

    Bone resorption of the posterior mandible can result in diminished bone edge and, therefore, the installation of implants in these regions becomes a challenge, especially in the presence of the mandibular canal and its contents, the inferior alveolar nerve. Several treatment alternatives are suggested: the use of short implants, guided bone regeneration, appositional bone grafting, distraction osteogenesis, inclined implants tangential to the mandibular canal, and the lateralization of the inferior alveolar nerve. The aim was to elucidate the success rate of implants in the lateralization technique and in inferior alveolar nerve transposition and to determine the most effective sensory test. We conclude that the success rate is linked to the possibility of installing implants with long bicortical anchor which favors primary stability and biomechanics. PMID:27433360

  8. Iatrogenic injury to the inferior alveolar nerve

    DEFF Research Database (Denmark)

    Hillerup, Søren

    2008-01-01

    The purpose of this prospective, non-randomised, descriptive study is to characterise the neurosensory deficit and associated neurogenic discomfort in 52 patients with iatrogenic injury to the inferior alveolar nerve (IAN). All patients were examined and followed up according to a protocol...

  9. Unusual facial pain secondary to inferior alveolar nerve compression caused by impacted mandibular second molar

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    Urvashi Sharma

    2014-01-01

    Full Text Available Symptoms of inferior alveolar nerve (IAN compression are reported during endodontic procedures, placement of implants, third molar surgeries, inferior alveolar nerve block injections, trauma, orthognathic injuries, ablative surgeries or use of medicaments. Presented is a rare case of a 15-year-old girl who reported severe pain in relation to an impacted permanent mandibular left second molar, the roots of which had entrapped the mandibular canal causing compression of IAN. Timely surgical intervention and sectional removal of the impacted molar is indicated to relieve the symptoms and avoid permanent damage to the nerve.

  10. ANESTHETIC EFFICACY OF COMBINATION OF TWO PERCENT LIDOCAINE WITH 1:80,000 EPINEPHRINE AND 0.5 MOL/L MANNITOL FOR INFERIOR ALVEOLAR NERVE BLOCKS IN PATIENTS WITH SYMPTOMATIC IRREVERSIBLE PULPITIS: AN IN VIVO STUDY

    Directory of Open Access Journals (Sweden)

    Thimmaiah. P. B.

    2013-08-01

    Full Text Available The purpose of this prospective randomized single blind study was to determine the anesthetic efficacy of combination of 2 % Lidocaine with 1 : 80,000 Epinephrine and 0.5 mol / L Mannitol in Inferior Alveolar Nerve (IAN Blocks in patients with symptomatic irreversible pulpitis. 60 subjects randomly received IAN Blocks using the following two anesthetic formulations: one formulation comprised of 2.5 ml of 2 % Lidocaine with 1 : 80,000 Epinephrine and the other formulation comprised of 1.6 ml of 2 % Lidocaine with 1 : 80,000 Epinephrine and 0.9 ml of 0.5 mol / L Mannitol. The pain response of the patient was recorded on endodontic access and initial instrumentation using the Heft-Parker Visual Analogue Scale. From the statistical analysis obtained following this study the addition of 0.5 mol / L Mannitol to lidocaine with epinephrine formulations significantly improved effectiveness in achieving a greater percentage of total pulpal anesthesias compared with a lidocaine formulation without Mannitol for IAN blocks. There is a significant improvement in the efficacy of IAN blocks when 2 % Lidocaine with 1 : 80,000 Epinephrine is administered in combination with 0.5 mol / L Mannitol. Based on the results of this study we can conclude that this combination of local anesthetic should be used on a regular basis to obtain successful anesthesia. However there is a need for more research as there are very few studies done on this aspect.

  11. Myelinated axon counts of human inferior alveolar nerves.

    OpenAIRE

    Heasman, P A; Beynon, A D

    1987-01-01

    A quantitative, postmortem study of 36 human inferior alveolar nerves is described. The total myelinated fibre count (TMFC) of nerves was not related to sex or age of the subjects but significant positive correlations were found between TMFC and subject body weight in both dentate (r = 0.616) and edentulous (r = 0.676) groups. The TMFC was significantly lower in nerves from edentulous subjects than in nerves from dentate subjects.

  12. [Anatomical rationale for lingual nerve injury prevention during mandibular block].

    Science.gov (United States)

    Semkin, V A; Dydikin, S S; Kuzin, A V; Sogacheva, V V

    2015-01-01

    The topographic and anatomical study of lingual nerve structural features was done. It was revealed that during mandibular anesthesia possible lingual nerve injury can occur if puncture needle is lower than 1 cm. of molars occlusal surface level. The position of the lingual nerve varies withmandible movements. At the maximum open mouth lingual nerve is not mobile and is pressed against the inner surface of the mandibular ramus by the medial pterygoid muscle and the temporal muscle tendon. When closing the mouth to 1.25±0.2 cmfrom the physiological maximum, lingual nerve is displaced posteriorly from the internal oblique line of the mandible and gets mobile. On the basis of topographic and anatomic features of the lingual nervestructure the authors recommend the re-do of inferior alveolar nerve block, a semi-closed mouth position or the use the "high block techniques" (Torus anesthesia, Gow-Gates, Vazirani-Akinozi). PMID:26271698

  13. Traumatic neuroma of the inferior alveolar nerve: a case report.

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    Arribas-García, Ignacio; Alcalá-Galiano, Andrea; Gutiérrez, Ramón; Montalvo-Moreno, Juan José

    2008-03-01

    Traumatic neuromas are rare entities which characteristically arise subsequently to surgery and are usually accompanied by pain, typically neuralgic. We present an unusual case of an intraosseous traumatic neuroma of the inferior alveolar nerve following tooth extraction. A 56-year-old man consulted for paresthesias and hyperesthesia in the left mandibular region following extraction of the left mandibular third molar (#38). The panoramic radiograph revealed a radiolucent lesion in the inferior alveolar nerve canal, and CT demonstrated the existence of a mass within the canal, producing widening of the same. Nerve-sparing excisional biopsy was performed. Histopathology and immunohistochemistry were consistent with traumatic neuroma of the left inferior alveolar nerve. After 3 years of follow-up, the patient is asymptomatic and there are no signs of recurrence.

  14. Variant Inferior Alveolar Nerves and Implications for Local Anesthesia.

    Science.gov (United States)

    Wolf, Kevin T; Brokaw, Everett J; Bell, Andrea; Joy, Anita

    2016-01-01

    A sound knowledge of anatomical variations that could be encountered during surgical procedures is helpful in avoiding surgical complications. The current article details anomalous morphology of inferior alveolar nerves encountered during routine dissection of the craniofacial region in the Gross Anatomy laboratory. We also report variations of the lingual nerves, associated with the inferior alveolar nerves. The variations were documented and a thorough review of literature was carried out. We focus on the variations themselves, and the clinical implications that these variations present. Thorough understanding of variant anatomy of the lingual and inferior alveolar nerves may determine the success of procedural anesthesia, the etiology of pathologic processes, and the avoidance of surgical misadventure. PMID:27269666

  15. Anesthetic efficacy of X-tip intraosseous injection using 2% lidocaine with 1:80,000 epinephrine in patients with irreversible pulpitis after inferior alveolar nerve block: A clinical study

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    Pushpendra Kumar Verma

    2013-01-01

    Full Text Available Introduction: The inferior alveolar nerve block (IAN is the most frequently used mandibular injection technique for achieving local anesthesia in endodontics. Supplemental injections are essential to overcome failure of IAN block in patients with irreversible pulpitis. Aim: To evaluate the anesthetic efficacy of X-tip intraosseous injection (2% lidocaine with 1:80,000 epinephrine in patients with irreversible pulpitis in mandibular posterior teeth when conventional IAN block failed. Materials and Methods: Thirty emergency patients diagnosed with irreversible pulpitis in a mandibular posterior tooth received an IAN block and experienced moderate to severe pain on endodontic access or initial instrumentation. The X-tip system was used to administer 1.8 ml of 2% lidocaine with 1:80,000 epinephrine. The success of X-tip intraosseous injection was defined as none or mild pain (Heft-Parker visual analogue scale ratings < 54 mm on endodontic access or initial instrumentation. Results: Ninety-three percent of X-tip injections were successful and 7% were unsuccessful. Discomfort rating for X-tip perforation: 96.66% patients reported none or mild pain, whereas 3.34% reported moderate to severe pain. For discomfort rating during solution deposition, 74.99% patients reported none or mild pain and 24.92% reported moderate to severe pain. Ninety-six percent of the patients had subjective/objective increase in heart rate. Conclusions: Supplemental X-tip intraosseous injection using 2% lignocaine with 1:80,000 epinephrine has a statistically significant influence in achieving pulpal anesthesia in patients with irreversible pulpitis.

  16. The etiology of altered sensation in the inferior alveolar, lingual, and mental nerves as a result of dental treatment.

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    Pogrel, M A; Thamby, S

    1999-07-01

    In a review of 163 consecutive patients referred with trigeminal nerve (inferior alveolar or lingual nerve) involvement following dental treatment, the most common etiology was third-molar removal (87 patients). The second most common cause was an inferior alveolar nerve block injection (34 patients), with a smaller number of endodontic and periodontal complications. Female patients outnumbered male 3.3 to 1. Twenty-seven patients were offered surgical exploration and possible nerve repair surgery; of them, 14 underwent surgery. Forty percent of the patients admitted to being involved in litigation during the time they were undergoing treatment. PMID:10530111

  17. Continuous peripheral nerve blocks in children.

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    Dadure, C; Capdevila, X

    2005-06-01

    In recent years, regional anaesthesia in children has generated increasing interest. Continuous peripheral nerve blocks have an important role in the anaesthetic arsenal, allowing effective, safe and prolonged postoperative pain management. Indications for continuous peripheral nerve blocks depend on benefits/risks analysis of each technique for each patient. The indications include surgery associated with intense postoperative pain, surgery requiring painful physical therapy, and complex regional pain syndrome. Continuous peripheral nerve blocks are usually performed under general anaesthesia or sedation, and require appropriate equipment in order to decrease the risk of nerve injury. New techniques, such as transcutaneous stimulation or ultrasound guidance, appear to facilitate nerve and plexus identification in paediatric patients. Nevertheless, continuous peripheral nerve block may mask compartment syndrome in certain surgical procedure or trauma. Finally, ropivacaine appears to be the best local anaesthetic for continuous peripheral nerve blocks in children, requiring low flow rate with low concentration of the local anaesthetic. PMID:15966500

  18. [Electrical nerve stimulation for plexus and nerve blocks].

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    Birnbaum, J; Klotz, E; Bogusch, G; Volk, T

    2007-11-01

    Despite the increasing use of ultrasound, electrical nerve stimulation is commonly used as the standard for both plexus and peripheral nerve blocks. Several recent randomized trials have contributed to a better understanding of physiological and clinical correlations. Traditionally used currents and impulse widths are better defined in relation to the distance between needle tip and nerves. Commercially available devices enable transcutaneous nerve stimulation and provide new opportunities for the detection of puncture sites and for training. The electrically ideal position of the needle usually is defined by motor responses which can not be interpreted without profound anatomical knowledge. For instance, interscalene blocks can be successful even after motor responses of deltoid or pectoral muscles. Infraclavicular blocks should be aimed at stimulation of the posterior fascicle (extension). In contrast to multiple single nerve blocks, axillary single-shot blocks more commonly result in incomplete anaesthesia. Blockade of the femoral nerve can be performed without any nerve stimulation if the fascia iliaca block is used. Independently of the various approaches to the sciatic nerve, inversion and plantar flexion are the best options for single-shot blocks. Further clinical trials are needed to define the advantages of stimulating catheters in continuous nerve blocks.

  19. Injury of the Inferior Alveolar Nerve during Implant Placement: a Literature Review

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    Gintaras Juodzbalys

    2011-01-01

    Full Text Available Objectives: The purpose of present article was to review aetiological factors, mechanism, clinical symptoms, and diagnostic methods as well as to create treatment guidelines for the management of inferior alveolar nerve injury during dental implant placement.Material and Methods: Literature was selected through a search of PubMed, Embase and Cochrane electronic databases. The keywords used for search were inferior alveolar nerve injury, inferior alveolar nerve injuries, inferior alveolar nerve injury implant, inferior alveolar nerve damage, inferior alveolar nerve paresthesia and inferior alveolar nerve repair. The search was restricted to English language articles, published from 1972 to November 2010. Additionally, a manual search in the major anatomy, dental implant, periodontal and oral surgery journals and books were performed. The publications there selected by including clinical, human anatomy and physiology studies.Results: In total 136 literature sources were obtained and reviewed. Aetiological factors of inferior alveolar nerve injury, risk factors, mechanism, clinical sensory nerve examination methods, clinical symptoms and treatment were discussed. Guidelines were created to illustrate the methods used to prevent and manage inferior alveolar nerve injury before or after dental implant placement.Conclusions: The damage of inferior alveolar nerve during the dental implant placement can be a serious complication. Clinician should recognise and exclude aetiological factors leading to nerve injury. Proper presurgery planning, timely diagnosis and treatment are the key to avoid nerve sensory disturbances management.

  20. Surgical treatment of painful lesions of the inferior alveolar nerve.

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    Biglioli, Federico; Allevi, Fabiana; Lozza, Alessandro

    2015-10-01

    Nerve-related complications are being reported with increasing frequency following oral and dental surgery, and typically involve the inferior alveolar nerve (IAN). We assess herein the etiology of neuropathic pain related to IAN injuries, and describe the various surgical treatment techniques available. Between 2007 and 2013, 19 patients were referred to the Maxillofacial Surgery Department of San Paolo Hospital (Milan, Italy) with pain in the area supplied by the IAN, which developed following endodontic treatment, oral surgery and maxillofacial surgery. All patients underwent IAN surgery by several different microsurgical procedures. Most of the patients affected by pain before surgery experienced complete or partial amelioration of symptoms. All patients receiving sural nerve grafts were pain-free 12 months after surgery. In five patients the operation was unsuccessful. In 78.94% of cases, a significant increase in nerve function was observed. Pain following IAN surgical damage may be addressed by microsurgery; nerve substitution with a sural nerve interpositional graft appears to represent the most efficacious procedure. Scar releasing, nerve decompression and nerve substitution using vein grafts are less effective. Removal of endodontic material extravasated into the mandibular canal is mandatory and effective in patients experiencing severe pain. Surgery should be performed within 12 months postoperatively, ideally during the first few weeks after symptoms onset. PMID:26315275

  1. Coronectomy - A viable alternative to prevent inferior alveolar nerve injury

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    Alok Sagtani

    2015-12-01

    Full Text Available Background and Objectives: Coronectomy is a relatively new method to prevent the risk of Inferior Alveolar Nerve (IAN injury during removal of lower third molars with limited scientific literature among Nepalese patients. Thus, a study was designed to evaluate coronectomy regarding its use, outcomes and complications.Materials and Methods: A descriptive study was conducted from December 2012 to December 2013 among patients attending Department of Oral and Maxillofacial Surgery, College of Dental Sciences, BP Koirala Institute of Health Sciences, Dharan, Nepal for removal of mandibular third molars. After reviewing the radiograph for proximity of third molar to the IAN, coronectomy was advised. A written informed consent was obtained from the patients and coronectomy was performed. Patients were recalled after one week. The outcome measures in the follow-up visit were primary healing, pain, infection, dry socket, root exposure and IAN injury. The prevalence of IAN proximity of lower third molars and incidence of complications were calculated.Results: A total 300 mandibular third molars were extracted in 278 patients during the study period. Out of 300 impacted mandibular third molar, 41 (13.7% showed close proximity to inferior alveolar nerve . The incidence of complications and failed procedure was 7.4% among the patients who underwent coronectomy. During the follow up visit, persistent pain and root exposure was reported while other complications like inferior alveolar nerve injury, dry socket and infection was not experienced by the study patients.Conclusion: With a success rate of 92.6% among the 41 patients, coronectomy is a viable alternative to conventional total extraction for mandibular third molars who have a higher risk for damage to the inferior alveolar nerve.JCMS Nepal. 2015;11(3:1-5.

  2. Injury of the Inferior Alveolar Nerve during Implant Placement: a Literature Review

    OpenAIRE

    Gintaras Juodzbalys; Hom-Lay Wang; Gintautas Sabalys

    2011-01-01

    ABSTRACT Objectives The purpose of present article was to review aetiological factors, mechanism, clinical symptoms, and diagnostic methods as well as to create treatment guidelines for the management of inferior alveolar nerve injury during dental implant placement. Material and Methods Literature was selected through a search of PubMed, Embase and Cochrane electronic databases. The keywords used for search were inferior alveolar nerve injury, inferior alveolar nerve injuries, inferior alveo...

  3. Inferior alveolar nerve injury with laryngeal mask airway: a case report.

    LENUS (Irish Health Repository)

    Hanumanthaiah, Deepak

    2011-01-01

    The incidence of damage to the individual cranial nerves and their branches associated with laryngeal mask airway use is low; there have been case reports of damage to the lingual nerve, hypoglossal nerve and recurrent laryngeal nerve. To the best of our knowledge we present the first reported case of inferior alveolar nerve injury associated with laryngeal mask airway use.

  4. Electrophysiological evaluation of nerve function in inferior alveolar nerve injury: relationship between nerve action potentials and histomorphometric observations.

    Science.gov (United States)

    Murayama, M; Sasaki, K; Shibahara, T

    2015-12-01

    The objective of this study was to improve the accuracy of diagnosis of inferior alveolar nerve (IAN) injury by determining degrees of nerve disturbance using the sensory nerve action potential (SNAP) and sensory nerve conduction velocity (SCV). Crush and partial and complete nerve amputation injuries were applied to the IAN of rabbits, then SNAPs and histomorphometric observations were recorded at 1, 5, and 10 weeks. For crush injury, most nerves were smaller in diameter at 5 weeks than at 1 week, however after 10 weeks, extensive nerve regeneration was observed. The SNAP showed a decrease in SCV at weeks 1 and 5, followed by an increase at week 10. For partial nerve amputation, small to medium-sized nerve fibres were observed at weeks 1 and 5, then larger nerves were seen at week 10. Minimal changes in SCV were observed at weeks 1 and 5, however SCV increased at week 10. For complete nerve amputation, nerve fibres were sparse at week 1, but gradual nerve regeneration was observed at weeks 5 and 10. SNAPs were detectable from week 10, however the SCV was extremely low. This study showed SCV to be an effective factor in the evaluation of nerve injury and regeneration. PMID:26433750

  5. The vascularized sural nerve graft based on a peroneal artery perforator for reconstruction of the inferior alveolar nerve defect.

    Science.gov (United States)

    Hayashida, Kenji; Hiroto, Saijo; Morooka, Shin; Kuwabara, Kaoru; Fujioka, Masaki

    2015-03-01

    The sural nerve has been described for nerve reconstruction of the maxillofacial region since it provides many advantages. We report a case of a vascularized sural nerve graft based on a peroneal artery perforator for immediate reconstruction after the removal of intraosseous neuroma originating in the inferior alveolar nerve. The patient had a neuroma caused by iatrogenic injury to the inferior alveolar nerve. A 4-cm long neuroma existed in the inferior alveolar nerve and was resected. A peroneal perforator was chosen as the pedicle of the vascularized sural nerve graft for the nerve gap. The graft including the skin paddle for monitoring the perfusion supplied by this perforator was transferred to the lesion. The nerve gap between the two stumps of the inferior alveolar nerve was repaired using the 6-cm long vascularized sural nerve. The perforator of the peroneal artery was anastomosed to the branch of the facial artery in a perforator-to-perforator fashion. There was no need to sacrifice any main arteries. The skin paddle with 1 cm × 3 cm in size was inset into the incised medial neck. Perceptual function tests with a Semmes-Weinstein pressure esthesiometer and two-point discrimination in the lower lip and chin at 10 months after surgery showed recovery almost to the level of the normal side. This free vascularized sural nerve graft based on a peroneal artery perforator may be a good alternative for reconstruction of inferior alveolar nerve defects. PMID:25346479

  6. Bruxism elicited by inferior alveolar nerve injury: a case report.

    Science.gov (United States)

    Melis, Marcello; Coiana, Carlo; Secci, Simona

    2012-02-01

    The aim of this case report is to describe the history of a patient who received an injury to the right inferior alveolar nerve after placement of a dental implant, with bruxism noted afterward. The symptoms were managed by the use of an occlusal appliance worn at night and occasionally during the day, associated with increased awareness of parafunction during the day to reduce muscle pain and fatigue. Paresthesia of the teeth, gingiva, and lower lip persisted but were reduced during appliance use. PMID:22254232

  7. Adductor Canal Block versus Femoral Nerve Block and Quadriceps Strength

    DEFF Research Database (Denmark)

    Jæger, Pia Therese; Nielsen, Zbigniew Jerzy Koscielniak; Henningsen, Lene Marianne;

    2013-01-01

    : The authors hypothesized that the adductor canal block (ACB), a predominant sensory blockade, reduces quadriceps strength compared with placebo (primary endpoint, area under the curve, 0.5-6 h), but less than the femoral nerve block (FNB; secondary endpoint). Other secondary endpoints were...

  8. A case of mental nerve paresthesia due to dynamic compression of alveolar inferior nerve along an elongated styloid process

    NARCIS (Netherlands)

    P.J.J. Gooris; J.C.M. Zijlmans; J.E. Bergsma; G. Mensink

    2014-01-01

    Spontaneous paresthesia of the mental nerve is considered an ominous clinical sign. Mental nerve paresthesia has also been referred to as numb chin syndrome. Several potentially different factors have been investigated for their role in interfering with the inferior alveolar nerve (IAN) and causing

  9. Neurologic complication after anterior sciatic nerve block.

    Science.gov (United States)

    Shah, Shruti; Hadzic, Admir; Vloka, Jerry D; Cafferty, Maureen S; Moucha, Calin S; Santos, Alan C

    2005-05-01

    The lack of reported complications related to lower extremity peripheral nerve blocks (PNBs) may be related to the relatively infrequent application of these techniques and to the fact that most such events go unpublished. Our current understanding of the factors that lead to neurologic complications after PNBs is limited. This is partly the result of our inability to conduct meaningful retrospective studies because of a lack of standard and objective monitoring and documentation procedures for PNBs. We report a case of permanent injury to the sciatic nerve after sciatic nerve block through the anterior approach and discuss mechanisms that may have led to the injury. Intraneural injection and nerve injury can occur in the absence of pain on injection and it may be heralded by high injection pressure (resistance).

  10. Nerve injury caused by mandibular block analgesia

    DEFF Research Database (Denmark)

    Hillerup, S; Jensen, Rigmor H

    2006-01-01

    : feather light touch, pinprick, sharp/dull discrimination, warm, cold, point location, brush stroke direction, 2-point discrimination and pain perception. Gustation was tested for recognition of sweet, salt, sour and bitter. Mandibular block analgesia causes lingual nerve injury more frequently than...

  11. Prevention of iatrogenic inferior alveolar nerve injuries in relation to dental procedures.

    Science.gov (United States)

    Renton, T

    2010-09-01

    This article aims to review current hypotheses on the aetiology and prevention of inferior alveolar nerve (IAN) injuries in relation to dental procedures. The inferior alveolar nerve can be damaged during many dental procedures, including administration of local anaesthetic, implant bed preparation and placement, endodontics, third molar surgery and other surgical interventions. Damage to sensory nerves can result in anaesthesia, paraesthesia, pain, or a combination of the three. Pain is common in inferior alveolar nerve injuries, resulting in significant functional problems. The significant disability associated with these nerve injuries may also result in increasing numbers of medico-legal claims. Many of these iatrogenic nerve injuries can be avoided with careful patient assessment and planning. Furthermore, if the injury occurs there are emerging strategies that may facilitate recovery. The emphasis of this review is on how we may prevent these injuries and facilitate resolution in the early post surgical phase. PMID:21133047

  12. Inferior Alveolar Nerve Injuries Following Implant Placement - Importance of Early Diagnosis and Treatment: a Systematic Review

    OpenAIRE

    Ilana Shavit; Gintaras Juodzbalys

    2014-01-01

    ABSTRACT Objectives The purpose of this article is to systematically review diagnostic procedures and risk factors associated with inferior alveolar nerve injury following implant placement, to identify the time interval between inferior alveolar nerve injury and its diagnosis after surgical dental implant placement and compare between outcomes of early and delayed diagnosis and treatment given based on case series recorded throughout a period of 10 years. Material and Methods We performed li...

  13. Low-intensity pulsed ultrasound accelerates nerve regeneration following inferior alveolar nerve transection in rats.

    Science.gov (United States)

    Sato, Mai; Motoyoshi, Mitsuru; Shinoda, Masamichi; Iwata, Koichi; Shimizu, Noriyoshi

    2016-06-01

    Inferior alveolar nerve (IAN) injury, which is frequently caused by orofacial surgery or trauma, induces sensory loss in orofacial regions innervated by the IAN. However, no effective treatment for orofacial sensory loss currently exists. We determined whether sensory loss in facial skin above the mental foramen following IAN transection was recovered by exposure of the transected IAN to low-intensity pulsed ultrasound (LIPUS). Inferior alveolar nerve transection (IANX) was performed in 7-wk-old male Sprague-Dawley rats. On day 7 after IANX, the effect of daily LIPUS (from day 0) on the transected IAN, in terms of sensitivity to mechanical stimulation of the facial skin above the mental foramen, was examined. Moreover, the number of trigeminal ganglion (TG) neurons innervating the facial skin above the mental foramen of rats with IANX treated daily with LIPUS was counted using the retrograde neurotracing technique. Daily exposure of the transected IAN to LIPUS significantly promoted recovery of the head-withdrawal threshold in response to mechanical stimulation of the facial skin above the mental foramen, and the number of TG neurons innervating the facial skin above mental foramen was significantly increased in rats with IANX treated daily with LIPUS compared with sham or LIPUS-unexposed rats. Daily treatment of stumps of the transected IAN with LIPUS facilitated morphological and functional regeneration, suggesting that LIPUS is an effective and novel therapy for IAN injury. PMID:27058986

  14. Nerve injury associated with orthognathic surgery. Part 2: inferior alveolar nerve.

    Science.gov (United States)

    McLeod, N M H; Bowe, D C

    2016-05-01

    The inferior alveolar nerve (IAN) is the most commonly injured structure during mandibular osteotomies. The prevalence of temporary injury has been reported as 70/100 patients (95% CI 67 to 73/100) or 56/100 nerves (95% CI 46 to 65/100), and the prevalence of permanent alteration in sensation was 33/100 patients (95% CI 30 to 35/100) or 20/100 nerves (95% CI 18 to 21/100) when assessed subjectively. The prevalence varied significantly between different operations (pInjury may result from traction during stripping or manipulation of the distal fragment, incorrect placement of the cuts, or misjudged placement of fixation in ramus ostotomy. During SSO, they can occur during retraction to make cuts in the medial ramus, when the bone is cut or split, and on fixation. The impact of injury is generally said to be low as it does not seem to affect patients' opinions about the operation. PMID:26922403

  15. Ultrasound-guided block of the axillary nerve

    DEFF Research Database (Denmark)

    Rothe, C; Lund, J; Jenstrup, M T;

    2012-01-01

    The specific blocking of the axillary nerve has never been investigated clinically. We present four cases illustrating potential applications of the axillary nerve block in the perioperative setting and discuss possible directions for future research in this area. The axillary nerve blocks were all...... performed using a newly developed in-plane ultrasound-guided technique. In one patient undergoing arthroscopic shoulder surgery, we used the axillary nerve block as the only analgesic combined with propofol sedation and spontaneous breathing. Chronic shoulder pain was eliminated after the axillary nerve...

  16. Inferior alveolar nerve injury following orthognathic surgery: a review of assessment issues

    OpenAIRE

    Phillips, C.; ESSICK, G.

    2010-01-01

    The sensory branches of the trigeminal nerve encode information about facial expressions, speaking and chewing movements, and stimuli that come into contact with the orofacial tissues. Whatever the cause, damage to the inferior alveolar nerve negatively affects the quality of facial sensibility as well as the patient's ability to translate patterns of altered nerve activity into functionally meaningful motor behaviours. There is no generally accepted, standard method of estimating sensory dis...

  17. Inferior Alveolar Nerve Injuries Following Implant Placement - Importance of Early Diagnosis and Treatment: a Systematic Review

    Directory of Open Access Journals (Sweden)

    Ilana Shavit

    2014-12-01

    Full Text Available Objectives: The purpose of this article is to systematically review diagnostic procedures and risk factors associated with inferior alveolar nerve injury following implant placement, to identify the time interval between inferior alveolar nerve injury and its diagnosis after surgical dental implant placement and compare between outcomes of early and delayed diagnosis and treatment given based on case series recorded throughout a period of 10 years. Material and Methods: We performed literature investigation through MEDLINE (PubMed electronic database and manual search through dental journals to find articles concerning inferior alveolar nerve injury following implant placement. The search was restricted to English language articles published during the last 10 years, from December 2004 to March 2014. Results: In total, we found 33 articles related to the topic, of which 27 were excluded due to incompatibility with established inclusion criteria. Six articles were eventually chosen to be suitable. The studies presented diagnostic methods of inferior alveolar nerve sensory deficit, and we carried out an assessment of the proportion of patients diagnosed within different time intervals from the time the injury occurred. Conclusions: Various diagnostic methods have been developed throughout the years for dealing with 1 quite frequent complication in the implantology field - inferior alveolar nerve injury. Concurrently, the importance of early diagnosis and treatment was proved repeatedly. According to the results of the data analysis, a relatively high percentage of the practitioners successfully accomplished this target and achieved good treatment outcomes.

  18. A contrast study of two different block anesthesia of inferior alveolar nerve used for the extraction of impacted mandibular third-molar%两种不同下牙槽神经阻滞麻醉方法用于下颌阻生第三磨牙拔除术的对比研究

    Institute of Scientific and Technical Information of China (English)

    张国权; 张国志; 翁汝涟; 汤剑明; 徐敏

    2011-01-01

    Objective:To discuss a more effective method of block anesthesia of inferior alveolar nerve. Method: ISO cases of patients who need extraction of the impacted mandibular third-molar by opening flapping and deboning were selected and divided randomly into three groups: Experimental group (50 cases) with Cow-Gates mandibular block, control group one (50 cases) with block anesthesia of internal ramus prominence and control group two (50 cases) with extra infiltration anesthesia of buccal mesiocclusion and distocclusion and lingual side of offending teeth after the same injection method as control group one. The pain situation was observed by Visual Analogue Scale. All the three groups used the arti-caine hydrochlorine and epinephrine tartrate injection. Result: The cases performed Gow-Gates mandibular block showed less pain than control group one, but contrast to control group two, the method showed no superiority. Conclusion: The conventional block anesthesia of internal ramus prominence added with local infiltration anesthesia could enhance the success ratio of block anesthesia of inferior alveolar nerve effectively and achieve the same effect as Gow-Gates mandibular block.%目的:探讨一种更加有效的下齿槽神经阻滞麻醉的方法。方法:随机选取需翻瓣去骨法拔除下颌阻生第三磨牙患者150例。实验组50例,采用Gow-Gates法阻滞麻醉,对照一组50例,采用下颌支内侧隆突阻滞麻醉,对照二组在采用对照组一的方法注射后保留少量局麻药加用患牙颊侧近远中及舌侧三点浸润麻醉。采用VAS评分法观察疼痛情况。三组病例均使用阿替卡因肾上腺素注射液。结果:与对照一组相比,采用Gow-Gates法阻滞麻醉的病例疼痛明显减轻,但是与对照二组相比,该法没有明显优势。结论:传统的下颌支内侧隆突阻滞麻醉加用局部浸润麻醉可以有效提高下牙槽神经阻滞麻醉的成功率,达到与Gow-Gates阻滞麻醉相同的麻醉效果。

  19. Ultrasonic doppler flowmeter-guided occipital nerve block

    OpenAIRE

    Na, Se Hee; Kim, Tae Wan; Oh, Se-Young; Kweon, Tae Dong; Yoon, Kyung Bong; Yoon, Duck Mi

    2010-01-01

    Background Greater occipital nerve block is used in the treatment of headaches and neuralgia in the occipital area. We evaluated the efficacy of ultrasonic doppler flowmeter-guided occipital nerve block in patients experiencing headache in the occipital region in a randomized, prospective, placebo-controlled study. Methods Twenty-six patients, aged 18 to 70, with headache in the occipital region, were included in the study. Patients received a greater occipital nerve block performed either un...

  20. The position of the mandibular canal and histologic feature of the inferior alveolar nerve.

    Science.gov (United States)

    Kilic, C; Kamburoğlu, K; Ozen, T; Balcioglu, H A; Kurt, B; Kutoglu, T; Ozan, H

    2010-01-01

    The inferior alveolar nerve is the one of the large branches of the mandibular division of the trigeminal nerve. It is vulnerable during surgical procedures of the mandible. Despite its importance, no anatomical and histological examination has been conducted to provide a detailed cross-sectional morphology of the mandibular canal according to dental status. Therefore, the present study aimed to identify the position of the mandibular canal through direct measurement and to determine the branches of the inferior alveolar nerve through histologic examination. The area between the anterior margin of the third molar and the anterior margin of the second premolar of dentulous, partially dentulous, and edentulous hemimandible specimens (n = 49) from 26 human cadavers was serially sectioned into seven segments, and specific distances were measured using digital calipers. Following this, 5-microm cross-sections were prepared along the mandibular canal and mental foramen, and examined by fluorescence microscopy. The mandibular canal was located at a mean distance of 10.52 mm above the inferior margin of the mandible. The mean maximum diameters of the mandibular canal, inferior alveolar nerve, inferior alveolar artery, and inferior alveolar vein were 2.52, 1.84, 0.42, and 0.58 mm, respectively. This study found that the inferior alveolar nerve often gives rise to several branches at each level (range 0-3). To minimize the risk of injury, knowledge of the small branches of the nerve and of the detailed findings regarding the position of the mandibular canal reported here should be considered when planning mandibular surgery, especially during implant placement. PMID:19918867

  1. Inferior Alveolar Nerve Injury after Mandibular Third Molar Extraction: a Literature Review

    Directory of Open Access Journals (Sweden)

    Rafael Sarikov

    2014-12-01

    Full Text Available Objectives: The purpose of this study was to systematically review the comprehensive overview of literature data about injury to the inferior alveolar nerve after lower third molar extraction to discover the prevalence of injury, the risk factors, recovery rates, and alternative methods of treatment. Material and Methods: Literature was selected through a search of PubMed electronic databases. Articles from January 2009 to June 2014 were searched. English language articles with a minimum of 6 months patient follow-up and injury analysis by patient’s reporting, radiographic, and neurosensory testing were selected. Results: In total, 84 literature sources were reviewed, and 14 of the most relevant articles that are suitable to the criteria were selected. Articles were analyzed on men and women. The influence of lower third molar extraction (especially impacted on the inferior alveolar nerve was clearly seen. Conclusions: The incidence of injury to the inferior alveolar nerve after lower third molar extraction was about 0.35 - 8.4%. The injury of the inferior alveolar nerve can be predicted by various radiological signs. There are few risk factors that may increase the risk of injury to the nerve such as patients over the age of 24 years old, with horizontal impactions, and extraction by trainee surgeons. Recovery is preferable and permanent injury is very rare.

  2. Comparison of two local anesthesia techniques (conventional & akinosi for inferior alveolar dental nerve

    Directory of Open Access Journals (Sweden)

    Refua Y

    2001-09-01

    Full Text Available Different techniques for local anesthesia are used in the mandible. The purpose of this study"nwas to determine the effects of inferior alveolar dental nerve blocks by comparing the two akinosi and"nconventional techniques. 80 patients (aged 15-60 years old were randomly divided into tow groups for"nextracting the mandibuler posterior teeth by akinosi and conventional techniques. Patients were all"ninjected with 1.8 ml of Lidocaine 2% plus Adernaline j^nnnn .Then the Pain Sensation during injection,"npositive aspiration, beginning time of anesthesia, duration of anesthesia depth of anesthesia, and the anesthesia of soft tissue related to sensory nerves were evaluated. The results showed that the pain sensation in conventional technique was significantly higher than that of akinosi technique. The number of positive aspirations in conventional technique (12,5% was higher than that of akinosi (5% but not significantly different. The long buccal nerve anesthesia in akinosi technique (75% was significantly higher than that of conventional technique. There was no significant difference between the two techniques for the depth of anesthesia. The success rate was 87.5% in conventional technique and 80% in akinosi technique. The average time of lips anesthesia in conventional technique was 3 minutes compared with 4 minutes in akinosi technique, which was not significantly different from each other. However, the beginning time of aneshtesia in tongue was significantly lower in conventional technique. No significant difference in the duration of anesthesia in lips and tonques between the two techniques was observed.

  3. Ultrasound Guidance for Deep Peripheral Nerve Blocks: A Brief Review

    Directory of Open Access Journals (Sweden)

    Anupama Wadhwa

    2011-01-01

    Full Text Available Nerve stimulation and ultrasound have been introduced to the practice of regional anesthesia mostly in the last two decades. Ultrasound did not gain as much popularity as the nerve stimulation until a decade ago because of the simplicity, accuracy and portability of the nerve stimulator. Ultrasound is now available in most academic centers practicing regional anesthesia and is a popular tool amongst trainees for performance of nerve blocks. This review article specifically discusses the role of ultrasonography for deeply situated nerves or plexuses such as the infraclavicular block for the upper extremity and lumbar plexus and sciatic nerve blocks for the lower extremity. Transitioning from nerve stimulation to ultrasound-guided blocks alone or in combination is beneficial in certain scenarios. However, not every patient undergoing regional anesthesia technique benefits from the use of ultrasound, especially when circumstances resulting in difficult visualization such as deep nerve blocks and/or block performed by inexperienced ultrasonographers. The use of ultrasound does not replace experience and knowledge of relevant anatomy, especially for visualization of deep structures. In certain scenarios, ultrasound may not offer additional value and substantial amount of time may be spent trying to find relevant structures or even provide a false sense of security, especially to an inexperienced operator. We look at available literature on the role of ultrasound for the performance of deep peripheral nerve blocks and its benefits.

  4. Ultrasound Guidance for Deep Peripheral Nerve Blocks: A Brief Review

    Science.gov (United States)

    Wadhwa, Anupama; Kandadai, Sunitha Kanchi; Tongpresert, Sujittra; Obal, Detlef; Gebhard, Ralf Erich

    2011-01-01

    Nerve stimulation and ultrasound have been introduced to the practice of regional anesthesia mostly in the last two decades. Ultrasound did not gain as much popularity as the nerve stimulation until a decade ago because of the simplicity, accuracy and portability of the nerve stimulator. Ultrasound is now available in most academic centers practicing regional anesthesia and is a popular tool amongst trainees for performance of nerve blocks. This review article specifically discusses the role of ultrasonography for deeply situated nerves or plexuses such as the infraclavicular block for the upper extremity and lumbar plexus and sciatic nerve blocks for the lower extremity. Transitioning from nerve stimulation to ultrasound-guided blocks alone or in combination is beneficial in certain scenarios. However, not every patient undergoing regional anesthesia technique benefits from the use of ultrasound, especially when circumstances resulting in difficult visualization such as deep nerve blocks and/or block performed by inexperienced ultrasonographers. The use of ultrasound does not replace experience and knowledge of relevant anatomy, especially for visualization of deep structures. In certain scenarios, ultrasound may not offer additional value and substantial amount of time may be spent trying to find relevant structures or even provide a false sense of security, especially to an inexperienced operator. We look at available literature on the role of ultrasound for the performance of deep peripheral nerve blocks and its benefits. PMID:21808644

  5. Clinical outcome of conservative treatment of injured inferior alveolar nerve during dental implant placement

    OpenAIRE

    Kim, Yoon-Tae; Pang, Kang-Mi; Jung, Hun-Jong; Kim, Soung-Min; Kim, Myung-Jin; Lee, Jong-Ho

    2013-01-01

    Objectives Infererior alveolar nerve (IAN) damage may be one of the distressing complications occurring during implant placement. Because of nature of closed injury, a large proportion is approached non-invasively. The purpose of this study was to analyze the outcomes of conservative management of the injured nerve during dental implant procedure. Materials and Methods Sixty-four patients of implant related IAN injury, who were managed by medication or observation from January 1997 to March 2...

  6. Ultrasound Guidance for Deep Peripheral Nerve Blocks: A Brief Review

    OpenAIRE

    Detlef Obal; Ralf Erich Gebhard; Sujittra Tongpresert; Sunitha Kanchi Kandadai; Anupama Wadhwa

    2011-01-01

    Nerve stimulation and ultrasound have been introduced to the practice of regional anesthesia mostly in the last two decades. Ultrasound did not gain as much popularity as the nerve stimulation until a decade ago because of the simplicity, accuracy and portability of the nerve stimulator. Ultrasound is now available in most academic centers practicing regional anesthesia and is a popular tool amongst trainees for performance of nerve blocks. This review article specifically discusses the role ...

  7. Inferior alveolar nerve injuries associated with mandibular fractures at risk: a two-center retrospective study

    NARCIS (Netherlands)

    P. Boffano; F. Roccia; C. Galessio; K. Karagozoglu; T. Forouzanfar

    2014-01-01

    The aim of the study was to investigate the incidence of the inferior alveolar nerve (IAN) injury in mandibular fractures. This study is based on two databases that have continuously recorded patients hospitalized with maxillofacial fractures in two departments—Department of Maxillofacial Surgery, V

  8. The contrast study of teaching and clinical operation between two different methods of block anesthesia of inferior alveolar nerve%改良下牙槽神经阻滞麻醉与传统方法教学疗效对比

    Institute of Scientific and Technical Information of China (English)

    姜德志; 屈波; 杜传亮

    2014-01-01

    Objective Through randomized controlled trials, we evaluated the clinical effects and teaching effects of two different methods of block anesthesia of inferior alveolar nerve. Methods In order to study the anesthesia effect, successful rate and hemorrhage rate, 40 participants randomly divided into two groups. Two different kinds of block anesthesia of inferioralveolar nerve were caried out. Results Improved injection onset time of anesthesia for (2.5±1.2) min, the traditional injection method for (4.4±3.2)min. The former anesthesia success rate was 98.75%, the latter 90% success rate, success rate was statistically significant (P0.05). Comclusion Analyzed and compared these two methods, they both can used in teaching and clinical operation. The modiifed method was signiifcant super to the traditional method. The modiifed method could signiifcantly increase the successful rate of beginners.%目的:通过随机对照试验,比较改良下牙槽神经阻滞麻醉与传统方法的教学疗效。方法40名参与者分组采用两种下牙槽神经阻滞麻醉方法,对比麻醉起效时间、麻醉成功率、麻醉回抽出血率。结果改良注射法麻醉起效时间为(2.5±1.2)min,传统注射方法为(4.4±3.2)min。前者麻醉成功率98.75%,后者成功率90%,差异有统计学意义(P<0.05)。两种方法的麻醉回抽出血率差异无统计学意义(P>0.05)。结论改良下牙槽神经阻滞麻醉教学疗效明显优于传统方法,两种方法都可应用于教学及临床,但改良下牙槽神经阻滞麻醉效果更佳,起效时间更短,更利于初学者掌握,能够显著提升初学者的麻醉成功率。

  9. Ultrasound-guided peripheral nerve blocks: what are the benefits?

    DEFF Research Database (Denmark)

    Nielsen, Zbigniew Jerzy Koscielniak

    2008-01-01

    MESH terms 'nerve block' and 'ultrasonography'. The following limits were applied: studies with abstracts, only in humans, published in core clinical journals. Trial type: meta-analysis, randomized-controlled trial and clinical trial. RESULTS: When peripheral nerves are adequately imaged by ultrasound......BACKGROUND: Use of ultrasound by anaesthesiologists performing regional blocks is rapidly gaining popularity. The aims of this review were to summarize and update accumulating evidence on ultrasound-guided nerve blocks, with an emphasis on the clinical relevance of the results and to critically...... appraise changing standards in regional anaesthesia. METHODS: A search of MEDLINE and EMBASE (1966 to 31 December 2007) was conducted using the following free terms: 'ultrasound and regional anesthesia', 'ultrasound and peripheral block' and 'ultrasound and nerve and block'. These were combined with the...

  10. Combined posterior lumbar plexus–sciatic nerve block versus combined femoral–obturator–sciatic nerve block for ACL reconstruction

    OpenAIRE

    Tharwat, Ayman I

    2011-01-01

    Ayman I TharwatAin Shams University, Cairo, EgyptBackground: We compared the efficacy of combined posterior lumbar plexus–sciatic nerve block with that of combined femoral–obturator–sciatic nerve block as anesthesia for anterior cruciate ligament reconstruction surgery, because both block combinations have been recommended for lower limb arthroscopic and reconstructive surgery.Methods: Forty-eight patients undergoing elective unilateral anterior cruciate ligament...

  11. [Perioperative analgesia with continuous peripheral nerve blocks in children].

    Science.gov (United States)

    Dadure, C; Capdevila, X

    2007-02-01

    Recently, regional anaesthesia in children has generated increasing interest. But single injection techniques have a limited duration of postoperative analgesia. Then, continuous peripheral nerve blocks have taken an important position in the anaesthetic arsenal, allowing an effective, safe and prolonged postoperative pain management. As adults, indications for continuous peripheral nerve blocks depend on the analysis of individual benefits/risks ratio. Main indications are intense postoperative pain surgical procedures, with or without postoperative rehabilitation, and complex regional pain syndrome. Contraindications to these procedures are rather similar to those in adults, plus parental and/or children refusal. Continuous peripheral nerve blocks are usually performed under general anaesthesia or sedation in children, and require appropriate equipment in order to decrease the risk of nerve injury. New techniques, such as transcutaneous nerve stimulation or ultrasound guidance, appeared to facilitate nerve and plexus approach identification in paediatric patients. Nevertheless, continuous peripheral nerve block may theoretically mask a compartment syndrome after trauma surgical procedures. Finally, ropivacaine appears to be the most appropriate drug for continuous peripheral nerve blocks in children, requiring low flow rates and concentrations of local anaesthetic. These techniques may facilitate early ambulation by an improved pain management or even postoperative analgesia at home with disposable pumps. One might infer from the current review that excellent pain relief coupled with a reduction of side effects would contribute to improve the quality of life and to decrease the frequency of disabling behavioural modifications in children, sometimes psychologically injured by hospital stay and postoperative pain. PMID:17174518

  12. Inferior Alveolar Nerve Injury after Mandibular Third Molar Extraction: a Literature Review

    OpenAIRE

    Rafael Sarikov; Gintaras Juodzbalys

    2014-01-01

    ABSTRACT Objectives The purpose of this study was to systematically review the comprehensive overview of literature data about injury to the inferior alveolar nerve after lower third molar extraction to discover the prevalence of injury, the risk factors, recovery rates, and alternative methods of treatment. Material and Methods Literature was selected through a search of PubMed electronic databases. Articles from January 2009 to June 2014 were searched. English language articles with a minim...

  13. Correction: Inferior alveolar nerve injury with laryngeal mask airway: a case report.

    LENUS (Irish Health Repository)

    Hanumanthaiah, Deepak

    2011-11-30

    ABSTRACT: Following the publication of our article [Inferior alveolar nerve injury with laryngeal mask airway: a case report. Journal of Medical Case Reports 2011, 5:122] it was brought to our attention that we inadvertently used the registered trademark of the Laryngeal Mask Company Limited (LMA) as the abbreviation for laryngeal mask airway. A Portex(R) Soft Seal(R) Laryngeal Mask was used and not a device manufactured by the Laryngeal Mask Company.

  14. Inferior alveolar nerve injury with laryngeal mask airway: a case report

    Directory of Open Access Journals (Sweden)

    Masud Sarmad

    2011-03-01

    Full Text Available Abstract Introduction The incidence of damage to the individual cranial nerves and their branches associated with laryngeal mask airway use is low; there have been case reports of damage to the lingual nerve, hypoglossal nerve and recurrent laryngeal nerve. To the best of our knowledge we present the first reported case of inferior alveolar nerve injury associated with laryngeal mask airway use. Case presentation A 35-year-old Caucasian man presented to our facility for elective anterior cruciate ligament repair. He had no background history of any significant medical problems. He opted for general anesthesia over a regional technique. He was induced with fentanyl and propofol and a size 4 laryngeal mask airway was inserted without any problems. His head was in a neutral position during the surgery. After surgery in the recovery room, he complained of numbness in his lower lip. He also developed extensive scabbing of the lower lip on the second day after surgery. The numbness and scabbing started improving after a week, with complete recovery after two weeks. Conclusion We report the first case of vascular occlusion and injury to the inferior alveolar nerve, causing scabbing and numbness of the lower lip, resulting from laryngeal mask airway use. This is an original case report mostly of interest for anesthetists who use the laryngeal mask airway in day-to-day practice. Excessive inflation of the laryngeal mask airway cuff could have led to this complication. Despite the low incidence of cranial nerve injury associated with the use of the laryngeal mask airway, vigilant adherence to evidence-based medicine techniques and recommendations from the manufacturer's instructions can prevent such complications.

  15. Evidence-based outcomes following inferior alveolar and lingual nerve injury and repair: a systematic review.

    Science.gov (United States)

    Kushnerev, E; Yates, J M

    2015-10-01

    The inferior alveolar nerve (IAN) and lingual (LN) are susceptible to iatrogenic surgical damage. Systematically review recent clinical evidence regarding IAN/LN repair methods and to develop updated guidelines for managing injury. Recent publications on IAN/LN microsurgical repair from Medline, Embase and Cochrane Library databases were screened by title/abstract. Main texts were appraised for exclusion criteria: no treatment performed or results provided, poor/lacking procedural description, cohort injury type, injury timing, neurosensory disturbances and intra-operative findings. Best functional nerve recovery occurred after direct apposition and suturing if nerve ending gaps were nerve grafting (sural/greater auricular nerve). Timing of microneurosurgical repair after injury remains debated. Most authors recommend surgery when neurosensory deficit shows no improvement 90 days post-diagnosis. Nerve transection diagnosed intra-operatively should be repaired in situ; minor nerve injury repair can be delayed. No consensus exists regarding optimal methods and timing for IAN/LN repair. We suggest a schematic guideline for treating IAN/LN injury, based on the most current evidence. We acknowledge that additional RCTs are required to provide definitive confirmation of optimal treatment approaches. PMID:26059454

  16. Adductor canal block versus femoral nerve block for analgesia after total knee arthroplasty

    DEFF Research Database (Denmark)

    Jaeger, Pia; Zaric, Dusanka; Fomsgaard, Jonna Storm;

    2013-01-01

    Femoral nerve block (FNB), a commonly used postoperative pain treatment after total knee arthroplasty (TKA), reduces quadriceps muscle strength essential for mobilization. In contrast, adductor canal block (ACB) is predominately a sensory nerve block. We hypothesized that ACB preserves quadriceps...... muscle strength as compared with FNB (primary end point) in patients after TKA. Secondary end points were effects on morphine consumption, pain, adductor muscle strength, morphine-related complications, and mobilization ability....

  17. Does obturator nerve block always occur in 3-1 block?

    Directory of Open Access Journals (Sweden)

    İbrahim Tekdemir

    2011-06-01

    Full Text Available In the femoral “3-in-1 block”, obturator nerve block is routinely unsuccessful. Anatomical studies are not available to explain why blockade of obturator nerve or lumbar plexus does not occur. The aim of this study was to examine the effectiveness of femoral “3-in-1 block” obturator nerve block on a cadaver model.Materials and methods: Totally, 12 mature adult human cadavers were selected. Methylene blue dye (30 ml was injected under the fascia iliaca in eight cadavers and into the femoral nerve sheath in four cadavers. Careful bilateral dissections were performed following dye injections.Results: It was seen that the dye did not spread to the medial part of the psoas major muscle and the obturator nerve was not stained with the dye in eight cadavers in whom dye was injected laterally into the femoral sheat. In four cadavers in whom dye was injected into the femoral nerve sheat, metylene blue spread through fascial layers in the plane under the psoas muscle and stained the obturator nerve just before emerging medially from the fascia psoas. At this point, the obturator nerve pierced the psoas fascia and extended extrafascially in the medial and deep borders of the psoas muscle. In this area, the upper section of the obturator nerve was found also to be stained with the dye.Conclusion: We concluded that the cause of an unsuccessful obturator nerve block might be the fascial anatomy of this region. The lateral cutaneous femoral nerve and the femoral nerve easily can be blocked in the fascia iliaca compartment, but the obturator nerve block fails because of its being extrafascial in this region. J Clin Exp Invest 2011;2(2:149-51

  18. Sciatic nerve block performed with nerve stimulation technique in an amputee a case study

    DEFF Research Database (Denmark)

    Heiring, C.; Kristensen, Billy

    2008-01-01

    We present a case of a sciatic nerve block performed with the nerve stimulation technique. This technique is normally not used in amputees because detection of a motor response to an electrical stimulation is impossible. In our patient the stimulation provoked a phantom sensation of movement in t...

  19. Anaesthesia of the inferior alveolar and lingual nerves following subcondylar fractures of the mandible.

    Science.gov (United States)

    Politis, Constantinus; Sun, Yi; De Peuter, Bruno; Vandersteen, Marjan

    2013-10-01

    A retrospective chart review of 387 patients with condylar and subcondylar fractures revealed 2 cases of inferior alveolar nerve (IAN) and lingual nerve (LN) anaesthesia following the subcondylar fracture. Only 5 cases have been reported previously. The mechanism of action remains unknown but a review of the literature and an analysis of 120 dry human skulls supported the hypothesis that compression of the mandibular nerve at a high level, close to the foramen ovale, could cause anaesthesia. This complication is rare, because it requires compression at a particular angle. The antero-median angulation of the condyle must be close to the foramen ovale, and the fracture must be a unilaterally displaced fracture. The presence of an enlarged lateral pterygoid plate appeared to enhance the risk of compression. The IAN and LN anaesthesia could be resolved after open reduction of the fracture and IAN and LN anaesthesia constitute a strict indication for an early open fracture reduction. PMID:23453271

  20. Sonographically guided superior laryngeal nerve block during awake fiberoptic intubation.

    Science.gov (United States)

    Sawka, Andrew; Tang, Raymond; Vaghadia, Himat

    2015-04-15

    We report 5 patients who underwent ultrasound-guided superior laryngeal nerve block before awake intubation and general anesthesia. We used a 8- to 15-MHz hockey stick-shaped ultrasound transducer (HST15-8/20 linear probe, Ultrasonix) to visualize the superior laryngeal nerve. A 3.8-cm 25-G needle was inserted in real time and directed toward the superior laryngeal nerve followed by circumferential placement of local anesthetic. All 5 patients tolerated subsequent awake fiberoptic intubation with either minimal or no sedation. Sonographically guided superior laryngeal nerve block may be useful in patients where identification of landmarks in the neck is difficult as a result of patient anatomy. PMID:25867195

  1. Coronectomy of the mandibular third molar: Respect for the inferior alveolar nerve.

    Science.gov (United States)

    Kouwenberg, A J; Stroy, L P P; Rijt, E D Vree-V D; Mensink, G; Gooris, P J J

    2016-05-01

    The aim of this study was to evaluate the outcomes of coronectomy as an alternative surgical procedure to complete removal of the impacted mandibular third molar in patients with a suspected close relationship between the tooth root(s) and the mandibular canal. A total of 151 patients underwent coronectomy and were followed up with clinical examinations and panoramic radiographs for a minimum of 6 months after surgery. None of the patients exhibited inferior alveolar nerve injury. Eruption of the retained root(s) was more frequent in younger patients (18-35 years). Thirty-six patients (23.8%) exhibited insufficient growth of new bone in the alveolar defect, and 11.3% required a second surgical procedure to remove the root remnant(s). Our results indicate that coronectomy can be a reliable alternative to complete removal of the impacted mandibular third molar in patients exhibiting an increased risk of damage to the inferior alveolar nerve on panoramic radiographs. PMID:26976696

  2. Efficacy of low level laser therapy on neurosensory recovery after injury to the inferior alveolar nerve

    Directory of Open Access Journals (Sweden)

    Gorur Ilker

    2006-02-01

    Full Text Available Abstract Background The most severe complication after the removal of mandibular third molars is injury to the inferior alveolar nerve or the lingual nerve. These complications are rather uncommon (0.4% to 8.4% and most of them are transient. However, some of them persist for longer than 6 months, which can leave various degrees of long-term permanent disability. While several methods such as pharmacologic therapy, microneurosurgery, autogenous and alloplastic grafting can be used for the treatment of long-standing sensory aberrations in the inferior alveolar nerve, there are few reports regarding low level laser treatment. This paper reports the effects of low level laser therapy in 4 patients with longstanding sensory nerve impairment following mandibular third molar surgery. Methods Four female patients had complaints of paresthesia and dysesthesia of the lip, chin and gingiva, and buccal regions. Each patient had undergone mandibular third molar surgery at least 1 year before. All patients were treated with low level laser therapy. Clinical neurosensory tests (the brush stroke directional discrimination test, 2-point discrimination test, and a subjective assessment of neurosensory function using a visual analog scale were used before and after treatment, and the responses were plotted over time. Results When the neurosensory assessment scores after treatment with LLL therapy were compared with the baseline values prior to treatment, there was a significant acceleration in the time course, as well as in the magnitude, of neurosensory return. The VAS analysis revealed progressive improvement over time. Conclusion Low level laser therapy seemed to be conducive to the reduction of long-standing sensory nerve impairment following third molar surgery. Further studies are worthwhile regarding the clinical application of this treatment modality.

  3. Evaluation of inferior alveolar nerve regeneration by bifocal distraction osteogenesis with retrograde transportation of horseradish peroxidase in dogs.

    Directory of Open Access Journals (Sweden)

    Yosuke Shogen

    Full Text Available BACKGROUND: Bifocal distraction osteogenesis has been shown to be a reliable method for reconstructing segmental mandibular defects. However, there are few reports regarding the occurrence of inferior alveolar nerve regeneration during the process of distraction. Previously, we reported inferior alveolar nerve regeneration after distraction, and evaluated the regenerated nerve using histological and electrophysiological methods. In the present study, we investigated axons regenerated by bifocal distraction osteogenesis using retrograde transportation of horseradish peroxidase in the mandibles of dogs to determine their type and function. METHODS AND FINDINGS: Using a bifocal distraction osteogenesis method, we produced a 10-mm mandibular defect, including a nerve defect, in 11 dogs and distracted using a transport disk at a rate of 1 mm/day. The regenerated inferior alveolar nerve was evaluated by retrograde transportation of HRP in all dogs at 3 and 6 months after the first operation. At 3 and 6 months, HRP-labeled neurons were observed in the trigeminal ganglion. The number of HRP-labeled neurons in each section increased, while the cell body diameter of HRP-labeled neurons was reduced over time. CONCLUSIONS: We found that the inferior alveolar nerve after bifocal distraction osteogenesis successfully recovered until peripheral tissue began to function. Although our research is still at the stage of animal experiments, it is considered that it will be possible to apply this method in the future to humans who have the mandibular defects.

  4. Delayed appearance of hypaesthesia and paralysis after femoral nerve block

    Directory of Open Access Journals (Sweden)

    Stefan Landgraeber

    2012-03-01

    Full Text Available We report on a female patient who underwent an arthroscopy of the right knee and was given a continuous femoral nerve block catheter. The postoperative course was initially unremarkable, but when postoperative mobilisation was commenced, 18 hours after removal of the catheter, the patient noticed paralysis and hypaesthesia. Examination confirmed the diagnosis of femoral nerve dysfunction. Colour duplex sonography of the femoral artery and computed tomography of the lumbar spine and pelvis yielded no pathological findings. Overnight the neurological deficits decreased without therapy and were finally no longer detectable. We speculate that during the administration of the local anaesthetic a depot formed, localised in the medial femoral intermuscular septa, which was leaked after first mobilisation. To our knowledge no similar case has been published up to now. We conclude that patients who are treated with a nerve block should be informed and physician should be aware that delayed neurological deficits are possible.

  5. Ventricular Pneumocephalus with Meningitis after Lumbar Nerve Root Block

    Directory of Open Access Journals (Sweden)

    Shin Ahn

    2013-01-01

    Full Text Available Lumbar nerve root block is a common modality used in the management of radiculopathy. Its complications are rare and usually minor. Despite its low morbidity, significant acute events can occur. Pneumocephalus is an accumulation of air in the intracranial space. It indicates a violation of the dura or the presence of infection. The object of this report is to describe the case of a patient with intraventricular pneumocephalus and bacterial meningitis after lumbar nerve root block. A 70-year-old female was brought into emergency department with severe headache and vomiting which developed during her sleep. She had received lumbar nerve block for her radiculopathy one day before her presentation. Cranial computed tomography scan revealed a few hypodense lesions in her left lateral ventricle frontal horn and basal cistern indicating ventricular pneumocephalus. Five hours later, she developed sudden hearing loss. Cerebrospinal fluid analysis showed bacterial meningitis, and she was treated with high dose steroid and antibiotics. However, her impaired hearing as a sequela from meningitis was persistent, and she is still in follow-up. Intracranial complications of lumbar nerve root block including meningitis and pneumocephalus can occur and should be considered as high-risk conditions that require prompt intervention.

  6. Nerve Conduction Block Using Combined Thermoelectric Cooling and High Frequency Electrical Stimulation

    OpenAIRE

    Ackermann, D. Michael; Foldes, Emily L.; Bhadra, Niloy; Kilgore, Kevin L.

    2010-01-01

    Conduction block of peripheral nerves is an important technique for many basic and applied neurophysiology studies. To date, there has not been a technique which provides a quickly initiated and reversible “on-demand” conduction block which is both sustainable for long periods of time and does not generate activity in the nerve at the onset of the conduction block. In this study we evaluated the feasibility of a combined method of nerve block which utilizes two well established nerve blocking...

  7. Long Term Follow-Up in Inferior Alveolar Nerve Transposition: Our Experience

    Directory of Open Access Journals (Sweden)

    Giulio Gasparini

    2014-01-01

    Full Text Available Introduction. Inferior alveolar nerve transposition (IANT is a surgical technique used in implantoprosthetic rehabilitation of the atrophic lower jaw which has not been well embraced because of the high risk of damage to the inferior alveolar nerve (IAN. There are cases in which this method is essential to obtain good morphologic and functional rebalancing of the jaw. In this paper, the authors present their experience with IANT, analyzing the various situations in which IANT is the only surgical preprosthetic option. Methods. Between 2003 and 2011, 35 patients underwent surgical IANT at our center. Thermal and physical sensitivity were evaluated in each patient during follow-up. The follow-up ranged from 14 to 101 months. Results and Conclusion. Based on our experience, absolute indications of IANT are as follows: (1 class IV, V, or VI of Cawood and Howell with extrusion of the antagonist tooth and reduced prosthetic free space; (2 class V or VI of Cawood and Howell with presence of interforaminal teeth; (3 class V or VI of Cawood and Howell if patient desires fast implantoprosthetic rehabilitation with predictable outcomes; (4 class VI of Cawood and Howell when mandibular height increase with inlay grafts is advisable.

  8. Simulation of spinal nerve blocks for training anesthesiology residents

    Science.gov (United States)

    Blezek, Daniel J.; Robb, Richard A.; Camp, Jon J.; Nauss, Lee A.; Martin, David P.

    1998-06-01

    Deep nerve regional anesthesiology procedures, such as the celiac plexus block, are challenging to learn. The current training process primarily involves studying anatomy and practicing needle insertion is cadavers. Unfortunately, the training often continues on the first few patients subjected to the care of the new resident. To augment the training, we have developed a virtual reality surgical simulation designed to provide an immersive environment in which an understanding of the complex 3D relationships among the anatomic structures involved can be obtained and the mechanics of the celiac block procedure practiced under realistic conditions. Study of the relevant anatomy is provided by interactive 3D visualization of patient specific data nd the practice simulated using a head mounted display, a 6 degree of freedom tracker, and a haptic feedback device simulating the needle insertion. By training in a controlled environment, the resident may practice procedures repeatedly without the risks associated with actual patient procedures, and may become more adept and confident in the ability to perform nerve blocks. The resident may select a variety of different nerve block procedures to practice, and may place the virtual patient in any desired position and orientation. The preliminary anatomic models used in the simulation have been computed from the Visible Human Male; however, patient specific models may be generated from patient image data, allowing the physician to evaluate, plan, and practice difficult blocks and/or understand variations in anatomy before attempting the procedure on any specific patient.

  9. The number and size of axons central and peripheral to inferior alveolar nerve injuries in the cat.

    OpenAIRE

    Holland, G R; Robinson, P P

    1990-01-01

    We have observed the effect of three different lesions on the inferior alveolar nerve of the cat. If the nerve is transected and the cut ends reapposed there is no significant difference between the number of myelinated axons in the nerve proximal to the lesion and the number in contralateral control nerves at 9 or 15 weeks post-operatively. Counts distal to the lesion also do not differ significantly from control values although the size of the myelinated axons is reduced. If recovery is imp...

  10. Mesenchymal stem cells modified with nerve growth factor improve recovery of the inferior alveolar nerve after mandibular distraction osteogenesis in rabbits.

    Science.gov (United States)

    Wang, L; Zhao, Y; Cao, J; Yang, X; Lei, D

    2015-03-01

    Distraction osteogenesis is widely used in the treatment of bony deformities and defects. However, injury to the inferior alveolar nerve is a concern. Our aim was to investigate the feasibility of using lentiviral-mediated human nerve growth factor beta (hNGFβ) of the inferior alveolar nerve in mandibular distraction osteogenesis in rabbits. To achieve this, mesenchymal stem cells (MSC) from the bone marrow of rabbit mandibles were isolated and genetically engineered using recombinant lentiviral vector containing hNGFβ. Twenty New Zealand white rabbits underwent mandibular distraction osteogenesis, and 5 million MSC transduced with hNGFβ-vector or control vector were transplanted around the nerve in the gap where the bone had been fractured during the operation (n=10 in each group). After gradual distraction, samples of the nerve were harvested for histological and histomorphometric analysis. We found that the genetically engineered MSC transduced by the lentiviral vector were able to secrete hNGFβ at physiologically relevant concentrations as measured by ELISA. Histological examination of the nerve showed more regenerating nerve fibres and less myelin debris in the group in which hNGFβ-modified MSC had been implanted than in the control group. Histomorphometric analysis of the nerve showed increased density of myelinated fibres in the group in which hNGFβ-modified MSC had been implanted than in the control group. The data suggest that implantation of hNGFβ-modified MSC can accelerate the morphological recovery of the inferior alveolar nerve during mandibular distraction osteogenesis in rabbits. The use of lentiviral-mediated gene treatment to deliver hNGFβ through MSC may be a promising way of minimising injury to the nerve. PMID:25600702

  11. Mesenchymal stem cells modified with nerve growth factor improve recovery of the inferior alveolar nerve after mandibular distraction osteogenesis in rabbits.

    Science.gov (United States)

    Wang, L; Zhao, Y; Cao, J; Yang, X; Lei, D

    2015-03-01

    Distraction osteogenesis is widely used in the treatment of bony deformities and defects. However, injury to the inferior alveolar nerve is a concern. Our aim was to investigate the feasibility of using lentiviral-mediated human nerve growth factor beta (hNGFβ) of the inferior alveolar nerve in mandibular distraction osteogenesis in rabbits. To achieve this, mesenchymal stem cells (MSC) from the bone marrow of rabbit mandibles were isolated and genetically engineered using recombinant lentiviral vector containing hNGFβ. Twenty New Zealand white rabbits underwent mandibular distraction osteogenesis, and 5 million MSC transduced with hNGFβ-vector or control vector were transplanted around the nerve in the gap where the bone had been fractured during the operation (n=10 in each group). After gradual distraction, samples of the nerve were harvested for histological and histomorphometric analysis. We found that the genetically engineered MSC transduced by the lentiviral vector were able to secrete hNGFβ at physiologically relevant concentrations as measured by ELISA. Histological examination of the nerve showed more regenerating nerve fibres and less myelin debris in the group in which hNGFβ-modified MSC had been implanted than in the control group. Histomorphometric analysis of the nerve showed increased density of myelinated fibres in the group in which hNGFβ-modified MSC had been implanted than in the control group. The data suggest that implantation of hNGFβ-modified MSC can accelerate the morphological recovery of the inferior alveolar nerve during mandibular distraction osteogenesis in rabbits. The use of lentiviral-mediated gene treatment to deliver hNGFβ through MSC may be a promising way of minimising injury to the nerve.

  12. CT-guided suprascapular nerve blocks: a pilot study

    International Nuclear Information System (INIS)

    The objective of this study was to describe the suprascapular nerve block using CT guidance and to evaluate the short- and medium-term efficacy in a range of shoulder pathologies. CT-guided infiltration around the suprascapular nerve was performed with bupivacaine and Celestone Chronodose on 40 consecutive patients presenting with chronic shoulder pathologies unresponsive to conventional treatment. Patients were interviewed using the Shoulder Pain and Disability Index (SPADI) before the procedure, 30 min after the procedure and at 3 days, 3 weeks and 6 weeks afterwards. Within 30 min of the block overall pain scores decreased from a mean (±SEM) pain score of 7.0 (±0.4) to 3.5 (±0.5) (n=39, P<0.001). At 3 days after the procedure, the mean overall improvement of the pain and disability scores were 20.4% (±4.9, P<0.001) and 16.8% (±4.8, P=0.004) respectively. Sustained pain relief and reduced disability were achieved in 10 of 35 (29%) patients at 3 weeks and longer. Patients suffering from soft tissue pathologies were the most likely patients to benefit from the injection. No serious side effects were noted. In some patients with chronic soft tissue pathologies who do not respond to conventional treatment, a CT-guided suprascapular nerve block can provide safe short- and medium-term relief from pain and disability. (orig.)

  13. The outcome of intraoral onlay block bone grafts on alveolar ridge augmentations: A systematic review

    OpenAIRE

    Aloy Prósper, Amparo; Peñarrocha Oltra, David; Peñarrocha Diago, María; Peñarrocha Diago, Miguel

    2015-01-01

    Aim: The purpose of this study was to systematically review clinical studies examining the survival and success rates of implants placed with intraoral onlay autogenous bone grafts to answer the following question: do ridge augmentations procedures with intraoral onlay block bone grafts in conjunction with or prior to implant placement influence implant outcome when compared with a control group (guided bone regeneration, alveolar distraction, native bone or short dental implants.)? Material ...

  14. Inferior Alveolar Nerve Lateralization and Transposition for Dental Implant Placement. Part II: a Systematic Review of Neurosensory Complications

    Directory of Open Access Journals (Sweden)

    Boris Abayev

    2015-03-01

    Full Text Available Objectives: This article, the second in a two-part series, continues the discussion of inferior alveolar nerve lateralization/transposition for dental implant placement. The aim of this article is to review the scientific literature and clinical reports in order to analyse the neurosensory complications, risks and disadvantages of lateralization/transposition of the inferior alveolar nerve followed by implant placement in an edentulous atrophic posterior mandible. Material and Methods: A comprehensive review of the current literature was conducted according to the PRISMA guidelines by accessing the NCBI PubMed and PMC databases, as well as academic sites and books. The articles were searched from January 1997 to July 2014. Articles in English language, which included adult patients between 18 - 80 years of age who had minimal residual bone above the mandibular canal and had undergone inferior alveolar nerve (IAN repositioning, with minimum 6 months of follow-up, were included. Results: A total of 21 studies were included in this review. Ten were related to IAN transposition, 7 to IAN lateralization and 4 to both transposition and lateralization. The IAN neurosensory disturbance function was present in most patients (99.47% [376/378] for 1 to 6 months. In total, 0.53% (2/378 of procedures the disturbances were permanent. Conclusions: Inferior alveolar nerve repositioning is related to initial transient change in sensation in the majority of cases. The most popular causes of nerve damage are spatula-caused traction in the mucoperiosteal flap, pressure due to severe inflammation or retention of fluid around the nerve and subsequent development of transient ischemia, and mandibular body fracture.

  15. Femoral nerve block for patient undergoing total knee arthroplasty

    Science.gov (United States)

    Heo, Bong Ha; Lee, Hyeon Jung; Lee, Hyung Gon; Kim, Man Young; Park, Keun Suk; Choi, Jeong Il; Yoon, Myung Ha; Kim, Woong Mo

    2016-01-01

    Abstract Background: The existence of peripheral opioid receptors and its effectiveness in peripheral nerve block remain controversial. The aim of this prospective, randomized, double-blinded study was to examine the analgesic effects of adding fentanyl to ropivacaine for continuous femoral nerve block (CFNB) using patient-controlled analgesia after total knee arthroplasty (TKA). Methods: The patients were divided into 2 groups, each with n = 40 in ropivacaine (R) group and n = 42 in R with fentanyl (R + F) group. After operation, the patients in each group received R + F and R alone via a femoral nerve catheter, respectively. We assessed the visual analog scale (VAS) pain immediately before administration (baseline) and at 15, 30, and 60 minutes on postanesthesia care unit (PACU), and resting and ambulatory VAS score up to 24 hours. Results: Overall, the average VAS scores in the R + F group were slightly lower than those of the R group. However, the VAS score differences between groups were not statistically significant, except for 30 minutes (P = 0.009) in PACU. R group showed higher supplemental analgesics consumption in average compared with R + F group, but not significant. Conclusion: Additional fentanyl did not show prominent enhancement of analgesic effect in the field of CFNB after TKA. PMID:27603376

  16. Effects of Repeated Injection of Local Anesthetic on Sciatic Nerve Blocks Response

    Institute of Scientific and Technical Information of China (English)

    王忱; 刘怀萍

    2004-01-01

    In order to examine whether repeated sciatic nerve blocks showed tachyphylaxis and continuity of sciatic nerve with spinal cord affected development of tachyphylaxis when assayed in vivo by duration of depression compound action potentials (CAP), rats were anesthetized with halothane, ventilated, monitored and supported with stable hemodynamics and temperature. Posterior tibial nerve distally and sciatic nerve in thigh were exposed, placed on bipolar silver electrodes for stimulation and recording respectively. Three sequential sciatic nerve blocks were performed between these electrodes using 0.15 ml of 3 % chloroprocaine. Nine rats were chosen to observe the effects of repeated sciatic nerve blocks on CAP. In another 18 rats, a second investigator exposed the sciatic nerve near its origin at spinal cord and randomly performed nerve cut and sham (n= 9),and closed the incision blinding the electrophysiologic investigator. The results showed that electrical stimulated tibial nerve induced sciatic nerve Aα/β, Aδ, C fiber mediated CAP waves. CAP amplitudes were remained stable during whole experimental procedure. CAP amplitudes were decreased completely with 3% chloroprocaine blocked sciatic nerve and recovered fully. The duration of CAP depression were reduced with repeated blocks. There were no selective blocked effects on Aα/β, Aδ, C fiber mediated CAP. With sciatic nerve cut proximally, there was no statistical significant tachyphylaxis with 3 % chloroprocaine repeated blocked sciatic nerve, and the duration of first and third blocked Aδ fiber mediated CAP was 108±20 and 92±14 min respectively (P>0.05). In normal rats the duration of first and third blocked Aδ fiber mediated CAP was 110±20 and 75±16min respectively (P<0.05). It was suggested that tachyphylaxis to local anesthetics can occur in rats repeated blocked sciatic nerve when assayed in vivo by duration of depression CAP. The continuity of sciatic nerve with spinal cord is one of the

  17. Real-time ultrasound-guided comparison of adductor canal block and psoas compartment block combined with sciatic nerve block in laparoscopic knee surgeries

    OpenAIRE

    Messeha, Medhat M.

    2016-01-01

    Background: Lumbar plexus block, combined with a sciatic nerve block, is an effective locoregional anesthetic technique for analgesia and anesthesia of the lower extremity. The aim of this study was to compare the clinical results outcome of the adductor canal block versus the psoas compartment block combined with sciatic nerve block using real time ultrasound guidance in patients undergoing elective laparoscopic knee surgeries. Patients and Methods: Ninety patients who were undergoing electi...

  18. Effect of preemptive nerve block on inflammation and hyperalgesia after human thermal injury

    DEFF Research Database (Denmark)

    Pedersen, J L; Crawford, M E; Dahl, J B;

    1996-01-01

    whether a prolonged nerve block administered before a superficial burn injury could reduce local inflammation and late hyperalgesia after recovery from the block. METHODS: The effects of a preemptive saphenous nerve block on primary and secondary hyperalgesia, skin erythema, and blister formation, were...

  19. Post-extraction inferior alveolar nerve neurosensory disturbances--a guide to their evaluation and practical management.

    Science.gov (United States)

    Mahon, Nicola; Stassen, Leo F A

    2014-01-01

    Inferior alveolar nerve injuries are a recognised complication of mandibular third molar extractions. This paper describes the different types of nerve injuries that may occur. A differential of possible causes is provided and an approach to the immediate and follow-up management is outlined. The prognosis of such injuries is reviewed so that patients can be informed of the possible postoperative outcome. The algorithm shows the timeline for monitoring/referring and the included tables outline the advantages and disadvantages of surgery versus watchful waiting. PMID:25638921

  20. Inferior Alveolar Nerve Lateralization and Transposition for Dental Implant Placement. Part I: a Systematic Review of Surgical Techniques

    Directory of Open Access Journals (Sweden)

    Boris Abayev

    2015-03-01

    Full Text Available Objectives: The purpose of this first part of a two-part series was to review the literature concerning the indications, contraindications, advantages, disadvantages and surgical techniques of the lateralization and transposition of the inferior alveolar nerve, followed by the placement of an implant in an edentulous atrophic posterior mandible. Material and Methods: A comprehensive review of the current literature was conducted according to the PRISMA guidelines by accessing the NCBI PubMed and PMC database, academic sites and books. The articles were searched from January 1997 to July 2014 and comprised English-language articles that included adult patients between 18 and 80 years old with minimal residual bone above the mandibular canal who had undergone inferior alveolar nerve (IAN repositioning with a minimum 6 months of follow-up. Results: A total of 16 studies were included in this review. Nine were related to IAN transposition, 4 to IAN lateralization and 3 to both transposition and lateralization. Implant treatment results and complications were presented. Conclusions: Inferior alveolar nerve lateralization and transposition in combination with the installation of dental implants is sometimes the only possible procedure to help patients to obtain a fixed prosthesis, in edentulous atrophic posterior mandibles. With careful pre-operative surgical and prosthetic planning, imaging, and extremely precise surgical technique, this procedure can be successfully used for implant placement in edentulous posterior mandibular segments.

  1. Accidental injury of the inferior alveolar nerve due to the extrusion of calcium hydroxide in endodontic treatment: a case report.

    Science.gov (United States)

    Shin, Yooseok; Roh, Byoung-Duck; Kim, Yemi; Kim, Taehyeon; Kim, Hyungjun

    2016-02-01

    During clinical endodontic treatment, we often find radiopaque filling material beyond the root apex. Accidental extrusion of calcium hydroxide could cause the injury of inferior alveolar nerve, such as paresthesia or continuous inflammatory response. This case report presents the extrusion of calcium hydroxide and treatment procedures including surgical intervention. A 48 yr old female patient experienced Calcipex II extrusion in to the inferior alveolar canal on left mandibular area during endodontic treatment. After completion of endodontic treatment on left mandibular first molar, surgical intervention was planned under general anesthesia. After cortical bone osteotomy and debridement, neuroma resection and neurorrhaphy was performed, and prognosis was observed. But no improvement in sensory nerve was seen following surgical intervention after 20 mon. A clinician should be aware of extrusion of intracanal medicaments and the possibility of damage on inferior alveolar canal. Injectable type of calcium hydroxide should be applied with care for preventing nerve injury. The alternative delivery method such as lentulo spiral was suggested on the posterior mandibular molar. PMID:26877992

  2. Inferior alveolar nerve injuries associated with mandibular fractures at risk: a two-center retrospective study.

    Science.gov (United States)

    Boffano, Paolo; Roccia, Fabio; Gallesio, Cesare; Karagozoglu, K; Forouzanfar, Tymour

    2014-12-01

    The aim of the study was to investigate the incidence of the inferior alveolar nerve (IAN) injury in mandibular fractures. This study is based on two databases that have continuously recorded patients hospitalized with maxillofacial fractures in two departments-Department of Maxillofacial Surgery, Vrije Universiteit University Medical Center, Amsterdam, the Netherlands, and Division of Maxillofacial Surgery, San Giovanni Battista Hospital, Turin, Italy. Demographic, anatomic, and etiology variables were considered for each patient and statistically assessed in relation to the neurosensory IAN impairment. Statistically significant associations were found between IAN injury and fracture displacement (p = 0.03), isolated mandibular fractures (p = 0.01), and angle fractures (p = 0.004). A statistically significant association was also found between IAN injury and assaults (p = 0.03). Displaced isolated mandibular angle fractures could be considered at risk for increased incidence of IAN injury. Assaults seem to be the most important etiological factor that is responsible for IAN lesions. PMID:25383147

  3. Involvement of medullary GABAergic system in extraterritorial neuropathic pain mechanisms associated with inferior alveolar nerve transection.

    Science.gov (United States)

    Okada-Ogawa, Akiko; Nakaya, Yuka; Imamura, Yoshiki; Kobayashi, Masayuki; Shinoda, Masamichi; Kita, Kozue; Sessle, Barry J; Iwata, Koichi

    2015-05-01

    In order to determine if the functional changes in the GABAergic system in the trigeminal spinal subnucleus caudalis (Vc) are involved in the mechanisms underlying extraterritorial neuropathic pain in the orofacial region following inferior alveolar nerve transection (IANX), mechanical noxious behavior, phosphorylated extracellular signal-regulated kinase (pERK) immunohistochemistry and single neuronal activity were analyzed in vesicular GABA transporter (VGAT)-VenusA rats expressing fluorescent protein and the VGAT in Vc neurons. The number of VGAT-VenusA positive neurons was significantly reduced in IANX rats than naive and sham rats at 7days after nerve transection. The number of VGAT-VenusA positive pERK-immunoreactive (IR) cells was significantly increased in IANX rats at 21days after IAN transection compared with naive and sham rats. The background activity and mechanical-evoked responses of Vc nociceptive neurons were significantly depressed after intrathecal application of the GABA receptor agonist muscimol in sham rats but not in IANX rats. Furthermore, the expression of potassium-chloride co-transporter 2 (KCC2) in the Vc was significantly reduced in IANX rats compared with sham rats. The head-withdrawal threshold (HWT) to mechanical stimulation of the whisker pad skin was significantly decreased in IANX rats compared with sham rats on days 7 and 21 after IANX. The significant reduction of the HWT and significant increase in the number of VGAT-VenusA negative pERK-IR cells were observed in KCC2 blocker R-DIOA-injected rats compared with vehicle-injected rats on day 21 after sham treatment. These findings revealed that GABAergic Vc neurons might be reduced in their number at the early period after IANX and the functional changes might occur in GABAergic neurons from inhibitory to excitatory at the late period after IANX, suggesting that the neuroplastic changes occur in the GABAergic neuronal network in the Vc due to morphological and functional changes at

  4. Ultrasound guided obturator nerve block: a single interfascial injection technique.

    Science.gov (United States)

    Lee, Seong Heon; Jeong, Cheol Won; Lee, Hyun Jung; Yoon, Myung Ha; Kim, Woong Mo

    2011-12-01

    We describe a new technique of single interfascial injection for 25 patients scheduled for transurethral bladder tumor resection. An ultrasound probe was placed at the midline of inguinal crease and moved medially and caudally to visualize the fascial space between the adductor longus (or pectineus) and adductor brevis muscles. We injected 20 mL 1% lidocaine containing epinephrine into the interfascial space using a transverse plane approach to make an interfascial injection, not an intramuscular swelling pattern. And just distally, firm pressure was applied for 3 min. Afterwards, surgery was performed under spinal anesthesia. The time required for identification and location of the nerve was 20 ± 15 and 30 ± 15 s, respectively. Adductor muscle strength, which was measured with a sphygmomanometer, decreased in all patients, from 122 ± 26 mmHg before blockade to 63 ± 11 mmHg 5 min after blockade. No movement or palpable muscle twitching occurred in 23 cases, slight movement of the thigh not interfering with the surgical procedure was observed in 1 case, thus the obturator reflex was successfully inhibited in 96% of cases. Ultrasound-guided single interfascial injection is an easy and successful technique for obturator nerve block. PMID:21918855

  5. Efficacy of ultrasound-guided obturator nerve block in transurethral surgery

    OpenAIRE

    Ahmed Thallaj; Dany Rabah

    2011-01-01

    Background: During transurethral resection surgery (TUR), accidental stimulation of the obturator nerve can cause violent adductor contraction, leading to serious intraoperative complications. General anesthesia with muscle relaxation is currently the preferred technique for TUR surgery. Spinal anesthesia combined with obturator nerve block has also been used for TUR surgery in geriatric population. Blind, anatomical methods for identifying the obturator nerve are often unsatisfactory. Theref...

  6. Clinical observation on thoracic paravertebral nerve block with ozone treatment in patients with postherpetic neuralgia

    Directory of Open Access Journals (Sweden)

    GUO Xiang-fei

    2013-10-01

    Full Text Available Objective To analyze the clinical efficacy of thoracic paravertebral nerve block with ozone in the treatment of postherpetic neuralgia. Methods Eighty-five patients suffered postherpetic neuralgia were divided into 4 groups: Group A (oral drugs + intramuscular injection of vitamin B12 + local nerve block of lesion area, Group B (oral drugs + intramuscular injection of compound trivitamin B + local nerve block of lesion area, Group C (oral drugs + intramuscular injection of compound trivitamin B + thoracic paravertebral nerve block + local nerve block of lesion area, Group D (oral drugs + intramuscular injection of compound trivitamin B + thoracic paravertebral nerve block with ozone + local nerve block of lesion area. Treatment outcomes were evaluated by Visual Analogue Scale (VAS, Quality of Sleep (QS, Self-Rating Depression Scale (SDS and C-reactive protein (CRP before treatment and 4 weeks after treatment. Results After treatment, VAS, QS and SDS scores of 4 groups were lower than that before treatment, and the differences were statistically significant (P 0.05, for all, while a significant change in CRP was observed in patients of group D between before and after treatment (P < 0.05. The improvement of VAS, QS and SDS scores of group D was significantly better than other 3 groups (P < 0.05, for all. Conclusion Thoracic paravertebral nerve block combined with ozone is a quick and effective method for postherpetic neuralgia patients.

  7. Nursing and psychological treatment during tension-free inguinal hernia repair under local nerve blocked anesthesia

    Institute of Scientific and Technical Information of China (English)

    ZHAO Li-hui

    2007-01-01

    Tension-free inguinal hernia repair under local nerve blocked anesthesia ia an up-to-date technology and is different from the traditional approach.The aim of this study isto evaluate the nursing and psychological treatment during operation under local nerve blocked anesthesia.

  8. Ultrasound guided distal peripheral nerve block of the upper limb: A technical review

    Directory of Open Access Journals (Sweden)

    Herman Sehmbi

    2015-01-01

    Full Text Available Upper extremity surgery is commonly performed under regional anesthesia. The advent of ultrasonography has made performing upper extremity nerve blocks relatively easy with a high degree of reliability. The proximal approaches to brachial plexus block such as supraclavicular plexus block, infraclavicular plexus block, or the axillary block are favored for the most surgical procedures of distal upper extremity. Ultrasound guidance has however made distal nerve blocks of the upper limb a technically feasible, safe and efficacious option. In recent years, there has thus been a resurgence of distal peripheral nerve blocks to facilitate hand and wrist surgery. In this article, we review the technical aspects of performing the distal blocks of the upper extremity and highlight some of the clinical aspects of their usage.

  9. Electrical nerve stimulation as an aid to the placement of a brachial plexus block : clinical communication

    Directory of Open Access Journals (Sweden)

    K.E. Joubert

    2002-07-01

    Full Text Available Most local anaesthetic blocks are placed blindly, based on a sound knowledge of anatomy. Very often the relationship between the site of deposition of local anaesthetic and the nerve to be blocked is unknown. Large motor neurons may be stimulated with the aid of an electrical current. By observing for muscle twitches, through electrical stimulation of the nerve, a needle can be positioned extremely close to the nerve. The accuracy of local anaesthetic blocks can be improved by this technique. By using the lowest possible current a needle could be positioned within 2-5mm of a nerve. The correct duration of stimulation ensures that stimulation of sensory nerves does not occur. The use of electrical nerve stimulation in veterinary medicine is a novel technique that requires further evaluation.

  10. Ultrasound and nerve stimulator guided continuous femoral nerve block analgesia after total knee arthroplasty: a multicenter randomized controlled study

    Directory of Open Access Journals (Sweden)

    Fen Wang

    2015-02-01

    Full Text Available BACKGROUND AND OBJECTIVES: Postoperative analgesia is crucial for early functional excise after total knee arthroplasty. To investigate the clinical efficacy of ultrasound and nerve stimulator guided continuous femoral nerve block analgesia after total knee arthroplasty. METHODS: 46 patients with ASA grade I-III who underwent total knee arthroplasty received postoperative analgesia from October 2012 to January 2013. In 22 patients, ultrasound and nerve stimulator guided continuous femoral nerve block were performed for analgesia (CFNB group; in 24 patients, epidural analgesia was done (PCEA group. The analgesic effects, side effects, articular recovery and complications were compared between two groups. RESULTS: At 6 h and 12 h after surgery, the knee pain score (VAS score during functional tests after active exercise and after passive excise in CFNB were significantly reduced when compared with PCEA group. The amount of parecoxib used in CFNB patients was significantly reduced when compared with PCEA group. At 48 h after surgery, the muscle strength grade in CFNB group was significantly higher, and the time to ambulatory activity was shorter than those in PCEA group. The incidence of nausea and vomiting in CFNB patients was significantly reduced when compared with PCEA group. CONCLUSION: Ultrasound and nerve stimulator guided continuous femoral nerve block provide better analgesia at 6 h and 12 h, demonstrated by RVAS and PVAS. The amount of parecoxib also reduces, the incidence of nausea and vomiting decreased, the influence on muscle strength is compromised and patients can perform ambulatory activity under this condition.

  11. [The efficacy of ultrasound-guided infraorbital nerve block with hockey stick typed probe].

    Science.gov (United States)

    Iwase, Naoto; Fukui, Hidekimi; Yuunaiyama, Youko; Kaneko, Kouki; Ohseto, Kiyoshige; Uchino, Hiroyuki

    2013-10-01

    We report a case of ultrasound-guided infraorbital nerve block with a hockey stick typed probe in plane approach. Individual difference of infraorbital anatomy makes it difficult to puncture the infraorbital for a man, and the risks include bleeding, double vision and paranasal sinus puncture. The advantage of ultrasound-guided nerve block has been reported. Compared with conventional land mark method approach, ultrasound technique is thought to be easy to perform, more quickly and safely without any complications. From our results, we have demonstrated that ultrasound-guided infraorbital nerve block assisted by hockey stick typed probe could become one of the safe methods for this purpose. PMID:24228458

  12. The anterior loop of the inferior alveolar nerve. A radiographic study of panoramic radiographs and review of the literature.

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    Konstantinos VLASTOS

    2014-04-01

    Full Text Available The inferior alveolar nerve sometimes extends anteriorly beyond the mental foramen and runs outward, upward and backward before it reaches the mental foramen, creating what is known as the anterior loop. Placement of dental implants in this area, has a high risk of injury to the inferior alveolar nerve. Aim: This study seeks to investigate the visualization of the anterior loop on panoramic radiographs. Material and methods: 100 panoramic radiographs were analysed in terms of loop visualization. Results: Anterior loop was observed in 34% of the radiographs. Its prevalence was higher in males (70.5% and in patients between 40-60 years old (47%. In most cases the loop was located bilaterally (64.7%, while the interforaminal area was mostly edentulous (64.7%. The loop length ranged between 0.5-8 mm, with an average length of 4.37mm. Conclusions: An analysis of the findings shows that implants should be placed at least 5-8mm anteriorly to the mental foramen. According to a review of the literature, computed tomography is more accurate than panoramic radiography in identifying the anterior loop.

  13. Use of ultrasound to facilitate femoral nerve block with stimulating catheter

    Institute of Scientific and Technical Information of China (English)

    LI Min; XU Ting; HAN Wen-yong; WANG Xue-dong; JIA Dong-lin; GUO Xiang-yang

    2011-01-01

    Background The adjunction of ultrasound to nerve stimulation has been proven to improve single-injection peripheral nerve block quality. However, few reports have been published determining whether ultrasound can facilitate continuous nerve blocks. In this study, we tested the hypothesis that the addition of ultrasound to nerve stimulation facilitates femoral nerve blocks with a stimulating catheter.Methods In this prospective randomized study, patients receiving continuous femoral nerve blocks for total knee replacement were randomly assigned to either the ultrasound guidance combined with stimulating catheter group (USNS group; n=60) or the stimulating catheter alone group (NS group; n=60). The primary end point was the procedure time (defined as the time from first needle contact with the skin until correct catheter placement). The numbers of needle passes and catheter insertions, onset and quality of femoral nerve blocks, postoperative pain score, and early knee function were also recorded.Results The procedure time was significantly less in the USNS group than in the NS group (9.0 (6.0-22.8) minutes vs.13.5 (6.0-35.9) minutes, P=0.024). The numbers of needle passes and catheter insertions were also significantly less in the USNS group. A greater complete block rate was achieved at 30 minutes in the USNS group (63.3% vs. 38.3%;P=0.010). The postoperative pain score, the number of patients who required bolus local anesthetic and intravenous patient-controlled analgesia, and knee flexion on the second postoperative day were not significantly different between the two groups of patients.Conclusions Ultrasound-assisted placement of a stimulating catheter for femoral nerve blocks decreases the time necessary to perform the block compared with just the nerve-stimulating technique. In addition, a more complete blockade is achieved using the ultrasound-assisted technique.

  14. Transsacral S2-S4 nerve block for vaginal pain due to pudendal neuralgia.

    Science.gov (United States)

    Cok, Oya Yalcin; Eker, H Evren; Cok, Tayfun; Akin, Sule; Aribogan, Anis; Arslan, Gulnaz

    2011-01-01

    Pudendal neuralgia is a type of neuropathic pain experienced predominantly while sitting, and causes a substantial decrease in quality of life in affected patients. Pudendal nerve block is a diagnostic and therapeutic option for pudendal neuralgia. Transsacral block at S2 through S4 results in pudendal nerve block, which is an option for successful relief of pain due to pudendal nerve injury. Herein is reported blockade of S2 through S4 using lidocaine and methylprednisolone for successful treatment of pudendal neuralgia in 2 patients with severe chronic vaginal pain. The patients, aged 44 and 58 years, respectively, were referred from the Gynecology Department to the pain clinic because of burning, stabbing, electric shock-like, unilateral pain localized to the left portion of the vagina and extending to the perineum. Their initial pain scores were 9 and 10, respectively, on a numeric rating scale. Both patients refused pudendal nerve block using classical techniques. Therefore, diagnostic transsacral S2-S4 nerve block was performed using lidocaine 1%, and was repeated using lidocaine 1% and methylprednisolone 80 mg after confirming block efficiency as demonstrated by an immediate decrease in pain scores. After 1 month, pain scores were 1 and 0, respectively, and both patients were free of pain at 6-month follow up. It is suggested that blockade of S2 through S4 using lidocaine and methylprednisolone is an effective treatment option in patients with chronic pudendal neuralgia when traditional pudendal nerve block is not applicable.

  15. Ultrasound-guided block of the axillary nerve: a volunteer study of a new method

    DEFF Research Database (Denmark)

    Rothe, C; Asghar, S; Andersen, H L;

    2011-01-01

    Interscalene brachial plexus block (IBPB) is the gold standard for perioperative pain management in shoulder surgery. However, a more distal technique would be desirable to avoid the side effects and potential serious complications of IBPB. Therefore, the aim of the present study was to develop a...... and describe a new method to perform an ultrasound-guided specific axillary nerve block....

  16. Role of Cone Beam Computed Tomography in Rehabilitation of a Traumatised Deficient Maxillary Alveolar Ridge Using Symphyseal Block Graft Placement

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    Shipra Arora

    2013-01-01

    Full Text Available Deficiencies in the alveolar ridges cause multiple problems in achieving aesthetic and functional outcome of implant therapy and are commonly restored by using onlay graft from intraoral source. Careful assessment of the recipient as well as the donor site using cone beam computed tomography (CBCT is a prerequisite to ideal treatment planning. This paper highlights the critical role of CBCT in planning a successful rehabilitation of traumatised deficient anterior maxillary alveolar ridge using autogenous block graft from mandibular symphysis, followed by implant placement. A 21-year-old male reported with missing right maxillary lateral incisor due to traumatic avulsion 6 months back. A concavity was found on the labial aspect of edentulous area. Serial transplanar images on CBCT revealed gross irregular radiolucency in place of labial cortical plate. Using CBCT, size of the required block was estimated, and mandibular symphyseal area was evaluated for the feasibility of harvesting a graft of suitable dimension. Onlay block graft was harvested from mandibular symphysis and placed at the edentulous site to augment the alveolar ridge. Implants were placed 5 months later and loaded successfully after osseointegration. After 1 year of followup, implant-based prosthesis is working well, without any complications.

  17. Severe cast burn after bunionectomy in a patient who received peripheral nerve blocks for postoperative analgesia

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    Joelle W Boeve

    2011-03-01

    Full Text Available Patrick K Boyle, John J Badal, Joelle W BoeveDepartment of Anesthesiology, Arizona Health Sciences Center, Tucson, AZ, USAAbstract: Although regional anesthesia offers advantages for intraoperative and postoperative pain relief, it is not possible without complications. A case of a significant burn injury after splint placement is described after a peripheral nerve block was performed for postoperative pain management. It is our hope that this case alerts physicians and others involved in the management of postoperative patients to the challenges of managing a blocked extremity after thermal cast placement and offers solutions that can be standardized.Keywords: Peripheral nerve block, cast burn, postoperative complication

  18. Effects of intraneural and perineural injection and concentration of Ropivacaine on nerve injury during peripheral nerve block in Wistar rats

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    Ilvana Hasanbegovic

    2013-12-01

    Full Text Available Introduction: Injury during peripheral nerve blocks is relatively uncommon, but potentially devastating complication. Recent studies emphasized that location of needle insertion in relationship to the fascicles may be the predominant factor that determines the risk for neurologic complications. However, it is wellestablished that concentration of local anesthetic is also associated with the risk for injury. In this study, we examined the effect of location of injection and concentration of Ropivacaine on risk for neurologic complications. Our hypothesis is that location of the injection is more prognostic for occurrence of nerve injury than the concentration of Ropivacaine.Methods: In experimental design of the study fi fty Wistar rats were used and sciatic nerves were randomized to receive: Ropivacaine or 0.9% NaCl, either intraneurally or perineurally. Pressure data during application was acquired by using a manometer and was analyzed using software package BioBench. Neurologic examination was performed thought the following seven days, there after the rats were sacrificed while sciatic nerves were extracted for histological examination.Results: Independently of tested solution intraneural injections in most of cases resulted with high injection pressure, followed by obvious neurologic defi cit and microscopic destruction of peripheral nerves. Also, low injection pressure, applied either in perineural or intraneural extrafascicular area, resulted with transitory neurologic defi cit and without destruction of the nerve normal histological structure.Conclusions: The main mechanism which leads to neurologic injury combined with peripheral nerve blockade is intrafascicular injection. Higher concentrations of Ropivacaine during intrafascicular applications magnify nerve injury.

  19. Effect of sympathetic nerve block on acute inflammatory pain and hyperalgesia

    DEFF Research Database (Denmark)

    Pedersen, J L; Rung, G W; Kehlet, H

    1997-01-01

    . METHODS: The study was made as a randomized, single blinded investigation, in which the volunteers served as their own controls. A lumbar sympathetic nerve block and a contralateral placebo block were performed in 24 persons by injecting 10 ml bupivacaine (0.5%) and 10 ml saline, respectively. The......BACKGROUND: Sympathetic nerve blocks relieve pain in certain chronic pain states, but the role of the sympathetic pathways in acute pain is unclear. Thus the authors wanted to determine whether a sympathetic block could reduce acute pain and hyperalgesia after a heat injury in healthy volunteers...... duration and quality of blocks were evaluated by the sympatogalvanic skin response and skin temperature. Bilateral heat injuries were produced on the medial surfaces of the calves with a 50 x 25 mm thermode (47 degrees C, 7 min) 45 min after the blocks. Pain intensity induced by heat, pain thresholds to...

  20. Ultrasound guided selective cervical nerve root block and superficial cervical plexus block for surgeries on the clavicle

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    Harsha Shanthanna

    2014-01-01

    Full Text Available We report the anaesthetic management of two cases involving surgeries on the clavicle, performed under superficial cervical plexus block and selective C5 nerve root block under ultrasound (US guidance, along with general anaesthesia. Regional analgesia for clavicular surgeries is challenging. Our patients also had significant comorbidities necessitating individualised approach. The first patient had a history of emphysema, obesity, and was allergic to morphine and hydromorphone. The second patient had clavicular arthritis and pain due to previous surgeries. He had a history of smoking, Stevens-Johnson syndrome, along with daily marijuana and prescription opioid use. Both patients had an effective regional block and required minimal supplementation of analgesia, both being discharged on the same day. Interscalene block with its associated risks and complications may not be suitable for every patient. This report highlights the importance of selective regional blockade and also the use of US guidance for an effective and safe block.

  1. Ultrasound-guided nerve blocks - is documentation and education feasible using only text and pictures?

    DEFF Research Database (Denmark)

    Worm, Bjarne Skjødt; Krag, Mette; Jensen, Kenneth

    2014-01-01

    With the advancement of ultrasound-guidance for peripheral nerve blocks, still pictures from representative ultrasonograms are increasingly used for clinical procedure documentation of the procedure and for educational purposes in textbook materials. However, little is actually known about...... the clinical and educational usefulness of these still pictures, in particular how well nerve structures can be identified compared to real-time ultrasound examination. We aimed to quantify gross visibility or ultrastructure using still picture sonograms compared to real time ultrasound for trainees...... and experts, for large or small nerves, and discuss the clinical or educational relevance of these findings....

  2. Transient Femoral Nerve Palsy Complicating “Blind” Transversus Abdominis Plane Block

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    Dimitrios K. Manatakis

    2013-01-01

    Full Text Available We present two cases of patients who reported quadriceps femoris weakness and hypoesthesia over the anterior thigh after an inguinal hernia repair under transversus abdominis plane (TAP block. Transient femoral nerve palsy is the result of local anesthetic incorrectly injected between transversus abdominis muscle and transversalis fascia and pooling around the femoral nerve. Although it is a minor and self-limiting complication, it requires overnight hospital stay and observation of the patients. Performing the block under ultrasound guidance and injecting the least volume of local anesthetic required are ways of minimizing its incidence.

  3. DEVELOPMENT OF RETROBULBAR AND AURICULOPALPEBRAL NERVE BLOCKS IN CALIFORNIA SEA LIONS (ZALOPHUS CALIFORNIANUS).

    Science.gov (United States)

    Gutiérrez, J; Simeone, C; Gulland, F; Johnson, S

    2016-03-01

    Eye lesions are commonly observed in pinnipeds. Clinical assessment is challenging because animals are often blepharospastic and under inhalant anesthesia the globe rotates ventrally, making observation difficult. Retrobulbar and auriculopalpebral nerve block techniques have been developed in other species to alleviate these difficulties and allow for a more thorough ophthalmic exam. Ocular nerve block techniques were developed for California sea lions (CSLs) (Zalophus californianus) using lidocaine hydrochloride 2%. To develop the retrobulbar block, a variety of needle sizes, anatomic approaches, and volumes of methylene blue were injected into the orbits of 10 CSL cadavers. An optimal technique, based on desired distribution of methylene blue dye into periocular muscles and tissues, was determined to be a two-point (ventrolateral and ventromedial) transpalpebral injection with a 20-ga, 1 1/2-inch needle. This technique was then tested using lidocaine on 26 anesthetized animals prior to euthanasia, and on one case with clinical ocular disease. A dose of 4 mg/kg of lidocaine was considered ideal, with positive results and minimal complications. The retrobulbar block had a 76.9% rate of success (using 4 mg/kg of lidocaine), which was defined as the globe returning at least halfway to its central orientation with mydriasis. No systemic adverse effects were noted with this technique. The auriculopalpebral nerve block was also adapted for CSLs from techniques described in dogs, cattle, and horses. Lidocaine was injected (2-3 ml) by subcutaneous infiltration lateral to the orbital rim, where the auriculopalpebral nerve branch courses over the zygomatic arch. This block was used in five blepharospastic animals that were anesthetized for ophthalmic examinations. The auriculopalpebral nerve block was successful in 60% of the cases, which was defined as reduction or elimination of blepharospasm for up to 3 hr. Success appeared to be dependent more on the location of

  4. Ultrasound-Guided Ilioinguinal/Iliohypogastric Nerve Blocks for Persistent Inguinal Postherniorrhaphy Pain

    DEFF Research Database (Denmark)

    Bischoff, Joakim Mutahi; Koscielniak-Nielsen, Zbigniew J; Kehlet, Henrik;

    2012-01-01

    Background:Ilioinguinal and iliohypogastric nerve blocks are used in the clinical management of persistent inguinal postherniorrhaphy pain, but no controlled studies have been published on the subject. In this controlled study, we investigated the analgesic and sensory effects of ultrasound......-guided blocks of the ilioinguinal and iliohypogastric nerves with lidocaine.Methods:A randomized, double-blind, placebo-controlled, crossover trial in 12 patients with severe persistent inguinal postherniorrhaphy pain, including a control group of 12 healthy controls, was performed. Assessments included pain...... pain patients was a lidocaine responder, 6 patients were nonresponders, and 5 patients were placebo responders. No consistent QST changes were observed in patients after the lidocaine block. In 10 of 12 healthy controls, a cool hypoesthesia area developed in the groin after the lidocaine block...

  5. The Analgesic Effect of Obturator Nerve Block Added to a Femoral Triangle Block After Total Knee Arthroplasty

    DEFF Research Database (Denmark)

    Runge, Charlotte; Børglum, Jens; Jensen, Jan Mick;

    2016-01-01

    BACKGROUND AND OBJECTIVES: Total knee arthroplasty (TKA) is associated with severe pain, and effective analgesia is essential for the quality of postoperative care and ambulation. The analgesic effects of adding an obturator nerve block (ONB) to a femoral triangle block (FTB) after TKA have not...... been tested previously. We hypothesized that combined ONB and FTB will reduce opioid consumption and pain compared with those of a single FTB or local infiltration analgesia (LIA). METHODS: Seventy-eight patients were randomized to combined ONB and FTB, single FTB, or LIA after primary unilateral TKA...

  6. Efficacy of ultrasound-guided obturator nerve block in transurethral surgery

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    Ahmed Thallaj

    2011-01-01

    Full Text Available Background: During transurethral resection surgery (TUR, accidental stimulation of the obturator nerve can cause violent adductor contraction, leading to serious intraoperative complications. General anesthesia with muscle relaxation is currently the preferred technique for TUR surgery. Spinal anesthesia combined with obturator nerve block has also been used for TUR surgery in geriatric population. Blind, anatomical methods for identifying the obturator nerve are often unsatisfactory. Therefore, we conducted this prospective study to validate the efficacy of ultrasound-guided obturator nerve block (USONB during TUR procedures. Methods: Eighteen male patients undergoing TURP surgery under spinal anesthesia were included in the study. Bilateral USONB with maximum 20 ml of 1% lidocaine per patient was performed. An independent observer was present to monitor any adduction movements during the operation and to record patient and surgeon satisfactions. Results: In all patients, obturator nerve was visualized from the first attempt, requiring an average of 4.3 min for blocking of each side. USONB was successful (97.2% in preventing an adductor spasm in all except one patient. Patient′s and surgeon′s satisfaction were appropriate. In all patients, adductor muscle strength recovered fully within 2 h following the surgical procedure. Conclusions: USONB is safe and effective during TUR surgery. It provides optimal intra-and postoperative conditions.

  7. Surgical extraction of lower third molars: diagnostic tests and operative technique in the prevention of inferior alveolar nerve injury. Case study

    OpenAIRE

    MELEO, D.; PACIFICI, L.

    2009-01-01

    Increased knowledge and technical refinement have broadened the limits of outpatient oral surgery; however, these changes have at the same time led to a greater number of complications and poor outcomes and, accordingly, to legal action for professional responsibility. Oral surgery represents 10% of all actions, and almost all of these are attributable to exodontic surgery, of which around a third are related to inferior alveolar nerve injury following the extraction of lower third molars.

  8. Low-level laser treatment improves longstanding sensory aberrations in the inferior alveolar nerve following surgical trauma

    Science.gov (United States)

    Khullar, Shelley M.; Brodin, P.; Barkvoll, P.; Haanoes, H. R.

    1996-01-01

    The incidence of inferior alveolar nerve (IAN) damage following removal of 3rd molar teeth or saggital split osteotomy has been reported as high as up to 5.5% and 100% respectively. Sensory aberrations in the IAN persisting for longer than 6 months leave some degree of permanent defect. Low level laser treatment (LLL) has a reported beneficial effect on regeneration of traumatically injured nerves. The purpose of this double blind clinical trial was to examine the effects of LLL using a GaAlAs laser (820 nm, Ronvig, Denmark) on touch and temperature sensory perception following a longstanding post surgical IAN injury. Thirteen patients were divided into two groups, one of which received real LLL (4 by 6 J per treatment along the distribution of the IAN to a total of 20 treatments during a time period between 36 - 69 days) and the other equivalent placebo LLL. The degree of mechanoreceptor injury as assessed by Semmes Weinstein Monofilaments (North Coast Medical, USA) were comparable in the two groups prior to treatment (p equals 0.9). Subsequent to LLL the real laser treatment group showed a significant improvement in mechanoreceptor sensory testing (p equals 0.01) as manifested by a decrease in load threshold (g) necessary to elicit a response from the most damaged area. The placebo LLL group showed no significant improvement, In addition, the real LLL group reported a subjective improvement in sensory function too. The degree of thermal sensitivity disability as assessed using a thermotester (Philips, Sweden) was comparable between the two groups prior to LLL p equals 0.5). However, there was no significant improvement in thermal sensitivity post LLL for either the real or placebo laser treated groups. In conclusion, GaAlAs LLL can improve mechanoreceptor perception in longstanding sensory aberration in the IAN.

  9. Is periprostatic nerve block a gold standard in case of transrectal ultrasound-guided prostate biopsy?

    Directory of Open Access Journals (Sweden)

    Ashok Kumar

    2013-01-01

    Conclusions: PNB provides better pain control in TRUS-guided prostate biopsy but still there is need of additional analgesic in the form of tramadol or INB. Tramadol has advantage of oral intake and analgesic effect at time of probe insertion and at nerve block. Both tramadol and INB may be used in combination along with PNB.

  10. Hip hemiarthroplasty using major lower limb nerve blocks: A preliminary report of a case series

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    Ahmad Muhammad Taha

    2014-01-01

    Full Text Available Background: Major lower limb nerve blocks are relatively safe techniques. However, their efficacy for hip hemiarthroplasty is unknown. The objective of this study was to determine the effectiveness of combined femoral, sciatic, obturator and lateral femoral cutaneous (LFC nerve blocks in providing adequate anesthesia for hip hemiarthroplasty. Materials and Methods: A total of 20 patients with fracture neck femur; who underwent hip hemiarthroplasty, participated in this observational study. In the induction room, all patients received ultrasound-guided femoral, proximal obturator, LFC and parasacral sciatic nerve blocks in addition to local infiltration at the proximal site of the skin incision. Anesthesia was considered to be adequate only if the surgery was completed without any requirement for opioid administration. Results: All patients (100% [95% confidence interval, 86-100%] had adequate anesthesia. Seventeen patients (85% [95% confidence interval, 63-96%] had mild discomfort during the reduction of the prosthetic femur head back into the hip socket; however, no supplementary analgesics were required. Conclusion: The combined femoral, sciatic, obturator and LFC nerve blocks in addition to local infiltration at the proximal site of skin incision could provide adequate anesthesia for hip hemiarthroplasty. Light sedation before reduction of the prosthetic femur head back into the hip socket is advisable.

  11. High Flow Priapism in a Pediatric Patient after Circumcision with Dorsal Penile Nerve Block

    Science.gov (United States)

    Fantony, Joseph J.; Routh, Jonathan C.

    2016-01-01

    We report the first documented case of high flow priapism after circumcision with dorsal penile nerve block. A 7-year-old male who had undergone circumcision three years before presented to our institution with a 3-year history of persistent nonpainful erections. Workup revealed a high flow priapism and, after discussion of the management options, the patient's family elected continued observation. PMID:27648333

  12. Bis-enoxacin blocks rat alveolar bone resorption from experimental periodontitis.

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    Mercedes F Rivera

    Full Text Available Periodontal diseases are multifactorial, caused by polymicrobial subgingival pathogens, including Porphyromonas gingivalis, Treponema denticola, and Tannerella forsythia. Chronic periodontal infection results in inflammation, destruction of connective tissues, periodontal ligament, and alveolar bone resorption, and ultimately tooth loss. Enoxacin and a bisphosphonate derivative of enoxacin (bis-enoxacin inhibit osteoclast formation and bone resorption and also contain antibiotic properties. Our study proposes that enoxacin and/or bis-enoxacin may be useful in reducing alveolar bone resorption and possibly bacterial colonization. Rats were infected with 10(9 cells of polymicrobial inoculum consisting of P. gingivalis, T. denticola, and T. forsythia, as an oral lavage every other week for twelve weeks. Daily subcutaneous injections of enoxacin (5 mg/kg/day, bis-enoxacin (5, 25 mg/kg/day, alendronate (1, 10 mg/kg/day, or doxycycline (5 mg/day were administered after 6 weeks of polymicrobial infection. Periodontal disease parameters, including bacterial colonization/infection, immune response, inflammation, alveolar bone resorption, and systemic spread, were assessed post-euthanasia. All three periodontal pathogens colonized the rat oral cavity during polymicrobial infection. Polymicrobial infection induced an increase in total alveolar bone resorption, intrabony defects, and gingival inflammation. Treatment with bis-enoxacin significantly decreased alveolar bone resorption more effectively than either alendronate or doxycycline. Histologic examination revealed that treatment with bis-enoxacin and enoxacin reduced gingival inflammation and decreased apical migration of junctional epithelium. These data support the hypothesis that bis-enoxacin and enoxacin may be useful for the treatment of periodontal disease.

  13. Success rate of two different methods of ilioinguinal-iliohypogastric nerve block in children inguinal surgery

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    Mahin Seyedhejazi

    2013-01-01

    Full Text Available Background: The ilioinguinal-iliohypogastric (ILIH nerve block is a safe, effective, and easy to perform in order to provide analgesia for a variety of inguinal surgical procedures in pediatric patients. A relatively high failure rate of 10%-25% has been reported, even in experienced hands. It is assumed that this high failure rate of the ILIH nerve block in this age group could be due to lack of special knowledge of the anatomy of these nerves in infants and neonates. There are two main techniques for landmark-based ILIH nerve block with regard to determining the best insertion point. This study compared the sucess rate and outcomes of these two techniques in children undergoing surgery in inguinal region. Patients and Methods: In a double-blind randomized clinical trial, 120 children were candidated for surgery in inguinal region, and ILIH nerve block was recruited in Tabriz Children Teaching Hospital in a 12-month period. They were randomly clustered in two groups and underwent two different methods of ILIH nerve block. In the first group, needle was inserted in a point placed between outer 1/4 and inner 3/4 of a line connecting anterior-superior iliac spine to umbilicus (n = 58, and in the second group, this point was 1 cm medial and 1 cm superior to anterior-superior iliac spine. Block failure was defined as the need for analgesia during operation. Results: There were 50 males (86.2% and 8 females (13.8% with a mean age of 5.55 ± 2.32 (3-11 years in the first group and 48 males (87.3% and 7 females (12.7% with a mean age of 5.32 ± 2.18 (3-11 years in the second group (P > 0.05. The success rate of ILIH block was 94.8% in the first group and 94.5% in the second group with no significant difference between the two groups (P = 0.64. Changes of vital signs including heart rate, systolic blood pressure, and diastolic blood pressure, as well as the SPO2 were not significantly different between the two groups during the study period. Change of

  14. Excitation block in a nerve fibre model owing to potassium-dependent changes in myelin resistance

    DEFF Research Database (Denmark)

    Brazhe, Alexey; Maksimov, G. V.; Mosekilde, Erik;

    2011-01-01

    The myelinated nerve fibre is formed by an axon and Schwann cells or oligodendrocytes that sheath the axon by winding around it in tight myelin layers. Repetitive stimulation of a fibre is known to result in accumulation of extracellular potassium ions, especially between the axon and the myelin......-spiking states. Intermittent conduction blocks are accompanied by oscillations of extracellular potassium. The mechanism of conductance block based on myelin restructuring complements the already known and modelled block via hyperpolarization mediated by the axonal sodium pump and potassium depolarization....

  15. Ultrasound-guided ilioinguinal/iliohypogastric nerve blocks versus caudal block for postoperative analgesia in children undergoing unilateral groin surgery

    Directory of Open Access Journals (Sweden)

    Abualhassan A Abdellatif

    2012-01-01

    Full Text Available Context: Ultrasound (US guidance is strongly recommended when performing peripheral nerve blocks in infants and children. Aims: To assess whether US-guided ilioinguinal/iliohypogastric (II/IH nerve blocks with local anesthetic (LA would provide comparable postoperative analgesia to blind technique caudal block with LA following pediatric unilateral groin surgery. Secondary endpoints included analgesic consumption, parental satisfaction, and postoperative complications. Settings and Design: Prospective, crossover randomized controlled trial performed on children undergoing unilateral groin surgery. Methods: Fifty children aged 1-6 years scheduled for unilateral groin surgery were included in the study. After induction of general anesthesia and prior to surgical incision, patients were prospectively randomized into one of two groups: Group B received US-guided II/IH nerve blocks with 0.1 ml.kg−1 of 0.25% bupivacaine and Group C received a caudal blockade with 0.7 ml.kg−1 of 0.25% bupivacaine. Patients were assessed in the recovery room, the day-stay unit and for 24 h at home for pain score, analgesic consumption, and parental satisfaction. Statistical Analysis: Arithmetic mean and standard deviation values were calculated and statistical analyses were performed for each group. Independent sample t-test was used to compare continuous variables exhibiting normal distribution, and Chi-squared test or Fisher exact test for non-continuous variables. P0.05. The average time to first rescue analgesia was longer in group B 253±102.6 min as compared to 219.6±48.4 min in group C. In recovery room, four patients in group C required pain rescue medication compared to five patients in group B (P>0.05. Similarly eight patients in the group C and six patients in group B required pain rescue medication at day-stay unit or at home (P>0.05. Group C received 0.74 pain rescue medication doses (range 0-8, while group B received 0.65 pain rescue medication doses

  16. Comparison of peripheral nerve stimulator versus ultrasonography guided axillary block using multiple injection technique

    Directory of Open Access Journals (Sweden)

    Alok Kumar

    2014-01-01

    Full Text Available Background: The established methods of nerve location were based on either proper motor response on nerve stimulation (NS or ultrasound guidance. In this prospective, randomised, observer-blinded study, we compared ultrasound guidance with NS for axillary brachial plexus block using 0.5% bupivacaine with the multiple injection techniques. Methods : A total of 120 patients receiving axillary brachial plexus block with 0.5% bupivacaine, using a multiple injection technique, were randomly allocated to receive either NS (group NS, n = 60, or ultrasound guidance (group US, n = 60 for nerve location. A blinded observer recorded the onset of sensory and motor blocks, skin punctures, needle redirections, procedure-related pain and patient satisfaction. Results: The median (range number of skin punctures were 2 (2-4 in group US and 3 (2-5 in group NS (P =0.27. Insufficient block was observed in three patient (5% of group US and four patients (6.67% of group NS (P > =0.35. Patient acceptance was similarly good in the two groups. Conclusion: Multiple injection axillary blocks with ultrasound guidance provided similar success rates and comparable incidence of complications as compared with NS guidance with 20 ml 0.5% bupivacaine.

  17. Comparison of continuous femoral nerve block (CFNB/SA) and continuous femoral nerve block with mini-dose spinal morphine (CFNB/SAMO) for postoperative analgesia after total knee arthroplasty (TKA): a randomized controlled study

    OpenAIRE

    Sundarathiti, Petchara; Thammasakulsiri, Jadesadha; Supboon, Supawadee; Sakdanuwatwong, Supalak; Piangjai, Molruedee

    2016-01-01

    Background Unsatisfactory analgesia for major knee surgery with femoral nerve block (FNB) alone was reported and the additional benefit of sciatic block to continuous femoral nerve block (CFNB) was not conclusive. The aim of the present study was to find the benefit of the additional mini-dose spinal morphine (0.035 mg) to CFNB for postoperative pain control and to compare their associated side effects after total knee arthroplasty (TKA). Methods After written informed consent and with Instit...

  18. US-Guided Femoral and Sciatic Nerve Blocks for Analgesia During Endovenous Laser Ablation

    Energy Technology Data Exchange (ETDEWEB)

    Yilmaz, Saim, E-mail: ysaim@akdeniz.edu.tr; Ceken, Kagan; Alimoglu, Emel; Sindel, Timur [Akdeniz University School of Medicine, Department of Radiology (Turkey)

    2013-02-15

    Endovenous laser ablation may be associated with significant pain when performed under standard local tumescent anesthesia. The purpose of this study was to investigate the efficacy of femoral and sciatic nerve blocks for analgesia during endovenous ablation in patients with lower extremity venous insufficiency. During a 28-month period, ultrasound-guided femoral or sciatic nerve blocks were performed to provide analgesia during endovenous laser ablation in 506 legs and 307 patients. The femoral block (n = 402) was performed at the level of the inguinal ligament, and the sciatic block at the posterior midthigh (n = 124), by injecting a diluted lidocaine solution under ultrasound guidance. After the blocks, endovenous laser ablations and other treatments (phlebectomy or foam sclerotherapy) were performed in the standard fashion. After the procedures, a visual analogue pain scale (1-10) was used for pain assessment. After the blocks, pain scores were 0 or 1 (no pain) in 240 legs, 2 or 3 (uncomfortable) in 225 legs, and 4 or 5 (annoying) in 41 legs. Patients never experienced any pain higher than score 5. The statistical analysis revealed no significant difference between the pain scores of the right leg versus the left leg (p = 0.321) and between the pain scores after the femoral versus sciatic block (p = 0.7). Ultrasound-guided femoral and sciatic nerve blocks may provide considerable reduction of pain during endovenous laser and other treatments, such as ambulatory phlebectomy and foam sclerotherapy. They may make these procedures more comfortable for the patient and easier for the operator.

  19. The Role of Selective Nerve Root Block in the Treatment of Lumbar Radicular Leg Pain.

    Science.gov (United States)

    Jonayed, S A; Kamruzzaman, M; Saha, M K; Alam, S; Akter, S

    2016-01-01

    The objective of this retrospective study was to investigate the clinical effectiveness of nerve root blocks (i.e., periradicular injection of Lidocaine and triamcinolone) for lumbar monoradiculopathy in patients with a mild neurological deficit in National Institute of Traumatology & Orthopaedic Rehabilitation (NITOR), Dhaka, Bangladesh from March 2014 to December 2014. We Included 24 patients (32-74 years) with a minor sensory/motor deficit and an unequivocal MRI finding (18 disc herniations, 6 foraminal stenosis) treated with a selective nerve root block. Based on the clinical and imaging findings, surgery (decompression of the nerve root) was justifiable in all cases. Seventeen patients (87%) had rapid (1-4 days) and substantial regression of pain, four required a repeat injection. Sixty percent (60%) of the patients with disc herniation or foraminal stenosis had permanent resolution of pain, so that an operation was avoided over an average of 6 months (2-9 months) follow-up. Nerve root blocks are very effective in the non-operative treatment of minor monoradiculopathy and should be recommended as the initial treatment of choice for this condition. PMID:26931264

  20. Interventional multispectral photoacoustic imaging with a clinical linear array ultrasound probe for guiding nerve blocks

    Science.gov (United States)

    Xia, Wenfeng; West, Simeon J.; Nikitichev, Daniil I.; Ourselin, Sebastien; Beard, Paul C.; Desjardins, Adrien E.

    2016-03-01

    Accurate identification of tissue structures such as nerves and blood vessels is critically important for interventional procedures such as nerve blocks. Ultrasound imaging is widely used as a guidance modality to visualize anatomical structures in real-time. However, identification of nerves and small blood vessels can be very challenging, and accidental intra-neural or intra-vascular injections can result in significant complications. Multi-spectral photoacoustic imaging can provide high sensitivity and specificity for discriminating hemoglobin- and lipid-rich tissues. However, conventional surface-illumination-based photoacoustic systems suffer from limited sensitivity at large depths. In this study, for the first time, an interventional multispectral photoacoustic imaging (IMPA) system was used to image nerves in a swine model in vivo. Pulsed excitation light with wavelengths in the ranges of 750 - 900 nm and 1150 - 1300 nm was delivered inside the body through an optical fiber positioned within the cannula of an injection needle. Ultrasound waves were received at the tissue surface using a clinical linear array imaging probe. Co-registered B-mode ultrasound images were acquired using the same imaging probe. Nerve identification was performed using a combination of B-mode ultrasound imaging and electrical stimulation. Using a linear model, spectral-unmixing of the photoacoustic data was performed to provide image contrast for oxygenated and de-oxygenated hemoglobin, water and lipids. Good correspondence between a known nerve location and a lipid-rich region in the photoacoustic images was observed. The results indicate that IMPA is a promising modality for guiding nerve blocks and other interventional procedures. Challenges involved with clinical translation are discussed.

  1. Infection Related Inferior Alveolar Nerve Paresthesia in the Lower Premolar Teeth.

    Science.gov (United States)

    Censi, Rachele; Vavassori, Virna; Borgonovo, Andrea Enrico; Re, Dino

    2016-01-01

    Introduction. The aim of this paper was to describe two cases of IAN infection-induced paresthesia and to discuss the most appropriate treatment solutions. Methods. For two patients, periapical lesions that induced IAN paresthesia were revealed. In the first case, the tooth was previously endodontically treated, whereas in the second case the lesion was due to pulp necrosis. Results. For the first patient, a progressive healing was observed only after the tooth extraction. In the second patient, the paresthesia had resolved after endodontic treatment. Conclusions. The endodontic-related paresthesia is a rare complication that can be the result of a combination of etiopathogenic mechanisms such as mechanical pressure on the nerve fibers due to the expanding infectious process and the production of microbial toxins. Paresthesia resulting from periapical lesions usually subsides through elimination of infection by root canal treatment. However, if there are no signs of enhancement, the immediate extraction of the tooth is the treatment of choice in order to prevent irreversible paresthesia because it was demonstrated that there is a correlation between the duration of mechanical or chemical irritation and the risk of permanent paresthesia. PMID:27597904

  2. Infection Related Inferior Alveolar Nerve Paresthesia in the Lower Premolar Teeth

    Science.gov (United States)

    2016-01-01

    Introduction. The aim of this paper was to describe two cases of IAN infection-induced paresthesia and to discuss the most appropriate treatment solutions. Methods. For two patients, periapical lesions that induced IAN paresthesia were revealed. In the first case, the tooth was previously endodontically treated, whereas in the second case the lesion was due to pulp necrosis. Results. For the first patient, a progressive healing was observed only after the tooth extraction. In the second patient, the paresthesia had resolved after endodontic treatment. Conclusions. The endodontic-related paresthesia is a rare complication that can be the result of a combination of etiopathogenic mechanisms such as mechanical pressure on the nerve fibers due to the expanding infectious process and the production of microbial toxins. Paresthesia resulting from periapical lesions usually subsides through elimination of infection by root canal treatment. However, if there are no signs of enhancement, the immediate extraction of the tooth is the treatment of choice in order to prevent irreversible paresthesia because it was demonstrated that there is a correlation between the duration of mechanical or chemical irritation and the risk of permanent paresthesia. PMID:27597904

  3. The periodontal ligament (PDL) injection: an alternative to inferior alveolar nerve block.

    Science.gov (United States)

    Malamed, S F

    1982-02-01

    The periodontal ligament (PDL) injection for mandibular anesthesia in isolated regions was evaluated, using both a conventional syringe and two devices designed for this procedure. A high success rate was achieved, with a low incidence of adverse reaction and highly favorable comment from both patients and administrators. Duration of pulpal anesthesia following the technique described proved adequate for most dental procedures. The newer devices appear to have some advantage over the conventional syringe technique. However, the PDL injection technique can readily be used with any conventional syringe. Further study is recommended to determine the response of periodontal and pulpal tissues.

  4. The effect of minocycline on the masticatory movements following the inferior alveolar nerve transection in freely moving rats

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    Mostafeezur Rahman

    2012-04-01

    Full Text Available Abstract Background To determine the effects of inferior alveolar nerve transection (IAN-X on masticatory movements in freely moving rats and to test if microglial cells in the trigeminal principal sensory nucleus (prV or motor nucleus (motV may be involved in modulation of mastication, the effects of microglial cell inhibitor minocycline (MC on masticatory jaw movements, microglia (Iba1 immunohistochemistry and the masticatory jaw movements and related masticatory muscle EMG activities were studied in IAN-X rats. Results The number of Iba1-immunoreactive (IR cells both in prV and motV was significantly larger in IAN-X rats compared with sham rats on day 3 after IAN-X. The intraperitoneal (i.p. administration of MC caused a significant reduction of the number of Iba1-IR cells both in prV and motV that was evident on day 14 after IAN-X. Furthermore, a significant reduction of the number of Iba1-IR cells could be observed in motV but not in prV after microinjection (m.i. of MC into the motV of IAN-X rats. The rats also exhibited a significant decrease in the head-withdrawal threshold on the side ipsilateral to the IAN-X compared to the threshold before IAN-X and it lasted to day 14. In addition, IAN-X markedly affected the ability to rat to carry out mastication. The number of complete masticatory sequences was significantly decreased. Furthermore, the total masticatory sequence time and food preparatory (PP period duration was significantly elongated in compared to sham rats. Although IAN-X significantly affected the total number of chewing cycles within the RC period of a masticatory sequence, it had no effect on the duration of the chewing cycles. On the other hand, systemic administration of MC (both i.p. and m.i. in IAN-X rats significantly improved decreased head-withdrawal threshold and the impaired masticatory jaw movements. Conclusions The present findings reveal that the strong modulation of masticatory jaw movements occurs following

  5. Comparative Finite Element Analysis of Short Implants and Lateralization of the Inferior Alveolar Nerve With Different Prosthesis Heights.

    Science.gov (United States)

    Jayme, Sérgio J; Ramalho, Paulo R; De Franco, Leonardo; Jugdar, Ricardo Elias; Shibli, Jamil Awad; Vasco, Marco A A

    2015-11-01

    The lateralization of the inferior alveolar nerve (LIAN) and short implants are efficient options for rehabilitation of the posterior atrophic mandible. However, the loss of bone leads to prosthesis with greater height and lever effect that in turn can have different impact on treatments. Through the finite element method, the present study tests the hypothesis that conventional implants placed under LIAN and short implants have similar risk of bone loss regarding variable height of the crown and that crown-to-implant ratio is not a reliable resource to evaluate risk in these treatments. Computed tomography scans of mandibles were processed and implants and prosthetic components were reverse engineered for reconstruction of three-dimensional models to simulate 3 elements fixed partial dentures supported by 2 osseointegrated implants. The models of implants were based on MK III implants (Nobel Biocare, Zurich, Switzerland) with 4 mm in diameter by 7 mm in length representing short implants, and 15 mm in length representing implants used in LIAN. The implant/crown ratio for short implants was 1:1.5, 1:2, and 1:2.5 and LIAN models were modeled with exactly the same prosthesis, resulting in implant/crown ratios of 1:0.67, 1:0.89, and 1:1.12. The results partially rejected the hypothesis that LIAN and short implants have similar risk of bone loss, showing that although LIAN results were better in the models evaluated, the variations in height had proportionally similar impact on both treatments and accepted the hypothesis that crown-to-implant ratio was not a reliable resource to evaluate risk. PMID:26491923

  6. [Femoral nerve block as pain relief in hip fracture. A good alternative in perioperative treatment proved by a prospective study].

    Science.gov (United States)

    Kullenberg, Björn; Ysberg, Benita; Heilman, Martin; Resch, Sylvia

    2004-06-10

    Almost 25% of all patients with hip fracture experience temporary confusion pre- and directly postoperatively due to trauma, advanced age, transport between units, and the use of analgesics, 35-50% of the patients suffer temporary or chronic decubitus. Analgesics often lead to nausea. A femoral nerve block can interrupt sensory impulses from the hip joint and provide complete pain relief without affecting the CNS, thus making preoperative care easier and postoperative rehabilitation can be started earlier. 80 consecutive patients with hip fracture were randomized to femoral nerve block or pharmacological treatment only. Paracetamol and tramadol were the standard analgesics used. All patients were followed up with regard to pain, duration of the block, number of analgesics doses, temporary confusion and time for postoperative mobilization. Pain was estimated by the patients using the visual analogue scale (VAS). A nerve block was performed to block the femoral nerve, the lateral femoral cutaneous nerve and the obturator nerve with 30 ml of ropivacaine 7.5 mg/ml. Mental status was evaluated with Pfeiffer-test. All patients experienced relatively intense pain on admission with an average VAS of 6. After nerve block the VAS was 2. Pain relief was the same in the control group. Pain relief was sustained for 15 hours. The time for mobilization after surgery was significantly lower, 23 hours compared to 36 for the control group. There was a lower number of patients temporarily confused in the block group compared to the control group, however no significant differences were seen. Femoral nerve block provides adequate pain relief, equivalent to pharmacological treatment in most patients. The time for postoperative mobilization was shorter and less temporary confusion was seen. There were no complications in this group, making nerve block a good alternative to traditional pharmacological preoperative treatment for patients with hip fractures. PMID:15282985

  7. The spread of injectate during saphenous nerve block at the adductor canal

    DEFF Research Database (Denmark)

    Andersen, H L; Andersen, S L; Tranum-Jensen, J

    2015-01-01

    BACKGROUND: The spread of injectate during a saphenous nerve block at the adductor canal has not been clearly described. METHODS: We examined the spread of 15 ml dyed injectate during ultrasound-guided saphenous nerve blocks at the adductor canal in 15 unembalmed cadavers' lower limbs followed...... by comparative dissections of the same limbs. RESULTS: The spread of the injectates was determined by the fascial limits and the muscles surrounding the adductor canal. The anteromedial limit of the adductor canal (the roof) was found to be a continuous fascia, with a thin proximal part and a thicker distal part...... and reached 1-2 cm into the popliteal fossa. Injections superficial to the adductor canal spread over the femoral artery within the subsartorial fat compartment resembling the injections within the canal but with ultrasonographic distinct features. These injections spread only half the length of the adductor...

  8. Lumbar Plexus and Sciatic Nerve Blocks for Fixation of Proximal Femoral Fractures in patients with Multiple Co-Morbidities

    Directory of Open Access Journals (Sweden)

    T.V.S Gopal

    2014-06-01

    Full Text Available Anaesthesia management for proximal femoral fractures of high risk patients with debilitating systemic co-morbidities is a challenging task. It is generally done under the effect of regional anaesthesia or general anaesthesia (GA, with systemic analgesics for alleviation of pain after surgery. A combination of lumbar plexus and sciatic nerve blocks can provide anaesthesia and analgesia to the entire lower extremity including the hip. Analgesic potency of lumbar plexus and sciatic nerve blocks is similar to epidural analgesia for hip surgery without the undesirable side effects. We describe here two cases of proximal femoral fractures which were done under combined lumbar plexus and sciatic nerve block.

  9. Rami Communicans Nerve Block for the Treatment of Symptomatic Schmorl's Nodes -A Case Report-

    OpenAIRE

    Jang, Ji Su; Kwon, Hyung Ki; Lee, Jae Jun; Hwang, Sung Mi; Lim, So Young

    2010-01-01

    Histologically, Schmorl's nodes are defined as the loss of nuclear material through the cartilage plate, growth plate, and end plate into the vertebral body. Most Schmorl's nodes are asymptomatic, although there are some reports of symptomatic Schmorl's nodes, which should be treated similarly to vertebral compression fractures, with conservative treatment as the first choice. We report the case that we reduced the pain by blocking the ramus communicans nerve in a patient with Schmorl's node.

  10. Ultrasound-Guided Nerve Block with Botulinum Toxin Type A for Intractable Neuropathic Pain.

    Science.gov (United States)

    Moon, Young Eun; Choi, Jung Hyun; Park, Hue Jung; Park, Ji Hye; Kim, Ji Hyun

    2016-01-01

    Neuropathic pain includes postherpetic neuralgia (PHN), painful diabetic neuropathy (PDN), and trigeminal neuralgia, and so on. Although various drugs have been tried to treat neuropathic pain, the effectiveness of the drugs sometimes may be limited for chronic intractable neuropathic pain, especially when they cannot be used at an adequate dose, due to undesirable severe side effects and the underlying disease itself. Botulinum toxin type A (BoNT-A) has been known for its analgesic effect in various pain conditions. Nevertheless, there are no data of nerve block in PHN and PDN. Here, we report two patients successfully treated with ultrasound-guided peripheral nerve block using BoNT-A for intractable PHN and PDN. One patient had PHN on the left upper extremity and the other patient had PDN on a lower extremity. Due to side effects of drugs, escalation of the drug dose could not be made. We injected 50 Botox units (BOTOX(®), Allergan Inc., Irvine, CA, USA) into brachial plexus and lumbar plexus, respectively, under ultrasound. Their pain was significantly decreased for about 4-5 months. Ultrasound-guided nerve block with BoNT-A may be an effective analgesic modality in a chronic intractable neuropathic pain especially when conventional treatment failed to achieve adequate pain relief. PMID:26761032

  11. Ultrasound-Guided Nerve Block with Botulinum Toxin Type A for Intractable Neuropathic Pain

    Directory of Open Access Journals (Sweden)

    Young Eun Moon

    2016-01-01

    Full Text Available Neuropathic pain includes postherpetic neuralgia (PHN, painful diabetic neuropathy (PDN, and trigeminal neuralgia, and so on. Although various drugs have been tried to treat neuropathic pain, the effectiveness of the drugs sometimes may be limited for chronic intractable neuropathic pain, especially when they cannot be used at an adequate dose, due to undesirable severe side effects and the underlying disease itself. Botulinum toxin type A (BoNT-A has been known for its analgesic effect in various pain conditions. Nevertheless, there are no data of nerve block in PHN and PDN. Here, we report two patients successfully treated with ultrasound-guided peripheral nerve block using BoNT-A for intractable PHN and PDN. One patient had PHN on the left upper extremity and the other patient had PDN on a lower extremity. Due to side effects of drugs, escalation of the drug dose could not be made. We injected 50 Botox units (BOTOX®, Allergan Inc., Irvine, CA, USA into brachial plexus and lumbar plexus, respectively, under ultrasound. Their pain was significantly decreased for about 4–5 months. Ultrasound-guided nerve block with BoNT-A may be an effective analgesic modality in a chronic intractable neuropathic pain especially when conventional treatment failed to achieve adequate pain relief.

  12. Glossopharyngeal Nerve Block versus Lidocaine Spray to Improve Tolerance in Upper Gastrointestinal Endoscopy

    Directory of Open Access Journals (Sweden)

    Moisés Ortega Ramírez

    2013-01-01

    Full Text Available Aim of the Study. To compare the effect of glossopharyngeal nerve block with topical anesthesia on the tolerance of patients to upper gastrointestinal endoscopy. Methods. We performed a clinical trial in one hundred patients undergoing upper gastrointestinal endoscopy. Subjects were randomly assigned to one of the following two groups: (1 treatment with bilateral glossopharyngeal nerve block (GFNB and intravenous midazolam or (2 treatment with topical anesthetic (TASS and intravenous midazolam. We evaluated sedation, tolerance to the procedure, hemodynamic stability, and adverse symptoms. Results. We studied 46 men and 54 women, from 17 to 78 years of age. The procedure was reported without discomfort in 48 patients (88% in the GFNB group and 32 (64% in the TAAS group; 6 patients (12% in GFNB group and 18 (36% in TAAS group reported the procedure as little discomfort (χ2=3.95, P=0.04. There was no difference in frequency of nausea (4% in both groups and retching, 4% versus 8% for GFNB and TASS group, respectively (P=0.55. Conclusions. The use of glossopharyngeal nerve block provides greater comfort and tolerance to the patient undergoing upper gastrointestinal endoscopy. It also reduces the need for sedation.

  13. Conduction block of mammalian myelinated nerve by local cooling to 15-30°C after a brief heating.

    Science.gov (United States)

    Zhang, Zhaocun; Lyon, Timothy D; Kadow, Brian T; Shen, Bing; Wang, Jicheng; Lee, Andy; Kang, Audry; Roppolo, James R; de Groat, William C; Tai, Changfeng

    2016-03-01

    This study aimed at understanding thermal effects on nerve conduction and developing new methods to produce a reversible thermal block of axonal conduction in mammalian myelinated nerves. In 13 cats under α-chloralose anesthesia, conduction block of pudendal nerves (n = 20) by cooling (5-30°C) or heating (42-54°C) a small segment (9 mm) of the nerve was monitored by the urethral striated muscle contractions and increases in intraurethral pressure induced by intermittent (5 s on and 20 s off) electrical stimulation (50 Hz, 0.2 ms) of the nerve. Cold block was observed at 5-15°C while heat block occurred at 50-54°C. A complete cold block up to 10 min was fully reversible, but a complete heat block was only reversible when the heating duration was less than 1.3 ± 0.1 min. A brief (<1 min) reversible complete heat block at 50-54°C or 15 min of nonblock mild heating at 46-48°C significantly increased the cold block temperature to 15-30°C. The effect of heating on cold block fully reversed within ∼40 min. This study discovered a novel method to block mammalian myelinated nerves at 15-30°C, providing the possibility to develop an implantable device to block axonal conduction and treat many chronic disorders. The effect of heating on cold block is of considerable interest because it raises many basic scientific questions that may help reveal the mechanisms underlying cold or heat block of axonal conduction. PMID:26740534

  14. Nerve Blocks

    Science.gov (United States)

    ... Comment: E-mail: Area code: Phone no: Images × Image Gallery Radiologist and patient consultation. View full size with caption Related Articles and Media Computed Tomography (CT) - Body Radiation Dose in X-Ray and CT Exams ...

  15. Percutaneous sciatic nerve block with tramadol induces analgesia and motor blockade in two animal pain models

    Directory of Open Access Journals (Sweden)

    A.M. Sousa

    2012-02-01

    Full Text Available Local anesthetic efficacy of tramadol has been reported following intradermal application. Our aim was to investigate the effect of perineural tramadol as the sole analgesic in two pain models. Male Wistar rats (280-380 g; N = 5/group were used in these experiments. A neurostimulation-guided sciatic nerve block was performed and 2% lidocaine or tramadol (1.25 and 5 mg was perineurally injected in two different animal pain models. In the flinching behavior test, the number of flinches was evaluated and in the plantar incision model, mechanical and heat thresholds were measured. Motor effects of lidocaine and tramadol were quantified and a motor block score elaborated. Tramadol, 1.25 mg, completely blocked the first and reduced the second phase of the flinching behavior test. In the plantar incision model, tramadol (1.25 mg increased both paw withdrawal latency in response to radiant heat (8.3 ± 1.1, 12.7 ± 1.8, 8.4 ± 0.8, and 11.1 ± 3.3 s and mechanical threshold in response to von Frey filaments (459 ± 82.8, 447.5 ± 91.7, 320.1 ± 120, 126.43 ± 92.8 mN at 5, 15, 30, and 60 min, respectively. Sham block or contralateral sciatic nerve block did not differ from perineural saline injection throughout the study in either model. The effect of tramadol was not antagonized by intraperitoneal naloxone. High dose tramadol (5 mg blocked motor function as well as 2% lidocaine. In conclusion, tramadol blocks nociception and motor function in vivo similar to local anesthetics.

  16. Percutaneous sciatic nerve block with tramadol induces analgesia and motor blockade in two animal pain models

    Energy Technology Data Exchange (ETDEWEB)

    Sousa, A.M.; Ashmawi, H.A.; Costa, L.S.; Posso, I.P. [LIM-08 - Anestesiologia Experimental, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP (Brazil); Slullitel, A. [Departamento de Anestesiologia, Hospital Santa Paula, São Paulo, SP (Brazil)

    2011-12-23

    Local anesthetic efficacy of tramadol has been reported following intradermal application. Our aim was to investigate the effect of perineural tramadol as the sole analgesic in two pain models. Male Wistar rats (280-380 g; N = 5/group) were used in these experiments. A neurostimulation-guided sciatic nerve block was performed and 2% lidocaine or tramadol (1.25 and 5 mg) was perineurally injected in two different animal pain models. In the flinching behavior test, the number of flinches was evaluated and in the plantar incision model, mechanical and heat thresholds were measured. Motor effects of lidocaine and tramadol were quantified and a motor block score elaborated. Tramadol, 1.25 mg, completely blocked the first and reduced the second phase of the flinching behavior test. In the plantar incision model, tramadol (1.25 mg) increased both paw withdrawal latency in response to radiant heat (8.3 ± 1.1, 12.7 ± 1.8, 8.4 ± 0.8, and 11.1 ± 3.3 s) and mechanical threshold in response to von Frey filaments (459 ± 82.8, 447.5 ± 91.7, 320.1 ± 120, 126.43 ± 92.8 mN) at 5, 15, 30, and 60 min, respectively. Sham block or contralateral sciatic nerve block did not differ from perineural saline injection throughout the study in either model. The effect of tramadol was not antagonized by intraperitoneal naloxone. High dose tramadol (5 mg) blocked motor function as well as 2% lidocaine. In conclusion, tramadol blocks nociception and motor function in vivo similar to local anesthetics.

  17. Percutaneous sciatic nerve block with tramadol induces analgesia and motor blockade in two animal pain models

    International Nuclear Information System (INIS)

    Local anesthetic efficacy of tramadol has been reported following intradermal application. Our aim was to investigate the effect of perineural tramadol as the sole analgesic in two pain models. Male Wistar rats (280-380 g; N = 5/group) were used in these experiments. A neurostimulation-guided sciatic nerve block was performed and 2% lidocaine or tramadol (1.25 and 5 mg) was perineurally injected in two different animal pain models. In the flinching behavior test, the number of flinches was evaluated and in the plantar incision model, mechanical and heat thresholds were measured. Motor effects of lidocaine and tramadol were quantified and a motor block score elaborated. Tramadol, 1.25 mg, completely blocked the first and reduced the second phase of the flinching behavior test. In the plantar incision model, tramadol (1.25 mg) increased both paw withdrawal latency in response to radiant heat (8.3 ± 1.1, 12.7 ± 1.8, 8.4 ± 0.8, and 11.1 ± 3.3 s) and mechanical threshold in response to von Frey filaments (459 ± 82.8, 447.5 ± 91.7, 320.1 ± 120, 126.43 ± 92.8 mN) at 5, 15, 30, and 60 min, respectively. Sham block or contralateral sciatic nerve block did not differ from perineural saline injection throughout the study in either model. The effect of tramadol was not antagonized by intraperitoneal naloxone. High dose tramadol (5 mg) blocked motor function as well as 2% lidocaine. In conclusion, tramadol blocks nociception and motor function in vivo similar to local anesthetics

  18. Pulmonary alveolar proteinosis

    OpenAIRE

    Crestani, B; Epaud, R.; Aubier, M.; M-C. Dombret; Taille, C.; M-P. Debray; Danel, C.; R. Borie

    2011-01-01

    Pulmonary alveolar proteinosis (PAP) is a rare pulmonary disease characterised by alveolar accumulation of surfactant. It may result from mutations in surfactant proteins or granulocyte macrophage-colony stimulating factor (GM-CSF) receptor genes, it may be secondary to toxic inhalation or haematological disorders, or it may be auto-immune, with anti-GM-CSF antibodies blocking activation of alveolar macrophages. Auto-immune alveolar proteinosis is the most frequent form of PAP, representing 9...

  19. Nerve Stimulator Guided Axillary Block in Painless Reduction of Distal Radius Fractures; a Randomized Clinical Trial

    Directory of Open Access Journals (Sweden)

    Hossein Alimohammadi

    2013-12-01

    Full Text Available Introduction: Given the high prevalence of upper extremity fractures and increasing need to perform painless reduction in the emergency departments, the use of analgesic methods with fewer complications and more satisfaction appears to be essential. The aim of this study is comparison the nerve stimulator guided axillary block (NSAB with intravenous sedation in induction of analgesia for painless reduction of distal radius fractures. Methods: In the present randomized clinical trial, 60 patients (18-70 years of age suffered from distal radius fractures, were divided into two equal groups. One group received axillary nerve block by nerve stimulator guidance and the other procedural sedation and analgesia (PSA using midazolam/fentanyl. Onset of analgesia, duration of analgesic effect, total procedure time and pain scores were recorded using visual analogue scale (VAS and the outcomes were compared. Chi-squared and student t test were performed to evaluate differences between two groups. Results: Sixty patients were randomly divided into two groups (83.3% male. The mean age of patients was 31 ±0.7 years. While the onset of analgesia was significantly longer in the NSAB group, the mean total time of procedure was shorter than PSA (p<0.001. The NSAB group needed a shorter post-operative observation time (P<0.001. Both groups experienced equal pain relief before, during and after procedure (p>0.05. Conclusion: It seems that shorter post-operative monitoring time and consequently lesser total time of procedure, make nerve stimulator guided axillary block as an appropriate alternative for procedural sedation and analgesia in painless reduction of distal radius fractures in emergency department. 

  20. Long-term outcomes of the use of allogeneic, radiation-sterilised bone blocks in reconstruction of the atrophied alveolar ridge in the maxilla and mandible.

    Science.gov (United States)

    Krasny, Marta; Krasny, Kornel; Fiedor, Piotr; Zadurska, Małgorzata; Kamiński, Artur

    2015-12-01

    Increasingly dental surgeons face the challenge of reconstruction of the height and/or thickness of the alveolar ridge as more and more patients wish to have permanent restoration of their dental defects based on intraosseous implants. Evaluation of human allogeneic bone tissue grafts in reconstruction of atrophied alveolar ridge as a pre-implantation procedure. The material comprised 21 patients aged 19-63, treated between 2009 and 2012 by the same surgeon. Restoration of bone tissue defects was performed with allogeneic, frozen, radiation-sterilised, corticocancellous blocks. The study included 26 grafting procedures with 7 procedures consisting in reconstruction of the alveolar ridge in the mandible and 19 in the maxilla. In all the cases the atrophied alveolar ridge was successfully reconstructed, which allowed placement of intraosseous implants in compliance with the initial treatment plan. After the treatment was completed the patients reported for follow-up annually. The average time of follow-up amounted to 39 months (28-50 months). None of the implants was lost during the follow-up period. There was one case of gingival recession causing aesthetics deterioration of the prosthetic restoration. In three cases the connector became unscrewed partially, which was corrected at the same visit. Frozen, radiation-sterilised, allogeneic bone blocks constitute good and durable bone-replacement material allowing effective and long-lasting reconstruction of the atrophied alveolar ridge to support durable, implant-based, prosthetic restoration.

  1. Ultrasound-Guided Greater Occipital Nerve Blocks and Pulsed Radiofrequency Ablation for Diagnosis and Treatment of Occipital Neuralgia

    OpenAIRE

    VanderHoek, Matthew David; Hoang, Hieu T; Goff, Brandon

    2013-01-01

    Occipital neuralgia is a condition manifested by chronic occipital headaches and is thought to be caused by irritation or trauma to the greater occipital nerve (GON). Treatment for occipital neuralgia includes medications, nerve blocks, and pulsed radiofrequency ablation (PRFA). Landmark-guided GON blocks are the mainstay in both the diagnosis and treatment of occipital neuralgia. Ultrasound is being utilized more and more in the chronic pain clinic to guide needle advancement when performing...

  2. Fluoroscopically Guided Extraforaminal Cervical Nerve Root Blocks: Analysis of Epidural Flow of the Injectate with Respect to Needle Tip Position

    OpenAIRE

    Shipley, Kyle; Riew, K. Daniel; Gilula, Louis A.

    2013-01-01

    Study Design Retrospective evaluation of consecutively performed fluoroscopically guided cervical nerve root blocks. Objective To describe the incidence of injectate central epidural flow with respect to needle tip position during fluoroscopically guided extraforaminal cervical nerve root blocks (ECNRBs). Methods Between February 19, 2003 and June 11, 2003, 132 consecutive fluoroscopically guided ECNRBs performed with contrast media in the final injected material (injectate) were reviewed on ...

  3. Feasibility and safety of ultrasound-guided nerve block for management of limb injuries by emergency care physicians

    OpenAIRE

    Sanjeev Bhoi; Tej P Sinha; Mahaveer Rodha; Amit Bhasin; Radhakrishna Ramchandani; Sagar Galwankar

    2012-01-01

    Background: Patients require procedural sedation and analgesia (PSA) for the treatment of acute traumatic injuries. PSA has complications. Ultrasound (US) guided peripheral nerve block is a safe alternative. Aim: Ultrasound guided nerve blocks for management of traumatic limb emergencies in Emergency Department (ED). Setting and Design: Prospective observational study conducted in ED. Materials and Methods: Patients above five years requiring analgesia for management of limb emergencies were ...

  4. Ultrasound-Assisted Mental Nerve Block and Pulsed Radiofrequency Treatment for Intractable Postherpetic Neuralgia: Three Case Studies

    OpenAIRE

    Park, Hae Gyun; Park, Pyung Gul; Kim, Won Joong; Park, Yong Hee; Kang, Hyun; Baek, Chong Wha; Jung, Yong Hun; Woo, Young Cheol; Koo, Gill Hoi; Shin, Hwa Yong

    2013-01-01

    Postherpetic neuralgia (PHN) is one of the most difficult pain syndromes to treat. Invasive treatments may be considered when patients fail to obtain adequate pain relief from noninvasive treatment approaches. Here, we present three cases of PHN in the mandibular branch treated with ultrasound-assisted mental nerve block and pulsed radiofrequency treatment. None of the patients had adequate pain relief from the medical therapy, so we performed the mental nerve block on the affected side under...

  5. Ultrasound-guided bilateral greater occipital nerve block for the treatment of post-dural puncture headache

    OpenAIRE

    Akyol, Fethi; Binici, Orhan; Kuyrukluyildiz, Ufuk; Karabakan, Guldane

    2015-01-01

    Background and Objective: Post-dural puncture headache (PDPH) is one of the complications frequently observed after spinal or epidural anesthesia with dural penetration. For PDPH patients who do not respond to conservative medical treatment, alternative treatments such as bilateral occipital nerve block should be considered.In this study the efficacy of bilateral occipital nerve block was retrospectively evaluated in patients with post-dural puncture headache. Methods: Ultrasound-guided bilat...

  6. Evaluation of nitrous oxide inhalation sedation during inferior alveolar block administration in children aged 7-10 years: A randomized control trial

    Directory of Open Access Journals (Sweden)

    Deepti Takkar

    2015-01-01

    Full Text Available Background: Nitrous oxide-oxygen (N 2 O-O 2 is being used in combination with many drugs and this possess risk for leading to deep sedation or reflexes being compromised. Aim: The purpose of our study was to use N 2 O-O 2 alone, to evaluate its effectiveness for pain control during inferior alveolar nerve block administration in children. Design: This was a single-centered, simple randomized, double-blinded, placebo-controlled parallel-group study involving 40 children in the age group of 7-10 years divided into 2 groups: N 2 O-O 2 sedation and oxygen. Pain perception for local anesthesia was assessed using face, legs, activity, cry, consolability scale. Children′s behavior was assessed using Frankl ratings, depth of sedation using Observer′s Assessment of Alertness/Sedation scale. The vital signs and oxygen saturation were recorded. Results: There was a significantly lower pain reaction to local anesthetic administration in the N 2 O-O 2 group (P < 0.01. Improvement in the behavior of the children belonging to N 2 O-O 2 group during and after the procedure as compared to the O 2 group (P < 0.01 was also observed. All the vital signs recorded were in the normal physiologic limits in both the groups. Conclusion: Pain experienced by children receiving N 2 O-O 2 sedation was significantly lower. N 2 O-O 2 inhalation sedation produces adequate sedation with vital signs within normal limits and treatments successfully completed.

  7. Comparison of Transcutaneous Electrical Nerve Stimulation and Parasternal Block for Postoperative Pain Management after Cardiac Surgery

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    Nilgun Kavrut Ozturk

    2016-01-01

    Full Text Available Background. Parasternal block and transcutaneous electrical nerve stimulation (TENS have been demonstrated to produce effective analgesia and reduce postoperative opioid requirements in patients undergoing cardiac surgery. Objectives. To compare the effectiveness of TENS and parasternal block on early postoperative pain after cardiac surgery. Methods. One hundred twenty patients undergoing cardiac surgery were enrolled in the present randomized, controlled prospective study. Patients were assigned to three treatment groups: parasternal block, intermittent TENS application, or a control group. Results. Pain scores recorded 4 h, 5 h, 6 h, 7 h, and 8 h postoperatively were lower in the parasternal block group than in the TENS and control groups. Total morphine consumption was also lower in the parasternal block group than in the TENS and control groups. It was also significantly lower in the TENS group than in the control group. There were no statistical differences among the groups regarding the extubation time, rescue analgesic medication, length of intensive care unit stay, or length of hospital stay. Conclusions. Parasternal block was more effective than TENS in the management of early postoperative pain and the reduction of opioid requirements in patients who underwent cardiac surgery through median sternotomy. This trial is registered with Clinicaltrials.gov number NCT02725229.

  8. Correlation between radiographic signs of third molar proximity with inferior alveolar nerve and postoperative occurrence of neurosensory disorders: A prospective, double-blind study

    Directory of Open Access Journals (Sweden)

    Fábio Wildson Gurgel Costa

    2013-03-01

    Full Text Available PURPOSE: To evaluate the interference of radiographic factors in the appearance of sensory deficit related to inferior alveolar nerve (IAN after third molars (3Ms removal. METHODS: A prospective, double-blind, observational, unicentric study was performed with 126 patients submitted to a surgical procedure of lower 3Ms removal in the period from March to October/2011. Collected data included gender, age, eruption stage of 3Ms, position/angle of 3Ms (Pell-Gregory and Winter classifications, respectively, presence/absence of radiographic signs of 3Ms proximity with the inferior alveolar canal and surgical technique. Occurrence evaluation of the IAN injury was performed on the seventh postoperative day through pin-prick, two-point discrimination and brush directional stroke tests. RESULTS: Predominant radiographic signs were: narrowing of the inferior alveolar canal (68.25%, darkening of root (46.82% and diversion of the canal (31%. None of the patients presented sensory loss. Sixty-one (48.41% of the cases had at least one or two radiographic signs of proximity with NAI. Forty-seven (37.3% had 3 or more signs, and 18 (14.29% did not have any radiographic signs of proximity to mandibular canal. CONCLUSION: There was not a positive correlation between presence of radiographic signs of 3Ms with IAN proximity and postoperative neurosensory disorders occurrence.

  9. Feasibility and safety of ultrasound-guided nerve block for management of limb injuries by emergency care physicians

    Directory of Open Access Journals (Sweden)

    Sanjeev Bhoi

    2012-01-01

    Full Text Available Background: Patients require procedural sedation and analgesia (PSA for the treatment of acute traumatic injuries. PSA has complications. Ultrasound (US guided peripheral nerve block is a safe alternative. Aim: Ultrasound guided nerve blocks for management of traumatic limb emergencies in Emergency Department (ED. Setting and Design: Prospective observational study conducted in ED. Materials and Methods: Patients above five years requiring analgesia for management of limb emergencies were recruited. Emergency Physicians trained in US guided nerve blocks performed the procedure. Statistical analysis: Effectiveness of pain control, using visual analogue scale was assessed at baseline and at 15 and 60 minutes after the procedure. Paired t test was used for comparison. Results: Fifty US guided nerve blocks were sciatic- 4 (8%, femoral-7 (14%, brachial- 29 (58%, median -6 (12%, and radial 2 (4% nerves. No patients required rescue PSA. Initial median VAS score was 9 (Inter Quartile Range [IQR] 7-10 and at 1 hour was 2(IQR 0-4. Median reduction in VAS score was 7.44 (IQR 8-10(75%, 1-2(25% (P=0.0001. Median procedure time was 9 minutes (IQR 3, 12 minutes and median time to reduction of pain was 5 minutes (IQR 1,15 minutes. No immediate or late complications noticed at 3 months. Conclusion: Ultrasound-guided nerve blocks can be safely and effectively performed for upper and lower limb emergencies by emergency physicians with adequate training.

  10. Peripheral nerve blocks in patients with Ehlers-Danlos syndrome, hypermobility type: a report of 2 cases.

    Science.gov (United States)

    Patzkowski, Michael S

    2016-03-01

    Ehlers-Danlos syndrome is an inherited disorder of collagen production that results in multiorgan dysfunction. Patients with hypermobility type display skin hyperextensibility and joint laxity, which can result in chronic joint instability, dislocation, peripheral neuropathy, and severe musculoskeletal pain. A bleeding diathesis can be found in all subtypes of varying severity despite a normal coagulation profile. There have also been reports of resistance to local anesthetics in these patients. Several sources advise against the use of regional anesthesia in these patients citing the 2 previous features. There have been reports of successful neuraxial anesthesia, but few concerning peripheral nerve blocks, none of which describe nerves of the lower extremity. This report describes 2 cases of successful peripheral regional anesthesia in the lower extremity. In case 1, a 16-year-old adolescent girl with hypermobility type presented for osteochondral grafting of tibiotalar joint lesions. She underwent a popliteal sciatic (with continuous catheter) and femoral nerve block under ultrasound guidance. She proceeded to surgery and tolerated the procedure under regional block and intravenous sedation. She did not require any analgesics for the following 15 hours. In case 2, an 18-year-old woman with hypermobility type presented for medial patellofemoral ligament reconstruction for chronic patella instability. She underwent a saphenous nerve block above the knee with analgesia in the distribution of the saphenous nerve lasting for approximately 18 hours. There were no complications in either case. Prohibitions against peripheral nerve blocks in patients with Ehlers-Danlos syndrome, hypermobility type, appear unwarranted. PMID:26897449

  11. Effects of continuous peripheral nerve block by tetrodotoxin on growth associated protein-43 expression during neuropathic pain development

    Institute of Scientific and Technical Information of China (English)

    Chen Wang; Xiaoyu Huang

    2007-01-01

    BACKGROUND: Peripheral nerve injury may lead to neuropathic pain and cause a markedly increase expression of growth associated protein-43 (GAP-43) in the spinal cord and dorsal root ganglion, local anesthetics blocking electrical impulse propagation of nerve fibers may also affect the expression of GAP-43 in the spinal cord and dorsal root ganglion.OBJECTIVE: To determine the effects of continuous peripheral nerve block by tetrodotoxin before and after nerve injury on GAP-43 expression in the dorsal root ganglion during the development of neuropathic pain.DESIGN: A randomized controlled animal experiment.SETTINGS: Department of Anesthesiology, the Second Hospital of Xiamen City; Department of Anesthesiology, the Second Affiliated Hospital of Shantou University Medical College. MATERIALS: Thirty-five Sprague Dawley (SD) rats, weighing 200 - 250 g, were randomly divided into four groups: control group (n =5), simple sciatic nerve transection group (n =10), peripheral nerve block before and after sciatic nerve transection groups (n =10). All the sciatic nerve transection groups were divided into two subgroups according to the different postoperative survival periods: 3 and 7 days (n =5) respectively. Mouse anti-GAP-43 monoclonal antibody (Sigma Co., Ltd.), supervision TM anti-mouse reagent (HRP, Changdao antibody diagnosis reagent Co., Ltd., Shanghai), and HMIAS-100 image analysis system (Qianping Image Engineering Company, Tongji Medical University) were employed in this study. METHODS: This experiment was carried out hi the Department of Surgery and Pathological Laboratory, the Second Affiliated Hospital of Shantou University Medical College from April 2005 to April 2006.①The animals were anesthetized and the right sciatic nerve was exposed and transected at 1 cm distal to sciatic notch.②Tetrodotoxin 10 μg/kg was injected percutaneously between the greater trochanter and the posterior superior iliac spine of right hind limb to block the sciatic nerve proximally

  12. Supra-Clavicular Brachial Plexus Block: Ultra-Sonography Guided Technique Offer Advantage Over Peripheral Nerve Stimulator Guided Technique

    Directory of Open Access Journals (Sweden)

    Krutika B Rupera

    2013-06-01

    Conclusion: Ultrasonography guided supraclavicular brachial plexus block is quick to perform, offers improved safety and accuracy in identifying the position of the nerves to be blocked and of the structures. [Natl J Med Res 2013; 3(3.000: 241-244

  13. Ultrasound-guided continuous suprascapular nerve block for adhesive capsulitis: one case and a short topical review

    DEFF Research Database (Denmark)

    Neimann, Jens Dupont Børglum; Bartholdy, Anne; Hautopp, H;

    2011-01-01

    impact passive and guided active mobilization by the performing physiotherapist for three consecutive weeks. This case and a short topical review on the use of SSN block in painful shoulder conditions highlight the possibility of a USG continuous nerve block of the SSN as sufficient pain management......We present a case with an ultrasound-guided (USG) placement of a perineural catheter beneath the transverse scapular ligament in the scapular notch to provide a continuous block of the suprascapular nerve (SSN). The patient suffered from a severe and very painful adhesive capsulitis of the left...... shoulder secondary to an operation in the same shoulder conducted 20 weeks previously for impingement syndrome and a superior labral anterior-posterior tear. Following a new operation with capsular release, the placement of a continuous nerve block catheter subsequently allowed for nearly pain-free low...

  14. Optimal Effect of Phenol Block in the Sciatic Nerve of Rats: Standardization of Minimized Dosage and Duration of Application.

    Science.gov (United States)

    Lin, Chuan-Chao; Chang, Chein-Wei; Tsai, Su-Ju

    2015-08-31

    The phenol nerve block has been widely used in clinical practice for spasticity reduction, but the correlation between the dosage of phenol and its effectiveness has seldom been discussed. The objective was to determine the optimal duration of phenol in contact with the nervous tissue and to investigate the dose-response relationship of 5% aqueous phenol solution by percutaneous nerve block in rats. Group I (n = 8) received sciatic nerve block by bathing the nerves in phenol solution, and group II (n = 40) by injecting phenol percutaneously. Group IIa to IId received different volumes (0.80, 0.16, 0.08 and 0.04 ml) and group IIe received normal saline. Compound muscle action potential (CMAP) was measured pre-injection and at 90 and 270 sec after injection and after surgical exposure of the nerves. The duration of CMAP reduced by 10%, 25%, 50%, 75% and 100% after phenol injection was also recorded. The mean latency for the evoked response to subside in direct phenol application (group I) and percutaneous nerve block (group IIa) were 73.5 ± 5.9 and 62.4 ± 7.6 sec, respectively. There was no statistical difference for the time periods in the blocking effect elicited by phenol solution between these two methods. Ninety sec was set as the optimal duration for phenol to produce complete conduction blockage. Higher volume of phenol produced more significant blocking effect at 90 and 270 sec after injection. Percutaneous injection with 0.16 ml of phenol solution had the same blocking effect as 0.8 ml. The continuous injection model for percutaneous phenol block indeed used significantly more phenol than actually needed. Clinically, the progressive injection model can be used to minimize injection volume. PMID:26211647

  15. Essential oil of Croton zehntneri and its main constituent anethole block excitability of rat peripheral nerve.

    Science.gov (United States)

    da Silva-Alves, Kerly Shamyra; Ferreira-da-Silva, Francisco Walber; Coelho-de-Souza, Andrelina Noronha; Albuquerque, Aline Alice Cavalcante; do Vale, Otoni Cardoso; Leal-Cardoso, José Henrique

    2015-03-01

    Croton zehntneri is an aromatic plant native to Northeast Brazil and employed by local people to treat various diseases. The leaves of this plant have a rich content of essential oil. The essential oil of C. zehntneri samples, with anethole as the major constituent and anethole itself, have been reported to have several pharmacological activities such as antispasmodic, cardiovascular, and gastroprotective effects and inducing the blockade of neuromuscular transmission and antinociception. Since several works have demonstrated that essential oils and their constituents block cell excitability and in view of the multiple effects of C. zehntneri essential oil and anethole on biological tissues, we undertook this investigation aiming to characterize and compare the effects of this essential oil and its major constituent on nerve excitability. Sciatic nerves of Wistar rats were used. They were mounted in a moist chamber, and evoked compound action potentials were recorded. Nerves were exposed in vitro to the essential oil of C. zehntneri and anethole (0.1-1 mg/mL) up to 180 min, and alterations in excitability (rheobase and chronaxie) and conductibility (peak-to-peak amplitude and conduction velocity) parameters of the compound action potentials were evaluated. The essential oil of C. zehntneri and anethole blocked, in a concentration-dependent manner with similar pharmacological potencies (IC50: 0.32 ± 0.07 and 0.22 ± 0.11 mg/mL, respectively), rat sciatic nerve compound action potentials. Strength-duration curves for both agents were shifted upward and to the right compared to the control curve, and the rheobase and chronaxie were increased following essential oil and anethole exposure. The time courses of the essential oil of C. zehntneri and anethole effects on peak-to-peak amplitude of compound action potentials followed an exponential decay and reached a steady state. The essential oil of C. zehntneri and anethole caused a similar reduction in

  16. Essential oil of Croton zehntneri and its main constituent anethole block excitability of rat peripheral nerve.

    Science.gov (United States)

    da Silva-Alves, Kerly Shamyra; Ferreira-da-Silva, Francisco Walber; Coelho-de-Souza, Andrelina Noronha; Albuquerque, Aline Alice Cavalcante; do Vale, Otoni Cardoso; Leal-Cardoso, José Henrique

    2015-03-01

    Croton zehntneri is an aromatic plant native to Northeast Brazil and employed by local people to treat various diseases. The leaves of this plant have a rich content of essential oil. The essential oil of C. zehntneri samples, with anethole as the major constituent and anethole itself, have been reported to have several pharmacological activities such as antispasmodic, cardiovascular, and gastroprotective effects and inducing the blockade of neuromuscular transmission and antinociception. Since several works have demonstrated that essential oils and their constituents block cell excitability and in view of the multiple effects of C. zehntneri essential oil and anethole on biological tissues, we undertook this investigation aiming to characterize and compare the effects of this essential oil and its major constituent on nerve excitability. Sciatic nerves of Wistar rats were used. They were mounted in a moist chamber, and evoked compound action potentials were recorded. Nerves were exposed in vitro to the essential oil of C. zehntneri and anethole (0.1-1 mg/mL) up to 180 min, and alterations in excitability (rheobase and chronaxie) and conductibility (peak-to-peak amplitude and conduction velocity) parameters of the compound action potentials were evaluated. The essential oil of C. zehntneri and anethole blocked, in a concentration-dependent manner with similar pharmacological potencies (IC50: 0.32 ± 0.07 and 0.22 ± 0.11 mg/mL, respectively), rat sciatic nerve compound action potentials. Strength-duration curves for both agents were shifted upward and to the right compared to the control curve, and the rheobase and chronaxie were increased following essential oil and anethole exposure. The time courses of the essential oil of C. zehntneri and anethole effects on peak-to-peak amplitude of compound action potentials followed an exponential decay and reached a steady state. The essential oil of C. zehntneri and anethole caused a similar reduction in

  17. Long-term effect of ropivacaine nanoparticles for sciatic nerve block on postoperative pain in rats

    Directory of Open Access Journals (Sweden)

    Wang Z

    2016-05-01

    Full Text Available Zi Wang,1,* Haizhen Huang,2,* Shaozhong Yang,1 Shanshan Huang,1 Jingxuan Guo,1 Qi Tang,1 Feng Qi1 1Department of Anesthesiology, Qilu Hospital of Shandong University, 2Department of Anesthesiology, Stomatology Hospital of Shandong University, Jinan, Shandong, People’s Republic of China *These authors contributed equally to this work Purpose: The analgesic effect of ropivacaine (Rop for nerve block lasts only ~3–6 hours for single use. The aim of this study was to develop long-acting regional anesthetic Rop nanoparticles and investigate the effects of sciatic nerve block on postoperative pain in rats.Materials and methods: Rop nanoparticles were developed using polyethylene glycol-co-polylactic acid (PELA. One hundred and twenty adult male Wistar rats were randomly divided into four groups (n=30, each: Con (control group; 0.9% saline, 200 µL, PELA (PELA group; 10 mg, Rop (Rop group; 0.5%, 200 µL, and Rop-PELA (Rop-PELA group; 10%, 10 mg. Another 12 rats were used for the detection of Rop concentration in plasma. The mechanical withdrawal threshold and thermal withdrawal latency were measured at 2 hours, 4 hours, 8 hours, 1 day, 2 days, 3 days, 5 days, and 7 days after incision. The expression of c-FOS was determined by immunohistochemistry at 2 hours, 8 hours, 48 hours, and 7 days. Nerve and organ toxicities were also evaluated at 7 days.Results: The duration of Rop absorption in the plasma of the Rop-PELA group was longer (>8 hours than that of the Rop group (4 hours. Mechanical withdrawal threshold and thermal withdrawal latency in the Rop-PELA group were higher than that in other groups (4 hours–3 days. c-FOS expression in the Rop-PELA group was lower than that in the control group at 2 hours, 8 hours, and 48 hours and lower than that in the Rop group at 8 hours and 48 hours after paw incision. Slight foreign body reactions were observed surrounding the sciatic nerve at 7 days. No obvious pathophysiological

  18. ULTRASOUND GUIDED ILIOINGUINAL AND ILIOHYPOGASTRIC NERVE BLOCK FOR INGUINAL HERNIA REPAIR IN ARTHROGRYPOSIS MULTIPLEX CONGENITA

    Directory of Open Access Journals (Sweden)

    Paul O.

    2015-06-01

    Full Text Available Arthrogryposis multiplex congenita (AMC refers to a syndrome of unknown etiology with multiple congenital contractures in one or more joints with a concomitant inability of passive extension and flexion . The overall prevalence of arthrogryposis is one in 3000 live births . The extensive contractures , tense skin , minimal muscle mass and subcutaneous tissue pose challenges in anaesthetic management. We report a seven year old boy (15 kg , known case of AMC with congenital talipes equino varus (CTEV and bilateral hip dislocation posted for right sided herniot omy and orchidopexy. We planned to combine general anaesthesia without muscle relaxants and regional nerve block. The child was induced with propofol and Classic LMA Size 2 was inserted. An ilioinguinal and i liohypogastric nerve block was given under ultrasound guidance using 0.2% ropivacaine. Pateint remained hemodynamically stable during surgery with minimal anaesthetic requirement and no anlgesics. Analgesia lasted for 8 hours postoperatively. Combining narcosis with regional anaesthesia leads to a reduced demand for anaesthetics , stable circulatory conditions , maintenance of spontaneous breathing , prevention of stress and sufficient postoperative analgesia

  19. 下牙槽神经损伤的原因及防治%Causes and prevention of inferior alveolar nerve injury

    Institute of Scientific and Technical Information of China (English)

    张宗敏; 胡开进; 周宏志

    2014-01-01

    下颌智齿拔除术是口腔外科最常见的手术,由拔除智齿引起的术后并发症也比较多见,其中,下牙槽神经(inferior alveolar nerve)损伤是比较严重的并发症之一.了解下牙槽神经的解剖特点、术前准确的评估以及合适的手术方法可有效预防这一并发症的产生.当发生下牙槽神经损伤时,临床诊断和治疗方法的选择也会影响到后期的恢复.

  20. Low cost continuous femoral nerve block for relief of acute severe cancer related pain due to pathological fracture femur

    Directory of Open Access Journals (Sweden)

    Rachel Cherian Koshy

    2010-01-01

    Full Text Available Pathological fractures in cancer patient cause severe pain that is difficult to control pharmacologically. Even with good pain relief at rest, breakthrough and incident pain can be unmanageable. Continuous regional nerve blocks have a definite role in controlling such intractable pain. We describe two such cases where severe pain was adequately relieved in the acute phase. Continuous femoral nerve block was used as an efficient, cheap and safe method of pain relief for two of our patients with pathological fracture femur. This method was proved to be quite efficient in decreasing the fracture-related pain and improving the level of well being.

  1. Study of the anatomical position of the femoral nerve by magnetic resonance imaging in patients with fractured neck of femur: relevance to femoral nerve block.

    LENUS (Irish Health Repository)

    Mehmood, Shehzad

    2012-01-31

    STUDY OBJECTIVE: To determine the anatomical location of the femoral nerve in patients who have sustained fracture of the neck of femur, and its relevance to femoral nerve block technique. DESIGN: Prospective, observational clinical study. SETTING: Orthopedic and Radiology departments of a regional hospital. SUBJECTS: 10 consecutive adult ASA physical status II and III patients (mean age, 78.5 yrs) and 4 adult healthy volunteers. INTERVENTIONS: A T1 magnetic resonance imaging scan was performed of both upper thighs in patients and healthy volunteers successfully. MEASUREMENTS: The distance (mm) between the midpoint of the femoral artery and the midpoint of the femoral nerve, and the distance of the femoral nerve from the skin was measured at the mid-inguinal ligament, the pubic tubercle, and at the mid-inguinal crease. Data are shown as means (SD). Differences between both sides were compared using paired Student\\'s t-tests. P < 0.05 was significant. MAIN RESULTS: In patients the mean distance (mm) between the midpoint of the femoral nerve from the midpoint of femoral artery at the mid-inguinal crease on the fractured and non-fractured sides was 10.7 and 11.0, respectively (P = 0.87). The mean distance (mm) between the midpoint of the femoral nerve from the midpoint of the femoral artery at the mid-inguinal ligament on the fractured and non-fractured sides was 9.64 and 12.5, respectively (P = 0.03). The mean distance (mm) between the midpoint of the femoral nerve from the midpoint of the femoral artery at the pubic tubercle on the fractured and non-fractured sides was 8.74 and 10.49, respectively (P = 0.18). CONCLUSIONS: Blockade of the femoral nerve may be easier to perform at the mid-inguinal crease in patients with fractured neck of femur.

  2. Heightened motor and sensory (mirror-touch) referral induced by nerve block or topical anesthetic.

    Science.gov (United States)

    Case, Laura K; Gosavi, Radhika; Ramachandran, Vilayanur S

    2013-08-01

    Mirror neurons allow us to covertly simulate the sensation and movement of others. If mirror neurons are sensory and motor neurons, why do we not actually feel this simulation- like "mirror-touch synesthetes"? Might afferent sensation normally inhibit mirror representations from reaching consciousness? We and others have reported heightened sensory referral to phantom limbs and temporarily anesthetized arms. These patients, however, had experienced illness or injury of the deafferented limb. In the current study we observe heightened sensory and motor referral to the face after unilateral nerve block for routine dental procedures. We also obtain double-blind, quantitative evidence of heightened sensory referral in healthy participants completing a mirror-touch confusion task after topical anesthetic cream is applied. We suggest that sensory and motor feedback exist in dynamic equilibrium with mirror representations; as feedback is reduced, the brain draws more upon visual information to determine- perhaps in a Bayesian manner- what to feel.

  3. Paravertebral Nerve Block for Donor Site Pain in Stage I Microtia Reconstruction: A Pilot Study.

    Science.gov (United States)

    Shaffer, Amber D; Jabbour, Noel; Visoiu, Mihaela; Yang, Charles I; Yellon, Robert F

    2016-05-01

    Acute Interventional Perioperative Pain Service consultants have routinely placed paravertebral nerve block (PVB) catheters for the continuous release of ropivacaine following stage I microtia reconstruction with costal cartilage graft at our institution since 2010. A retrospective chart review from July 2006 was performed to compare the length of hospital stay, median pain score (0-10 scale), and opioid use of patients receiving PVB with those of historical controls. Statistical analysis included t, Mann-Whitney U, and Fisher's exact tests. A total of 15 stage I microtia surgeries were included, 10 with PVB and 5 without. Patients with and without PVB had high peak pain scores (8.4 vs 7.8), remained in the hospital for 3.5 and 3.8 days, and consumed 0.69 and 0.36 mg/kg morphine equivalents, respectively. These findings highlight the feasibility of PVB, but larger studies are needed to optimize pain relief in this population. PMID:26908556

  4. EFFECT OF BUPRENORPHINE ON POST OPERATIVE ANALGESI A IN SUPRACLAVICULAR BRACHIAL PLEXUS BLOCK USING PERIPHE RAL NERVE LOCATOR

    OpenAIRE

    Ritesh; De, Vivek; Gayatri.V

    2013-01-01

    ABSTRACT : Supraclavicular brachial plexus block is known for its simplicity, effectiveness, safety, reliability and being economical for day ca re and emergency surgery, circumventing problems of full stomach. In our randomized prospective, double blind study, t otal 60 adult ASA class I and II patients undergoing upper limb surgeri es were given supraclavicular brachial plexus block with peripheral nerve locator and studied for effect of addition of buprenor...

  5. The use of piezoelectric surgery to lateralize the inferior alveolar nerve with simultaneous implant placement and immediate buccal cortical bone repositioning: a prospective clinical study.

    Science.gov (United States)

    de Vicente, J C; Peña, I; Braña, P; Hernández-Vallejo, G

    2016-07-01

    A prospective study was conducted to assess a variation of inferior alveolar nerve (IAN) lateralization. This study included 13 patients. An osteotomy was made with a piezoelectric device, and the IAN bundle was moved buccally. Dental implants were then inserted medial to the nerve bundle, and the inner surface of the buccal cortical bone plate was shaped to reduce its thickness. Finally, the bone plate was repositioned to restore the original shape and contour of the mandible. Neurosensory examinations of the lower lip and chin were performed using three tests: light touch, pain, and two-point discrimination. Three months after surgery, the function of the IAN was judged to be completely restored at 11 of the 13 surgical sites. Differences in the tests comparing the operated and non-operated sides were not significant. No implants were lost, and all patients were satisfied with the result. Although IAN lateralization in conjunction with dental implant placement is rarely indicated, the use of a piezoelectric device to perform a buccal osteotomy with final repositioning of the buccal cortical plate over the bony defect contributes to the recovery of the contour and shape of the mandible, without impairment of IAN function. PMID:26897328

  6. Essential Oil of Ocimum basilicum L. and (-)-Linalool Blocks the Excitability of Rat Sciatic Nerve.

    Science.gov (United States)

    Medeiros Venancio, Antonio; Ferreira-da-Silva, Francisco Walber; da Silva-Alves, Kerly Shamyra; de Carvalho Pimentel, Hugo; Macêdo Lima, Matheus; Fraga de Santana, Michele; Barreto Alves, Péricles; Batista da Silva, Givanildo; Leal-Cardoso, José Henrique; Marchioro, Murilo

    2016-01-01

    The racemate linalool and its levogyrus enantiomer [(-)-LIN] are present in many essential oils and possess several pharmacological activities, such as antinociceptive and anti-inflammatory. In this work, the effects of essential oil obtained from the cultivation of the Ocimum basilicum L. (EOOb) derived from Germplasm Bank rich in (-)-LIN content in the excitability of peripheral nervous system were studied. We used rat sciatic nerve to investigate the EOOb and (-)-LIN effects on neuron excitability and the extracellular recording technique was used to register the compound action potential (CAP). EOOb and (-)-LIN blocked the CAP in a concentration-dependent way and these effects were reversible after washout. EOOb blocked positive amplitude of 1st and 2nd CAP components with IC50 of 0.38 ± 0.2 and 0.17 ± 0.0 mg/mL, respectively. For (-)-LIN, these values were 0.23 ± 0.0 and 0.13 ± 0.0 mg/mL. Both components reduced the conduction velocity of CAP and the 2nd component seems to be more affected than the 1st component. In conclusion EOOb and (-)-LIN inhibited the excitability of peripheral nervous system in a similar way and potency, revealing that the effects of EOOb on excitability are due to the presence of (-)-LIN in the essential oil.

  7. CT-guided obturator nerve block for diagnosis and treatment of painful conditions of the hip

    Energy Technology Data Exchange (ETDEWEB)

    Heywang-Koebrunner, S.H.; Amaya, B.; Pickuth, D.; Spielmann, R.P. [Dept. of Diagnostic Radiology, Martin-Luther University Halle-Wittenberg (Germany); Okoniewski, M. [Dept. of Orthopaedics, Martin-Luther University Halle-Wittenberg (Germany)

    2001-06-01

    Obturator nerve blocks (ONB) have been performed by anaesthesiologists mainly to eliminate the obturator reflex during transurethral resections. An effect on hip pain has also been described. However, being a time-consuming and operator-dependent procedure if performed manually, it has not been widely used for chronic hip pain. The purpose of this pilot study was to check whether CT guidance could improve reproducibility of the block (= immediate effect) and to test its potential value for treatment of chronic hip pain. Fifteen chronically ill patients with osteoarthritis underwent a single ONB. Sixteen millilitres of Lidocaine 1 % mixed with 2 ml Iopramide was injected into the obturator canal. The patients were followed up to 9 months after the intervention. With a single injection pain relief was achieved for 1-8 weeks in 7 of 15 patients. Excellent pain relief for 3-11 months was achieved in another 4 patients. Reasons for a mid-term or even long-term effect based on a single injection of local anaesthetic are not exactly known. The CT-guided ONB is a fast, easy and safe procedure that may be useful for mid-term (weeks) and sometimes even long-term (months) treatment of hip pain. (orig.)

  8. Essential Oil of Ocimum basilicum L. and (-)-Linalool Blocks the Excitability of Rat Sciatic Nerve.

    Science.gov (United States)

    Medeiros Venancio, Antonio; Ferreira-da-Silva, Francisco Walber; da Silva-Alves, Kerly Shamyra; de Carvalho Pimentel, Hugo; Macêdo Lima, Matheus; Fraga de Santana, Michele; Barreto Alves, Péricles; Batista da Silva, Givanildo; Leal-Cardoso, José Henrique; Marchioro, Murilo

    2016-01-01

    The racemate linalool and its levogyrus enantiomer [(-)-LIN] are present in many essential oils and possess several pharmacological activities, such as antinociceptive and anti-inflammatory. In this work, the effects of essential oil obtained from the cultivation of the Ocimum basilicum L. (EOOb) derived from Germplasm Bank rich in (-)-LIN content in the excitability of peripheral nervous system were studied. We used rat sciatic nerve to investigate the EOOb and (-)-LIN effects on neuron excitability and the extracellular recording technique was used to register the compound action potential (CAP). EOOb and (-)-LIN blocked the CAP in a concentration-dependent way and these effects were reversible after washout. EOOb blocked positive amplitude of 1st and 2nd CAP components with IC50 of 0.38 ± 0.2 and 0.17 ± 0.0 mg/mL, respectively. For (-)-LIN, these values were 0.23 ± 0.0 and 0.13 ± 0.0 mg/mL. Both components reduced the conduction velocity of CAP and the 2nd component seems to be more affected than the 1st component. In conclusion EOOb and (-)-LIN inhibited the excitability of peripheral nervous system in a similar way and potency, revealing that the effects of EOOb on excitability are due to the presence of (-)-LIN in the essential oil. PMID:27446227

  9. Perioperative pain control after total knee arthroplasty: An evidence based review of the role of peripheral nerve blocks.

    Science.gov (United States)

    Danninger, Thomas; Opperer, Mathias; Memtsoudis, Stavros G

    2014-07-18

    Over the last decades, the number of total knee arthroplasty procedures performed in the United States has been increasing dramatically. This very successful intervention, however, is associated with significant postoperative pain, and adequate postoperative analgesia is mandatory in order to allow for successful rehabilitation and recovery. The use of regional anesthesia and peripheral nerve blocks has facilitated and improved this goal. Many different approaches and techniques for peripheral nerve blockades, either landmark or, more recently, ultrasound guided have been described over the last decades. This includes but is not restricted to techniques discussed in this review. The introduction of ultrasound has improved many approaches to peripheral nerves either in success rate and/or time to block. Moreover, ultrasound has enhanced the safety of peripheral nerve blocks due to immediate needle visualization and as consequence needle guidance during the block. In contrast to patient controlled analgesia using opioids, patients with a regional anesthetic technique suffer from fewer adverse events and show higher patient satisfaction; this is important as hospital rankings and advertisement have become more common worldwide and many patients use these factors in order to choose a certain institution for a specific procedure. This review provides a short overview of currently used regional anesthetic and analgesic techniques focusing on related implications, considerations and outcomes.

  10. Intra-articular versus intravenous magnesium-sulfate as adjuvant to femoral nerve block in arthroscopic knee sur

    Directory of Open Access Journals (Sweden)

    Mohamed Abdulatif

    2015-07-01

    Conclusion: The combined use of femoral nerve block with IA or IV MgSO4 is associated with significant reduction of the intensity and duration of postoperative pain and postoperative analgesic requirements in patients undergoing arthroscopic knee surgery with the IA MgSO4 being superior to IV route of administration.

  11. Ultrasound guidance for brachial plexus block decreases the incidence of complete hemi-diaphragmatic paresis or vascular punctures and improves success rate of brachial plexus nerve block compared with peripheral nerve stimulator in adults

    Institute of Scientific and Technical Information of China (English)

    YUAN Jia-min; YANG Xiao-hu; FU Shu-kun; YUAN Chao-qun; CHEN Kai; LI Jia-yi; LI Quan

    2012-01-01

    Background The use of traditional techniques (such as landmark techniques,paresthesia and peripheral nerve stimulator) for upper-limb anesthesia has often been restricted to the expert or enthusiast,which was blind.Recently,ultrasound (US) has been applied to differ blood vessel,pleura and nerve,thus may reduce the risk of complications while have a high rate of success.The aim of this study was to determine if the use of ultrasound guidance (vs.peripheral nerve stimulator,(PNS)) decreases risk of vascular puncture,risk of hemi-diaphragmatic paresis and risk of Horner syndrome and improves the success rate of nerve block.Methods A search strategy was developed to identify randomized control trials (RCTs) reporting on complications of US and PNS guidance for upper-extremity peripheral nerve blocks (brachial plexus) in adults available through PubMed databases,the Cochrane Central Register of Controlled Trials,Embase databases,SinoMed databases and Wanfang data (date up to 2011-12-20).Two independent reviewers appraised eligible studies and extracted data.Risk ratios (OR)were calculated for each outcome and presented with 95% confidence intervals (CI) with the software of ReviewManager 5.1.0 System (Cochrane Library).Results Sixteen trials involving 1321 adults met our criteria were included for analysis.Blocks performed using US guidance were more likely to be successful (risk ratio (RR) for block success 0.36,95% CI 0.23-0.56,P <0.00001),decreased incidence of vascular puncture during block performance (RR 0.13,95% CI 0.06-0.27,P <0.00001),decreased the risk of complete hemi-diaphragmatic paresis (RR 0.09,95% CI 0.03-0.52,,P=0.0001).Conclusions US decreases risks of complete hemi-diaphragmatic paresis or vascular puncture and improves success rate of brachial plexus nerve block compared with techniques that utilize PNS for nerve localization.Larger studies are needed to determine whether or not the use of US can decrease risk of neurologic complications.

  12. Factors that are associated with injury to the inferior alveolar nerve in high-risk patients after removal of third molars.

    Science.gov (United States)

    Selvi, Firat; Dodson, Thomas B; Nattestad, Anders; Robertson, Kevin; Tolstunov, Len

    2013-12-01

    Our aim was to answer the question: "Among patients at high risk of injury to the inferior alveolar nerve (IAN) after removal of 3rd molars, what factors are associated with postoperative neurosensory deficits?" We organized a retrospective, two-center study and enrolled a group of subjects who were at increased risk of injury to the IAN after removal of 3rd molars because radiographic findings indicated a risk on panoramic radiography that was high enough to warrant preoperative computed tomography (CT). The primary outcome variable was postoperative injury to the IAN. We used descriptive, bivariate, and multivariate analyses to assess the significance of differences, and probabilities of less than 0.05 were accepted as significant. We studied 149 subjects who had 235 3rd molars removed. Their mean (SD) age was 31 (11) years and 25/235 (11%) of 3rd molars were associated with injury to the IAN. In the multiple logistic regression model, increasing age (odds ratio (OR) 1.05, 95% CI 1.01-1.1, p=0.04), female sex (OR 5.3, 95% CI 1.6-16.9, p=0.005), and the size (mm) of the cortical perforation in the inferior alveolar canal (IAC) viewed on the coronal CT cut (OR 1.3; 95% CI 1.0-1.6, p=0.03) were associated with an increased risk of postoperative injury to the IAN. Age, sex, and the size of the perforation in the IAC on the coronal CT were associated with an increased risk of injury to the IAN. These findings may help to guide recommendations for treatment of patients at high risk of injury to the IAN during removal of 3rd molars. PMID:24012054

  13. Management of low back pain with facet joint injections and nerve root blocks under computed tomography guidance. A prospective study

    International Nuclear Information System (INIS)

    The aim of this work was to assess the performance of facet joint and nerve root infiltrations under computed tomography guidance for the management of low back pain and to investigate the complications and patient tolerance. The study was board-certified and informed consent was obtained from all patients. In 1 year, 86 consecutive patients (47 male, 39 female, age range 47-87 years, mean age 63) with low back pain for more than 2 years were included. All patients were clinically examined and had cross-sectional imaging performed before the procedure. Fifty-five facet joint infiltrations and 31 nerve blocks were performed under computed tomography guidance. All patients completed two valid pain questionnaires before and 3 months after the procedures. At the same time, they were clinically examined by the referring Orthopaedic Surgeon. The pain response was assessed by comparing the scores of the questionnaires. The improvement in clinical examination findings was assessed as well. In patients who underwent facet joint infiltrations, long-term pain improvement was achieved in 79% and in those with nerve blocks in 85%. Immediate pain relief was demonstrated in 83% of patients with nerve infiltrations. No complications were observed. All procedures were very well tolerated by patients. Facet joint and nerve infiltrations under computed tomography guidance constitute an accurate and safe method that could be used to relieve low back pain and minimize the risk of disability. (orig.)

  14. Management of low back pain with facet joint injections and nerve root blocks under computed tomography guidance. A prospective study

    Energy Technology Data Exchange (ETDEWEB)

    Fotiadou, Anastasia; Wojcik, Andrew; Shaju, Antony [Hinchingbrooke Hospital NHS Trust, Huntingdon, Cambridge (United Kingdom)

    2012-09-15

    The aim of this work was to assess the performance of facet joint and nerve root infiltrations under computed tomography guidance for the management of low back pain and to investigate the complications and patient tolerance. The study was board-certified and informed consent was obtained from all patients. In 1 year, 86 consecutive patients (47 male, 39 female, age range 47-87 years, mean age 63) with low back pain for more than 2 years were included. All patients were clinically examined and had cross-sectional imaging performed before the procedure. Fifty-five facet joint infiltrations and 31 nerve blocks were performed under computed tomography guidance. All patients completed two valid pain questionnaires before and 3 months after the procedures. At the same time, they were clinically examined by the referring Orthopaedic Surgeon. The pain response was assessed by comparing the scores of the questionnaires. The improvement in clinical examination findings was assessed as well. In patients who underwent facet joint infiltrations, long-term pain improvement was achieved in 79% and in those with nerve blocks in 85%. Immediate pain relief was demonstrated in 83% of patients with nerve infiltrations. No complications were observed. All procedures were very well tolerated by patients. Facet joint and nerve infiltrations under computed tomography guidance constitute an accurate and safe method that could be used to relieve low back pain and minimize the risk of disability. (orig.)

  15. Comparative evaluation of femoral nerve block and intravenous fentanyl for positioning during spinal anaesthesia in surgery of femur fracture

    Directory of Open Access Journals (Sweden)

    Ashok Jadon

    2014-01-01

    Full Text Available Background: Spinal anaesthesia is the preferred technique to fix fracture of the femur. Extreme pain does not allow ideal positioning for this procedure. Intravenous fentanyl and femoral nerve block are commonly used techniques to reduce the pain during position for spinal anaesthesia however; results are conflicting regarding superiority of femoral nerve block over intravenous fentanyl. Aims: We conducted this study to compare the analgesic effect provided by femoral nerve block (FNB and intra- venous (IV fentanyl prior to positioning for central neuraxial block in patients undergoing surgery for femur fracture. Patients and Methods: In this randomized prospective study 60 patients scheduled for fracture femur operation under spinal were included. Patients were distributed in two groups through computer generated random numbers table; Femoral nerve block group (FNB and Intravenous fentanyl group (FENT. In FNB group patients received FNB guided by a peripheral nerve stimulator (Stimuplex; B Braun, Melsungen, AG 5 minutes prior to positioning. 20mL, 1.5% lidocaine with adrenaline (1:200,000 was injected incrementally after a negative aspiration test. Patients in the fentanyl group received injection fentanyl 1 μg/kg IV 5 mins prior to positioning. Spinal block was performed and pain scores before and during positioning were recorded. Statistical analysis was done with Sigmaplot version-10 computer software. Student t-test was applied to compare the means and P < 0.05 was taken as significant. Results: VAS during positioning in group FNB: 0.57 ± 0.31 versus FENT 2.53 ± 1.61 (P = 0.0020. Time to perform spinal anesthesia in group FNB: 15.33 ± 1.64 min versus FENT 19.56 ± 3.09 min (P = 0.000049. Quality of patient positioning for spinal anesthesia in group FNB 2.67± 0.606 versus FENT 1.967 ± 0.85 (P = 0.000027. Patient acceptance was less in group FENT (P = 0.000031. Conclusion: Femoral nerve block provides better analgesia, patient

  16. A comparison between acute pressure block of the sciatic nerve and acupressure: methodology, analgesia, and mechanism involved

    Directory of Open Access Journals (Sweden)

    Luo D

    2013-07-01

    Full Text Available Danping Luo,1,2 Xiaolin Wang,1 Jiman He1,31Pain Medicine Program, Nanfang Hospital, Southern Medical University, Guangzhou, People's Republic of China; 2The First Affiliated Hospital of Guangdong College of Pharmacy, Guangzhou, People's Republic of China; 3Department of Medicine, Brown University, Providence, RI, USAAbstract: Acupressure is an alternative medicine methodology that originated in ancient China. Treatment effects are achieved by stimulating acupuncture points using acute pressure. Acute pressure block of the sciatic nerve is a newly reported analgesic method based on a current neuroscience concept: stimulation of the peripheral nerves increases the pain threshold. Both methods use pressure as an intervention method. Herein, we compare the methodology and mechanism of these two methods, which exhibit several similarities and differences. Acupressure entails variation in the duration of manipulation, and the analgesic effect achieved can be short- or long-term. The acute effect attained with acupressure presents a scope that is very different from that of the chronic effect attained after long-term treatment. This acute effect appears to have some similarities to that achieved with acute pressure block of the sciatic nerve, both in methodology and mechanism. More evidence is needed to determine whether there is a relationship between the two methods.Keywords: acupressure, acute pressure block, sciatic nerve, pain

  17. Bilateral Infraorbital Nerve Block Versus Intravenous Pentazocine: A Comparative Study on Post-operative Pain Relief Following Cleft Lip Surgery

    Science.gov (United States)

    Grewal, Gurpreeti; Grewal, Anju

    2015-01-01

    Background and Objectives Infra orbital nerve block is utilized for postoperative pain control in children undergoing cleft lip repair. This study was conducted to compare the effectiveness, advantages and disadvantages of infra orbital nerve block and opioids for postoperative pain relief following cheiloplasty. Materials and Methods Sixty paediatric patients aged 3 months – 13 years undergoing cheiloplasty were selected by simple random sampling and were divided into two groups. All the children received standardized premedication with midazolam, were operated upon under general anaesthesia and the block was performed at the end of surgery before reversal. Group B patients were administered bilateral infra orbital nerve block with 0.25% Bupivacaine (upto 2 mg/kg). Group O patients received Pentazocine 0.5 mg / kg IV. Postoperatively, the heart rate and respiratory rates were recorded every 15 minutes for the first 60 minutes, half hourly till 4 hours and then at 12 and 24 hours. Behavioural assessment for pain / discomfort was done at intervals of ½, 1, 2, 3, 4, 12 and 24 hours. Need for supplementary analgesics and duration between the administration of block/opioid and the first dose of supplementary analgesics were noted. Side effects such as nausea and vomiting, pruritus, respiratory depression and bradycardia during each of these periods were noted. Results Both the groups were comparable for age, sex, weight and operative time with no statistical difference. The mean duration of analgesia for infra orbital nerve block was 357.5 minutes i.e. 5 hours 58 minutes and that for opioid was 231 minutes i.e. 3 hours 51 minutes which was significantly lower than the hours of analgesia provided by the block. Further, at the 4th hour, 76.6% of the patients in Group O required supplementary analgesics, in contrast to only 16.6% in Group B. The incidence of nausea and vomiting and pruritus was also higher in Group O. Conclusion The results indicate that bilateral

  18. Ultrasound-guided continuous suprascapular nerve block for adhesive capsulitis: one case and a short topical review.

    Science.gov (United States)

    Børglum, J; Bartholdy, A; Hautopp, H; Krogsgaard, M R; Jensen, K

    2011-02-01

    We present a case with an ultrasound-guided (USG) placement of a perineural catheter beneath the transverse scapular ligament in the scapular notch to provide a continuous block of the suprascapular nerve (SSN). The patient suffered from a severe and very painful adhesive capsulitis of the left shoulder secondary to an operation in the same shoulder conducted 20 weeks previously for impingement syndrome and a superior labral anterior-posterior tear. Following a new operation with capsular release, the placement of a continuous nerve block catheter subsequently allowed for nearly pain-free low impact passive and guided active mobilization by the performing physiotherapist for three consecutive weeks. This case and a short topical review on the use of SSN block in painful shoulder conditions highlight the possibility of a USG continuous nerve block of the SSN as sufficient pain management in the immediate post-operative period following capsular release of the shoulder. Findings in other painful shoulder conditions and suggestions for future studies are discussed in the text. PMID:21226866

  19. Systematic review of the incidence of inferior alveolar nerve injury in bilateral sagittal split osteotomy and the assessment of neurosensory disturbances.

    Science.gov (United States)

    Agbaje, J O; Salem, A S; Lambrichts, I; Jacobs, R; Politis, C

    2015-04-01

    Extreme variation in the reported incidence of inferior alveolar nerve (IAN) disturbances suggests that neurosensory disturbances after orthognathic surgery have not been evaluated adequately. Here we review the reported incidence of IAN injury after orthognathic surgery and assess recently reported methods for evaluating sensory disturbances. A search was conducted of the English-language scientific literature published between 1 January 1990 and 31 December 2013 using the Limo KU Leuven search platform. Information on various aspects of assessing IAN injury was extracted from 61 reports. In 16 reports (26%), the incidence of injury was not indicated. Preoperative IAN status was not assessed in 22 reports (36%). The IAN assessor was described in detail in 21 reports (34%), while information on the training of the assessors was mentioned in only two reports (3%). Subjective evaluation was the most common method for assessing neurosensory deficit. We conclude that the observed wide variation in the reported incidence of IAN injury is due to a lack of standardized assessment procedures and reporting. Thus, an international consensus meeting on this subject is needed in order to establish a standard-of-care method. PMID:25496848

  20. The effect of a platelet-rich fibrin conduit on neurosensory recovery following inferior alveolar nerve lateralization: a preliminary clinical study.

    Science.gov (United States)

    Khojasteh, A; Hosseinpour, S; Nazeman, P; Dehghan, M M

    2016-10-01

    This retrospective study aimed to assess the recovery of neurosensory dysfunction following modified inferior alveolar nerve (IAN) lateralization surgery compared to the conventional approach. Data from two groups of patients who underwent IAN lateralization in 2014 were included in this study. In one group, platelet-rich fibrin was placed over the IAN and this was protected with a collagen membrane conduit; the other group underwent the conventional IAN lateralization procedure. Implants were placed immediately. Neurosensory dysfunction was evaluated at 3, 6, and 12 months post-surgery. Demographic, neurosensory disturbance (NSD), subjective two-point discrimination test (TPD), and static light touch test (SLT) data were obtained. Twenty-three IAN lateralization procedures with the placement of 51 implants were performed in 14 patients. At the 6-month follow-up, the number of patients experiencing normal sensation was greater in the modified surgery group, but the 12-month follow-up results were the same in the two groups. More precise sensation was observed with the TPD in the modified group at 6 months, and the modified group demonstrated better SLT scores at 6 months. Although the two groups had comparable results at the 12-month follow-up, it was observed that the modified technique accelerated neural healing within 6 months and reduced the length of the discomfort period.

  1. Nerve block plus manual management in the treatment of occipital neuralgia%神经阻滞加手法治疗枕神经痛112例

    Institute of Scientific and Technical Information of China (English)

    胡伟民; 张坤全

    2002-01-01

    Objective To investigate management approaches and therapeutic effect of occipital neuralgia.Method 112 patients were randomly divided into 2 groups,study group and control group,each having 10 patients.Study group received nerve block plus manual management.Control group received manual management alone.Result 3~ 6 months follow up was performed.Results showed cure rate of study group was higher compared with control group(P< 0.05).Numbers of nerve block in study group was less than control group(P< 0.01). Conclusion Nerve block plus manual management is effective in treating occipital neuralgia.

  2. Pectoralis Minor Nerve Block versus Thoracic Epidural and Paravertebral Block in Perioperative Pain Control of Breast Surgery - Mini Review

    Directory of Open Access Journals (Sweden)

    Rafik Sedra

    2015-03-01

    Full Text Available Pectoralis minor blocks are still relatively new and require further evaluation, but may have a place in peri-operative pain management for the appropriate cases. Still considered as less invasive procedure in comparison to thoracic epidurals and para-vertebral blocks. Complications of thoracic epidural and para-vertebral blocks like spinal cord injury and pneumothorax makes many anaesthetists interested in practising pectoralis minor block guided by ultrasound. Blanco first introduced the pectoralis minor block in 2011, he did study on 50 patients within 2 years. Results were very promising, all patients did not need any opiates but only paracetamol and non-steroidal anti-inflammatory (NSAID drugs got used.

  3. Ultrasound-guided block of the suprascapular nerve - a volunteer study of a new proximal approach

    DEFF Research Database (Denmark)

    Rothe, C; Steen-Hansen, C; Lund, J;

    2014-01-01

    the suprascapular nerve in a more superficial and proximal location. METHODS: Twelve healthy volunteers were included. We located the brachial plexus in transverse section with ultrasound, and by longitudinal slide, we identified the departure of the suprascapular nerve from the superior trunk. The suprascapular...

  4. Perineural Dexamethasone to Improve Postoperative Analgesia with Peripheral Nerve Blocks: A Meta-Analysis of Randomized Controlled Trials

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    Gildasio S. De Oliveira

    2014-01-01

    Full Text Available Background. The overall effect of perineural dexamethasone on postoperative analgesia outcomes has yet to be quantified. The main objective of this quantitative review was to evaluate the effect of perineural dexamethasone as a nerve block adjunct on postoperative analgesia outcomes. Methods. A systematic search was performed to identify randomized controlled trials that evaluated the effects of perineural dexamethasone as a block adjunct on postoperative pain outcomes in patients receiving regional anesthesia. Meta-analysis was performed using a random-effect model. Results. Nine randomized trials with 760 subjects were included. The weighted mean difference (99% CI of the combined effects favored perineural dexamethasone over control for analgesia duration, 473 (264 to 682 minutes, and motor block duration, 500 (154 to 846 minutes. Postoperative opioid consumption was also reduced in the perineural dexamethasone group compared to control, −8.5 (−12.3 to −4.6 mg of IV morphine equivalents. No significant neurological symptoms could have been attributed to the use of perineural dexamethasone. Conclusions. Perineural dexamethasone improves postoperative pain outcomes when given as an adjunct to brachial plexus blocks. There were no reports of persistent nerve injury attributed to perineural administration of the drug.

  5. Efficacy of arthroscopically placed pain catheter adjacent to the suprascapular nerve (continuous arthroscopically assisted suprascapular nerve block following arthroscopic rotator-cuff repair

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    Yamakado K

    2014-05-01

    Full Text Available Kotaro YamakadoDepartment of Orthopaedics, Fukui General Hospital, Fukui, JapanBackground: Rotator-cuff surgery is well recognized to be a painful procedure.Objectives: The purpose of this study was to examine the effectiveness of an arthroscopically placed perineural catheter at the scapular notch to provide a continuous block of the suprascapular nerve (continuous arthroscopically assisted suprascapular nerve block [ca-SSNB] following arthroscopic rotator-cuff repair (ARCR.Materials and methods: This level II, prospective, randomized, controlled trial without postoperative blinding included 40 patients, who had a 48-hour pain pump, with 0.2% ropivacaine infusion and a continuous rate of 3 mL/hour, placed via an arthroscopically placed catheter following ARCR with arthroscopic release of the superior transverse ligament: 21 patients had a ca-SSNB, and 19 patients had a continuous subacromial bursal block (SAB. The visual analog scale (at 6 hours and on the first, second, and third postoperative days and the total number of additional pain-reduction attempts during the 3 postoperative days were calculated.Results: The respective visual analog scale scores (mm obtained from the ca-SSNB and SAB groups were 62.4 and 67.6 (P=0.73 before surgery, 9.1 and 19.4 (P=0.12 at 6 hours after surgery, 24.4 and 44.6 (P=0.019 on the first postoperative day, 19.4 and 40.4 (P=0.0060 on the second postoperative day, and 18.5 and 27.8 (P=0.21 on the third postoperative day. Total additional pain-reduction attempts recorded for the ca-SSNB and SAB groups during the 3 postoperative days were 0.3 times and 1.2 times (P=0.0020, respectively.Conclusion: ca-SSNB was highly effective in controlling postoperative pain after ARCR.Keywords: shoulder, rotator cuff tear, postoperative pain control, continuous suprascapular nerve block, arthroscopic rotator cuff repair

  6. Adenovirus Vectors Block Human Immunodeficiency Virus–1 Replication in Human Alveolar Macrophages by Inhibition of the Long Terminal Repeat

    OpenAIRE

    Kaner, Robert J.; Santiago, Francisco; Rahaghi, Franck; Michaels, Elizabeth; Moore, John P.; Crystal, Ronald G.

    2009-01-01

    Heterologous viruses may transactivate or suppress human immunodeficiency virus (HIV)–1 replication. An adenovirus type 5 gene transfer vector (Ad5) HIV-1 vaccine was recently evaluated in a clinical trial, without efficacy. In this context, it is relevant to ask what effect Ad vectors have on HIV-1 replication, particularly in cells that are part of the innate immune system. Infection of HIV-1–infected human alveolar macrophages (AMs) obtained from HIV-1+ individuals with an Ad vector contai...

  7. Combination of diagnostic medial calcaneal nerve block followed by pulsed radiofrequency for plantar fascitis pain: A new modality

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    Deepak Thapa

    2014-01-01

    Full Text Available Plantar fasciitis (PF is the most common cause of chronic heel pain which may be bilateral in 20 to 30% of patients. It is a very painful and disabling condition which can affect the quality of life. The management includes both pharmacological and operative procedures with no single proven effective treatment modality. In the present case series, we managed three patients with PF (one with bilateral PF. Following a diagnostic medial calcaneal nerve (MCN block at its origin, we observed reduction in verbal numerical rating scale (VNRS in all the three patients. Two patients has relapse of PF pain which was managed with MCN block followed with pulsed radio frequency (PRF. All the patients were pain-free at the time of reporting. This case series highlights the possible role of combination of diagnostic MCN block near its origin followed with PRF as a new modality in management of patients with PF.

  8. Combination of diagnostic medial calcaneal nerve block followed by pulsed radiofrequency for plantar fascitis pain: A new modality.

    Science.gov (United States)

    Thapa, Deepak; Ahuja, Vanita

    2014-03-01

    Plantar fasciitis (PF) is the most common cause of chronic heel pain which may be bilateral in 20 to 30% of patients. It is a very painful and disabling condition which can affect the quality of life. The management includes both pharmacological and operative procedures with no single proven effective treatment modality. In the present case series, we managed three patients with PF (one with bilateral PF). Following a diagnostic medial calcaneal nerve (MCN) block at its origin, we observed reduction in verbal numerical rating scale (VNRS) in all the three patients. Two patients has relapse of PF pain which was managed with MCN block followed with pulsed radio frequency (PRF). All the patients were pain-free at the time of reporting. This case series highlights the possible role of combination of diagnostic MCN block near its origin followed with PRF as a new modality in management of patients with PF.

  9. Angiogenesis and bone regeneration of porous nano-hydroxyapatite/coralline blocks coated with rhVEGF165 in critical-size alveolar bone defects in vivo.

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    Du, Bing; Liu, Weizhen; Deng, Yue; Li, Shaobing; Liu, Xiangning; Gao, Yan; Zhou, Lei

    2015-01-01

    To improve the regenerative performance of nano-hydroxyapatite/coralline (nHA/coral) block grafting in a canine mandibular critical-size defect model, nHA/coral blocks were coated with recombinant human vascular endothelial growth factor(165) (rhVEGF) via physical adsorption (3 μg rhVEGF165 per nHA/coral block). After the nHA/coral blocks and VEGF/nHA/coral blocks were randomly implanted into the mandibular box-shaped defects in a split-mouth design, the healing process was evaluated by histological observation and histomorphometric and immunohistological analyses. The histological evaluations revealed the ingrowth of newly formed blood vessels and bone at the periphery and cores of the blocks in both groups at both 3 and 8 weeks postsurgery, respectively. In the histomorphometric analysis, the VEGF/nHA/coral group exhibited a larger quantity of new bone formation at 3 and 8 weeks postsurgery. The percentages of newly formed bone within the entire blocks in the VEGF/nHA/coral group were 27.3% ± 8.1% and 39.3% ± 12.8% at 3 weeks and 8 weeks, respectively, and these values were slightly greater than those of the nHA/coral group (21.7% ± 3.0% and 32.6% ± 10.3%, respectively), but the differences were not significant (P>0.05). The immunohistological evaluations revealed that the neovascular density in the VEGF/nHA/coral group (146 ± 32.9 vessel/mm(2)) was much greater than that in the nHA/coral group (105 ± 51.8 vessel/mm(2)) at the 3-week time point (P0.05). The present study indicated that nHA/coral blocks might be optimal scaffolds for block grafting in critical-size mandibular defects and that additional VEGF coating via physical adsorption can promote angiogenesis in the early stage of bone healing, which suggests that prevascularized nHA/coral blocks have significant potential as a bioactive material for bone regeneration in large-scale alveolar defects. PMID:25848271

  10. The Safety of EXPAREL ® (Bupivacaine Liposome Injectable Suspension Administered by Peripheral Nerve Block in Rabbits and Dogs

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    Brigitte M. Richard

    2012-01-01

    Full Text Available A sustained-release DepoFoam injection formulation of bupivacaine (EXPAREL, 15 mg/mL is currently being investigated for postsurgical analgesia via peripheral nerve block (PNB. Single-dose toxicology studies of EXPAREL (9, 18, and 30 mg/kg, bupivacaine solution (Bsol, 9 mg/kg, and saline injected around the brachial plexus nerve bundle were performed in rabbits and dogs. The endpoints included clinical pathology, pharmacokinetics, and histopathology evaluation on Day 3 and Day 15 (2/sex/group/period. EXPAREL resulted in a nearly 4-fold lower Cmax versus Bsol at the same dose. EXPAREL was well tolerated at doses up to 30 mg/kg. The only EXPAREL-related effect seen was minimal to mild granulomatous inflammation of adipose tissue around nerve roots (8 of 24 rabbits and 7 of 24 dogs in the brachial plexus sites. The results indicate that EXPAREL was well tolerated in these models and did not produce nerve damage after PNB in rabbits and dogs.

  11. Comparative outcomes of peripheral nerve blocks versus general anesthesia for hip fractures in geriatric Chinese patients

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    Liu JL

    2014-05-01

    Full Text Available Jun Le Liu,1,* Xiao Lin Wang,1,* Mao Wei Gong,1,* Hai Xing Mai,2 Shu Jun Pei,1 Wei Xiu Yuan,1 Hong Zhang11Anesthesia and Operation Center, Chinese People’s Liberation Army General Hospital and Medical School of Chinese People’s Liberation Army, Beijing, People’s Republic of China; 2Department of Urology, Affiliated Hospital of Academy of Military Medical Sciences, Beijing, People’s Republic of China*These authors contributed equally to this workBackground: Geriatric patients undergoing hemiarthroplasty for hip fractures have unacceptably high rates of postoperative complications and mortality. Whether anesthesia type can affect the outcomes has still been inconclusive.Objectives: We compared general anesthesia (GA and peripheral nerve blocks (PNBs on postoperative complications and mortality in elderly patients with femoral neck fractures (FNF undergoing hemiarthroplasty.Materials and methods: This retrospective study involved data collection from an electronic database. Two hundred and seventeen patients underwent hemiarthroplasty for FNF between January 2008 and December 2012 at the Chinese People’s Liberation Army General Hospital. Data on mortality within in-hospital, 30-day, and 1-year, complications, comorbidities, blood loss and transfusion, operative time, postoperative hospital length of stay, intensive care unit admission, and hospital charge were collected and analyzed. Univariate and multivariate Cox regression analyses of all variables were used for 30-day and 1-year mortality.Results: Seventy-two patients receiving GA and 145 receiving PNBs were eventually submitted and analyzed. Mortality was 6.9%, 14.7%, and 23.5% at in-hospital, 30-day, and 1-year, respectively postoperatively, while mortality and cardiovascular complications did not differ between the two anesthetic techniques. Preoperative comorbidities and intraoperative parameters were not statistically different except that patients receiving GA were more likely

  12. Effect of Adductor Canal Block Versus Femoral Nerve Block on Quadriceps Strength, Mobilization, and Pain After Total Knee Arthroplasty

    DEFF Research Database (Denmark)

    Grevstad, Jens Ulrik; Mathiesen, Ole; Valentiner, Laura Risted Staun;

    2015-01-01

    BACKGROUND AND OBJECTIVES: Total knee arthroplasty (TKA) is often associated with severe pain. Different regional anesthetic techniques exist, all with varying degrees of motor blockade. We hypothesized that pain relief provided by the adductor canal block (ACB) could increase functional muscle s...

  13. Subdural spread of injected local anesthetic in a selective transforaminal cervical nerve root block: a case report

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    Tofuku Katsuhiro

    2012-06-01

    Full Text Available Abstract Introduction Although uncommon, selective cervical nerve root blocks can have serious complications. The most serious complications that have been reported include cerebral infarction, spinal cord infarction, transient quadriplegia and death. Case presentation A 40-year-old Japanese woman with a history of severe right-sided cervical radicular pain was scheduled to undergo a right-sided C6 selective cervical nerve root block using a transforaminal approach under fluoroscopic guidance. An anterior oblique view of the C5-C6 intervertebral foramen was obtained, and a 23-gauge spinal needle, connected to the normal extension tube with a syringe filled with contrast medium, was introduced into the posterior-caudal aspect of the C5-C6 intervertebral foramen on the right side. In the anteroposterior view, the placement of the needle was considered satisfactory when it was placed no more medial than halfway across the width of the articular pillar. Although the spread of the contrast medium along the C6 nerve root was observed with right-sided C6 radiculography, the subdural flow of the contrast medium was not observed with real-time fluoroscopy. The extension tube used for the radiculography was removed from the spinal needle and a normal extension tube with a syringe filled with lidocaine connected in its place. We performed a negative aspiration test and then injected 1.5 mL of 1.0% lidocaine slowly around the C6 nerve root. Immediately after the injection of the local anesthetic, our patient developed acute flaccid paralysis, complained of breathing difficulties and became unresponsive; her respiratory pattern was uncoordinated. After 20 minutes, she regained consciousness and became alert, and her muscle strength in all four limbs returned to normal without any sensory deficits after receiving emergent cardiorespiratory support. Conclusions We believe that confirming maintenance of the appropriate needle position in the anteroposterior

  14. Are Modic changes related to outcomes in lumbar disc herniation patients treated with imaging-guided lumbar nerve root blocks?

    Energy Technology Data Exchange (ETDEWEB)

    Peterson, Cynthia K., E-mail: cynthia.peterson@balgrist.ch [Department of Radiology, Orthopaedic University Hospital Balgrist, University of Zürich (Switzerland); Pfirrmann, Christian W.A. [Department of Radiology, Orthopaedic University Hospital Balgrist, University of Zürich (Switzerland); Hodler, Jürg [Department of Radiology, University Hospital, University of Zürich (Switzerland)

    2014-10-15

    Objective: To compare outcomes after imaging-guided transforaminal lumbar nerve root blocks in MRI confirmed symptomatic disc herniation patients with and without Modic changes (MC). Methods: Consecutive adult patients with MRI confirmed symptomatic lumbar disc herniations and an imaging-guided lumbar nerve root block injection who returned an outcomes questionnaire are included. Numerical rating scale (NRS) pain data was collected prior to injection and 20–30 min after injection. NRS and overall improvement were assessed using the patient's global impression of change (PGIC) scale at 1 day, 1 week and 1 month post injection. The proportion of patients with and without MC on MRI as well as Modic I and Modic II was calculated. These groups were compared for clinically relevant ‘improvement’ using the Chi-squared test. Baseline and follow-up NRS scores were compared for the groups using the unpaired t-test. Results: 346 patients are included with MC present in 57%. A higher percentage of patients without MC reported ‘improvement’ and a higher percentage of patients with MC reported ‘worsening’ but this did not reach statistical significance. The numerical scores on the PGIC and NRS scales showed that patients with MC had significantly higher pain and worse overall improvement scores at 1 month (p = 0.048 and p = 0.03) and a significantly lower 1 month NRS change score (p = 0.04). Conclusions: Patients with MRI confirmed symptomatic lumbar disc herniations and MC report significantly lower levels of pain reduction after a lumbar nerve root block compared to patients without MC.

  15. The impact of peripheral nerve blocks on perioperative outcome in hip and knee arthroplasty-a population-based study.

    Science.gov (United States)

    Memtsoudis, Stavros G; Poeran, Jashvant; Cozowicz, Crispiana; Zubizarreta, Nicole; Ozbek, Umut; Mazumdar, Madhu

    2016-10-01

    The role of anesthesia techniques on perioperative outcomes on a population level has recently gained widespread interest. Although mainly neuraxial vs general anesthesia has been addressed, population-level data on the impact of peripheral nerve blocks (PNBs) are still lacking. Therefore, we investigated the association between PNB use and outcomes using retrospective data on 1,062,152 recipients of hip and knee arthroplasties (total hip arthroplasty [THA]/total knee arthroplasty [TKA]) from the national Premier Perspective database (2006-2013). Multilevel multivariable logistic regression models measured associations between PNB use and outcomes. Complications included cardiac, pulmonary, gastrointestinal and renal complications, cerebrovascular events, infections, wound complications, thromboembolic complications, inpatient falls, and mortality. Resource utilization variables included blood transfusions, intensive care unit admissions, opioid consumption, cost, and length of stay. Overall, 12.5% of patients received a PNB, with an increase over time particularly among TKAs. Peripheral nerve block use was associated with lower odds for most adverse outcomes mainly among patients with THA. Notable beneficial effects were seen for wound complications (odds ratio 0.60 [95% confidence interval, 0.49-0.74]) among THA recipients and pulmonary complications (odds ratio 0.83 [95% confidence interval, 0.72-0.94]) in patients with TKA. Peripheral nerve block use was significantly (P < 0.0001) associated with a -16.2% and -12.7% reduction in opioid consumption for patients with THA and TKA, respectively. In conclusion, our results indicate that PNBs might be associated with superior perioperative population-level outcomes. In light of the inability to establish a causal relationship and the presence of residual confounding, we strongly advocate for further prospective investigation, ideally in multicenter, randomized trials, to establish the potential impact of PNBs on

  16. A novel concept for continuous peripheral nerve blocks. Presentation of a new ultrasound-guided device

    DEFF Research Database (Denmark)

    Rothe, C; Steen-Hansen, C; Madsen, M H;

    2015-01-01

    concept and prototype for ultrasound-guided in-plane positioning and readjustment of peripheral nerve catheters (patent pending). The integrated catheter-needle prototype comprises three parts: a curved needle, a catheter with clear echogenic markings attached to the needle tail and a detachable hub...

  17. Does suprascapular nerve block reduce shoulder pain following stroke: a double-blind randomised controlled trial with masked outcome assessment

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    Crotty Maria

    2010-09-01

    Full Text Available Abstract Background Shoulder pain is a common complication of a stroke which can impede participation in rehabilitation programs and has been associated with poorer outcomes. The evidence base for current medical and therapeutic management options of hemiplegic shoulder pain is limited. This study will evaluate the use of suprascapular nerve block injection as part of an interdisciplinary approach to the treatment of shoulder pain following stroke. The technique has previously been proven safe and effective in the treatment of shoulder pain associated with rheumatoid arthritis and degenerative shoulder conditions but its usefulness in a stroke population is unclear. Methods/Design A double blind randomised placebo controlled trial will assess the effect of a suprascapular nerve block compared with placebo in a population of 66 stroke patients. The trial will measure effect of injection on the primary outcome of pain, and secondary outcomes of function and quality of life. Measurements will take place at baseline, and 1, 4 and 12 weeks post intervention. Both groups will continue to receive routine physiotherapy and standard ward care. Discussion The results of this study could reduce pain symptoms in persons with mechanical shoulder pain post stroke and provide improvement in upper limb function. Trial Registration This trial is registered with the Australian New Zealand Clinical Trials Registry (ANZCTR - ACTRN12609000621213.

  18. Angiogenesis and bone regeneration of porous nano-hydroxyapatite/coralline blocks coated with rhVEGF165 in critical-size alveolar bone defects in vivo

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    Du B

    2015-03-01

    that in the nHA/coral group (105±51.8 vessel/mm2 at the 3-week time point (P<0.05, but no significant difference was observed at the 8-week time point (341±86.1 and 269±50.7 vessel/mm2, respectively, P>0.05. The present study indicated that nHA/coral blocks might be optimal scaffolds for block grafting in critical-size mandibular defects and that additional VEGF coating via physical adsorption can promote angiogenesis in the early stage of bone healing, which suggests that prevascularized nHA/coral blocks have significant potential as a bioactive material for bone regeneration in large-scale alveolar defects. Keywords: angiogenesis, bone regeneration, tissue engineering, block grafting, nano-hydroxyapatite/coralline, critical size, bone defect 

  19. A randomised placebo-controlled trial examining the effect on hand supination after the addition of a suprascapular nerve block to infraclavicular brachial plexus blockade.

    Science.gov (United States)

    Flohr-Madsen, S; Ytrebø, L M; Valen, K; Wilsgaard, T; Klaastad, Ø

    2016-08-01

    Some surgeons believe that infraclavicular brachial plexus blocks tends to result in supination of the hand/forearm, which may make surgical access to the dorsum of the hand more difficult. We hypothesised that this supination may be reduced by the addition of a suprascapular nerve block. In a double-blind, randomised, placebo-controlled study, our primary outcome measure was the amount of supination (as assessed by wrist angulation) 30 min after infraclavicular brachial plexus block, with (suprascapular group) or without (control group) a supplementary suprascapular block. All blocks were ultrasound-guided. The secondary outcome measure was an assessment by the surgeon of the intra-operative position of the hand. Considering only patients with successful nerve blocks, mean (SD) wrist angulation was lower (33 (27) vs. 61 (44) degrees; p = 0.018) and assessment of the hand position was better (11/11 vs. 6/11 rated as 'good'; p = 0.04) in the suprascapular group. The addition of a suprascapular nerve block to an infraclavicular brachial plexus block can provide a better hand/forearm position for dorsal hand surgery. PMID:27396247

  20. EFFECT OF BUPRENORPHINE ON POST OPERATIVE ANALGESI A IN SUPRACLAVICULAR BRACHIAL PLEXUS BLOCK USING PERIPHE RAL NERVE LOCATOR

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    Ritesh

    2013-01-01

    Full Text Available ABSTRACT : Supraclavicular brachial plexus block is known for its simplicity, effectiveness, safety, reliability and being economical for day ca re and emergency surgery, circumventing problems of full stomach. In our randomized prospective, double blind study, t otal 60 adult ASA class I and II patients undergoing upper limb surgeri es were given supraclavicular brachial plexus block with peripheral nerve locator and studied for effect of addition of buprenorphine on post operative analgesia. 30 Patients received 0.2 5% bupivacaine 40 ml in group Bupivacaine (B and added buprenorphine 3 μgm/kg in th e other group Bupivacaine + Buprenorphine (BB. All the patients were monitored fo r onset of effect, post op analgesia, time of first analgesic drug and number of analgesic dru g require in first 24 hrs. Onset and duration of motor and sensory block were same in both groups. Post operative analgesia was significantly better in BB. Consequently, number of doses of analgesic required in first 24 hours was less in buprenorphine group (BB.

  1. Therapeutic effectiveness of epicranial nerve blocks on post-traumatic syndrome from head injury

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    C. A. Caputi

    2011-03-01

    Full Text Available The autor describes the case of a 53-year-old woman suffering from headache and dizziness, sometimes nausea, tinnitus in the right ear, and diffuse scalp allodynia following an occupational accident involving a head injury. Hyposensitizing treatment by anesthetic blockade at the emergence points of the epicranial nerves, which were hyperalgesic to fi nger pressure, rapidly controlled the allodynia and eventually the headache. Unexpectedly, the patient also reported reduced dizziness and resolution of the tinnitus. The unforeseen outcome highlights the unpredictable therapeutic potential of a simple and modestly invasive procedure. The neuropathophysiological interpretation is consequently very interesting.

  2. Minimum effective local anesthetic volume for surgical anesthesia by subparaneural, ultrasound-guided popliteal sciatic nerve block: A prospective dose-finding study.

    Science.gov (United States)

    Bang, Seung Uk; Kim, Dong Ju; Bae, Jin Ho; Chung, Kyudon; Kim, Yeesuk

    2016-08-01

    Because of its rapid onset time, recent years have seen an increase in the use of ultrasound (US)-guided popliteal sciatic nerve block (PSNB) via subparaneural injection for induction of surgical anesthesia. Moreover, in below-knee surgery, combined blocks, as opposed to sciatic nerve block alone, have become more common. These combined blocks often require a large volume of local anesthetic (LA), thus increasing the risk of local-anesthetic systemic toxicity (LAST). Thus, to decrease the risk of LAST, it is important to know the minimum effective volume (MEV) required for an adequate block. We, therefore, aimed to determine the MEV of ropivacaine 0.75% for induction of surgical anesthesia by the method of US-guided popliteal sciatic nerve block via subparaneural injection.Thirty patients underwent a US-guided PSNB with ropivacaine 0.75% at a 20-mL starting volume. Using a step-up/step-down method, we determined injection volumes for consecutive patients from the preceding patient's outcome. When an effective block was achieved within 40 minutes after injection, the next patient's volume was decreased by 2 mL. If the block failed, the next patient's volume was increased by 2 mL. The sensory and motor blockade was graded according to a 4-point scale. The block was considered a success if a combination of anesthesia and paresis (a score of 3 for both the sensory and motor nerves) was achieved within 40 minutes. The primary outcome measure was the MEV resulting in a successful subparaneural block of the sciatic nerve in 50% of patients (MEV50). Additionally, the data were processed with a probit regression analysis to determine the volume required to produce a complete sciatic nerve block in 90% of subjects (ED90).The MEV50 of 0.75% ropivacaine is 6.14 mL (95% confidence interval, 4.33-7.94 mL). The ED90 by probit analysis for a subparaneural injection was 8.9 mL (95% CI, 7.09-21.75 mL).The 6.14-mL MEV50 of ropivacaine 0.75% represents a 71% reduction

  3. Bloqueios nervosos guiados por ultra-som Bloqueos nerviosos guiados por ultrasonido Ultrasound-guided nerve blocks

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    Pablo Escovedo Helayel

    2007-02-01

    referencias anatómicas, menor volumenn de solución anestésica y una mayor seguridad. CONCLUSION: El artículo revisa los aspectos relativos a los mecanismos físicos para la formación de imágenes, la anatomía ultra sonográfica del neuro eje y de los plexos braquial y lumbo sacral, los equipos y materiales empleados en los bloqueos, los ajustes del aparato de ultrasonido para mejorar las imágenes, los planos de visualización de las agujas de bloqueo y las técnicas y el entrenamiento en bloqueos guiados por ultrasonido. CONCLUSIONES: Los pasos para obtener el éxito en anestesia regional incluyen la identificación exacta de la posición de los nervios, la localización precisa de la aguja, sin lesiones en las estructuras adyacentes y, finalmente, la inyección cuidadosa de anestésico local junto a los nervios. Aunque la neuro estimulación sea de gran ayuda en la identificación de los nervios, ella no logra, aisladamente, rellenar todas esas exigencias. A causa de eso, se cree que los bloqueos guiados por ultrasonido serán la técnica de elección para la anestesia regional en un futuro no muy distante.BACKGROUND AND OBJECTIVES: Ultrasound-guided nerve blocks are based on the direct visualization of nerve structures, needle, and adjacent anatomic structures. Thus, it is possible to place the local anesthetic precisely around the nerves and follow its dispersion in real time, obtaining, therefore, more effective blockades, reduced dependency on anatomic references, decreased anesthetic volume, and increased safety. CONTENTS: The aim of this paper was to review the physical mechanisms of image formation, ultrasound anatomy of the neuro axis and of the brachial and lumbosacral plexuses, equipment and materials used in the blockades, settings of the ultrasound equipment to improve the image, planes of visualization of the needles, the techniques, and training in ultrasound-guided nerve blocks. CONCLUSIONS: The steps for a successful regional block include the

  4. Ultrasound-guided block of the axillary nerve: a volunteer study of a new method

    DEFF Research Database (Denmark)

    Rothe, C; Asghar, S; Andersen, H L;

    2011-01-01

    Interscalene brachial plexus block (IBPB) is the gold standard for perioperative pain management in shoulder surgery. However, a more distal technique would be desirable to avoid the side effects and potential serious complications of IBPB. Therefore, the aim of the present study was to develop...

  5. Surgery versus Nerve Blocks for Lumbar Disc Herniation : Quantitative Analysis of Radiological Factors as a Predictor for Successful Outcomes

    Science.gov (United States)

    Kim, Joohyun; Hur, Junseok W.; Lee, Jang-Bo

    2016-01-01

    Objective To assess the clinical and radiological factors as predictors for successful outcomes in lumbar disc herniation (LDH) treatment. Methods Two groups of patients with single level LDH (L4–5) requiring treatment were retrospectively studied. The surgery group (SG) included 34 patients, and 30 patients who initially refused the surgery were included in the nerve blocks group (NG). A visual analogue scale (VAS) for leg and back pain and motor deficit were initially evaluated before procedures, and repeated at 1, 6, and 12 months. Radiological factors including the disc herniation length, disc herniation area, canal length-occupying ratio, and canal area-occupying ratio were measured and compared. Predicting factors of successful outcomes were determined with multivariate logistic regression analysis after the optimal cut off values were established with a receiver operating characteristic curve. Results There was no significant demographic difference between two groups. A multivariate logistic regression analysis with radiological and clinical (12 months follow-up) data revealed that the high disc herniation length with cutoff value 6.31 mm [odds ratio (OR) 2.35; confidence interval (CI) 1.21–3.98] was a predictor of successful outcomes of leg pain relief in the SG. The low disc herniation length with cutoff value 6.23 mm (OR 0.05; CI 0.003–0.89) and high baseline VAS leg (OR 12.63; CI 1.64–97.45) were identified as predictors of successful outcomes of leg pain relief in the NG. Conclusion The patients with the disc herniation length larger than 6.31 mm showed successful outcomes with surgery whereas the patients with the disc herniation length less than 6.23 mm showed successful outcomes with nerve block. These results could be considered as a radiological criteria in choosing optimal treatment options for LDH.

  6. The Patterns of Utilization of Interscalene Nerve Blocks for Total Shoulder Arthroplasty.

    Science.gov (United States)

    Gabriel, Rodney A; Nagrebetsky, Alexander; Kaye, Alan D; Dutton, Richard P; Urman, Richard D

    2016-09-01

    The interscalene block (ISB) is a common adjunct to general anesthesia for total shoulder arthroplasty (TSA). The aim of the study was to report the current national demographics of the patients who are receiving ISB for TSAs. We performed a retrospective analysis of data from the National Anesthesia Clinical Outcomes Registry from 2010 to 2015. Of 28,810 cases, 42.1% received an ISB. Only 0.83% of cases received regional anesthesia as the primary anesthetic. From 2010 to 2014, there has been an increase in ISB utilization for this surgery (odds ratio, 1.21; 95% confidence interval, 1.19-1.23; P < .0001). Furthermore, we report a geographic distribution of block utilization in the United States. We have identified national patterns for the utilization of regional anesthesia for TSAs that may provide insight into future design of research studies. PMID:27537763

  7. Continuous epidural block versus continuous popliteal nerve block for postoperative pain relief after major podiatric surgery in children: a prospective, comparative randomized study.

    Science.gov (United States)

    Dadure, Christophe; Bringuier, Sophie; Nicolas, Florence; Bromilow, Luke; Raux, Olivier; Rochette, Alain; Capdevila, Xavier

    2006-03-01

    Foot and ankle surgery in children is very painful postoperatively. Adverse effects from opioids and continuous epidural block (CEB) limit their use in children. Continuous popliteal nerve blocks (CPNB) have not been studied for this indication in children. In this prospective, randomized study we evaluated the effectiveness and adverse events of CPNB or CEB in children after podiatric surgery. Fifty-two children scheduled for foot surgery were separated into four groups by age and analgesia technique. After general anesthesia, 0.5 to 1 mL/kg of an equal-volume mixture of 0.25% bupivacaine and 1% lidocaine with 1:200000 epinephrine was injected via epidural or popliteal catheters. In the postoperative period, 0.1 mL x kg(-1) x h(-1) (group CPNB) or 0.2 mL x kg(-1) x h(-1) (group CEB) of 0.2% ropivacaine was administered for 48 h. Niflumic acid was routinely used. Adverse events were noted in each treatment group. Postoperative pain during motion was evaluated at 1, 6, 12, 18, 24, 36, and 48 h. Requirement for rescue analgesia (first-line propacetamol 30 mg/kg 4 times daily or second-line 0.2 mg/kg IV nalbuphine), and motor blockade were recorded. Parental satisfaction was noted at 48 h. Twenty-seven patients were included in the CEB groups and 25 in CPNB groups. There were 32 children 1 to 6 yr of age (CPNB = 15; CEB = 17) and 20 children 7 to 12 yr of age (CPNB = 10; CEB = 10). The demographic data were comparable among groups. Postoperative analgesia was excellent for the two continuous block techniques and in the two age groups. Motor block intensity was equal between techniques. Adverse events (postoperative nausea or vomiting, urinary retention, and premature discontinuation of local anesthetic infusion in the 1- to 6-yr-old group) were significantly more frequent in the CEB group (P < 0.05). Eighty-six percent of the parents in the CEB groups and 100% in the CPNB groups were satisfied. We conclude that although both CEB and CPNB resulted in excellent

  8. Essential Oil of Ocimum basilicum L. and (−-Linalool Blocks the Excitability of Rat Sciatic Nerve

    Directory of Open Access Journals (Sweden)

    Antonio Medeiros Venancio

    2016-01-01

    Full Text Available The racemate linalool and its levogyrus enantiomer [(−-LIN] are present in many essential oils and possess several pharmacological activities, such as antinociceptive and anti-inflammatory. In this work, the effects of essential oil obtained from the cultivation of the Ocimum basilicum L. (EOOb derived from Germplasm Bank rich in (−-LIN content in the excitability of peripheral nervous system were studied. We used rat sciatic nerve to investigate the EOOb and (−-LIN effects on neuron excitability and the extracellular recording technique was used to register the compound action potential (CAP. EOOb and (−-LIN blocked the CAP in a concentration-dependent way and these effects were reversible after washout. EOOb blocked positive amplitude of 1st and 2nd CAP components with IC50 of 0.38±0.2 and 0.17±0.0 mg/mL, respectively. For (−-LIN, these values were 0.23±0.0 and 0.13±0.0 mg/mL. Both components reduced the conduction velocity of CAP and the 2nd component seems to be more affected than the 1st component. In conclusion EOOb and (−-LIN inhibited the excitability of peripheral nervous system in a similar way and potency, revealing that the effects of EOOb on excitability are due to the presence of (−-LIN in the essential oil.

  9. Essential Oil of Ocimum basilicum L. and (−)-Linalool Blocks the Excitability of Rat Sciatic Nerve

    Science.gov (United States)

    Medeiros Venancio, Antonio; da Silva-Alves, Kerly Shamyra; de Carvalho Pimentel, Hugo; Macêdo Lima, Matheus; Fraga de Santana, Michele; Batista da Silva, Givanildo; Marchioro, Murilo

    2016-01-01

    The racemate linalool and its levogyrus enantiomer [(−)-LIN] are present in many essential oils and possess several pharmacological activities, such as antinociceptive and anti-inflammatory. In this work, the effects of essential oil obtained from the cultivation of the Ocimum basilicum L. (EOOb) derived from Germplasm Bank rich in (−)-LIN content in the excitability of peripheral nervous system were studied. We used rat sciatic nerve to investigate the EOOb and (−)-LIN effects on neuron excitability and the extracellular recording technique was used to register the compound action potential (CAP). EOOb and (−)-LIN blocked the CAP in a concentration-dependent way and these effects were reversible after washout. EOOb blocked positive amplitude of 1st and 2nd CAP components with IC50 of 0.38 ± 0.2 and 0.17 ± 0.0 mg/mL, respectively. For (−)-LIN, these values were 0.23 ± 0.0 and 0.13 ± 0.0 mg/mL. Both components reduced the conduction velocity of CAP and the 2nd component seems to be more affected than the 1st component. In conclusion EOOb and (−)-LIN inhibited the excitability of peripheral nervous system in a similar way and potency, revealing that the effects of EOOb on excitability are due to the presence of (−)-LIN in the essential oil. PMID:27446227

  10. A COMPARATIVE STUDY OF PEDIATRIC CARDIAC CATHETERIZATION PROCEDURE UNDER GENERAL ANESTHESIA WITH OR WITHOUT FEMORAL NERVE BLOCK

    Directory of Open Access Journals (Sweden)

    Jigisha

    2016-02-01

    Full Text Available OBJECTIVE Anesthetic management for interventional cardiac procedures/cardiac catheterization in pediatric patients is challenging. Cardiac anomalies vary from simple to complex congenital cardiac anomalies, shunts may be present at multiple levels and patients may be profoundly cyanotic, may be with ventricular dysfunction. They usually require sedation and analgesia to maintain steady stable state. In adults, such type of procedures can be well managed with local anesthesia. METHODS Fifty patients were included in the study. They were randomly divided into two groups- Group A (n=25 patients received femoral N. block along with IV sedation and analgesia while group B (n=25 patients received only IV sedation and analgesia. Both groups were compared for hemodynamics, pain score and requirement of IV anesthetic agents and any complications if come up. RESULTS Group A patients required IV ketamine 3.24mg/kg (±0.31SD as compared to 5.58mg/kg (±1.6SD in group B, which suggests significantly reduced requirement of IV anesthetic agents in group where femoral nerve block has been given. Hemodynamic parameters remained stable and comparable (no statistically significant variation Pain score was less in group A patients than group B. CONCLUSION It has been observed that Group A patients required less dosages of IV anesthetic agents, with stable hemodynamics and less pain score and sedation score as compared to group B patients.

  11. Time Course of the Soleus M Response and H Reflex after Lidocaine Tibial Nerve Block in the Rat

    Directory of Open Access Journals (Sweden)

    Kévin Buffenoir

    2013-01-01

    Full Text Available Aims. In spastic subjects, lidocaine is often used to induce a block predictive of the result provided by subsequent surgery. Lidocaine has been demonstrated to inhibit the Hoffmann (H reflex to a greater extent than the direct motor (M response induced by electrical stimulation, but the timecourse of these responses has not been investigated. Methods. An animal (rat model of the effects of lidocaine on M and H responses was therefore developed to assess this time course. M and H responses were recorded in 18 adult rats before and after application of lidocaine to the sciatic nerve. Results. Two to five minutes after lidocaine injection, M responses were markedly reduced (mean reduction of 44% and H reflexes were completely abolished. Changes were observed more rapidly for the H reflex. The effects of lidocaine then persisted for 100 minutes. The effect of lidocaine was therefore more prolonged on the H reflex than on the M response. Conclusion. This study confirms that lidocaine blocks not only alpha motoneurons but also Ia afferent fibres responsible for the H reflex. The authors describe, for the first time, the detailed time course of the effect of lidocaine on direct or reflex activation of motoneurons in the rat.

  12. Particle-induced indentation of the alveolar epithelium caused by surface tension forces

    OpenAIRE

    Mijailovich, S. M.; Kojic, M.; Tsuda, A.

    2010-01-01

    Physical contact between an inhaled particle and alveolar epithelium at the moment of particle deposition must have substantial effects on subsequent cellular functions of neighboring cells, such as alveolar type-I, type-II pneumocytes, alveolar macrophage, as well as afferent sensory nerve cells, extending their dendrites toward the alveolar septal surface. The forces driving this physical insult are born at the surface of the alveolar air-liquid layer. The role of alveolar surfactant submer...

  13. Neuraxial and peripheral nerve blocks in patients taking anticoagulant or thromboprophylactic drugs: challenges and solutions

    Directory of Open Access Journals (Sweden)

    Li J

    2015-08-01

    Full Text Available Jinlei Li, Thomas Halaszynski Department of Anesthesiology, Yale University, Yale New Haven Hospital, New Haven, CT, USA Abstract: Incidence of hemorrhagic complications from neuraxial blockade is unknown, but classically cited as 1 in 150,000 epidurals and 1 in 220,000 spinals. However, recent literature and epidemiologic data suggest that for certain patient populations the frequency is higher (1 in 3,000. Due to safety concerns of bleeding risk, guidelines and recommendations have been designed to reduce patient morbidity/mortality during regional anesthesia. Data from evidence-based reviews, clinical series and case reports, collaborative experience of experts, and pharmacology used in developing consensus statements are unable to address all patient comorbidities and are not able to guarantee specific outcomes. No laboratory model identifies patients at risk, and rarity of neuraxial hematoma defies prospective randomized study so “patient-specific” factors and “surgery-related” issues should be considered to improve patient-oriented outcomes. Details of advanced age, older females, trauma patients, spinal cord and vertebral column abnormalities, organ function compromise, presence of underlying coagulopathy, traumatic or difficult needle placement, as well as indwelling catheter(s during anticoagulation pose risks for significant bleeding. Therefore, balancing between thromboembolism, bleeding risk, and introduction of more potent antithrombotic medications in combination with regional anesthesia has resulted in a need for more than “consensus statements” to safely manage regional interventions during anticoagulant/thromboprophylactic therapy. Keywords: antithrombotics, novel oral anticoagulant, regional, neurologic dysfunction, hematoma, peripheral nerve blockade

  14. Part and Parcel of the Cardiac Autonomic Nerve System: Unravelling Its Cellular Building Blocks during Development

    Directory of Open Access Journals (Sweden)

    Anna M. D. Végh

    2016-09-01

    Full Text Available The autonomic nervous system (cANS is essential for proper heart function, and complications such as heart failure, arrhythmias and even sudden cardiac death are associated with an altered cANS function. A changed innervation state may underlie (part of the atrial and ventricular arrhythmias observed after myocardial infarction. In other cardiac diseases, such as congenital heart disease, autonomic dysfunction may be related to disease outcome. This is also the case after heart transplantation, when the heart is denervated. Interest in the origin of the autonomic nerve system has renewed since the role of autonomic function in disease progression was recognized, and some plasticity in autonomic regeneration is evident. As with many pathological processes, autonomic dysfunction based on pathological innervation may be a partial recapitulation of the early development of innervation. As such, insight into the development of cardiac innervation and an understanding of the cellular background contributing to cardiac innervation during different phases of development is required. This review describes the development of the cANS and focuses on the cellular contributions, either directly by delivering cells or indirectly by secretion of necessary factors or cell-derivatives.

  15. Pulmonary alveolar proteinosis

    Directory of Open Access Journals (Sweden)

    B. Crestani

    2011-06-01

    Full Text Available Pulmonary alveolar proteinosis (PAP is a rare pulmonary disease characterised by alveolar accumulation of surfactant. It may result from mutations in surfactant proteins or granulocyte macrophage-colony stimulating factor (GM-CSF receptor genes, it may be secondary to toxic inhalation or haematological disorders, or it may be auto-immune, with anti-GM-CSF antibodies blocking activation of alveolar macrophages. Auto-immune alveolar proteinosis is the most frequent form of PAP, representing 90% of cases. Although not specific, high-resolution computed tomography shows a characteristic “crazy paving” pattern. In most cases, bronchoalveolar lavage findings establish the diagnosis. Whole lung lavage is the most effective therapy, especially for auto-immune disease. Novel therapies targeting alveolar macrophages (recombinant GM-CSF therapy or anti-GM-CSF antibodies (rituximab and plasmapheresis are being investigated. Our knowledge of the pathophysiology of PAP has improved in the past 20 yrs, but therapy for PAP still needs improvement.

  16. Minimum Alveolar Concentration Needed to Block Adrenergic Response of Sevoflurane with Nitrous Oxide Varies Depending on the Stimulation Sites in Adult Surgical Patients

    Directory of Open Access Journals (Sweden)

    Tetsu Kimura

    2015-02-01

    Full Text Available Background We examined whether minimum alveolar anesthetic concentration needed to block adrenergic response (MAC-BAR of sevoflurane with nitrous oxide (N2O varies depending on body surface sites to which noxious stimuli are applied. Methods Seventy-seven ASA I adult patients, aged 18-50 years old, were anesthetized with sevoflurane and 66% N2O in O2, and their tracheas were intubated. The anesthesia was maintained with 66% N2O in O2 plus sevoflurane at predetermined end-tidal concentrations (0.8, 1.1, 1.4, 1.7, 2.0, 2.3, or 2.6%, n = 11 in each concentration for at least 15 minutes. Heart rate (HR and non-invasive blood pressure (BP was recorded at 1-minute interval automatically. As a noxious stimulus, electrical tetanic stimulation with a 15 sec burst of 50 Hz, 0.25 msec square-wave, 55 mA electric current was applied at three different sites; forehead, abdomen, or thigh. A positive cardiovascular response was defined as an increase of either mean BP or HR by more than 15% from the pre-stimulation value. Logistic regression analysis was used to determine MAC-BAR. Results MAC-BAR of sevoflurane with 66% N2O obtained by stimulating forehead, abdomen, and thigh were 2.01% (95% CI: 1.70-2.57%, 1.71% (1.13-2.74%, and 1.31% (0.77-1.66%, respectively. MAC-BAR on the forehead was significantly higher than that on the thigh. Conclusion MAC-BAR of sevoflurane with 66% N2O varied depending on the body surface sites to which noxious stimuli were applied. These findings support our clinical impression that sensitivities to pain vary among body surface sites, and that anesthetic requirement to stabilize hemodynamic variables vary among surgical sites.

  17. CBCT在减少下牙槽神经损伤风险中的应用%Application of Cone Beam Computed Tomography in Reducing the Risk of Interior Alveolar Nerve Injury

    Institute of Scientific and Technical Information of China (English)

    赵宾; 王继红

    2016-01-01

    目的:探讨CBCT在减少行下颌阻生第三磨牙拔除术治疗的患者下牙槽神经损伤风险中的应用价值。方法选取2014年3月~2015年4月于本院治疗的下颌神经管与第三磨牙根端重叠的患者,经评估下牙槽神经易损伤病例共64例,其中下颌阻生第三磨牙81侧,对患者行CBCT检查。选取具有多年临床经验的口腔外科医师、影像医师各两名,分两组根据CBCT图像以及曲面体层片对拔除第三磨牙患者的下牙槽神经损伤风险进行预估,同时设计相应的手术方案,对两组医师的设计方案进行测评。结果与曲面体层片比较,CBCT图像可呈现下颌神经管与阻生磨牙间三维图像的空间分布,可让医师做出更为精准的手术方案(P<0.001)。结论在对行下颌阻生第三磨牙拔出术患者的下牙槽神经损伤的风险评估中,CBCT图像较曲面体层片更具识别力,可有效帮助医师设计更为合适的手术方案。%Objective To discuss the application value of cone beam computed tomography (CBCT) in reducing the risk of inferior alveolar nerve injury in patients who have underwent mandibular third molar extraction surgery.Methods The research selected patients with mandibular canal overlapped by third molar root canal from March 2014 to April 2015. The assessment showed that there were sixty-four cases of inferior alveolar nerve injury, among which there were eighty-one sides of impacted mandibular third molars. All the sixty-four patients underwent CBCT examination. Two experienced denta surgeon and two radiologists were chosen to conduct preliminary assessment of the risk of interior alveolar nerve injury in patients undergoing third molar extraction surgery based on CBCT and panoramic tomography images. Meanwhile the correspondent surgical plans were designed,the design schemes proposed by the two groups of physicians were tested and evaluated.Results Compared with images of panoramic

  18. Analgesic efficacy of continuous femoral nerve block commenced prior to operative fixation of fractured neck of femur

    LENUS (Irish Health Repository)

    Szucs, Szilard

    2012-06-27

    AbstractBackgroundPeripheral nerve blocks are effective in treating acute pain, thereby minimizing the requirement for opiate analgesics. Fractured neck of femur (FNF) is a common, painful injury. The provision of effective analgesia to this cohort is challenging but an important determinant of their functional outcome. We investigated the analgesic efficacy of continuous femoral nerve block (CFNB) in patients with FNF.MethodsFollowing institutional ethical approval and with informed consent, patients awaiting FNF surgery were randomly allocated to receive either standard opiate-based analgesia (Group 1) or a femoral perineural catheter (Group 2). Patients in Group 1 received parenteral morphine as required. Those in Group 2 received a CFNB comprising a bolus of local anaesthetic followed by a continuous infusion of 0.25% bupivacaine. For both Groups, rescue analgesia consisted of intramuscular morphine as required and all patients received paracetamol regularly. Pain was assessed using a visual analogue scale at rest and during passive movement (dynamic pain score) at 30 min following first analgesic intervention and six hourly thereafter for 72 hours. Patient satisfaction with the analgesic regimen received was recorded using verbal rating scores (0-10). The primary outcome measured was dynamic pain score from initial analgesic intervention to 72 hours later.ResultsOf 27 recruited, 24 patients successfully completed the study protocol and underwent per protocol analysis. The intervals from recruitment to the study until surgery were similar in both groups [31.4(17.7) vs 27.5(14.2) h, P = 0.57]. The groups were similar in terms of baseline clinical characteristics. For patients in Group 2, pain scores at rest were less than those reported by patients in Group 1 [9.5(9.4) vs 31(28), P = 0.031]. Dynamic pain scores reported by patients in Group 2 were less at each time point from 30 min up to 54 hours [e.g at 6 h 30.7(23.4) vs 67.0(32.0), P = 0

  19. Cold bupivacaine versus magnesium sulfate added to room temperature bupivacaine in sonar-guided femoral and sciatic nerve block in arthroscopic anterior cruciate ligament reconstruction surgery

    Science.gov (United States)

    Alzeftawy, Ashraf Elsayed; El-Daba, Ahmad Ali

    2016-01-01

    Background: Cooling of local anesthetic potentiates its action and increases its duration. Magnesium sulfate (MgSo4) added to local anesthetic prolongs the duration of anesthesia and postoperative analgesia with minimal side effects. Aim: The aim of this prospective, randomized, double-blind study was to compare the effect of cold to 4°C bupivacaine 0.5% and Mg added to normal temperature (20–25°C) bupivacaine 0.5% during sonar-guided combined femoral and sciatic nerve blocks on the onset of sensory and motor block, intraoperative anesthesia, duration of sensory and motor block, and postoperative analgesia in arthroscopic anterior cruciate ligament (ACL) reconstruction surgery. Patients and Methods: A total of 90 American Society of Anesthesiologists classes I and II patients who were scheduled to undergo elective ACL reconstruction were enrolled in the study. The patients were randomly allocated to 3 equal groups to receive sonar-guided femoral and sciatic nerve blocks. In Group I, 17 ml of room temperature (20–25°C) 0.5% bupivacaine and 3 ml of room temperature saline were injected for each nerve block whereas in Group II, 17 ml of cold (4°C) 0.5% bupivacaine and 3 ml of cold saline were injected for each nerve block. In Group III, 17 ml of room temperature 0.5% bupivacaine and 3 ml of MgSo4 5% were injected for each nerve block. The onset of sensory and motor block was evaluated every 3 min for 30 min. Surgery was started after complete sensory and motor block were achieved. Intraoperatively, the patients were evaluated for heart rate and mean arterial pressure, rescue analgesic and sedative requirements plus patient and surgeon satisfaction. Postoperatively, hemodynamics, duration of analgesia, resolution of motor block, time to first analgesic, total analgesic consumption, and the incidence of side effects were recorded. Results: There was no statistically significant difference in demographic data, mean arterial pressure, heart rate, and duration of

  20. Treatment outcomes of intradiscal steroid injection/selective nerve root block for 161 patients with cervical radiculopathy.

    Science.gov (United States)

    Ito, Keigo; Yukawa, Yasutsugu; Machino, Masaaki; Inoue, Taro; Ouchida, Jun; Tomita, Keisuke; Kato, Fumihiko

    2015-02-01

    Patients with cervical radiculopathy (CR) were treated with intradiscal injection of steroids (IDIS) and/or selective nerve root block (SNRB) at our hospital. We retrospectively report the outcomes of these nonsurgical treatments for CR. 161 patients who were followed up for >2months were enrolled in this study. Patients' clinical manifestations were classified as arm pain, arm numbness, neck and/or scapular pain, and arm paralysis. Improvement in each manifestation was classified as "disappeared," "improved," "poor," or "worsened." Responses of "disappeared" or "improved" manifestations suggested treatment effectiveness. Final clinical outcomes were evaluated using the Odom criteria. Changes in herniated disc size were evaluated by comparing the initial and final MRI scans. On the basis of these changes, the patients were divided into regression, no-change, or progression groups. We investigated the relationship between the Odom criteria and changes observed on MRI. Effectiveness rates were 89% for arm pain, 77% for arm numbness, 82% for neck and/or scapular pain, and 76% for arm paralysis. In total, 91 patients underwent repeated MRI. In 56 patients (62%), the size of the herniated disc decreased, but 31 patients (34%) exhibited no change in disc size. The regression group showed significantly better Odom criteria results than the no-change group. In conclusion, IDIS and SNRB for CR are not widely performed. However, other extremely effective therapies that can rapidly improve neuralgia should be considered before surgery. PMID:25797986

  1. A Self-Administered Method of Acute Pressure Block of Sciatic Nerves for Short-Term Relief of Dental Pain: A Randomized Study

    Science.gov (United States)

    Wang, Xiaolin; Zhao, Wanghong; Wang, Ye; Hu, Jiao; Chen, Qiu; Yu, Juncai; Wu, Bin; Huang, Rong; Gao, Jie; He, Jiman

    2014-01-01

    Objectives While stimulation of the peripheral nerves increases the pain threshold, chronic pressure stimulation of the sciatic nerve is associated with sciatica. We recently found that acute pressure block of the sciatic nerve inhibits pain. Therefore, we propose that, the pain pathology-causing pressure is chronic, not acute. Here, we report a novel self-administered method: acute pressure block of the sciatic nerves is applied by the patients themselves for short-term relief of pain from dental diseases. Design This was a randomized, single-blind study. Setting Hospital patients. Patients Patients aged 16–60 years with acute pulpitis, acute apical periodontitis, or pericoronitis of the third molar of the mandible experiencing pain ≥3 on the 11-point numerical pain rating scale. Interventions Three-minute pressure to sciatic nerves was applied by using the hands (hand pressure method) or by having the patients squat to force the thigh and shin as tightly as possible on the sandwiched sciatic nerve bundles (self-administered method). Outcomes The primary efficacy variable was the mean difference in pain scores from the baseline. Results One hundred seventy-two dental patients were randomized. The self-administered method produced significant relief from pain associated with dental diseases (P ≤ 0.001). The analgesic effect of the self-administered method was similar to that of the hand pressure method. Conclusions The self-administered method is easy to learn and can be applied at any time for pain relief. We believe that patients will benefit from this method. PMID:24400593

  2. Long term outcomes from CT-guided indirect cervical nerve root blocks and their relationship to the MRI findings. A prospective study

    Energy Technology Data Exchange (ETDEWEB)

    Bensler, Susanne; Sutter, Reto; Pfirrmann, Christian W.A.; Peterson, Cynthia K. [Orthopedic University Hospital Balgrist, Department of Radiology, Zurich (Switzerland); University of Zurich, Faculty of Medicine, Zurich (Switzerland)

    2015-11-15

    To investigate long-term pain reduction and 'improvement' in patients with indirect cervical nerve-root-blocks in comparison to MRI findings. One hundred and twelve patients with MRI confirmed cervical radiculopathy and an indirect cervical nerve-root-block were included. Two radiologists independently evaluated the MRI examinations. 12 different MRI abnormalities at the level and side of infiltration were compared to pain relief and 'improvement' at 1-month, 3-months and 1-year post injection. The proportion of patients reporting clinically relevant 'improvement' was 36.7 % at 1-month, 53.9 % at 3-months and 68.1 % at 1-year. At 1-month post injection, a statistically significantly lower percentage of patients eventually requiring surgery reported improvement and lower NRS change scores compared to those who did not undergo surgery (p = 0.001). Patients with extrusion of the disc were around 4-times more likely to have surgery. At 1-year post-injection the presence of nerve-root compromise was significantly linked to treatment outcome (p = 0.011). Patients with nerve root compression were more likely to report improvement at 1 year. Patients with disc extrusions have less pain relief and are 4 times more likely to go to surgery than patients with disc protrusions. (orig.)

  3. Survey of Current Practices: Peripheral Nerve Block Utilization by ED Physicians for Treatment of Pain in the Hip Fracture Patient Population

    OpenAIRE

    Haslam, Lynn; Lansdown, Andrew; Lee, Jacques; van der Vyver, Martin

    2013-01-01

    Background In 2010–11 approximately 968 hip fracture patients presented to emergency departments in the Greater Toronto Local Health Integration Network (GTA-LHIN). Optimal pain management is a frequently overlooked aspect of hip fracture patient care, which may contribute to patient outcomes. Although recommendations have been published, there is currently not a standardized approach to the analgesic management of pain in the hip fracture patient. Nerve blocks, including the fascia iliaca co...

  4. Comparison of eutectic mixture of local anesthetics cream with dorsal penile nerve block using lignocaine for circumcision in infants

    Science.gov (United States)

    Mujeeb, Sabeen; Akhtar, Jamshed; Ahmed, Soofia

    2013-01-01

    Objective: Circumcision is a commonly performed surgical procedure but choice of anesthesia remained an issue of research and debate. This study was conducted to find out the effectiveness of the eutectic mixture of local anesthetic (EMLA) cream with dorsal penile nerve block (DPNB) using lignocaine, for reduction of pain during circumcision. Methodology: This was comparative study carried out in Surgical Unit B of National Institute of Child Health Karachi, from May 2008 to October 2008. Patients under six month of age were randomized in to two groups (EMLA and DPNB) of fifty patients each. The effectiveness of pain control was assessed by measuring the baseline heart rate (HR), respiratory rate (RR) and Neonatal infant Pain Scale (NIPS scale) before the start of procedure and measuring of these parameters for each step of circumcision. Independent sample t -test was used to compare means and repeated ANOVA was used to compare means of HR, RR, oxygen (O2) saturations and NIPS. Results: The mean age in both the groups was 2.3 months. There was no statistically significant difference in baseline parameters in both the groups except the respiratory rate, which was significantly raised in DPNB group (33 breaths/min in EMLA and 38 in DPNB P < 0.04). During circumcision there was significant increase in heart rate in DPNB group, especially in step three and step four (p < 0.04). Oxygen saturation dropped in both the groups (baseline saturation 98% up to 91% in step 4). While assessing NIPS scores in both the groups, statistically significant difference was found between NIPS at step two and step four in two groups (p < 0.04). Conclusions: The overall pain control was equal in both the groups, although NIPS score was higher in DPNB in step two and four of circumcision. There was difference in application and cost. EMLA was easy to apply but has increased cost; while DPNB required expertise. PMID:24353502

  5. Superior Hypogastric Nerve Block to Reduce Pain After Uterine Artery Embolization: Advanced Technique and Comparison to Epidural Anesthesia

    Energy Technology Data Exchange (ETDEWEB)

    Binkert, Christoph A., E-mail: christoph.binkert@ksw.ch [Kantonsspital Winterthur, Institute of Radiology and Nuclear Medicine (Switzerland); Hirzel, Florian C. [Kantonsspital Winterthur, Department of Gynecology (Switzerland); Gutzeit, Andreas; Zollikofer, Christoph L. [Kantonsspital Winterthur, Institute of Radiology and Nuclear Medicine (Switzerland); Hess, Thomas [Kantonsspital Winterthur, Department of Gynecology (Switzerland)

    2015-10-15

    PurposeTo evaluate a modified superior hypogastric nerve block (SHNB) to reduce pain after uterine artery embolization (UAE) compared to epidural anesthesia.Materials and methodsIn this retrospective study, the amount of opiate drugs needed after UAE was compared between SHNB and epidural anesthesia. Eighty one consecutive women (mean age: 43.67 years) were in the SHNB group and 27 consecutive women (mean age: 43.48 years) treated earlier at the same institution in the epidural anesthesia group. UAE was performed from a unilateral femoral artery approach using a 4F catheter. 500–700 or 700–900 μm trisacryl gelatine microspheres were used as embolic agents. The SHNB was performed by advancing a 21G from the abdominal wall below the umbilicus to the anterior portion of the 5th vertebral body. For optimal guidance a cranio-caudal tilt of 5°–15° was used. On a lateral view the correct contrast distribution in front of the vertebral body is confirmed. Then 20 ml local anesthesia (ropivacain 0.75 %) is injected. In case of an asymmetric right–left distribution the needle was repositioned.ResultsAll SHNB were successful without severe complications. The mean time for the SHNB was 4 min 38 s (2 min 38 s–9 min 27 s). The needle was repositioned in average 0.87 times. The opiate dose for the SHNB group was 19.33 ± 22.17 mg which was significantly lower. The average time to receive an opiate drug after SHNB was 4 h 41 min.ConclusionThe SHNB is a safe and minimally time-consuming way to reduce pain after UAE especially within the first 4 h.

  6. 皮质骨块加松质骨治疗牙槽嵴裂的临床研究%Clinical study on the treatment of alveolar cleft with cortical bone block affiliate with cancellous bone

    Institute of Scientific and Technical Information of China (English)

    陈恒丕; 王涛

    2013-01-01

    目的:牙槽嵴裂常与唇腭裂伴发,表现为牙槽嵴的骨质缺损。目前,自体髂骨移植治疗牙槽嵴裂是目前的最广泛治疗方式。但髂骨松质骨移植吸收率高,移植的最终治疗效果并不能完全满足临床要求。本研究采用皮质骨块加松质骨移植治疗牙槽嵴裂,了解是否能提高治疗效果。材料和方法:牙槽嵴裂患者21例,采用髂骨植骨,包括髂骨皮质骨块加骨松质移植和单纯松质骨移植两种方式。术后6个月,采用锥形束CT复查获取影像学资料,对比两种治疗方式的影像学资料中的牙槽骨的剩余量,确定治疗效果。结果:通过髂骨皮质骨块加松质骨移植后的牙槽骨的剩余量大于单纯松质骨移植的牙槽骨的剩余量。结论:对于治疗牙槽嵴裂,皮质骨块加松质骨移植作为一种治疗方法能够提高治疗效果。%Objective :Autologous bone grafts are widely used to treat alveolar cleft associated with cleft lip and palate , showing alveolar bone defects . However ,due to the high absorption rate of iliac cancellous bone grafts ,the clinical requirements are not fully satisfied .In this study ,cortical bone block affiliate with cancellous bone were used to treat alveolar cleft to determine whether there could be any improvement on therapeutic results .Materials and Methods :21 patients with alveolar cleft were treated with cortical bone block affiliate with cancellous bone grafts and cancellous bone grafts from iliac .Six months after the surgical procedures ,Cone-beam CT scanning were executed and the volume of bone of each type of the two treatment methods was calculated to find out the therapeutic results .Results :The volume of alveolar bone formed from cortical bone block affiliate with cancellous bone grafts is greater than cancellous bone grafts alone .Conclusions :For treatment of alveolar cleft ,cortical bone block affiliate with cancellous bone grafts is one method

  7. Comparison of bupivacaine alone and in combination with fentanyl or pethidine for bilateral infraorbital nerve block for postoperative analgesia in paediatric patients for cleft lip repair: A prospective randomized double blind study

    Directory of Open Access Journals (Sweden)

    Rajesh S Mane

    2011-01-01

    Conclusion: Thus we conclude that addition of fentanyl or pethidine to bupivacaine for Bilateral Intraoral Infraorbital Nerve Block prolong the duration of analgesia with no complications and can be used safely in paediatric patients.

  8. Our anesthesia experiences with geriatric patients at high risk group undergoing hip surgery under combined psoas compartment-sciatic nerve block

    Directory of Open Access Journals (Sweden)

    Kasım Tuzcu

    2013-09-01

    Full Text Available Aim. The effect of psoas compartment and sciatic nerve block combination on hemodynamic parameters in high risk geriatric patients with hip fracture surgeries was evaluated. Methods. In this study, high risk old patients who underwent psoas compartment block and sciatic nerve block for hip surgery anesthesia were evaluated retrospectively. In Group 1 there were 14 patients with levobupivacaine and lidocaine combination and in Group 2 there were 10 patients with levobupivacaine and prilocaine combination. In our study we evaluated the heart rate, systolic blood pressure, diastolic blood pressure, mean arterial blood pressure levels and sedation need between groups, between age over and below 85 years and in all patients. Results. There were no statistically significant difference in heart rate and mean arterial blood pressure levels between groups and age groups (p˃0.05. There were a 6.18% and 16.52% decrease in mean arterial blood pressure in Group 1 and 2 respectively. When we evaluated the whole patients there was a 10.06% decrease in mean arterial blood pressure. Conclusion. We consider that the combination of psoas and sciatic block as an anesthetic method may be a proper option especially in the elderly and high-risk patients who were underwent the hip surgery.

  9. Comparative efficacy of ropivacaine and levobupivacaine in combined femoral and lateral femoral cutaneous nerve block with adjuvant magnesium for post-operative analgesia

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    Prakash Khairnar

    2016-01-01

    Full Text Available Background and Aims: Patients with burns may require multiple surgeries, but poor general condition and underlying protein energy malnutrition make them unsuitable candidates for general or spinal anaesthesia. This study evaluated the role of magnesium sulphate as an adjuvant with levobupivacaine and ropivacaine used in combined femoral and lateral femoral cutaneous nerve (LFCN blocks in burn patients with relative sparing of thigh portion. Methods: This prospective, randomised, double-blind study included 54 adult patients of 18-65 years age, undergoing split-thickness skin graft harvest from the thigh, allotted to three equal groups of 18 each. Group L patients received femoral nerve (FN block with 15 mL of 0.5% levobupivacaine and 8 mL for LFCN block; Group LM patients received 14 mL of 0.5% levobupivacaine along with 1.0 mL of 15% magnesium sulphate for FN block, 7.5 mL of 0.5% levobupivacaine with 0.5 mL of 15% of magnesium sulphate to LFCN block and Group R patients received 15 mL of 0.5% ropivacaine for FN block and 8 mL of 0.5% ropivacaine for LFCN block. Time to block onset and complete surgical block, duration of analgesia, total analgesic dose and the overall analgesia satisfaction score were measured in the first 24 h post-operatively. Quantitative data were analysed with ANOVA and qualitative data subjected to Chi-square tests. Intergroup comparison was performed with independent t-test. Results: The duration of post-operative analgesia did not differ with the addition of magnesium (P = 0.610. Time to onset of the block was significantly decreased with the addition of magnesium (P = 0.0341, but time to complete surgical block onset was similar across the groups. Conclusion: Both ropivacaine and levobupivacaine have good perioperative analgesic efficacy. Magnesium as an analgesia adjuvant with levobupivacaine does not prolong the duration of post-operative analgesia.

  10. A preliminary study of the sensory distribution of the penile dorsal and ventral nerves: implications for effective penile block for circumcision.

    LENUS (Irish Health Repository)

    Long, Ronan M

    2012-01-31

    OBJECTIVE: To determine the sensory innervation of the penis, as regional anaesthesia is often used either for postoperative analgesia or as the sole anaesthetic technique for circumcision. Since first described in 1978 the dorsal penile nerve block has become the standard technique, but some blocks are ineffective; a better understanding of the sensory innervation of the penis might improve the efficacy of the dorsal penile block technique. PATIENTS AND METHODS: In 13 men undergoing circumcision with local anaesthetic, cutaneous sensation was tested before and after infiltration of the dorsal aspect of the penis, and then again after infiltration of the ventral aspect. The area of anaesthesia was mapped using pin-prick sensation. RESULTS: Ten of the 13 patients showed a similar pattern of sensory distribution. After the dorsal block, the dorsal aspect of the shaft of the penis and glans penis became insensate. The ventral aspect of the shaft remained sensate up to and including the frenulum. After successful ventral infiltration all sensate areas became insensate and circumcision proceeded. In one case the frenulum and distal ventral foreskin was anaesthetized after the dorsal block and ventral infiltration was not required. No patient experienced pain during circumcision. CONCLUSION: For consistently successful regional anaesthesia of the foreskin in circumcision, a dorsal block must be used. This should be combined with ventral infiltration at the site of incision. This method will avoid inconsistencies and allow pain-free circumcision using local anaesthesia in most men.

  11. Nerve block treatment and nursing on herpes zoster ophthalmicus%眼部带状疱疹神经阻滞治疗及护理

    Institute of Scientific and Technical Information of China (English)

    周丽

    2013-01-01

    目的:探讨神经阻滞治疗眼部带状疱疹及护理方法。方法对21例眼部带状疱疹患者进行神经阻滞治疗的病人给予治疗前、治疗中、治疗后细致的护理及健康指导。结果全部病人顺利完成治疗,达到预期的疗效。结论对眼部带状疱疹病人进行神经阻滞治疗时,做好细致的治疗前护理,加强治疗中密切观察及治疗后护理和健康指导,可使病人积极主动配合治疗,确保疗效,减少并发症,保障医疗安全,促进疾病痊愈。%Objective To explore the effect of nerve block treatment and dedicate nursing on herpes zoster ophthalmicus .Methods 21 herpes zoster ophthalmic patients who accepted before nerve block treatment ,To analysis the effect of the to during and after the treatment by dedicate nursing care and health guideline .Results All patients completed the treatment smoothly ,and therapeutic effect turned out to be as expectation .Conclusion Dedicate nursing care before treatment ,enhance the close observation during treatment and health guide after treatment to herpes zoster ophthalmic by nerve block ,which would be help of patient's cooperation to ensure medical safety and recovery .

  12. Intravenous analgesia with opioids versus femoral nerve block with 0.2% ropivacaine as preemptive analgesic for fracture femur: A randomized comparative study

    Science.gov (United States)

    Singh, Arvinder Pal; Kohli, Vaneet; Bajwa, Sukhminder Jit Singh

    2016-01-01

    Background and Objective: Femoral fractures are extremely painful and pain invariably worsens on any movement. Anesthesia for fracture femur surgery is usually provided by spinal block. This study was undertaken to compare the analgesic effects of femoral nerve block (FNB) using nerve stimulator with 0.2% ropivacaine (15 ml) and intravenous (I.V.) fentanyl before patient positioning for fracture femur surgery under spinal anesthesia. Materials and Methods: A prospective, randomized, double-blind, comparative study was conducted on 60 American Society of Anesthesiologists I and II patients (18–60 years) scheduled for femur surgery under combined spinal epidural anesthesia. Patients in Group I (n = 30), were administered FNB using nerve stimulator with 0.2% ropivacaine (15 ml) and in Group II patients (n = 30), I.V. fentanyl 0.5 μg/kg was given as preemptive analgesia. Parameters observed included time to spinal anesthesia, intra-operative and postoperative visual analog scale (VAS) for any pain and postoperative epidural top-ups dosages. Results: Demographic profile was comparable in both the groups. VAS at 2 min in Group I was 5.63 and in Group II it was 8.00. Satisfaction score was better in Group I as compared to Group II patients. Time to administer subarachnoid block was 17.80 min in patients of Group I as compared to 25.03 min in Group II patients. Postoperatively, VAS scores were lower in Group I than Group II patients. The frequency of epidural top-ups was higher in Group II than in Group I patients. Conclusions: FNB is comparatively better in comparison to I.V. fentanyl when used as preemptive and postoperative analgesic in patients being operated for fracture femur. PMID:27212771

  13. Pulmonary alveolar proteinosis

    Science.gov (United States)

    Alveolar proteinosis; Pulmonary alveolar phospholipoproteinosis ... In some cases, the cause of pulmonary alveolar proteinosis is unknown. In others, it occurs with lung infection or an immune problem. It also can occur with cancers of the blood system, ...

  14. CT-guided plexus and splanchnic nerve neurolytic block. Experience in 150 cases and techniques optimization; Il blocco neurolitico del plesso celiaco e dei nervi splancnici con tomografia computerizzata

    Energy Technology Data Exchange (ETDEWEB)

    Marra, V.; Frigerio, A.; Menna, S.; Di Virgilio, M.R. [Ospedale San Giovanni, Turin (Italy). Serv. di Radiologia; Debernardi, F.; Musso, L. [Ospedale San Giovanni, Turin (Italy). Serv. di Anestesia, Rianimazione e Terapia Antalgica

    1999-09-01

    The paper reports the personal experience in computerized tomography guided celiac plexus and splanchnic nerve neurolytic block blocks. [Italian] Scopo del lavoro e' illustrare l'esperienza personale nell'uso della tomografia computerizzata nel trattamento del dolore da neoplasie addominali superiori, rivoluzionando le tecniche di esecuzione, aumentandone la precisione e riducendone notevolmente il rischio di complicanze.

  15. Fluoroscopic-guided supra-scapular nerve block in the management of shoulder pain in a Nigerian Teaching Hospital: Report of five cases

    Directory of Open Access Journals (Sweden)

    Zakari Aliyu Suleiman

    2015-01-01

    Full Text Available Shoulder pain complaints are common in our environment. The disorder can occur among the young active age group or in the older patients as a result of degenerative changes with its attendant limitations of the function of the affected upper limb, hindrance of the performance of activities of daily living, and reduced quality of life. The traditional oral analgesics, physiotherapy, and intra-articular corticosteroid injections are seldom ineffective at providing the desired pain relief and functional improvement at the shoulder joint. We investigated the role of fluoroscopic-guided supra-scapular nerve blocks (SSNBs in patients with shoulder pain who failed to respond to the routine conservative management. With the patient lying prone and the C-arm fluoroscope placed in anterior-posterior position, the scapula notch was visualized and a 22G spinal needle was directed toward the nerve. The mixture of local anesthetic agent and steroid was injected as close to the nerve as possible after negative aspiration. Fluoroscopic-guided SSNB can produce substantial pain relief and improved range of movement in patients with painful shoulders. The procedure is safe, well tolerated, and can be done on a day-case basis.

  16. Establishment of the inferior alveolar nerve transection combined experimental periodontitis animal modal in rats%大鼠下牙槽神经离断和牙周炎双重动物实验模型的建立

    Institute of Scientific and Technical Information of China (English)

    孙静; 李纾; 高艳; 张盼盼; 杨丕山

    2012-01-01

    PURPOSE: To establish an animal model of the inferior alveolar nerve (IAN) transected combined experimental periodontitis in rats, in order to provide a foundation for exploring the function of nerve factor in the occurrence and development of periodontitis and periodontal tissue regeneration in vivo. METHODS: Thirty-six adult SPF Wistar rats were divided into 3 groups randomly. The IAN-transection and periodontitis group (P1): steel-wire was used to ligate to the dental cervix of the dual first lower molars, the gingiva was lacerated using a dental probe, and the surgical transection of the IAN-transection was applied to the left side of the experimental rats, the animals were provided with high-carbonhydrate diet after surgery;the IAN-transection group (P2): the surgical transection of the IAN-transection was applied to the left side of the experimental group, the animals were fed on in routine way after surgery; the sham surgical group (N): no surgery was performed, the animals were fed on in routine way after surgery.6 weeks after the operation, specimens were collected by dissecting the operation areas after internal fixation and observed by clinical examination, X -ray, and histological examination. SPSS 13.0 software package were used for statistical analysis. RESULTS: The IAN-transection operation was successfully conducted in the study and there was no significant necrosis or ulceration observed in the nerve dissected rats. All experimental periodontitis models were established successfully at the time point; there was severe destruction of the periodontal tissues especially in the P1 group. There was bone losses in the specimens of IAN-transection side than that in non IAN-transection side according to X-ray examination 6 weeksafter operation both in the P1 and P2 group, especially in the P1 group. Periodontal tissues on both sides of the P2 group hadno obvious inflammation and periodontal destruction. CONCLUSIONS: The experimental periodontitis animal

  17. Nerve growth factor-modified mesenchymal stem cells in the acceleration of recovery of inferior alveolar nerve injury in rabbit mandibular distraction osteogenesis%神经生长因子修饰的间充质干细胞促进兔下颌骨牵张成骨时下牙槽神经损伤修复的实验研究

    Institute of Scientific and Technical Information of China (English)

    赵英华; 刘晓昌; 高乐; 陈李彤; 杨子桧; 王磊

    2016-01-01

    Objective To study the effects of lentiviral-mediated human nerve growth factor beta ( hNGFβ) on repair of inferior alveolar nerve ( IAN) in mandibular distraction osteogenesis ( DO) in rabbits.Methods Bone marrow mesenchymal stem cells (MSCs) from rabbit mandibles were isolated and genetically engineered using re-combinant lentiviral vector containing hNGFβ. Twenty New Zealand white rabbits underwent mandibular DO and transplantation of 5 million MSCs transduced with hNGFβ-vector or control vector around the IAN in the bone frac-ture gap during the surgery(n=10).After the distraction,IAN samples were collected for histological and quantita-tive analysis at the 14th day of consolidation period.Results IAN histology showed that the experiment group had more regenerating nerve fibers and less nerve degeneration than the control group. Quantitative analysis of nerve morphology showed that the density of myelinated nerve fibers increased significantly compared with the control group.This indicated that the MSCs transduced with hNGFβcould significantly promote IAN repair during mandi-blar DO.Conclusion Lentiviral-mediated transduction with hNGFβin MSCs may provide an effective gene thera-py for reduction of nerve injury in mandibular DO clinically.%目的:探讨慢病毒介导的人神经生长因子β( hNGFβ)在兔下颌骨牵张成骨模型中促进下牙槽神经损伤修复的作用。方法分离兔下颌骨中的骨髓间充质干细胞( MSC)并通过重组的慢病毒将hNGFβ基因插入到其基因序列中。对20只新西兰白兔进行下颌骨牵张成骨,并在手术时向骨牵张缝隙下牙槽神经周围植入经hNGFβ基因重组质粒转染的MSC或对照MSC(每组10只)。经过牵张,在固定期第14天处死动物并获取下牙槽神经样本进行神经组织学分析和神经组织形态定量分析。结果下牙槽神经组织分析显示,移植hNGFβ基因修饰MSC组与对照组相比较,有更多的再生神

  18. Ultrasound-Guided Intercostobrachial Nerve Block for Intercostobrachial Neuralgia in Breast Cancer Patients: A Case Series.

    Science.gov (United States)

    Wisotzky, Eric M; Saini, Vikramjeet; Kao, Cyrus

    2016-03-01

    This case series describes 3 cases in which ultrasound-guided intercostobrachial perineural injection was used for intercostobrachial neuralgia, a common cause of postmastectomy pain syndrome. All cases had undergone modified radical mastectomy with axillary lymph node dissection for breast cancer. Two cases developed axillary and unilateral chest wall pain. The third case initially presented with axillary pain and lateral shoulder pain 1 year out from radical mastectomy. After a cervical epidural steroid injection, her lateral shoulder pain resolved, but she continued to have residual chest wall paresthesia. It was at this time, we decided to treat with an intercostobrachial nerve perineural injection. Injury to the intercostobrachial nerve is thought to be a common cause of postmastectomy pain. In our case series, all patients had pain relief after the intercostobrachial perineural injection. There is a relative dearth of published information on the treatment of postmastectomy pain and more specifically intercostobrachial neuralgia. We review the anatomy of the intercostobrachial nerve and its variants, etiologies of intercostobrachial neuralgia, and current indications and methods of an intercostobrachial perineural injection. PMID:26493855

  19. 罗哌卡因用于神经刺激仪引导下的闭孔神经阻滞的临床研究%Clinical study of ropivacaine for nerve stimulator- guided obturator nerve block

    Institute of Scientific and Technical Information of China (English)

    唐毅; 耿智隆; 马辉兰; 时圣武

    2011-01-01

    目的:探讨0.4%罗哌卡因用于神经刺激仪引导下的闭孔神经阻滞用于经尿道膀胱肿瘤电切术(transurethral resec-tion of bladder tumor TURBT)的可行性.方法:膀胱侧壁肿瘤择期行TURBT的男性患者60例,ASA Ⅰ~Ⅱ级,随机分为实验组和对照组,每组30例.采用蛛网膜下腔麻醉,辅以神经刺激仪引导闭孔神经阻滞.闭孔神经阻滞局麻药10 ml:实验组采用0.4%罗哌卡因,对照组采用1%利多卡因.观察并记录闭孔神经阻滞的麻醉效果及并发症.结果:两组闭孔神经阻滞的麻醉效果和安全性没有显著差异(P>0.05).结论:0.4%罗哌卡因用于神经刺激仪引导下的闭孔神经阻滞安全、有效.%Objective:To explore the feasibility of 0.4% ropivacaine in nerve stimulator guided obturator nerve block (ONB) in patients undergoing transurethral resection of bladder tumor (TURBT).Methods: Sixty female patients with the lateral bladder wall tumor, ASA classified grade Ⅰ or Ⅱ, were randomly allocated into two groups:experimental and control group, thirty patients in each group.The patients received spinal anesthesia adding nerve stimulator guided ONB.0.4 % ropivacaine ( 10 ml) and 1% lidocaine ( 10 ml) respectively.The anesthetic effects and side effects of ONB were recorded.Results: There was no significant difference between the two groups in anesthetic effect and safety (P > 0.05 ).Conclusion: The trial showed that 0.4 % ropivacaine in nerve stimulator guided ONB can produce a satisfactory anesthetic effect.

  20. Applicability of equine hydroxyapatite collagen (eHAC) bone blocks for lateral augmentation of the alveolar crest. A histological and histomorphometric analysis in rats

    NARCIS (Netherlands)

    Zecha, P. J.; Schortinghuis, J.; van der Wal, J. E.; Nagursky, H.; van den Broek, K. C.; Sauerbier, S.; Vissink, A.; Raghoebar, G. M.

    2011-01-01

    This study assessed the mechanical characteristics, biocompatibility and osteoconductive properties of an equine hydroxyapatite collagen (eHAC) bone block when applied as a bone substitute for lateral augmentation of rat mandible. 96 rats underwent lateral augmentation of the mandible, using two sub

  1. 肩胛上神经联合肩胛背神经阻滞治疗颈肩部疼痛综合征的临床观察%The clinical observation of suprascapular nerve block combined with dorsal scapular nerve block in the treatment for patients with neck ;and shoulder pain syndrome

    Institute of Scientific and Technical Information of China (English)

    刘永彬; 李彦平; 罗克金

    2016-01-01

    目的:观察应用肩胛上神经联合肩胛背神经阻滞治疗颈肩部疼痛综合征的临床疗效。方法选择颈肩部疼痛患者30例,随机分为局部痛点封闭组(LB组,n=15)和肩胛上神经联合肩胛背神经阻滞组(NB组,n=15),其中LB组接受局部痛点封闭与耸肩运动康复治疗,而NB组接受肩胛上神经联合肩胛背神经阻滞与耸肩运动康复治疗。对比观察两组治疗前、治疗后1周、治疗后3周的疼痛程度、颈部及肩关节活动度。结果两组治疗后疼痛程度均较治疗前显著降低( P ﹤0.05),且NB组治疗后1周和3周的疼痛程度显著低于LB组( P ﹤0.05)。NB组颈椎及肩关节功能活动度在治疗后显著升高( P ﹤0.05),且治疗后1周和3周的颈椎及肩关节功能活动度明显高于LB组( P ﹤0.05)。结论肩胛上神经联合肩胛背神经阻滞治疗颈肩部疼痛综合征可以有效减轻疼痛症状,并明显改善因疼痛所致的颈椎及肩关节功能活动受限。%Objective To observe the therapeutic effect of suprascapular nerve block combined with dorsal scapular nerve block in the treatment for patients with neck and shoulder pain syndrome. Methods Thirty patients with neck and shoulder pain syndrome were randomly as-signed group LB(n=15)in which patients received local pain point injection and shoulder rehabilitation and group NB(n=15)in which pa-tients received suprascapular nerve block combined with dorsal scapular nerve block and shoulder rehabilitation. The pain intensity and range of motion in neck and shoulder were observed. Results The pain intensity after the treatment was significantly lower than that before the treatment in both groups( P ﹤0. 05),and the pain intensity after the treatment in group NB was significantly lower than that in group LB( P ﹤0. 05). The range of motion in neck and shoulder after the treatment was significantly greater than that before the treatment in

  2. Prospective randomized trial of iliohypogastric-ilioinguinal nerve block on post-operative morphine use after inpatient surgery of the female reproductive tract

    Directory of Open Access Journals (Sweden)

    Saltzman Steven L

    2008-11-01

    Full Text Available Abstract Objective To determine the impact of pre-operative and intra-operative ilioinguinal and iliohypogastric nerve block on post-operative analgesic utilization and length of stay (LOS. Methods We conducted a prospective randomized double-blind placebo controlled trial to assess effectiveness of ilioinguinal-iliohypogastric nerve block (IINB on post-operative morphine consumption in female study patients (n = 60. Patients undergoing laparotomy via Pfannenstiel incision received injection of either 0.5% bupivacaine + 5 mcg/ml epinephrine for IINB (Group I, n = 28 or saline of equivalent volume given to the same site (Group II, n = 32. All injections were placed before the skin incision and after closure of rectus fascia via direct infiltration. Measured outcomes were post-operative morphine consumption (and associated side-effects, visual analogue pain scores, and hospital length of stay (LOS. Results No difference in morphine use was observed between the two groups (47.3 mg in Group I vs. 45.9 mg in Group II; p = 0.85. There was a trend toward lower pain scores after surgery in Group I, but this was not statistically significant. The mean time to initiate oral narcotics was also similar, 23.3 h in Group I and 22.8 h in Group II (p = 0.7. LOS was somewhat shorter in Group I compared to Group II, but this difference was not statistically significant (p = 0.8. Side-effects occurred with similar frequency in both study groups. Conclusion In this population of patients undergoing inpatient surgery of the female reproductive tract, utilization of post-operative narcotics was not significantly influenced by IINB. Pain scores and LOS were also apparently unaffected by IINB, indicating a need for additional properly controlled prospective studies to identify alternative methods to optimize post-surgical pain management and reduce LOS.

  3. Time Course of the Soleus M Response and H Reflex after Lidocaine Tibial Nerve Block in the Rat

    OpenAIRE

    Kévin Buffenoir; Philippe Decq; Chantal Pérot

    2013-01-01

    Aims. In spastic subjects, lidocaine is often used to induce a block predictive of the result provided by subsequent surgery. Lidocaine has been demonstrated to inhibit the Hoffmann (H) reflex to a greater extent than the direct motor (M) response induced by electrical stimulation, but the timecourse of these responses has not been investigated. Methods. An animal (rat) model of the effects of lidocaine on M and H responses was therefore developed to assess this time course. M and H responses...

  4. An isolated, antegrade, perfused, peroneal nerve anterior tibialis muscle model in the rat - A novel model developed to study the factors governing the time course of action of neuromuscular blocking agents

    NARCIS (Netherlands)

    De Haes, A; Houwertjes, MC; Proost, JH; Wierda, JMKH

    2002-01-01

    Background: A model of an antegrade, perfused, isolated rat peroneal nerve anterior tibial muscle was developed to study potentially important factors governing the time course of action of (nondepolarizing) neuromuscular blocking agents such as concentration, blood flow, and temperature. The model

  5. 下颌阻生第三磨牙拔除损伤下牙槽神经风险的全景片影像分析%Panoramic radiographic study on the risk of inferior alveolar nerve injury after impacted mandibular third molar extraction

    Institute of Scientific and Technical Information of China (English)

    梁荣奇; 潘文中

    2016-01-01

    Objective To observe the risk factors of inferior alveolar nerve damage after impacted mandib-ular third molar surgical extraction on panoramic radiography (PR). Methods The shortest vertical distance between impacted mandibular third molars and inferior alveolar canal on PR were measured for 522 teeth from 464 patients,and the images were classified.Relationship analysis of impacted molar type and the risks of inju-ring alveolar nerve were also performed.Fisher exact probability test and a rank test were performed for col-lected data. Results Among 522 teeth,different distance between mandibular third molars and mandibular canal differed in type of molar impaction and risks of injuring nerve after molar extraction.The shortest dis-tance was found in mesioangular impacted tooth and there was statistical difference.Tooth extraction resulting in mandibular nerve canal exposure and inferior alveolar nerve damage was correlated with the cross and over-lapped distance between impacted tooth and mandibular canal.But the type of impacted tooth and its extraction was not correlated with the results of mandibular nerve canal exposure and inferior alveolar nerve damage.Me-sioangular impacted tooth had the shortest distance,and next was horizontal impacted tooth,and vertical im-pacted tooth and distoangular impacted teeth had the longest distance.When mandibular third impacted molar presented cross,overlapped PR image correlation with mandibular canal,it would strengthen the risk of inferi-or alveolar nerve injury after molar extraction. Conclusion Tooth extraction operator should completely ana-lyze the image materials and clinical records for obtaining valuable information,and should summarize tooth extraction experiences continuously at the same time to avoid or to decrease the risk of inferior alveolar nerve damage during tooth extraction.%目的:在全景片(panoramic radiography,PR)中分析下颌阻生第三磨牙拔牙损伤下牙槽神经风

  6. Polymer Coatings of Cochlear Implant Electrode Surface - An Option for Improving Electrode-Nerve-Interface by Blocking Fibroblast Overgrowth.

    Directory of Open Access Journals (Sweden)

    C Hadler

    Full Text Available Overgrowth of connective tissue and scar formation induced by the electrode array insertion increase the impedance and, thus, diminish the interactions between neural probes as like cochlear implants (CI and the target tissue. Therefore, it is of great clinical interest to modify the carrier material of the electrodes to improve the electrode nerve interface for selective cell adhesion. On one side connective tissue growth needs to be reduced to avoid electrode array encapsulation, on the other side the carrier material should not compromise the interaction with neuronal cells. The present in vitro-study qualitatively and quantitatively characterises the interaction of fibroblasts, glial cells and spiral ganglion neurons (SGN with ultrathin poly(N,N-dimethylacrylamide (PDMAA, poly(2-ethyloxazoline (PEtOx and poly([2-methacryloyloxyethyl]trimethylammoniumchlorid (PMTA films immobilised onto glass surfaces using a photoreactive anchor layer. The layer thickness and hydrophilicity of the polymer films were characterised by ellipsometric and water contact angle measurement. Moreover the topography of the surfaces was investigated using atomic force microscopy (AFM. The neuronal and non-neuronal cells were dissociated from spiral ganglions of postnatal rats and cultivated for 48 h on top of the polymer coatings. Immunocytochemical staining of neuronal and intermediary filaments revealed that glial cells predominantly attached on PMTA films, but not on PDMAA and PEtOx monolayers. Hereby, strong survival rates and neurite outgrowth were only found on PMTA, whereas PDMAA and PEtOx coatings significantly reduced the SG neuron survival and neuritogenesis. As also shown by scanning electron microscopy (SEM SGN strongly survived and retained their differentiated phenotype only on PMTA. In conclusion, survival and neuritogenesis of SGN may be associated with the extent of the glial cell growth. Since PMTA was the only of the polar polymers used in this study

  7. Vagal nerve stimulation blocks interleukin 6-dependent synaptic hyperexcitability induced by lipopolysaccharide-induced acute stress in the rodent prefrontal cortex.

    Science.gov (United States)

    Garcia-Oscos, Francisco; Peña, David; Housini, Mohammad; Cheng, Derek; Lopez, Diego; Borland, Michael S; Salgado-Delgado, Roberto; Salgado, Humberto; D'Mello, Santosh; Kilgard, Michael P; Rose-John, Stefan; Atzori, Marco

    2015-01-01

    The ratio between synaptic inhibition and excitation (sI/E) is a critical factor in the pathophysiology of neuropsychiatric disease. We recently described a stress-induced interleukin-6 dependent mechanism leading to a decrease in sI/E in the rodent temporal cortex. The aim of the present study was to determine whether a similar mechanism takes place in the prefrontal cortex, and to elaborate strategies to prevent or attenuate it. We used aseptic inflammation (single acute injections of lipopolysaccharide, LPS, 10mg/kg) as stress model, and patch-clamp recording on a prefrontal cortical slice preparation from wild-type rat and mice, as well as from transgenic mice in which the inhibitor of IL-6 trans-signaling sgp130Fc was produced in a brain-specific fashion (sgp130Fc mice). The anti-inflammatory reflex was activated either by vagal nerve stimulation or peripheral administration of the nicotinic α7 receptor agonist PHA543613. We found that the IL-6-dependent reduction in prefrontal cortex synaptic inhibition was blocked in sgp130Fc mice, or - in wild-type animals - upon application sgp130Fc. Similar results were obtained by activating the "anti-inflammatory reflex" - a neural circuit regulating peripheral immune response - by stimulation of the vagal nerve or through peripheral administration of the α7 nicotinic receptor agonist PHA543613. Our results indicate that the prefrontal cortex is an important potential target of IL-6 mediated trans-signaling, and suggest a potential new avenue in the treatment of a large class of hyperexcitable neuropsychiatric conditions, including epilepsy, schizophrenic psychoses, anxiety disorders, autism spectrum disorders, and depression. PMID:25128387

  8. Laser-guided cervical selective nerve root block with the Dyna-CT: initial experience of three-dimensional puncture planning with an ex-vivo model.

    Directory of Open Access Journals (Sweden)

    Miriam I E Freundt

    Full Text Available BACKGROUND: Cervical selective nerve root block (CSNRB is a well-established, minimally invasive procedure to treat radicular cervical pain. However, the procedure is technically challenging and might lead to major complications. The objective of this study was to evaluate the feasibility of a three-dimensional puncture planning and two-dimensional laser-guidance system for CSNRB in an ex-vivo model. METHODS: Dyna-CT of the cervical spine of an ex-vivo lamb model was performed with the Artis Zee® Ceiling (Siemens Medical Solutions, Erlangen, Germany to acquire multiplanar reconstruction images. 15 cervical nerve root punctures were planned and conducted with the syngo iGuide® laser-guidance system. Needle tip location and contrast dye distribution were analyzed by two independent investigators. Procedural, planning, and fluoroscopic time, tract length, and dose area product (DAP were acquired for each puncture. RESULTS: All 15 punctures were rated as successful with 12 punctures on the first attempt. Total procedural time was approximately 5 minutes. Mean planning time for the puncture was 2.03 (±0.39 min. Mean puncture time was 2.16 (±0.32 min, while mean fluoroscopy time was 0.17 (±0.06 min. Mean tract length was 2.68 (±0.23 cm. Mean total DAP was 397.45 (±15.63 µGy m(2. CONCLUSION: CSNRB performed with Dyna-CT and the tested laser guidance system is feasible. 3D pre-puncture planning is easy and fast and the laser-guiding system ensures very accurate and intuitive puncture control.

  9. The Gow-Gates mandibular block. Evaluation after 4,275 cases.

    Science.gov (United States)

    Malamed, S F

    1981-05-01

    The Gow-Gates mandibular block, introduced in the United States in 1973, represents the first new approach to intraoral regional anesthesia in many years. The technique is being taught at most United States dental schools. This article presents a clinical evaluation of the Gow-Gates technique after 5 years of application and more than 4,000 cases. Advantages of this technique over the conventional inferior alveolar nerve block include a greater success rate, decreased positive aspiration rate, and fewer postinjection problems.

  10. 头皮神经阻滞在小儿开颅手术中的应用%Scalp nerve block in pediatric patients undergoing craniotomy

    Institute of Scientific and Technical Information of China (English)

    阳垚鑫(综述); 李羽(审校)

    2016-01-01

    Noxious stimulation of neurosurgery can cause violent fluctuation of hemodynamics in children during perioperative period,leading to occurance or aggravation of intracranial hypertension.Meanwhile the sudden increased blood pressure may cause ruptures of intracranial aneurysm and other intracranial hemorrhage.Because of the drug adverse reaction of opioid analgesics, such as nausea, emesis and miosis, may interference with neurophysician examination results, postoperative pain of craniotomy is frequently uncontrolled in children.Scalp nerve block can block the nerves which innervate the involved region of the scalp,so as to reduce the conduction of noxious stimulation,relieve the perioperative pain, maintain the steady of hemodynamics,decrease the consumption of narcotic analgesics, minimized drug adverse reaction and provided satisfactory postoperative analgesia.Timely and effectively pain relief can reduce postoperative pediatric neuro-behavior change and improve the long-term prognosis.%小儿神经外科开颅手术的强烈刺激可引起围手术期血流动力学的剧烈波动,导致颅内压增高或者加重已经存在的颅内高压。同时,随着血压的骤然升高,可能引起颅内动脉瘤破裂或颅内其他部位出血。由于阿片类镇痛药物引起的恶心、呕吐、瞳孔缩小等药物不良反应会干扰小儿术后神经系统的检查结果,因而小儿开颅手术的术后镇痛治疗常常不足。头皮神经阻滞通过阻滞支配头部的感觉神经,可减少伤害性刺激的传入,有效减轻围手术期疼痛,维持术中血流动力学的平稳,减少术中和术后镇痛药物的使用,降低药物不良反应的发生,提供较为满意的术后镇痛效果。而及时、有效的缓解小儿术后疼痛,能够减少小儿术后神经行为学的改变,改善其长期预后。

  11. Scalp nerve block in pediatric patients undergoing craniotomy%头皮神经阻滞在小儿开颅手术中的应用

    Institute of Scientific and Technical Information of China (English)

    阳垚鑫(综述); 李羽(审校)

    2016-01-01

    Noxious stimulation of neurosurgery can cause violent fluctuation of hemodynamics in children during perioperative period,leading to occurance or aggravation of intracranial hypertension.Meanwhile the sudden increased blood pressure may cause ruptures of intracranial aneurysm and other intracranial hemorrhage.Because of the drug adverse reaction of opioid analgesics, such as nausea, emesis and miosis, may interference with neurophysician examination results, postoperative pain of craniotomy is frequently uncontrolled in children.Scalp nerve block can block the nerves which innervate the involved region of the scalp,so as to reduce the conduction of noxious stimulation,relieve the perioperative pain, maintain the steady of hemodynamics,decrease the consumption of narcotic analgesics, minimized drug adverse reaction and provided satisfactory postoperative analgesia.Timely and effectively pain relief can reduce postoperative pediatric neuro-behavior change and improve the long-term prognosis.%小儿神经外科开颅手术的强烈刺激可引起围手术期血流动力学的剧烈波动,导致颅内压增高或者加重已经存在的颅内高压。同时,随着血压的骤然升高,可能引起颅内动脉瘤破裂或颅内其他部位出血。由于阿片类镇痛药物引起的恶心、呕吐、瞳孔缩小等药物不良反应会干扰小儿术后神经系统的检查结果,因而小儿开颅手术的术后镇痛治疗常常不足。头皮神经阻滞通过阻滞支配头部的感觉神经,可减少伤害性刺激的传入,有效减轻围手术期疼痛,维持术中血流动力学的平稳,减少术中和术后镇痛药物的使用,降低药物不良反应的发生,提供较为满意的术后镇痛效果。而及时、有效的缓解小儿术后疼痛,能够减少小儿术后神经行为学的改变,改善其长期预后。

  12. Bloqueio do nervo supraescapular: procedimento importante na prática clínica. Parte II Suprascapular nerve block: important procedure in clinical practice. Part II

    Directory of Open Access Journals (Sweden)

    Marcos Rassi Fernandes

    2012-08-01

    Full Text Available O bloqueio do nervo supraescapular é um método de tratamento reprodutível, confiável e extremamente efetivo no controle da dor no ombro. Esse método tem sido amplamente utilizado por profissionais na prática clínica, como reumatologistas, ortopedistas, neurologistas e especialistas em dor, na terapêutica de enfermidades crônicas, como lesão irreparável do manguito rotador, artrite reumatoide, sequelas de AVC e capsulite adesiva, o que justifica a presente revisão (Parte II. O objetivo deste estudo foi descrever as técnicas do procedimento e suas complicações descritas na literatura, já que a primeira parte reportou as indicações clínicas, drogas e volumes utilizados em aplicação única ou múltipla. Apresentamse, detalhadamente, os acessos para a realização do procedimento tanto direto como indireto, anterior e posterior, lateral e medial, e superior e inferior. Diversas são as opções para se realizar o bloqueio do nervo supraescapular. Apesar de raras, as complicações podem ocorrer. Quando bem indicado, este método deve ser considerado.The suprascapular nerve block is a reproducible, reliable, and extremely effective treatment method in shoulder pain control. This method has been widely used by professionals in clinical practice such as rheumatologists, orthopedists, neurologists, and pain specialists in the treatment of chronic diseases such as irreparable rotator cuff injury, rheumatoid arthritis, stroke sequelae, and adhesive capsulitis, which justifies the present review (Part II. The objective of this study was to describe the techniques and complications of the procedure described in the literature, as the first part reported the clinical indications, drugs, and volumes used in single or multiple procedures. We present in details the accesses used in the procedure: direct and indirect, anterior and posterior, lateral and medial, upper and lower. There are several options to perform suprascapular nerve block

  13. Retrospective comparison of the effects of epidural anesthesia versus peripheral nerve block on postoperative outcomes in elderly Chinese patients with femoral neck fractures

    Directory of Open Access Journals (Sweden)

    Jin JW

    2015-08-01

    Full Text Available Jianwen Jin,1 Gang Wang,2 Maowei Gong,3 Hong Zhang,3 Junle Liu21Department of Clinical Medicine, Fujian Health College, Fuzhou, 2Department of Anesthesiology, Chinese People’s Liberation Army 105 Hospital, Hefei, 3Anesthesia and Operation Center, Chinese People’s Liberation Army General Hospital, Beijing, People’s Republic of ChinaBackground: Geriatric patients with femoral neck fracture (FNF have unacceptably high rates of postoperative complications and mortality. The purpose of this study was to compare the effects of epidural anesthesia versus peripheral nerve block (PNB on postoperative outcomes in elderly Chinese patients with FNF.Methods: This retrospective study explored mortality and postoperative complications in geriatric patients with FNF who underwent epidural anesthesia or PNB at the Chinese People’s Liberation Army General Hospital from January 2008 to December 2012. The electronic database at the Chinese People’s Liberation Army General Hospital includes discharge records for all patients treated in the hospital. Information on patient demographics, preoperative comorbidity, postoperative complications, type of anesthesia used, and in-hospital, 30-day, and 1-year mortality after surgery was obtained from this database.Results: Two hundred and fifty-eight patients were identified for analysis. The mean patient age was 79.7 years, and 71.7% of the patients were women. In-hospital, 30-day, and 1-year postoperative mortality was 4.3%, 12.4%, and 22.9%, respectively, and no differences in mortality or cardiovascular complications were found between patients who received epidural anesthesia and those who received PNB. More patients with dementia or delirium were given PNB. No statistically significant differences were found between groups for other comorbidities or intraoperative parameters. The most common complications were acute cardiovascular events (23.6%, electrolyte disturbances (20.9%, and hypoxemia (18.2%. Patients

  14. Does audiovisual stimulation with music and nature sights (MuViCure) reduce pain and discomfort during placement of a femoral nerve block?

    Science.gov (United States)

    Nikolajsen, Lone; Lyndgaard, Kirsten; Schriver, Nina B; Moller, Jytte F

    2009-02-01

    MuViCure (Photobia ApS, Copenhagen, Denmark) is a new program for audiovisual stimulation. We hypothesized that audiovisual stimulation would reduce pain and discomfort and improve patients' well-being during placement of a femoral nerve block. Fifty-five outpatients scheduled for anterior cruciate ligament reconstruction were randomly allocated into three groups: the first group received audiovisual stimulation (MuViCure), the second group received audio stimulation (MusiCure, Gefion Records ApS, Virum, Denmark), and the third group received no intervention (control). Ten of the 55 patients underwent a qualitative in-depth interview 1-2 days after surgery. Pain and discomfort during the procedure were more prominent in the MuViCure group when compared with the other two groups. Despite these negative results, 14 of the 19 patients in the MuViCure group answered that MuViCure had a positive effect on their well-being. The qualitative interviews revealed that a number of factors other than the audiovisual stimulation had a significant impact on the patients' experience. The use of MuViCure may be more appropriate in other settings. PMID:19185817

  15. Pulmonary alveolar proteinosis

    OpenAIRE

    Patel, Sandeep M; Sekiguchi, Hiroshi; Jordan P Reynolds; Krowka, Michael J.

    2012-01-01

    Pulmonary alveolar proteinosis (PAP) is a disease of alveolar accumulation of phospholipoproteinaceous material that results in gas exchange impairment leading to dyspnea and alveolar infiltrates. There are three forms of PAP: congenital, acquired and idiopathic; of which the latter two are predominant in the adult population. Previous case studies have found that the acquired form can be secondary to various autoimmune, infectious, malignant and environmental etiologies. Recent advances in t...

  16. Pulmonary Alveolar Proteinosis

    OpenAIRE

    Patel, Sandeep M; Hiroshi Sekiguchi; Jordan P Reynolds; Krowka, Michael J.

    2012-01-01

    Pulmonary alveolar proteinosis (PAP) is a disease of alveolar accumulation of phospholipoproteinaceous material that results in gas exchange impairment leading to dyspnea and alveolar infiltrates. There are three forms of PAP: congenital, acquired and idiopathic; of which the latter two are predominant in the adult population. Previous case studies have found that the acquired form can be secondary to various autoimmune, infectious, malignant and environmental etiologies. Recent advances in t...

  17. Primary pulmonary alveolar proteinosis

    OpenAIRE

    Šarac Sanja; Milić Rade; Zolotarevski Lidija; Aćimović Slobodan; Tomić Ilija; Plavec Goran

    2012-01-01

    Introduction. Pulmonary alveolar proteinosis is an uncommon disease characterized by the accumulation of surfactant proteins and phospholipids within the alveolar spaces. Acquired disease can be idiopathic (primary) and secondary. The prevalence of acquired pulmonary alveolar proteinosis is about 0.37 per 100,000 persons. Common symptoms are dyspnea and cough. Chest X-ray shows bilateral perihilar infiltrates. Open-lung biopsy is the gold standard for the diagnosis. Treatment includes w...

  18. Extensive pulmonary alveolar microlithiasis

    OpenAIRE

    Rittayamai, Nuttapol; Muangman, Nisa; Ruangchira-Urai, Ruchira

    2013-01-01

    Pulmonary alveolar microlithiasis is a rare pulmonary disorder that is caused by abnormal sodium-dependent phosphate co-transporter from the mutation of SLC34A2 gene, leading to accumulation of microliths in the alveoli. We report the extensive pulmonary alveolar microlithiasis in an elderly woman who presented with progressive dyspnea for 2 months. Chest radiograph revealed diffuse pulmonary calcification. Tissue histopathology from open lung biopsy demonstrated widespread intra-alveolar lam...

  19. 帕瑞昔布钠联合头皮神经阻滞用于神经外科开颅术后镇痛的研究%Parecoxib sodium combined scalp nerve block for postoperative analgesia in craniotomy

    Institute of Scientific and Technical Information of China (English)

    黄福森; 吴超然

    2014-01-01

    目的:研究帕瑞昔布钠联合头皮神经阻滞对神经外科术后镇痛作用的时间,探讨其是否为一种可行的镇痛方案.方法:60例择期开颅手术病人按数字随机分为2组:头皮神经阻滞组(对照组),帕瑞昔布钠+头皮神经阻滞组(试验组).麻醉诱导前根据手术切口部位用0.5%的罗哌卡因选择性阻滞眶上神经、耳颞神经、枕大及枕小神经,术毕用0.5%罗哌卡因浸润手术切口.记录拔管后即刻(0时),术后1、2、4、12、24时各时点疼痛评分、镇静评分、恶心呕吐评分、生命体征.结果:帕瑞昔布钠+头皮神经阻滞组镇痛时间可以维持18h左右,对呼吸、镇静程度及生命体征的影响较小.与对照组相比,延长了追加镇痛药物的时间(P=0.00),但没有改变追加药物的剂量.结论:帕瑞昔布钠联合头皮神经阻滞是一种良好的神经外科术后镇痛方案,值得推广运用.%Objective:To observe the acting time of postoperative analgesic effects after applying Parecoxib sodium combined scalp nerve block and to explore whether scalp nerve block combined with Parecoxib sodium is a good analgesic method for craniotomy.Methods:Totally 60 craniotomy patients were randomly divided into scalp nerve block group(control group) and scalp nerve block combined with Parecoxib sodium group(experimental group).Based on the location of incision,the supraorbital nerve,auriculotemporal nerve,greater occipital and lesser occipital nerve were selectively blocked with 0.5% ropivacaine.In experimental group,Parecoxib sodium was given before surgery.Postoperative pain score,sedation score,nausea and vomiting score,vital signs were recorded at 0,1,2,4,12,24 h postoperatively.Results:In experimental group,the analgesic effect acted for 18 h and exerted slight effect on respiratory depression,sedation and vital signs.In control group,Parecoxib sodium combined scalp nerve block extended the rescue analgesic time,but did not change the dose

  20. Simulation study of unmyelinated nerve model blocked by high frequency biphasic electrical stimulation%高频双向电刺激下无髓神经模型传导阻断的仿真研究

    Institute of Scientific and Technical Information of China (English)

    陈茜; 赵守国

    2015-01-01

    目的:神经纤维异常兴奋会造成许多功能障碍疾病,因此,研究无髓神经纤维受到电刺激时动作电位的传播规律及传导阻断情况有重要的科研意义和临床价值。方法本文基于 Hodgkin-Huxley模型,在高频双向电刺激下研究无髓神经纤维的阻断阈和阻断机制,并提出一种电刺激结束后轴突恢复初始状态的时间测量方法。结果电刺激下直径大的神经纤维先被阻断,直径小的神经纤维后被阻断,并随着刺激频率的增加,阻断阈在12~16 kHz时达到峰值。阻断电极处钠离子和钾离子通道的持续开放造成神经纤维的传导阻断。电刺激结束后,神经纤维恢复初始状态的时间随着频率的增加而增加。结论本研究揭示了无髓神经纤维的阻断机制以及电刺激结束后神经纤维恢复初始状态的时间与电刺激频率的关系,这些结果将为相关动物实验和功能电刺激的临床应用提供更多的信息。%Objective Abnormal nerve fiber activation can cause many disorder diseases. Therefore, the study on action potential propagation and conduction block of unmyelinated nerve with electrical stimulation has great values for science research and clinical application. Methods Based on Hodgkin-Huxley model,we research on fiber blocking threshold and blocking mechanism of unmyelinated nerve under high frequency biphasic electrical stimulation. A measurement method for the recovery time of axon to the initial state after electrical stimulation is proposed in this paper. Results Larger diameter fibers tend to be blocked early than smaller nerve fibers under electrical stimulation. With the increase of frequency,the biggest block threshold is 12 kHz to 16 kHz. The high frequency stimulation produces constant activation of both sodium and potassium channels at the nerve fiber node under the block electrode,which causes the conduction block of nerve fiber. After the electrical

  1. 翼腭窝神经阻滞相关解剖及其临床意义%Anatomy and Clinical Research of the Pterygolatine Fossa Nerve Block

    Institute of Scientific and Technical Information of China (English)

    孙光孝; 朱亚文; 陶高见

    2011-01-01

    Objective: To explore the anatomy and the clinical use of the pterygolatine fossa nerve block. Methods :Anatomical parameters and communications of the pterygolatine fossa were obtained from 33 dried - specimen skulls , the data were analyzed by SPSS17. 0 and compared. Results : Major clinical approaches and their results are : Infrazygomatic approach - Flank front approach: left( 54. 87 ±3. 44 )mm , right( 54. 79 ±2. 81 )mm; Infrazygomatic approach - Flank front approach: left( 52. 90 ± 3. 39 )mm, right( 52. 98 ± 2. 76 )mm; Suprazygomatic approach: left( 47. 59 ±2. 93 )mm, right( 47. 34 ± 3. 05 )mm; the 3 major clinical approaches'angles ( between middle sagittal plane of skull and puncture needle ) is : left( 75. 5 ±6. 4 )° , right ( 73. 4 ±4. 7 )° ; left ( 83. 0 ±7. 1 )° , right( 82. 7 ±5. 2 )° ; left( 101. 4 ±7. 4 )° , right( 101. 9 ±6. 6 )°. Conclusions: Suprazygomatic approach and infrazygomatic approach are the two major ways of the pterygolatine fossa nerve block. Suprazygomatic approach is recommended.%目的:探讨翼腭窝神经阻滞相关解剖及其临床意义.方法:在33个干性颅骨标本上对翼腭窝相关孔道和穿刺路径进行解剖观测.应用SPSS17.0分析并比较相关解剖数据.结果:不同穿刺测量法测量翼腭窝的长度,分别为:颧弓下法之侧入法,左侧为(54.87±3.44)mm、右侧为(54.79±2.81)mm;颧弓下法之侧前入法,左侧为(52.90±3.39)mm、右侧为(52.98±2.76)mm;颧骨上法,左侧为(47.59±2.93)mm、右侧为(47.34±3.05)mm.穿刺针与颅骨正中矢状面的角度上述3种方法依次为:左侧(75.5±6.4)°、右侧为(73.4±4.7)°,左侧(83.0±7.1)°、右侧(82.7±5.2)°,左侧(101.4±7.4)°、右侧(101.9±6.6 )°.结论:翼腭窝神经阻滞术以颧骨上法、颧骨下法应用较多.以颧骨上法风险较小,效果较好.

  2. Pulmonary alveolar microlithiasis

    OpenAIRE

    Gayathri Devi, H.J.; K N Mohan Rao; Prathima, K. M.; Das, Jayanth K.

    2011-01-01

    Pulmonary alveolar microlithiasis is a rare disease of unknown cause. We report a case in a young boy who presented with history of failure to thrive and chest X-ray finding suggestive of miliary mottling. Open lung biopsy revealed pulmonary alveolar microlithiasis.

  3. Morphological changes of mitochondria in trigeminal ganglion neurons following inferior alveolar nerve crush in rats%电镜下大鼠下牙槽神经压榨损伤后半月神经节神经元线粒体的超微结构观察

    Institute of Scientific and Technical Information of China (English)

    赵佳明; 高璐; 田英; 何国金; 陈劲宏; 金海威

    2013-01-01

    目的 观察大鼠下牙槽神经损伤后半月神经节(TG)神经元线粒体的超微结构变化,探讨线粒体参与外周神经损伤及修复机制的结构基础.方法 选取健康SD雄性大鼠10只,随机分为空白对照组2只,实验组8只,建立大鼠单侧下牙槽神经压榨损伤的动物模型,选取代表性时间点制备TG电镜样品,透射电镜下观察TG神经元细胞体及其轴突中线粒体的超微结构变化.结果 电镜下,空白对照组及实验对照侧TG神经元细胞体及其轴突中均富含线粒体,线粒体双层膜结构清楚,嵴致密、排列整齐,罕见线粒体的肿胀或空泡样变性.实验组大鼠下牙槽神经压榨损伤24h后,损伤侧TG神经元细胞体及其轴突中线粒体发生肿胀、嵴溶解等结构异常性变性.1周时,实验侧TG神经元、无髓鞘的C型及有髓鞘的A型轴突中均出现大量空泡样变性线粒体.结论 下牙槽神经压榨损伤后,损伤的TG神经元线粒体会发生肿胀等结构变化.%Objective To observe the dynamic ultrastructure of mitochondria in trigeminal ganglion (TG) neurons, which possibly involve in the mechanisms of peripheral nerve injury and repair induced by inferior alveolar nerve injury in rats. Methods Ten Sprague - Dawley female rats were randomly divided into control group and inferior alveolar nerve crush group. After nerve injury, the TG were dissected and prepared for observation with transmission electron microscopy at representative time points. The mitochondrial ultrastructure in TG neuronal cell bodies and their axons were observed. Results At 24 h post inferior alveolar nerve crush, atypical mitochondria which appeared as swollen structures with both vacuoles and collapsed cristae were found. At 1 w after injury, a number of abnormal mitochondria that appeared as swollen structures with both large vacuoles and an accumulation of electron - dense material at one pole were observed in cells bodies, C - fibers and

  4. Gabapendin combined with nerve block for the treatment of patients with post-herpetic neuralgia%加巴喷丁联合神经阻滞治疗带状疱疹后神经痛

    Institute of Scientific and Technical Information of China (English)

    潘涛; 林福清; 李泉; 傅舒昆; 季煊

    2011-01-01

    Objective To study the effect and safety of Gabapentin combined with nerve block on the treatment of post-herpetic neuralgia (PHN). Methods Sixty patients with PHN were randomly divided into two groups: nerve block group (group A, n= 30) and Gabapentin combined with nerve block group (group B, n = 30 ). The effects were valuated in visual analogue scale (VAS) and according to 24-hour sleeping time, and the side effects and complications were also observed.Results The pain scores after the treatment decreased with time compared with those before treatment in 2 groups during 6 weeks, both the decrease of VAS and the sleeping time within 24 hrs were higher in group B (P < 0.05 ). Compared with group A, sleeping time in 24 hour increased in B group (P < 0.05). Side effects and complications were not found in 2 groups. Conclusion The strategy of oral Gabapentin combined with nerve block is effective and safe for the treatment of PHN, and it is better than nerve block alone.%目的 采用加巴喷丁联合神经阻滞治疗带状疱疹后神经痛,观察其有效性和安全性.方法 将60例PHN患者随机分为2组,每组30例,分别接受神经阻滞(A组)和口服加巴喷丁联合神经阻滞治疗(B组),共治疗6周.用视觉模拟评分(visual analogue scale,VAS)和24 h睡眠时间来评价治疗效果,同时观察并发症及药物不良反应.结果 在6周观察期间,两组患者治疗后各时点与治疗前相比疼痛评分随时间下降,睡眠时间均增加(P<0.05).B组的VAS评分下降大于A组,24 h睡眠时间增加大于A组(P<0.05).两组未出现并发症及严重的药物副作用.结论 加巴喷丁联合神经支阻滞治疗带状疱疹后神经痛,可迅速缓解疼痛,改善睡眠质量,疗效确切,效果优于单独神经阻滞,且无明显不良反应.

  5. 锁骨上神经复合臂丛神经阻滞在锁骨手术中的应用%Application of supraclavicular nerves combined with brachial plexus block in the clavicle surgery

    Institute of Scientific and Technical Information of China (English)

    王锐; 韩凤

    2014-01-01

    目的:观察锁骨上神经复合臂丛神经阻滞在锁骨手术中的麻醉效果。方法选取80例锁骨骨折的患者作为研究对象,随机分成A、B两组,各40例。 A组采用单纯高位肌间沟的臂丛神经阻滞方法,B组采用锁骨上神经复合臂丛神经阻滞的麻醉方法。比较两组的麻醉效果及不良反应。结果 B组的麻醉效果显著优于A组,差异有统计学意义(P<0.05);两组均无明显不良反应。结论锁骨上神经联合臂丛神经阻滞用于锁骨骨折手术,能产生良好的麻醉效果,值得临床推广应用。%Objective To observe the anesthesia effect of supraclavicular nerves combined with brachial plexus block in the clavicle surgery. Methods 80 cases with clavicular fracture were selected and randomly divided into group A and group B,40 cases in each group.Group A was given brachial plexus block,group B was given supraclavicular nerves combined with brachial plexus block.Anesthetic effects and adverse reactions was observed respectively. Results Anes-thetic effect in Group B was better than that in Group A,with statistical difference(P<0.05).There were no significant ad-verse reactions in the two groups. Conclusion The anesthesia effect of supraclavicular nerves combined with brachial plexus block in the clavicle surgery is good,it is worthy of clinical promotion and application.

  6. 神经阻滞疗法治疗颈性疼痛疗效及安全性的系统评价%Effectiveness and Safety of Nerve Block Therapy for Neck Pain: A Systematic Review

    Institute of Scientific and Technical Information of China (English)

    许菁; 贾功伟; 谭波涛; 虞乐华

    2012-01-01

    目的 系统评价神经阻滞疗法治疗颈性疼痛的疗效及安全性.方法 计算机检索The Cochrane Library、PubMed、Ovid、ISI、EBSCO、CBM和CNKI数据库,检索时限均从建库至2011年11月,并辅以文献追溯、手工检索的方法,收集国内外公开发表的关于神经阻滞疗法治疗颈性疼痛的疗效及安全性的随机对照试验.由2位研究者按照纳入和排除标准筛选文献、提取资料并评价纳入研究的方法学质量后,采用RevMan 5.0软件进行Meta分析.结果 最终纳入10个RCT,共625例患者.定性分析结果显示神经阻滞治疗颈性疼痛的短期疗效明显优于安慰剂组、认知疗法组以及经皮电神经刺激组;联合神经阻滞治疗的短期疗效明显优于单一神经阻滞.Meta分析结果显示枕大神经阻滞与C2/3椎旁阻滞的短期疗效[SMD=-0.13,95%CI(-0.58,0.32),P=0.58]及中期疗效[SMD=-0.01,95%CI(-0.46,0.44),P=0.98]差异无统计学意义;注射液中是否添加激素的短期疗效[SMD=0.16,95%CI(-0.13,0.44),P=0.28]及长期疗效[SMD=0.27,95%CI(-0.02,0.55),P=0.07]差异无统计学意义.结论 现有临床证据显示神经阻滞治疗颈性疼痛安全性好,且短期疗效有一定优势,联合阻滞疗效可能更佳,但阻滞液中是否添加激素及不同阻滞方法的选择对疗效无明显影响.受纳入研究质量和数量限制,且总体样本量少,上述结论尚需开展更多高质量、大样本研究加以验证.%Objective To systematically evaluate effectiveness and safety of nerve block therapy for neck pain. Methods Databases including CENTRAL, PubMed, Ovid, ISI, EBSCO, CBM and CNKI were searched from the date of their establishment to November 2011, and relevant references were also retrieved manually to collect both domestic and abroad randomized controlled trials (RCTs) about nerve block therapy for neck pain. According to the inclusion and exclusion criteria, two researchers independently screened literature

  7. A precise radiographic method to determine the location of the inferior alveolar canal in the posterior edentulous mandible: implications for dental implants. Part 1: Technique.

    Science.gov (United States)

    Stella, J P; Tharanon, W

    1990-01-01

    In severely atrophic or osteoporotic mandibles, the location of the inferior alveolar nerve may vary considerably, both superoinferiorly and mediolaterally. A clinician's ability to reliably locate this nerve within the mandible would permit the surgical planning of implant placement in the posterior edentulous mandible. Eight edentulous cadaver mandibles were studied. A technique that precisely locates the inferior alveolar nerve within the mandible is described. The technique will aid the surgeon in planning a surgical approach to the posterior mandible with reduced risk of injury to the inferior alveolar nerve. PMID:2391135

  8. Congenital Pulmonary Alveolar Proteinosis

    OpenAIRE

    Saber Hammami; Khaled Harrathi; Khaled Lajmi; Samir Hadded; Chebil Ben Meriem; Mohamed Néji Guédiche

    2013-01-01

    Pulmonary alveolar proteinosis (PAP) is a rare syndrome characterized by pulmonary surfactant accumulation within the alveolar spaces. It occurs with a reported prevalence of 0.1 per 100,000 individuals. Two clinically different pediatric types have been defined as congenital PAP which is fatal and a late-onset PAP which is similar to the adult form and less severe. The clinical course of PAP is variable, ranging from spontaneous remission to respiratory failure. Whole-lung lavage is the curr...

  9. Nerve biopsy

    Science.gov (United States)

    Biopsy - nerve ... A nerve biopsy is most often done on a nerve in the ankle, forearm, or along a rib. The health care ... feel a prick and a mild sting. The biopsy site may be sore for a few days ...

  10. 双侧阴部神经阻滞麻醉减少会阴裂伤的临床效果观察%Clinical Effect Observation for Nerve Block Anesthesia of Two Sides Privates Reducing Perineum Laceration

    Institute of Scientific and Technical Information of China (English)

    窦桂珍

    2014-01-01

    Objective Observation for treatment effect of perineum laceration through the nerve block anesthesia of two sides privates.Methods Wil obstetric hospital 369 cases of ful-term normal vaginal labor primipara, were randomly divided into two groups, the observation group given perineal bilateral nerve block anesthesia, the control group by routine protection of perineum spontaneous vaginal delivery, observe two groups of perineal tear.Results The observation group can effectively reduce the perineum with lower cutting perineum laceration compared with the comparison group.Conclusion It is worthy of the promotion for the nerve block anesthesia of two sides privates be able to reduce perineum laceration of soft production passage.%目的:通过对产妇双侧阴部神经阻滞麻醉,观察对影响会阴裂伤的效果。方法将我院产科369例经阴道头位分娩的足月正常初产妇,随机分为两组,观察组给予会阴部双侧神经阻滞麻醉,对照组按常规保护会阴自然阴道分娩,观察两组会阴裂伤情况。结果观察组能有效减少会阴裂伤,与对照组比较,会阴切开率低。结论双侧阴部神经阻滞麻醉能有效减少软产道的裂伤,值得推广。

  11. Clinical effect of nerve block combined with ozone treatment on Herpes Zoster%神经阻滞联合臭氧治疗带状疱疹的疗效观察

    Institute of Scientific and Technical Information of China (English)

    张玉红; 张永红; 肖春才; 彭希亮; 郑战伟; 倪文琼

    2016-01-01

    目的:观察神经阻滞联合臭氧防治带状疱疹后遗神经痛的临床疗效。方法将75例带状疱疹患者随机分为3组,A组口服加巴喷丁胶囊,300 mg/次,3次/d;B组采用神经阻滞治疗;C组采用神经阻滞联合臭氧治疗。于治疗前、治疗1周及治疗后3个月进行VAS评分检测,综合评价治疗效果。结果3组患者治疗后评分均低于治疗前(<0.05),C组疼痛缓解、痊愈时间短于A、B组(<0.05),无PHN发生。结论神经阻滞联合臭氧治疗带状疱疹是安全、有效、便捷的方法。%Objective To observe the clinical curative effect of nerve block combined with ozone treatment of postherpetic neuralgia (PHN). Methods Seventy-five patients with Herpes Zoster were randomly divided into three groups. Group A took 300 mg of Gabapentin capsules orally 3 times a day, group B was treated with nerve block, and group C was treated with nerve block combined with ozone therapy. Before treatment, 1 week and 3 months after treatment VAS score was evaluated, the treatment effect was comprehensively evaluated. Results In the three groups, VAS scores after treatment were lower than those before treatment ( < 0.05). Pain relief and recovery time of the group C was shorter than that of the groups A and B ( <0.05). No PHN occurred. Conclusions Nerve block combined with ozone is a safe, effective and convenient therapy for Herpes Zoster.

  12. Pulmonary Alveolar Proteinosis

    Directory of Open Access Journals (Sweden)

    Sandeep M Patel

    2012-01-01

    Full Text Available Pulmonary alveolar proteinosis (PAP is a disease of alveolar accumulation of phospholipoproteinaceous material that results in gas exchange impairment leading to dyspnea and alveolar infiltrates. There are three forms of PAP: congenital, acquired and idiopathic; of which the latter two are predominant in the adult population. Previous case studies have found that the acquired form can be secondary to various autoimmune, infectious, malignant and environmental etiologies. Recent advances in the understanding of the pathophysiology of PAP demonstrate that the idiopathic form is due to antigranulocyte macrophage-colony stimulating factor antibodies. Therapeutic targets that replace granulocyte macrophage colony stimulating factor or remove these antibodies are being actively developed. The current standard of care is to perform whole lung lavage on these patients to clear the alveolar space to help improve respiratory physiology. A case of PAP is reported, followed by a literature review on the diagnosis and management of this rare condition with the aim of increasing awareness among physicians when treating patients who present with alveolar infiltrates.

  13. Bloqueos nerviosos periféricos de la extremidad inferior para analgesia postoperatoria y tratamiento del dolor crónico Lower limb continuous peripheral nerve blocks for postoperative analgesia and chronic pain

    Directory of Open Access Journals (Sweden)

    V. Domingo

    2004-05-01

    Full Text Available Existe un interés creciente por la realización de los bloqueos de nervio periférico (BNP debido a sus potenciales beneficios como los concernientes a las interacciones de los fármacos anticoagulantes y los bloqueos neuroaxiales. Los BNP de la extremidad inferior, y sobre todo, los bloqueos periféricos del nervio ciático son el pariente pobre de las técnicas de anestesia regional y, en general, son poco conocidos y por tanto poco utilizados. En este artículo se realiza una revisión de los bloqueos del plexo lumbosacro, realizando especial énfasis en los bloqueos continuos mediante catéteres para analgesia postoperatoria y para el tratamiento del dolor crónico. La utilización de anestésicos locales de larga duración de acción, asociada a un escaso bloqueo motor, como es el caso de la ropivacaína, nos permite combinar técnicas de punción única para conseguir una adecuada analgesia intraoperatoria, con las técnicas de perfusión continua para analgesia postoperatoria. Es necesario un conocimiento anatómico preciso, así como de los territorios cutáneos de inervación de las ramas del plexo lumbosacro, para la realización de estas técnicas de bloqueo. La introducción de diferentes técnicas de imagen, fundamentalmente la ultrasonografía, para la localización de las estructuras nerviosas, facilita la realización de estos bloqueos y disminuye el riesgo de lesiones de los órganos adyacentes. La realización de los bloqueos continuos de nervio periférico ofrece el beneficio de una analgesia postoperatoria prolongada, con menores efectos adversos, mayor grado de satisfacción del paciente, y una recuperación funcional más rápida después de la cirugía.There is increasing interest in peripheral nerve blocks (PNB because of potential benefits relative to interactions of anticoagulants and central neuraxial techniques. Among all the regional anesthesia procedures, PNB of the lower limb, and specially sciatic nerve block

  14. Diffuse alveolar hemorrhages

    International Nuclear Information System (INIS)

    The Diffuse Alveolar Hemorrhage (DAH) it is a clinical syndrome that generally manifests with hemoptysis, anemia and infiltrated in the thorax x-ray. From the anatomical point of view, the DAH is defined as the presence of blood in the distal alveolar spaces without it can identify any endobronchial abnormality. The radiological presentation of the DAH is characterized by the presence of having infiltrated of alveolar occupation in the Rx of thorax of prevalence perihiliar and bilateral that goes converging to configure an image of complete consolidation of the air space, the apexes and the periphery of the lungs are generally respected. These infiltrated are solved in one to two weeks, but with the repeated episodes of having bled it can develop interstitial fibrosis

  15. Congenital Pulmonary Alveolar Proteinosis

    Directory of Open Access Journals (Sweden)

    Saber Hammami

    2013-01-01

    Full Text Available Pulmonary alveolar proteinosis (PAP is a rare syndrome characterized by pulmonary surfactant accumulation within the alveolar spaces. It occurs with a reported prevalence of 0.1 per 100,000 individuals. Two clinically different pediatric types have been defined as congenital PAP which is fatal and a late-onset PAP which is similar to the adult form and less severe. The clinical course of PAP is variable, ranging from spontaneous remission to respiratory failure. Whole-lung lavage is the current standard treatment for PAP patients. We report a new congenital case of PAP.

  16. 超声联合神经刺激器引导下臂丛神经阻滞在上肢手术中的应用%Brachial plexus nerve block guided by ultrasound and nerve stimulator in upper limb surgery

    Institute of Scientific and Technical Information of China (English)

    汪涛; 何开华; 刘小男; 高进

    2013-01-01

    Objectives :To Investigate the effect of brachial plexus nerve block guided by ultrasound combined with nerve stimulator in upper extremity surgery . Methods :120 cases of upper limb surgery patients were randomly divided into 3 groups ,40 cases of each group .Patients in Group A were done brachial plexus block by traditional methods .Patients in Group B were done brachial plexus guided by nerve stimulator .Patients in Group C were done brachial plexus guided by nerve stimulator and ultrasound .To observe the anesthesia effect of Brachial plexus block ,duration of anesthesia ,intravenous adjuvant ,and adverse reactions (needle strayed into the blood vessels ,local anesthetic toxicity ,nerve injury ,pneumothorax) .Results :Anesthetic effect of group C was better than group A and group B (P <0 .05) .Anesthesia duration time of group C was longer than group A (P <0 .05) .Intravenous adjuvant of group C was less than group A and group B (P <0 .05) .The incidence of adverse reactions of group C was less than group A and group B (P <0 .05) .Conclusions :The anesthetic effect of brachial plexus nerve block guided by ultrasound combined with nerve stimulator was good in upper extremity surgery ,and the incidence of adverse reactions was low ,so this method is worthy of promotion .%目的:探讨超声联合神经刺激器引导下臂丛神经阻滞在上肢手术中的应用效果。方法:选择上肢手术120例,随机分为3组,每组40例。A组为传统方法定位组,B组为神经刺激器定位组,C组为超声联合神经刺激器定位组。观察三组的臂丛神经阻滞麻醉起效时间、麻醉效果、麻醉持续时间、静脉辅助用药情况、不良反应(穿刺针误入血管、局麻药毒性反应、神经损伤、气胸)。结果:C组麻醉起效时间短于A组及B组(P<0.05),C组麻醉效果优于A组及B组(P<0.05),C组麻醉持续时间长于A组(P<0.05),C组静脉辅

  17. Preliminary study of panoramic radiographs and extraction of impacted inferior third molars at risk of inferior alveolar nerve injury%曲面断层片与下颌阻生第三磨牙拔除术中下牙槽神经损伤风险预测的初步研究

    Institute of Scientific and Technical Information of China (English)

    马立

    2012-01-01

    目的:通过术前下颌阻生第三磨牙曲面断层片检查,结合拔牙术中所见,探讨牙齿根尖和下颌管之间X线关系与下牙槽神经损伤风险的相关因素.方法:收集129例术前行曲面断层片检查的下颌阻生第三磨牙拔除术患者,通过曲面断层片分析牙根与下颌管的关系及术中下牙槽神经的暴露及损伤情况.术后6个月定期进行临床检查,评估患者下唇及颏部的感觉是否异常.结果:曲面断层片显示根尖或根管透射影像和根管与下颌管重叠影像的患者中,12例术中出现下颌管暴露,其中有3例术后出现暂时性感觉迟钝,需要药物治疗.结论:下颌阻生第三磨牙拔牙术前曲面断层片显示根尖或根管透射影像和根管与下颌管重叠影像,提示下牙槽神经损伤的高风险.术前仔细分析患者的曲面断层片非常重要.%Objective To evaluate the intraoperative findings and the radiographic signs of patients with impacted mandibular third molars at risk of inferior alveolar nerve injury. Methods One hundred and twenty.nine cases with impacted mandibular third molars were selected by pantomogram. Radiographic signs of possible close relationship between the roots and canal, intraoperative exposition and damage of the inferior alveolar nerve were analysed. The clinical examinations and assessment for the sensation of the lower lip and chin were followed-up during 6 months. Results Intraoperative neural exposition was observed in 12 patients of those who have the signs of radiolucent apex or root and superimposition.3 patients complained of postoperative temporary hypoesthesia then healed by drugs. Conclusion At panoramic radiograph, the presence of signs of radiolucent apex or root.superimposition should be considered at high risk for the inferior alveolar neurovascular bundle damage.lt is important to analyse the adiographic signs of patients with impacted mandibular third molars before extraction.

  18. Primary pulmonary alveolar proteinosis

    Directory of Open Access Journals (Sweden)

    Šarac Sanja

    2012-01-01

    Full Text Available Introduction. Pulmonary alveolar proteinosis is an uncommon disease characterized by the accumulation of surfactant proteins and phospholipids within the alveolar spaces. Acquired disease can be idiopathic (primary and secondary. The prevalence of acquired pulmonary alveolar proteinosis is about 0.37 per 100,000 persons. Common symptoms are dyspnea and cough. Chest X-ray shows bilateral perihilar infiltrates. Open-lung biopsy is the gold standard for the diagnosis. Treatment includes whole-lung lavage, application of granulocyte-macrophage colonystimulating factor and lung transplantation. Case report. We reported a 51 year-old man with primary form of the disease. It was the second case of this extremely rare disease in the past 30 years in our clinic. The symptoms were longlasting dry cough, fever and physical deterioration. Chest Xray revealed bilateral pulmonary infiltrates; computed tomography showed patchy ground-glass opacification with interlobular thickening. The diagnosis was established by open lung biopsy. Additional tests were performed to exclude secondary form of the disease. Conclusion. We presented a rare clinical entity with typical clinical features and clinical and radiological course of the disease, in order to improve differential diagnostic approach to patients with bilateral lung infiltrations. In patients with pulmonary alveolar proteinosis timely diagnosis and adequate treatment can improve a prognosis.

  19. Pulmonary alveolar proteinosis

    OpenAIRE

    Chan, Adrian Kwok Wai; Takano, Angela; Hsu, Ann Ling; Low, Su Ying

    2014-01-01

    We report a 68-year-old female who presented with chronic cough and progressive dyspnoea. Computed tomography of the thorax and subsequent bronchoscopy confirmed the diagnosis of pulmonary alveolar proteinosis (PAP), which was treated with whole lung lavage. This case is reported in view of the low incidence of PAP.

  20. 兔乙醇胫神经干阻滞的量效关系研究%The research of dose-response relationship following alcohol-induced rabbits tibial nerve block

    Institute of Scientific and Technical Information of China (English)

    李冰; 励建安; 朱杰; 刘守国

    2011-01-01

    目的:明确兔乙醇胫神经阻滞的量效关系。方法:新西兰兔24只,胫神经44条,外周神经电刺激器引导下,行胫神经无水乙醇阻滞。按注射容量分为4组:0.1ml、0.3ml、0.5ml和1.0ml。分别于阻滞前和阻滞后第1、2、4、7天及2、3、4、5、6、7、8周,记录腓肠肌复合肌肉动作电位(CMAP);实验终止时,取胫神经和注射部位肌肉行HE染色,观察组织学损害。结果:小容量0.1ml组CMAP波幅在第1周有所恢复,但第2周作用基本消失(P>0.05),而0.3ml组的作用持续到第8周(P<0.05);大容量组(0.5ml和1.0ml)CMAP波幅降低更明显(P<0.05),但并发症也显著增加。大部分动物(9/15)因并发症死亡,故实验在第4周终止。前4周CMAP波幅降低,除0.3ml与0.5ml组间差异不显著(P>0.05),其他各组间差异显著(P<0.05);组织学示各组出现不同程度神经轴索变性;0.5ml和1.0ml组肌肉局灶性结缔组织增生。结论:兔乙醇胫神经干阻滞的理想有效安全容量是0.3ml/点。%Objective: To verify the dose-response relationship in alcohol-induced rabbits' tibial nerve block. Method: Twenty-four New Zealand white rabbits were randomly assigned to four groups based on alcohol volume (0.1ml、0.3ml、0.5ml、1.0ml). All tibial nerves were successfully located with a nerve electrical stimulator. Compound muscle action potential (CMAP) was measured on the skin surface of gastrocnemius muscle belly preinter-vention and at days 1, 2, 4, 7 and weeks 2, 3, 4, 5, 6, 7, 8 postblock. Histologic studies were performed to evaluate the destruction of tibial nerves and muscles.Result: In four groups, CMAP amplitude showed reduction 1 day after nerve block. In group 0.1ml, CMAP amplitude showed the smallest reduction at 1 day and recovered in 1 week after block, but the block effect disappeared at 2 week after block(P>0.05). In group 0.3ml, the block effect last 8 weeks. In groups 0.5ml and 1.0ml, CMAP amplitudes showed

  1. Clinical observation on Ozone therapy for cervicogenic headache with combined cervical nerve block%臭氧联合颈椎旁神经阻滞治疗颈源性头痛的临床疗效观察

    Institute of Scientific and Technical Information of China (English)

    郭向飞; 郭玉娜; 倪家骧; 卿恩明

    2012-01-01

    Objective To assess clinical observation on ozone therapy for cervicogenic headache with combined cervical nerve block. Methods From September 2009 to September 2011,178 cases of clinic patients with cervicogenic headache which were divided into control group (n=88) and treatment group (n =90),through the pain scores of patients with visual scale (VAS) and clinical manifestations of clinical efficacy. Results After treatment, both groups were significantly lower VAS score, treatment group scores decreased more significantly,the difference between the two groups was significant (P<0.05); treatment group improved the cure rate and a higher rate, two difference between groups was significant (P<0.05). Conclusion Ozone combined cervical nerve block is adjacent to more precise clinical treatment, side effect better than cervical nerve block treatment of cervicogenic headache.%目的 评估臭氧联合颈椎旁神经阻滞治疗颈源性头痛的临床疗效.方法 对2009-09-2011-09我院疼痛门诊178例颈源性头痛患者进行了臭氧联合颈椎旁神经阻滞,将患者分为对照组(n=88)和治疗组(n=90),治疗组采用臭氧联合颈椎旁神经阻滞,对照组仅使用颈椎旁神经阻滞,通过对患者进行视觉疼痛评分比例尺(VAS)和临床表现进行临床疗效观察.结果 两组患者治疗后VAS评分均有明显的降低,治疗组评分的下降更为明显,两组之间差异具有显著性(P<0.05);治疗组的痊愈率和好转率较高,两组之间差异具有显著性(P<0.05).结论 臭氧联合颈椎旁神经阻滞是临床上比较确切的治疗方法,疗效优于单纯颈椎旁神经阻滞治疗颈源性头痛.

  2. Simulation of Myelinated Nerve Conduction Block Induced by Electrical Stimulus of Monopolar and Bipolar Electrodes%不同电极电刺激对有髓神经传导阻断影响的仿真研究

    Institute of Scientific and Technical Information of China (English)

    孙晨; 张旭; 任朝晖; 董谦; 崔南

    2011-01-01

    目的 比较双电极双向脉冲刺激和单电极双向脉冲刺激在神经纤维传导阻断中的阻断阈值以及对神经纤维的损伤,并通过该研究为电刺激促进脊髓损伤后下尿路功能重建的动物实验选择最优的刺激模式.方法 以有限长单根有髓神经为研究对象,以两栖动物的有髓神经纤维FrankenhaeuserHuxley(F-H)模型为仿真研究基础.结果 比较了单、双电极在双向对称方波以及双向间歇方波作用下的阻断阈值以及单双电极在同样的刺激条件下(包括刺激波形、频率以及电流强度)产生的离子电流强度大小.结论 双电极的阻断阈值大于单电极的阻断阈值.在相同的刺激条件下,双电极双向脉冲刺激对神经的损伤程度小于单电极双向脉冲刺激.%To compare the thresholds and the degrees of axonal injury caused by the impulse stimulations of monopolar and bipolar electrodes in simulation study of nerve conduction block. This study aimed to find an optimal stimulus pattern for the animal experiment of restoring the normal function of lower urinary tract after spinal cord injury through electrical stimulation. We used the myelinated nerve fiber with limited length as the research object, and the Frankenhaeuser-Huxley ( F - H) model for mammal' s marrow nerve fiber as the basic system. We simulated the symmetry biphasic pulses and intermittent biphasic pulses to compare the block threshold and ionic current intensity generated by monopolar and bipolar electrodes. The simulating results indicated that the conduction block threshold induced by bipolar electrode is higher than that of monopolar electrode, and monopolar electrode caused greater damage to the axon when the other situations were same.

  3. An unusual communication between the mylohyoid and lingual nerves in man: Its significance in lingual nerve injury

    Directory of Open Access Journals (Sweden)

    Potu Bhagath

    2010-01-01

    Full Text Available The mylohyoid nerve is the branch of the inferior alveolar nerve (IAN which arises above the mandibular foramen. An abnormal communication between the mylohyoid nerve and lingual nerve (LN was noted during the routine dissection of a male cadaver. Communicating branches between IAN and LN have been identified as a possible explanation for the inefficiency of mandibular anesthesia. The communication between mylohyoid and lingual nerve was found in this case after the LN passes in close relation to third molar tooth, which makes it more susceptible to injury during third molar extractions.

  4. Controle da dor pós-operatória da artroplastia total do joelho: é necessário associar o bloqueio do nervo isquiático ao bloqueio do nervo femoral? Control del dolor postoperatorio de la artroplastia total de la rodilla: ¿es necesario asociar el bloqueo del nervio isquiático al bloqueo del nervio femoral? Control of postoperative pain following total knee arthroplasty: is it necessary to associate sciatic nerve block to femoral nerve block?

    Directory of Open Access Journals (Sweden)

    Affonso H. Zugliani

    2007-10-01

    ón del bloqueo de los nervios isquiático y femoral. MÉTODO: Fueron estudiados 17 pacientes sometidos a ATR bajo raquianestesia, divididos en dos grupos: A y B. En el Grupo A (n = 9 fue realizado bloqueo del nervio femoral y en el Grupo B (n = 8 bloqueo de los nervios femoral e isquiático. Los bloqueos fueron realizados en el postoperatorio inmediato utilizando 20 mL de ropivacaína a 0,5% en cada uno. El dolor se comprobó en las primeras 24 horas a través de la Escala Analógica Visual y escala verbal. Fue observado el tiempo transcurrido entre los bloqueos y el primer quejido de dolor (M1. RESULTADOS: La mediana del tiempo de analgesia (M1 en el Grupo A fue de 110 min y en el Grupo B de 1.285 min (p = 0,0001. No fueron observadas complicaciones atribuibles a las técnicas utilizadas. CONCLUSIONES: El bloqueo del nervio isquiático, cuando se asocia al bloqueo del nervio femoral, e las condiciones de este estudio, mejoró de manera significativa la calidad de la analgesia en postoperatorio de la ATR.BACKGROUND AND OBJECTIVES: Total knee arthroplasty (TKA causes severe tissue trauma, leading to severe postoperative pain. Good postoperative analgesia is fundamental and one should consider that early mobilization of the joint is an important aspect to obtain good results. There is a controversy in the literature on the efficacy of isolated femoral nerve block. The objective of this study was to evaluate postoperative analgesia with the association of sciatic and femoral nerve block. METHODS: Seventeen patients undergoing TKA under spinal anesthesia were divided in two groups: A and B. In Group A (n = 9, femoral nerve block was performed, while in Group B (n = 8, femoral and sciatic nerve block were done. The blockades were done in the immediate postoperative period with 20 mL of 0.5% of ropivacaine. Pain was evaluated in the first 24 hours using the Visual Analog Scale and the verbal scale. The length of time between the nerve block and the first complaint of pain (M1

  5. Pulmonary alveolar proteinosis

    International Nuclear Information System (INIS)

    Since the original description of pulmonary alveolar proteinosis (PAP) as bilaterally symmetric, confluent, perihilar infiltrates, no large series evaluating the relative frequency of radiographic findings has been published. The authors reviewed 53 histologically proved cases and found a predominantly confluent pattern in 77.4%; of these, 61% had a nodular component. A predominantly nodular pattern was seen in 22.6% often with some coalescence or reticular shadows. Distribution was perhilar 56.6%, diffuse in 26.4%, basilar in 26.4%, and asymmetric in 35.8%. The classic pattern was seen in 18.9%. The authors conclude that the spectrum of patterns in pulmonary alveolar proteinosis is wider than generally appreciated

  6. The alveolar macrophage.

    OpenAIRE

    Bowden, D. H.

    1984-01-01

    The pulmonary macrophagic system is critical to the defense of the lung, keeping the alveoli clean and sterile and responding on demand with an adaptive outpouring of new cells into the air sacs. Under basal conditions alveolar macrophages, in common with other mononuclear phagocytes, are derived from the bone marrow. A population of macrophage precursors within the pulmonary interstitium provides a reserve pool capable of proliferation and delivery of phagocytes in response to unusually heav...

  7. Alveolar Development and Disease

    OpenAIRE

    Jeffrey A Whitsett; Weaver, Timothy E.

    2015-01-01

    Gas exchange after birth is entirely dependent on the remarkable architecture of the alveolus, its formation and function being mediated by the interactions of numerous cell types whose precise positions and activities are controlled by a diversity of signaling and transcriptional networks. In the later stages of gestation, alveolar epithelial cells lining the peripheral lung saccules produce increasing amounts of surfactant lipids and proteins that are secreted into the airspaces at birth. T...

  8. Pulmonary alveolar microlithiasis

    International Nuclear Information System (INIS)

    Pulmonary alveolar microlithiasis (PAM) is a rare disease characterized by the diffuse and bilateral presence of calcium phosphate microlite in the alveolar spaces. The progression of this potentially lethal disease is show and most of the patients remain asymptomatic during years or decades, resulting in a show deterioration of the pulmonary function. The typical finding of the sand storm in the chest X-ray is characteristic of this entity. Mutations in the SLC34A2 gene that does the coding for the type II co-transporter of sodium phosphate were identified as responsible for this disease. Of the almost 600 cases, only 6 have been reported in Colombia. We are presenting a case of pulmonary alveolar microlite in a 27 year old man, with progressive respiratory distress whose diagnosis was made by the X-ray findings and confirmed by trans bronchial biopsy. In the 2 years follow-up, shows evolution towards deterioration of his respiratory function making him a candidate for lung transplantation.

  9. Alveolar development and disease.

    Science.gov (United States)

    Whitsett, Jeffrey A; Weaver, Timothy E

    2015-07-01

    Gas exchange after birth is entirely dependent on the remarkable architecture of the alveolus, its formation and function being mediated by the interactions of numerous cell types whose precise positions and activities are controlled by a diversity of signaling and transcriptional networks. In the later stages of gestation, alveolar epithelial cells lining the peripheral lung saccules produce increasing amounts of surfactant lipids and proteins that are secreted into the airspaces at birth. The lack of lung maturation and the associated lack of pulmonary surfactant in preterm infants causes respiratory distress syndrome, a common cause of morbidity and mortality associated with premature birth. At the time of birth, surfactant homeostasis begins to be established by balanced processes involved in surfactant production, storage, secretion, recycling, and catabolism. Insights from physiology and engineering made in the 20th century enabled survival of newborn infants requiring mechanical ventilation for the first time. Thereafter, advances in biochemistry, biophysics, and molecular biology led to an understanding of the pulmonary surfactant system that made possible exogenous surfactant replacement for the treatment of preterm infants. Identification of surfactant proteins, cloning of the genes encoding them, and elucidation of their roles in the regulation of surfactant synthesis, structure, and function have provided increasing understanding of alveolar homeostasis in health and disease. This Perspective seeks to consider developmental aspects of the pulmonary surfactant system and its importance in the pathogenesis of acute and chronic lung diseases related to alveolar homeostasis. PMID:25932959

  10. Alveolar development and disease.

    Science.gov (United States)

    Whitsett, Jeffrey A; Weaver, Timothy E

    2015-07-01

    Gas exchange after birth is entirely dependent on the remarkable architecture of the alveolus, its formation and function being mediated by the interactions of numerous cell types whose precise positions and activities are controlled by a diversity of signaling and transcriptional networks. In the later stages of gestation, alveolar epithelial cells lining the peripheral lung saccules produce increasing amounts of surfactant lipids and proteins that are secreted into the airspaces at birth. The lack of lung maturation and the associated lack of pulmonary surfactant in preterm infants causes respiratory distress syndrome, a common cause of morbidity and mortality associated with premature birth. At the time of birth, surfactant homeostasis begins to be established by balanced processes involved in surfactant production, storage, secretion, recycling, and catabolism. Insights from physiology and engineering made in the 20th century enabled survival of newborn infants requiring mechanical ventilation for the first time. Thereafter, advances in biochemistry, biophysics, and molecular biology led to an understanding of the pulmonary surfactant system that made possible exogenous surfactant replacement for the treatment of preterm infants. Identification of surfactant proteins, cloning of the genes encoding them, and elucidation of their roles in the regulation of surfactant synthesis, structure, and function have provided increasing understanding of alveolar homeostasis in health and disease. This Perspective seeks to consider developmental aspects of the pulmonary surfactant system and its importance in the pathogenesis of acute and chronic lung diseases related to alveolar homeostasis.

  11. Can low dose spinal anesthesia combined with ultrasound guided bilateral ilioinguinal-iliohypogastric nerve blocks avoid use of additional epidural catheter in high risk obstetric cases? Our experience from two cases.

    Science.gov (United States)

    Bhakta, P; Sharma, P K; Date, R R; Mohammad, A K

    2013-01-01

    Critical obstetric cases associated with cardiac pathology may pose real challenge for anaesthesiologist during Caesarean section. Meticulous perioperative care and suitable selection of anaesthesia technique are the key to successful outcome. Single shot spinal anaesthesia is not used any more because of serious haemodynamic consequence. Progressive and controlled epidural local anaesthetic injection is mostly used in such cases. But recently combined spinal epidural anaesthesia and continuous spinal anaesthesia are suggested due to better precise control of haemodynamics and quicker onset. However, institution of such complex technique may require time which may not be feasible in emergency situations. Use of bilateral ilioinguinal-iliohypogastric nerve block along with low dose spinal anaesthesia may obviate the need of additional epidural catheter in such complicated cases. We hereby present our experience from two cases.

  12. Quantitative site of the related structures for approach of blocking the facial nerve%面神经阻滞入路相关结构的位置定量应用分析

    Institute of Scientific and Technical Information of China (English)

    王福; 齐聪儒; 杨国军; 陈志宏

    2005-01-01

    BACKGROUND: The blocking treatment can improve the clinic symptom of facial spasm. But the site, depth and the angle of puncturing point are very difficult to be defined, which will seriously infect the curative effect.OBJECTIVE: To study the applied anatomy of the related structures of facial muscle for blocking the facial nerve, and to provide anatomical bases for accurate puncturing point and preventing complications.DESIGN: An observation study based on cadavers and making the mimic puncture and measuring the correlative structures with anatomical method.SETTING: Department of anatomy in a medical college.PARTICIPANTS: Totally 28 adult male cadavers(56 sides) were used and the correlative index were measured.METHODS: The blocking point was located at the convergent point of the interior edge of cartilage of the external acoustic canal, the anterior fringe of mastoid processes and the posterior fringe of mandible ramus, the needle must be thrust vertically to the median sagittal plane. The puncturing needle stopped until it was barred. A longitudinal incision was made from the puncturing point to mandibula angle, and skin, superficial fascia were cut separately. Then carotid superficial fascia was cut from the posterior fringe of parotidean. The facial nerve trunk and the posterior auricular artery were preserved in site. A blunt isolation was made along its incision. Jugular glomus was appeared. Then the correlative index were measured and dealt with statistics method.MAIN OUTCOME MEASURES: The puncturing point, angle and depth,the distance between facial nerve trunk and puncturing point, the position relationship between facial nerve and puncturing needle and the distance relationship between facial nerve and principal structures adjacent to it.RESULTS: The blocking point was located at the convergent point of the interior edge of the external acoustic canal, the anterior fringe of mastoid processes and the posterior fringe of mandible ramus, the needle must

  13. Semmes-Weinstein单丝检测下颌骨矢状劈开截骨术后下牙槽神经功能的初步研究%Initial study on inferior alveolar nerve paresthesia after Bilateral Sagittal Split Osteotomy with Semmes-Weinstein testing

    Institute of Scientific and Technical Information of China (English)

    李强; 华泽权; 鲍海宏; 张力; 王燕; 李欣欣

    2013-01-01

    目的:客观评价下颌失状劈开截骨术后下齿槽神经感觉障碍发生及自然恢复的发生率.方法:选择30例双侧下颌升支矢状截骨的患者在术前和术后1周、4周、2个月和6个月进行下齿槽神经感觉障碍的临床评价.30例患者均采用Semmes-Weinstein单丝测试法.结果:术后7天感觉障碍发生率为100%.在所有检测区域,术后6个月的测量结果与术前最接近.6个月时20例患者感觉恢复术前水平.左右侧及性别间感觉障碍恢复优秀率的差异在各个随访时期均无统计学意义(P>0.05).结论:BSS0术后早期感觉功能障碍较为普遍,然而在术后6个月,大多数患者的神经功能可达到自然恢复.%Objective The aim of this prospective study was to objectively evaluate the inferior alveolar nerve (IAN) paresthesia in patients who underwent bilateral sagittal split osteotomy (BSSO) and its spontaneous recovery and to define the incidence of sensibility loss. Methods Clinical evaluation of the IAN sensory disturbance was undertaken preoperatively and at the first week, fourth week,2 months.and 6 months postoperatively in 30 patients who underwent BSSO.The 30 patients were examined at all periods regarding the IAN functionality by Semmes-Weinstein testing. Results All patients showed sensibility loss at the 7-day evaluation time. The comparison between sides and gender did not show any significant difference (P>0.05).The examined data collected at 6 months were statistically similar to the data collected at the preoperative period.Twenty patients had total spontaneous recovery at the final period. Conclusion The BSSO presents the disadvantage of temporary paresthesia, however, spontaneous nerve function recovery does occur.

  14. Pourfour Du Petit syndrome after interscalene block

    Directory of Open Access Journals (Sweden)

    Mysore Chandramouli Basappji Santhosh

    2013-01-01

    Full Text Available Interscalene block is commonly associated with reversible ipsilateral phrenic nerve block, recurrent laryngeal nerve block, and cervical sympathetic plexus block, presenting as Horner′s syndrome. We report a very rare Pourfour Du Petit syndrome which has a clinical presentation opposite to that of Horner′s syndrome in a 24-year-old male who was given interscalene block for open reduction and internal fixation of fracture upper third shaft of left humerus.

  15. A randomised, controlled, double-blind trial of ultrasound-guided phrenic nerve block to prevent shoulder pain after thoracic surgery

    DEFF Research Database (Denmark)

    Blichfeldt-Eckhardt, M R; Laursen, C B; Berg, H;

    2016-01-01

    Moderate to severe ipsilateral shoulder pain is a common complaint following thoracic surgery. In this prospective, parallel-group study at Odense University Hospital, 76 patients (aged > 18 years) scheduled for lobectomy or pneumonectomy were randomised 1:1 using a computer-generated list...... vials assuring that all participants, healthcare providers and data collectors were blinded. The primary outcome was the incidence of unilateral shoulder pain within the first 6 h after surgery. Pain was evaluated using a numeric rating scale. Nine of 38 patients in the ropivacaine group and 26 of 38...... patients in the placebo group experienced shoulder pain during the first 6 h after surgery (absolute risk reduction 44% (95% CI 22-67%), relative risk reduction 65% (95% CI 41-80%); p = 0.00009). No major complications, including respiratory compromise or nerve injury, were observed. We conclude...

  16. Theoretical basis of alveolar sampling.

    OpenAIRE

    Kelman, G R

    1982-01-01

    The conditions under which the partial pressure of a solvent in the alveolar gas is likely to provide a valid index of its partial pressure in the mixed venous blood, and thus of whole-body exposure, is explored on a theoretical basis. Under steady-state conditions, providing the solvent's blood/gas partition coefficient exceeds 10, its mixed venous and alveolar pressures will agree within 10% and become virtually identical during the prolonged expiration necessary to obtain an alveolar sampl...

  17. 下颌阻生智牙拔除术中下牙槽神经血管束损伤风险因素分析%Risk factors of inferior alveolar nerve and vessels injury in the mandibular third molar extractions: the contact and positional relation between root and inferior alveolar canal

    Institute of Scientific and Technical Information of China (English)

    叶周熹; 杨驰

    2016-01-01

    目的:以下颌阻生智牙与下牙槽管(inferior alveolar canal,IAC)的接触程度和方位关系为下牙槽神经血管束损伤风险因素,对阻生牙行分级和分类,以预测风险和指导手术.方法:筛选同一术者用超声骨刀拔除的105例连续病例116颗困难下颌阻生智牙中全景片示与IAC接触的92颗牙,利用全景片和锥形束CT(CBCT),根据牙与IAC的接触程度分接触(Ⅰ级)、压迫(Ⅱ级)和突入(Ⅲ级).用Kappa值和youden指数(以CBCT为金标准)比较2种影像学检查结果.利用CBCT,根据牙与IAC的方位关系将样本分为牙根位于IAC舌侧(Ⅰ类)、正上方(Ⅱ类)、颊侧(Ⅲ类)和包绕IAC(Ⅳ类).统计不同级别和类别阻生牙拔除的实际下牙槽神经血管束损伤率,用Fisher确切概率法分析更易引起损伤的阻生牙类型.采用SAS 8.2软件包对数据进行统计学分析.结果:79.31%(92/116)的困难阻生牙具有下牙槽神经血管束损伤风险.全景片评价Ⅰ、Ⅱ、Ⅲ级分别占33.70%、28.26%和38.04%,CBCT评价Ⅰ、Ⅱ、Ⅲ级分别占36.96%、33.70%和29.35%,两者一致性很好(Kappa值0.8699).全景片误判为Ⅲ级者实际可为Ⅰ或Ⅱ级.Ⅰ、Ⅱ、Ⅲ、Ⅳ类分别占31.52% 、55.43%、11.96%和1.09%.7.61%(7/92)的阻生牙拔除时出现下牙槽神经血管束损伤(3例Ⅲ级Ⅲ类,2例Ⅲ级Ⅱ类,2例Ⅱ级Ⅱ类).接触程度级别越高,出现损伤的比例越高(P<0.05);出现损伤比例以牙根位于IAC颊侧者最高,正上方次之(P<0.05).结论:全景片能较好评价牙与IAC的关系,CBCT能弥补全景片重叠影像的缺陷,并可提供两者的方位关系.该分级和分类能全面预测风险和指导手术.Ⅱ~Ⅲ级和Ⅱ~Ⅲ类阻生牙更易出现下牙槽神经血管束损伤,操作时勿对神经直接施力.

  18. 蛛网膜下腔神经阻滞麻醉对兔脊髓神经元形态及c-fos蛋白表达的影响%Effects of spinal nerve block anesthesia on morphology of spinal cord nerve cells and expression of c-fos in rabbits

    Institute of Scientific and Technical Information of China (English)

    张勇; 李霞; 甘子明

    2011-01-01

    目的:观察蛛网膜下腔神经阻滞麻醉对兔脊髓神经细胞的生物学影响.方法:选用健康新西兰大白兔30只,随机分为实验组和对照组.每组15只.基础麻醉后实验组用5 g/L布比卡冈进行蛛网膜下腔神经阻滞麻醉(腰麻),对照组用生理盐水代替局麻药.于麻醉后30 min灌注取材,HE染色观察2组兔L5-7节段脊髓神经元形态的变化,免疫组化法检测脊髓神经元中c-fos蛋白的表达.结果:与对照组相比,实验组L5-7节段脊髓灰质后角Ⅲ、Ⅳ板层的小圆细胞及前角Ⅸ板层外侧大多角细胞胞质中均有尼氏体减少、神经元c-fos蛋白阳性细胞数减少[(68.9±1.4) vs (12.3±1.6),t=60.352,P<0.001]和脊髓软脊膜分层或断裂现象(P<0.001).结论:蛛网膜下腔神经阻滞麻醉后,兔脊髓相应节段的神经细胞功能受到抑制,脊髓软脊膜有分层或断裂现象.%Aim: To obsereve the effect of spinal nerve block anesthesia on morphology of spinal cord nerve cells and expression of c-fos in rabbits. Methods :Thity healthy New Zealand white rabbits were randomly divided into experimental and control group,15 in each group. After basal anesthesia,the rabbits in the experimental group were given 5 g/L bupiva-caine for subarachnoid nerve block anesthesia( spinal anesthesia for short) ,and those in the control group were given normal saline. After 30 minutes, spinal cord samples were prepared. HE staining and immunohistochemistry were used to observe the morphological changes of neurons and the expression of c-fos,respectively. Results;Compared with those of the control group, Nissl bodies reduced and nuclear bias in the horn of lumbosacral spinal cord gray matter III , IV plate layer of small round cells and anterior horn of the lateral lamina mostly IX horn cells in experimental group. The expression of c-fos protein in the control group was higher than that in the experimental group [ (68. 9 ±1.4) vs ( 12. 3 ± 1. 6) , t = 60. 352, P < 0

  19. Stimulation of neoplastic mouse lung cell proliferation by alveolar macrophage-derived, insulin-like growth factor-1 can be blocked by inhibiting MEK and PI3K activation

    Directory of Open Access Journals (Sweden)

    Malkinson Alvin M

    2011-06-01

    Full Text Available Abstract Background Worldwide, lung cancer kills more people than breast, colon and prostate cancer combined. Alterations in macrophage number and function during lung tumorigenesis suggest that these immune effector cells stimulate lung cancer growth. Evidence from cancer models in other tissues suggests that cancer cells actively recruit growth factor-producing macrophages through a reciprocal signaling pathway. While the levels of lung macrophages increase during tumor progression in mouse models of lung cancer, and high pulmonary macrophage content correlates with a poor prognosis in human non-small cell lung cancer, the specific role of alveolar macrophages in lung tumorigenesis is not clear. Methods After culturing either an immortalized lung macrophage cell line or primary murine alveolar macrophages from naïve and lung-tumor bearing mice with primary tumor isolates and immortalized cell lines, the effects on epithelial proliferation and cellular kinase activation were determined. Insulin-like growth factor-1 (IGF-1 was quantified by ELISA, and macrophage conditioned media IGF-1 levels manipulated by IL-4 treatment, immuno-depletion and siRNA transfection. Results Primary macrophages from both naïve and lung-tumor bearing mice stimulated epithelial cell proliferation. The lungs of tumor-bearing mice contained 3.5-times more IGF-1 than naïve littermates, and media conditioned by freshly isolated tumor-educated macrophages contained more IGF-1 than media conditioned by naïve macrophages; IL-4 stimulated IGF-1 production by both macrophage subsets. The ability of macrophage conditioned media to stimulate neoplastic proliferation correlated with media IGF-1 levels, and recombinant IGF-1 alone was sufficient to induce epithelial proliferation in all cell lines evaluated. Macrophage-conditioned media and IGF-1 stimulated lung tumor cell growth in an additive manner, while EGF had no effect. Macrophage-derived factors increased p-Erk1/2, p

  20. Effect of Preoperative Greater Occipital Nerve Block on Suboccipital Pain after Thyroid Surgery%术前枕大神经阻滞对甲状腺手术患者术后枕下痛的影响

    Institute of Scientific and Technical Information of China (English)

    张浩; 魏关子; 张兰兰; 陈卫平

    2012-01-01

    目的 探讨术前枕大神经(greater occipital nerve,GON)阻滞对甲状腺次全切患者术后枕下痛的影响.方法 选择80例ASA Ⅰ~Ⅱ级择期在全身麻醉下甲状腺次全切除术的甲状腺腺瘤患者,随机分为GON阻滞组(A组)和对照组(B组),每组40例.A组术前行GON阻滞,观察患者术后8h和24h枕部头痛、颈后疼痛情况,用VAS、VRS进行评估.结果 术后12h和24hVAS评分A组明显低于B组(P<0.05).术后12h和24hA组中重度疼痛患者明显少于B组(P<0.05).结论 术前GON阻滞是一种可以明显降低甲状腺手术患者术后枕下痛的方法.%Objective To study the effect of preoperative greater occipital nerve ( GON) block on suboccipital pain after total thy-roidectomy. Methods Eighty ASA I - II patients with general anesthetic undergoing selective thyroid gland inferior total excision were randomly assigned to two groups (n =40) : group A ( GON block) ,and group B( control group). The intensity of pain was measured by u-sing VAS and VRS, and recorded at 12 and 24 hour after operation. Results At postoperative 12 and 24 hours, VAS of occipital headache and posterior neck pain in group A was significantly lower compared to group B( P < 0. 05 ) . The proportion of patients reporting moderate or severe occipital and posterior neck pain at 12 and 24 hours postoperatively in group A was significantly less than that in group B(P <0.05). Conclusion Preoperative GON block is an effective technique to reduce suboccipital pain after thyroid surgery.

  1. CT in alveolar proteinosis

    International Nuclear Information System (INIS)

    Nine patients with pulmonary alveolar proteinosis (PAP) were scanned with CT. Results were not specific for PAP but may be help0ful in the differential diagnosis is visualization of pulmonary vessels is maintained and air bronchograms are scarce in diseased areas. CT is better than conventional radiography in identifying infectious complications and evaluating disease extent and may help in deciding whether or not therapeutic lavage is indicated. CT has also identified an interstitial component of PAP that correlates histologically with an inflammatory cell infiltrate. The cellular infiltrate may play a role in the development of the interstitial fibrosis seen in some cases of PAP

  2. Efficacy of ultrasound-guided obturator nerve block using proximal interfascial technique%超声引导近端筋膜间闭孔神经阻滞的效果

    Institute of Scientific and Technical Information of China (English)

    杨定东; 夏中元; 张晶晶; 张宣

    2015-01-01

    Objective To evaluate the efficacy of ultrasound-guided obturator nerve block using proximal interfascial technique.Methods Seventy ASA physical status Ⅰ or Ⅱ patients of both sexes, aged 43-82 yr, with body mass index of 18.0-30.5 kg/m2, scheduled for elective trans-urethral resection of bladder tumor, were randomly divided into 2 groups (n =35 each) using a random number table: remote interfascial technique group (group R) and proximal interfascial technique group (group P).In group R, interfascial injections at 2 planes, lateral and deep to the adductor brevis muscle, were carried out with 0.375% ropivacaine 7.5 ml to block each obturator nerve branch separately.In group P, 0.375% ropivacaine 15.0 ml was injected under ultrasound guidance at the interfascial plane inferior to the superior pubic ramus (between the pectineus and obturator externus).The strength of thigh adduction was measured before injection (baseline) and at 5, 10, and 15 min after injection.Then combined spinal-epidural anesthesia was performed at L3,4 interspace.The 50% strength reduction indicated a successful block.The block performance time was recorded.The success rate of block at 15 min after injection was calculated.It was considered clinically effective when obvious muscle twitching interfering with the surgical procedure did not appear.The clinical outcome was assessed, and the effective rate of clinical outcome was calculated.Results Compared with group R, the block performance time was significantly shortened, the success rate of block, strength reduction at 10 and 15 min after injection, and clinical outcome were increased in group P.There were no significant differences in the effective rate of clinical outcome.Conclusion Compared with remote interfascial technique, ultrasound-guided obturator nerve block using proximal interfascial technique provides easier and rapid procedure, higher success rate of block and better clinical outcome of block.%目的 评价超声引导

  3. The comparison of three different methods of nerve localization applied in interscalene brachial plexus block%三种常用定位方法肌间沟臂丛阻滞的比较

    Institute of Scientific and Technical Information of China (English)

    张干; 袁新平; 何绍明; 周宁; 方凯凯

    2010-01-01

    目的 比较筋膜突破(facial pop,FP)、异感(paresthesia,PAR)、外周神经刺激(peripheral nerve stimulation,PNS)3种定位法应用于肌间沟臂丛阻滞的临床效果以及局麻药在臂丛鞘内的分布与扩散状况.方法 90例拟行上肢手术的患者,采用随机数字表法分为筋膜突破组(FP组)、异感组(PAR组)和外周神经刺激组(PNS组),每组30例.评估感觉和运动神经的阻滞程度、手术过程中的麻醉效果,观察和记录并发症的发生情况,每组6例行C_4~T_3的横断面及注药侧肌问沟的冠、矢状面计算机体层摄影(computed tomography,CT).结果 3组患者中腋神经、肌皮神经、正中神经、桡神经的感觉及运动评分差异均无统计学意义;前臂内侧皮神经的感觉评分和尺神经的感觉及运动评分FP组明显高于PAR组(P<0.05)和PNS组(P<0.01),PAR组明显高于PNS组(P<0.05);损伤血管发生率PAR组明显高于FP组(P<0.01)和PNS组(P<0.05). CT结果显示局麻药在臂从鞘内呈不均匀扩散,仅在肌间沟水平似乎有鞘的特征,其以下有明显的分隔及囊袋,并有伪足.PNS组的总体麻醉效果高于FP组(P<0.05);尺侧手术麻醉效果FP组低于PAR组(P<0.05)和PNS组(P<0.01).结论 上臂及前臂桡侧手术采用3种定位均可,但FP法更安全简便;偏向尺侧的手术宜采用PAR或PNS定位法,以PNS定位为佳.%Objective To compare the effects of the interscalene brachial plexus block performed by three different methods of nerve localization-facial pop (FP), paresthesia (PAR), peripheral nerve stimulation (PINS) and the distribution of local anesthet-ics. Methods 90 patients scheduled for upper extremity operations were randomized to three groups (n=30 in each group): group FP, group PAR and group PNS. The extent of sensory and motor blockade of each innervated region was assessed by scale scores,the anesthetic effects of surgical field and the complications were observed and recorded. Computed tomography (CT

  4. Clinical Observation of Spinal Nerve Dorsal Root Impulse Radio Frequency Combined with Epidural Nerve Block in the Treatment of Post Herpes Zoster Neuralgia%脊神经背根脉冲射频联合硬膜外神经阻滞治疗带状疱疹后神经痛的临床观察

    Institute of Scientific and Technical Information of China (English)

    邓茹; 刘庆

    2016-01-01

    目的:采用新型微创脊神经背根脉冲射频联合硬膜外神经阻滞治疗带状疱疹后神经痛,探讨两种方法结合治疗带状疱疹后神经痛的临床疗效,观测它和生活质量之间关系,从而为PHN治疗提供借。方法以泸州医学院附属中医院疼痛科2011年12月~2012年12月符合标准的带状疱疹后神经痛患者60例作为研究对象。并随机将其划分成硬膜外神经阻滞复合加巴喷丁和硬膜外神经阻滞复合加巴喷丁+脊神经背根脉冲射频组。进行五次A、B两组患者的视觉模拟评分,自评抑郁量表以及焦虑自评量表评分。结果①VAS评分、抑郁评分院与T0比较,A组和B组T1~T4时VAS评分、抑郁评分显著降低。和A组相比,B组T1~T4各时点VAS评分、抑郁评分显著降低。②焦虑评分院与T0比较,A组和B组T1~T4时焦虑评分显著降低;与A组比较,B组T2~T4各时点焦虑评分显著降低。结论①两种方案治疗PHN均有效,但联合脊神经背根脉冲射频疗效更好。②PHN患者的抑郁和焦虑评分随着疼痛的缓解降低。%Objective A new minimally invasive dorsal root pulsed radiofrequency treatment combined with epidural nerve block postherpetic neuralgia, explore the relationship between clinical efficacy neuralgia, observing that the two methods and quality of life after combined treatment of herpes zoster , by providing for the treatment of PHN. Methods Affiliated Hospital of Luzhou Pain in December 2011 - after the period December 2012-compliant herpetic neuralgia 60 patients for the study. And randomly divided into epidural nerve block combined gabapentin (A group, n=30) and epidural nerve block combined gabapentin+dorsal root pulsed radiofrequency (group B, n=30). Five times A, B groups were visual analog scale, self-rating depression scale and self-rating anxiety scale score. Results ①VAS score, depression score: Compared with T0, A group A and group B T1-T4 when the VAS

  5. Genetics Home Reference: pulmonary alveolar microlithiasis

    Science.gov (United States)

    ... Genetics Home Health Conditions pulmonary alveolar microlithiasis pulmonary alveolar microlithiasis Enable Javascript to view the expand/collapse boxes. Print All Open All Close All Description ...

  6. Pulmonary alveolar proteinosis

    Directory of Open Access Journals (Sweden)

    Hadice Selimoğlu Şen

    2011-06-01

    Full Text Available Pulmonary alveolar proteinosis is a rare disease characterized by the accumulation of lipoproteinosis material within the alveoli. A 36 age male patient applied to our hospital with dyspnea that began 5 months ago. Bilateral diffuse infiltration on postero-anterior chest graphy was seen. Arterial blood gas measurements (ABG was: pH:7.44, pCO2: 36 mmHg, pO2: 49 mmHg, SaO2: 85%, HCO3: 24 mmol/L. High resolution computed tomography (HRCT reported as bilateral diffuse ground glass areas and interlobuler septal thickening on this areas. Asido resistant bacillus was negative in sputum at three times and was also negative in post bronchoscopic sputum and bronchoalveoler lavage material. Wedge resection was made by video-assisted thoracoscopic surgery. Histopathology report of biopsy material revealed “Pulmonary alveolar proteinosis (PAP”. Massive lung lavage under general anesthesia was planned for patient. Clinical improvement was seen in patient beginning from admission and ABG measurements entered the recovery trend in follow-up. Partial pressure of oxygen was increased to 65 mmHg and patient was followed without lung lavage. Control chest radiography and HRCT showed significant radiological improvement. After three months, radiological lesions had completely regressed at control HRCT. As a result, in patients with symptoms and radiologically bilateral diffuse infiltration physicians should consider PAP as a rare disease in the differential diagnosis.

  7. Domestic chlorprocaine hydrochloride for nerve stimulator-guided obturator nerve block%国产盐酸氯普鲁卡因用于神经刺激仪引导下的闭孔神经阻滞的临床研究

    Institute of Scientific and Technical Information of China (English)

    唐毅; 徐鹏; 耿智隆; 马辉兰; 李兴福

    2011-01-01

    目的:探讨国产盐酸氯普鲁卡因用于神经刺激仪引导下的闭孔神经阻滞用于经尿道膀胱肿瘤电切术(Transurethral resection of bladder tumor,TURBT)的可行性.方法:膀胱侧壁肿瘤择期行TURBT的男性患者60例,ASAI~Ⅱ级,采用蛛网膜下腔麻醉,辅以神经刺激仪引导闭孔神经阻滞.随机分为实验组和对照组,每组30例.闭孔神经阻滞局麻药10 ml;实验组采用2%氯普鲁卡因(含1∶20万U肾上腺素),对照组采用1%利多卡因.观察并记录闭孔神经阻滞的麻醉效果及并发症.结果:两组闭孔神经阻滞的麻醉效果和安全性没有显著差异( P>0.05).结论:2%氯普鲁卡因用于神经刺激仪引导下的闭孔神经阻滞安全、有效.%Objective:To explore the feasibility of domestic chlorprocaine hydrochloride in nerve stimulator guided obturator nerve block (ONB) in patients undergoing transurethral resection of bladder tumor (TURBT).Methods: Sixty male patients with the lateral bladder wall tumor, ASA Ⅰ to Ⅱ, were randomly divided into two groups: experimental group ( n = 30) and control group ( n = 30).Spinal anesthesia plus nerve stimulator guided ONB were used in the operations.2% chloroprocaine ( contain 1∶ 200 000 U adrenaline ) was given to the experimental group and 1% lidocaine (10 ml) to the control group.The anesthesia effects and side effects of ONB were recorded.Results:There was no significant difference between the two groups in anesthesia effect and safety (P > 0.05 ).Conclusion: The trial showed that 2% chloroprocaine in nerve stimulator guided ONB can exert a satisfactory anesthesia effect.

  8. Postoperative Analgesia by Femoral Nerve Block after Total Knee Replacement: Randomized Controlled Trial%全膝关节置换术后股神经阻滞自控镇痛的随机对照研究

    Institute of Scientific and Technical Information of China (English)

    王宁; 戎玉兰; 魏越; 杨晓霞; 李民; 郭向阳

    2011-01-01

    目的 比较患者自控与恒速输注2种给药方案对全膝关节置换术后患者股神经阻滞镇痛的效果.方法 2010年3月~11月选择60例单侧全膝关节置换术,椎管内麻醉前在超声及神经刺激器引导下置入连续股神经阻滞导管,将阻滞效果完全的患者按随机数字表随机分为2组:恒速输注组(CI组)和患者自控镇痛组(PCA组).CI组经导管持续输注0.2%罗哌卡因5 ml/h,PCA组输注0.2%罗哌卡因背景量5 ml/h,单次注射5 ml/次,锁定时间60 min.记录2组患者静息痛及运动状态下疼痛评分、满意率以及不良反应发生情况.结果 3例在首次给药后30 min内没有达到完全阻滞而被排除.术后1~3 d静息及主动锻炼时疼痛评分2组无显著性差异(P>0.05).术后1~3 d被动锻炼时疼痛评分PCA组(4.7±1.3.4·5±1.0,4.5±1.0)显著低于CI组(6.5±1.6,6.1.4-1.6,5.9±1.6)(P<0.05=.患者满意度PCA组显著高于CI组[8(6~10)VS·7(4~9)](Z=16.957,P=0.031).2组患者均无耳鸣、口周麻木、眩晕等局麻药中毒症状同,均无因下肢无力而跌倒,无导管脱出.结论 与恒速输注相比,患者自控股神经阻滞能够提高术后康复运动时的镇痛效果.%Objective To compare the effects of patient-controlled and continuous-infusion femoral nerve block for postoperative analgesia after total knee replacement (TKR). Methods Sixty patients who underwent TKR in our hospital between March 2010 and November 2010 in our hospital were enrolled in this study. Before neuraxial block, the patients were scheduled to receive femoral nerve block catheter insertion under the guidance by ultrasonography and nerve stimulation. After confirmation of a successful block, the patients were randomly assigned to continuous infusion group (CI group) and patient controlled analgesia group (PCA group). 0.2% ropivacaine was infused through the femoral catheter, 5 ml/h for CI group, and 5 ml/h plus boluses of 5 ml with a lockout time of 60

  9. 改良区域神经阻滞麻醉腹股沟疝无张力修补术麻醉体会%Anesthesia of Improved regional Nerve block Anesthesia for Inguinal Hernia Repair

    Institute of Scientific and Technical Information of China (English)

    段彩萍

    2016-01-01

    目的:分析研讨改良区域神经阻滞麻醉腹股沟疝无张力修补术的麻醉体会。方法此研究所研讨的221例患者均随机选取于2013年3月至2015年3月期间我院收治的行改良区域神经阻滞麻醉腹股沟疝无张力修补术患者内,回顾性分析其临床资料,随访时间为一年,总结其麻醉体会。结果221例患者麻醉效果为:195例Ⅰ型、22例Ⅱ型、4例Ⅲ型,平均手术时间为(51±1.5)分钟,手术过程中,患者肌肉松弛度均较为良好,出血量不多,存在清楚的解剖层次,各体征指数平稳,均未发生不良反应和并发症。术后9小时左右则可下床活动、进食,平均住院时间为(4.1±0.5)天,术后7天其疼痛感均消失。术后给予一年随访,患者均未复发。结论腹股沟疝无张力修补术采用改良区域神经阻滞麻醉方式,其效果明显,安全可靠,费用低,操作简单,推广价值大。%Objective To analyze and discuss the anesthesia experience of improving regional nerve block anesthesia in inguinal hernia repair without tension. Methods This research institute of 221 patients were randomly selected during a march in March 2013 to 2015 in our hospital improve regional nerve block anesthesia of inguinal hernia tension-free repair in patients, retrospective analysis of the clinical data, follow-up time for a year, to sum up the experience of anesthesia. Results 221 patients anesthesia is:195 patients with type I, type II in 22 patients, 4 type III, the mean operation time was (51+1.5) minutes, surgical procedures, patients with muscle re-laxation is good, small amount of bleeding, there are clear anatomical level, the signs from exponential to stationary did not occur in all the adverse reactions and complications. 9 hours after operation, the patients can get out of bed activities, eating, the average length of stay was (4.1+0.5) days, 7 days after the operation, the pain was disappeared

  10. 持续周围神经阻滞在围手术期疼痛治疗中的应用%Continuous peripheral nerve blocks for the perioperative pain management

    Institute of Scientific and Technical Information of China (English)

    蒋鑫; 蒋京京

    2013-01-01

    背景 近年来持续周围神经阻滞(continuous peripheral nerve blocks,CPNB)在围手术期疼痛治疗中取得了令人鼓舞的效果. 目的 阐述CPNB在围手术期疼痛治疗中的作用机制、优势、技术方法及并发症. 内容 CPNB的镇痛机制在于阻断伤害性冲动向中枢传导,预防脊髓背角突触长时程增强和中枢敏化的形成.CPNB可减少围手术期阿片类药物的用量及与之相关的副作用,避免形成硬膜外血肿的风险.超声引导和神经刺激技术均可用于CPNB导管置入,罗哌卡因、布比卡因是CPNB最常用的局麻药.CPNB可安全用于四肢、躯体手术以及创伤、门诊和居家患者的疼痛治疗.CPNB的常见并发症包括导管堵塞、移位、短暂的神经功能障碍以及感染. 趋向 今后的研究需要进一步优化CPNB的置管技术、用药方案和持续时间,评估其对术后远期效果的影响.%Background Continuous peripheral nerve blocks (CPNB) have achieved encouraging effects in the management of perioperative pain in recent years.Objective To offer an updated overview about CPNB in the management of perioperative pain,including the mechanisms,superiority,techniques and complications.Content CPNB can block the conduction of nociceptive impulses to the CNS,prevent the induction of synaptic long-term potentiation and central sensitization in spinal dorsal horn.CPNB have proved effective in reducing perioperative opioid consumption and related side-effects,avoiding the risk of epidural hematoma during anticoagulant administration.Ultrasound guidance and nerve stimulation techniques can be used for catheter insertion,and both techniques have to be considered equal if properly used.Ropivacaine and bupivacaine are the most commonly used local anesthetics for CPNB.CPNB are safe for pain treatment of limbs,body surgery and trauma,ambulatory or home patients.Common complications of CPNB include catheter obstruction,dislodgement,fluid leakage

  11. Particle-induced indentation of the alveolar epithelium caused by surface tension forces.

    Science.gov (United States)

    Mijailovich, S M; Kojic, M; Tsuda, A

    2010-10-01

    Physical contact between an inhaled particle and alveolar epithelium at the moment of particle deposition must have substantial effects on subsequent cellular functions of neighboring cells, such as alveolar type-I, type-II pneumocytes, alveolar macrophage, as well as afferent sensory nerve cells, extending their dendrites toward the alveolar septal surface. The forces driving this physical insult are born at the surface of the alveolar air-liquid layer. The role of alveolar surfactant submerging a hydrophilic particle has been suggested by Gehr and Schürch's group (e.g., Respir Physiol 80: 17-32, 1990). In this paper, we extended their studies by developing a further comprehensive and mechanistic analysis. The analysis reveals that the mechanics operating in the particle-tissue interaction phenomena can be explained on the basis of a balance between surface tension force and tissue resistance force; the former tend to move a particle toward alveolar epithelial cell surface, the latter to resist the cell deformation. As a result, the submerged particle deforms the tissue and makes a noticeable indentation, which creates unphysiological stress and strain fields in tissue around the particle. This particle-induced microdeformation could likely trigger adverse mechanotransduction and mechanosensing pathways, as well as potentially enhancing particle uptake by the cells. PMID:20634359

  12. Application of dexmedetomidine on upper limb operation by brachial plexus nerve block anesthesia%右美托咪啶在臂丛神经阻滞麻醉上肢手术中的应用

    Institute of Scientific and Technical Information of China (English)

    李世建; 郭新玲; 李佩宏; 李韶山

    2013-01-01

    目的 观察术中持续泵注右美托咪啶在臂丛神经阻滞麻醉上肢手术中的应用效果.方法 40例择期行上肢手术患者分为右美托咪啶组和对照组.臂丛神经阻滞后10 min,右美托咪啶组患者静脉泵入右美托咪啶,对照组患者泵人生理盐水.记录麻醉前(T0)、臂丛神经阻滞后10 min(T1)、静脉给药后5(T2)、10(T3)、30(T4)、60 min(T5)及手术结束时(T6)患者的平均动脉压(MAP)、心率(HR)和动脉血氧饱和度(SpO2),并观察患者术中不良反应发生率,术后评估患者的麻醉满意度.结果 T0~ T2时,2组患者MAP、HR及SpO2比较差异均无统计学意义(P>0.05);T3 ~T6时,右美托咪啶组患者MAP和HR显著低于对照组(P<0.05),但2组患者SpO2比较差异无统计学意义(P>0.05);右美托咪啶组T3~ T6时患者MAP和HR显著低于To时(P<0.05),对照组T3~ T6时患者MAP和HR与T0时比较差异均无统计学意义(P>0.05);T0~T6时,2组患者SpO2比较差异均无统计学意义(P>0.05).右美托咪啶组患者满意度显著高于对照组(P<0.05).2组患者术中、术后均未出现恶心、呕吐等不良反应.结论 在臂丛神经阻滞麻醉中持续泵注右美托咪啶,镇静镇痛效果更好,安全性高,患者术后满意度高.%Objective To observe the effect of dexmedetomidine's continuous pump injection during upper limb operation by brachial plexus nerve block anesthesia.Methods A total of 40 patients who were treated with upper limb operation were divided into dexmedetomidine group and control group.Ten minutes after brachial plexus nerve block anesthesia,the dexmedetomidine was pumped into vein in dexmedetomidine group and the saline was pumped into vein in control group.The mean arterial pressure(MAP),heart rate(HR) and arterial oxygen saturation(SpO2) were recorded at the points of before anaesthesia(T0),10 minutes after brachial plexus nerve block (T1),5 (T2),10 (T3),30(T4) and 60 min (T5) after intravenous

  13. 神经阻滞疗法应用于慢性疼痛性肌腱炎48例临床观察%Effects of Nerve Block Therapy for 48 Patients with Chronic Pain Tendonitis

    Institute of Scientific and Technical Information of China (English)

    易进科; 汤治中

    2015-01-01

    【目的】探讨神经阻滞疗法应用于慢性疼痛性肌腱炎的临床效果。【方法】选取本院2010年12月至2012年12月收治的慢性疼痛性肌腱炎患者96例作为研究对象,将患者按照数字随机的方法分为观察组和对照组,每组各48例。其中对照组采用常规的处理方法,包括休息、冷敷和使用布洛芬进行对症处理,观察组在对照组的基础上采用神经阻滞疗法进行相关治疗。观察两组患者治疗效果及不良反应情况,以及采用疼痛评分量表(VAS)对患者治疗后疼痛情况进行评分,并对患者治疗期间生活质量进行对比分析。【结果】观察组显效24例,有效20例,无效4例,总有效率为91.67%,对照组显效14例,有效18例,无效16例,总有效率为66.67%,两组总有效率比较差异具有统计学意义( P <0.05)。但对照组患者治疗过程中出现12例胃肠道反应,4例皮肤瘙痒,其他不良反应7例,不良反应发生率为47.92%,观察组在未出现不良情况( P <0.05)。治疗后观察组VAS评分显著低于对照组,两组相比(2.13±0.79vs4.03±0.68),差异具有统计学意义( P <0.05)。且采用神经阻滞疗法,患者的生活质量明显改善,其心理指数、情感指数和健康指数与对照组比较,差异且有统计学意义( P <0.05)。【结论】神经阻滞疗法对慢性疼痛性肌腱炎治疗效果显著,患者疼痛程度减轻,且提高了患者的生活质量。%[Objective] To explore the effects of nerve block therapy for chronic pain with tendinitis .[Methods] A total of 96 patients with chronic pain with tendinitis were recruited from December 2010 to De‐cember 2012 at our hospital .They were divided randomly into two groups ( n=48 each) .The control group received such conventional measures as rest ,cold compression and use of ibuprofen for symptomatic treat‐ment .And the

  14. PPARs in Alveolar Macrophage Biology

    Directory of Open Access Journals (Sweden)

    Monica R. Smith

    2007-01-01

    Full Text Available PPARs, most notably PPAR-γ, play a crucial role in regulating the activation of alveolar macrophages, which in turn occupy a pivotal place in the immune response to pathogens and particulates drawn in with inspired air. In this review, we describe the dual role of the alveolar macrophage as both a first-line defender through its phagocytotic activity and a regulator of the immune response. Depending on its state of activation, the alveolar macrophage may either enhance or suppress different aspects of immune function in the lung. We then review the role of PPAR-γ and its ligands in deactivating alveolar macrophages—thus limiting the inflammatory response that, if unchecked, could threaten the essential respiratory function of the alveolus—while upregulating the cell's phagocytotic activity. Finally, we examine the role that inadequate or inappropriate PPAR-γ responses play in specific lung diseases.

  15. The effect of adductor canal block and femoral nerve block under multimodal analgesia for early analgesic effect and re-habilitation after total knee replacement%多模式镇痛下收肌管与股神经阻滞在全膝关节置换术后初期镇痛及早期康复中的作用

    Institute of Scientific and Technical Information of China (English)

    谭振; 康鹏德; 裴福兴; 沈彬; 杨静; 周宗科; 张燕姿

    2015-01-01

    Objective To compare adductor canal block with femoral nerve block under multimodal analgesia for early analgesic effect and rehabilitation after total knee replacement (TKA). Methods Eighty patients who were scheduled to undergo TKA were randomly divided into two groups:adductor canal block (ACB) group and femoral nerve block (FNB) group. All the pa⁃tients were given Celecoxib (200 mg, bid) three days preoperative. The ACB group was given adductor canal block with ropivacaine (5 g/L, 20 ml) and 0.1 mg epinephrine half an hour before the surgery. The FNB group was given femoral nerve block with ropivacaine (3.33 g/L, 30 ml) and 0.1 mg epinephrine half an hour before the surgery. Both of the two groups were given local infiltration analge⁃sia with ropivacaine (2.5 g/L, 20 ml) and 0.1 mg epinephrine after click into the prosthesis. After surgery, all the patients were given Diclofenac Sodium (50 mg, q12h, p.o.), oxycodone hydrochloride sustained⁃release tablets (10 mg, q12 h, p.o.) and Parecoxib (40 mg, q12 h, i.m.) until discharged. The resting and motion Numeric Rating Scales (NRS) scores, the knee joint range of motion, the muscle strength of quadriceps femoris, total Meperidine hydrochloride consumption, postoperative hospital stay and the side effects and complications were recorded. Results The resting and motion NRS scores were similar to the ACB group of FNB group which were not statistically significant. The range of motion (1, 2, 3 days after surgery) and muscular strength of quadriceps femofis (within 24 hours) in the ACB group was better than in the FNB group. The average length of postoperative hospital stay was shorter in the ACB group than it was in FNB group. In the ACB group the range of motion at 14 day, total Meperidine hydrochloride con⁃sumption and the side effects were similar to the FNB group. Conclusion Under multimodal analgesia, the adductor canal block had similar early analgesia effects with the femoral nerve block when TKA was

  16. Abses Alveolar Akut Pada Anak

    OpenAIRE

    Delfitri, Meri

    2008-01-01

    Abses alveolar akut adalah suatu kumpulan nanah yang terlokalisasi dalam tulang alveolar sekitar apeks gigi setelah kematian pulpa yang merupakan kelanjutan proses infeksi yang mulai di pulpa dan berkembang ke jaringan periapikal. Perluasan infeksi dari pulpa non vital dapat melalui foramen apikal menuju jaringan periapikal yang mengakibatkan inflamasi akut, bila disertai dengan meningkatnya virulensi bakteri streptokokus alfa, disertai staffilokokus dan sejumlah anaerob lainnya serta r...

  17. Micronuclei in human alveolar macrophages.

    Science.gov (United States)

    D'Agostini, F; Bonatti, S; Oddera, S; De Flora, S

    1992-01-01

    Occurrence of micronuclei was monitored in pulmonary alveolar macrophages collected from 31 individuals undergoing diagnostic bronchoalveolar lavage. The overall frequency of micronucleated cells was 3.88 +/- 1.84/1000, without any significant difference attributable to sex, age, pathology, occupation, or smoking habits. The lack of influence of cigarette smoke on this clastogenicity index presumably reflects the very low rate of mitoses of macrophages in the alveolar lumen. PMID:1579732

  18. Intraoperative recurrent laryngeal nerve monitoring during thyroid surgery under block anaesthesia of the cervical plexus%颈丛麻醉下甲状腺手术中喉返神经的功能监测

    Institute of Scientific and Technical Information of China (English)

    谢启伟; 周刚; 刘献增; 姜可伟; 曲军; 梁斌; 刘征; 叶颖江; 王杉

    2010-01-01

    目的 探讨在颈丛麻醉下,通过针电极记录环杓侧肌复合肌肉动作电位(CMAP)对甲状腺手术中喉返神经功能进行监测的可行性.方法 使用美国尼高力Endeavor CR术中神经功能监测仪,通过针电极记录环杓侧肌CMAP,同心圆电极间断性刺激暴露或未暴露的喉返神经,对颈丛麻醉下甲状腺手术中喉返神经功能进行监测.结果 28例患者术中暴露31条喉返神经,刺激后均出现潜伏期恒定的CMAP;所需要的刺激强度为0.2~1.6mA,平均为0.96mA;而沿着同一神经未暴露段的可能行径进行刺激时,其中25条神经出现稳定的复合肌肉动作电位,刺激强度1.3~3.5 mA,平均为2.03 mA,其余6条神经即使刺激强度达5 mA未能诱发出CMAP,但该6例神经完全解剖暴露后,仍可出现稳定的环杓侧肌诱发肌电图.28例患者术后发音全部正常.结论 通过环杓侧肌记录CMAP对颈丛麻醉下甲状腺术中的喉返神经功能进行监测,是一项安全、有效、可行的方法.%Objective To investigate the monitoring of the recurrent laryngeal nerve (RLN)function during thyroid surgery by recording the compound muscle action potential (CMAP) of lateral cricoarytenoid muscle(LCA) under block anaesthesia of the cervical plexus. Methods Nicolet Endeavor CR(Viasys Healthcare, USA) was applied for the intraoperative monitoring. A pair of needle electrodes were inserted into LCA to record CMAP, and a concentric electrode was used to intermittently stimulate the RLN for monitoring the RLN function during operation under block anaesthesia of the cervical plexus.Results In these 28 cases 31 RLNs were exposed during operation, CMAPs appeared with consistent latency when stimulation was applied at the exposed segment. The stimulating intensity threshold ranged from 0.2 to 1.6 mA. The average value was 0.96 mA. 25 of 31 showed CMAPs with consistent latency when stimulation was provided along the possible pathway of the unexposed segment

  19. 连续腰丛神经阻滞联合单次坐骨神经阻滞用于膝关节置换术后镇痛%Continuous Lumbar Plexus Block Combined with Single Sciatic Nerve Block for the Postoperative Analgesia after Knee Arthroplasty

    Institute of Scientific and Technical Information of China (English)

    李海华; 王春华

    2013-01-01

    [目的]探讨连续腰丛神经阻滞联合单次坐骨神经阻滞用于膝关节置换术后镇痛的价值。[方法]选择2010年1月至2012年12月本院住院治疗的膝关节置换术后患者83例,随机分为两组:观察组42例使用连续腰丛神经阻滞联合单次坐骨神经阻滞,对照组41例则使用硬膜外阻滞。比较两组患者术后8 h、24 h、36 h和48 h疼痛视觉模拟评分(VAS)及下肢肌力改良Bromage评分,并统计治疗期间发生的不良反应。[结果]两组术后8 h、24 h、36 h和48 h患者下肢VAS评分各个时间点之间差异均无统计学意义( P>0.05),观察组从术后24 h开始其下肢肌力改良Bromage评分即低于对照组( P <0.05),观察组治疗期间发生尿潴留和下肢麻木的比率显著低于对照组( P <0.05)。[结论]连续腰丛神经阻滞联合单次坐骨神经术后镇痛,在确保有效镇痛的前提下,有效减少术后并发症,更有利于患者术后功能锻炼。%[Objective] To explore the value of continuous lumbar plexus block combined with single sciatic block for postoperative analgesia after knee arthroplasty .[Methods]A total of 83 inpatients after knee arthroplas-ty in our hospital from Jan .2010 to Dec .2012 were chosen and divided into two groups .The observation group( n =42) received continuous lumbar plexus block combined with single sciatic nerve block ,while the control group ( n =41) received epidural anesthesia .Pain visual analog scale(VAS) at 8h ,24h ,36h and 48h after the operation and the modified Bromage score of lower limb muscle strength were compared between two groups .Adverse reac-tions during the treatment were recorded .[Results] There was no significant difference in VAS of lower limbs at 8h ,24h ,36h and 48h after the operation between two groups( P>0 .05) .From 24h after the operation ,the mod-ified Bromage score of muscle strength of lower limbs in the observation group was lower than

  20. Sessile alveolar macrophages communicate with alveolar epithelium to modulate immunity

    Science.gov (United States)

    Westphalen, Kristin; Gusarova, Galina A.; Islam, Mohammad N.; Subramanian, Manikandan; Cohen, Taylor S.; Prince, Alice S.; Bhattacharya, Jahar

    2014-02-01

    The tissue-resident macrophages of barrier organs constitute the first line of defence against pathogens at the systemic interface with the ambient environment. In the lung, resident alveolar macrophages (AMs) provide a sentinel function against inhaled pathogens. Bacterial constituents ligate Toll-like receptors (TLRs) on AMs, causing AMs to secrete proinflammatory cytokines that activate alveolar epithelial receptors, leading to recruitment of neutrophils that engulf pathogens. Because the AM-induced response could itself cause tissue injury, it is unclear how AMs modulate the response to prevent injury. Here, using real-time alveolar imaging in situ, we show that a subset of AMs attached to the alveolar wall form connexin 43 (Cx43)-containing gap junction channels with the epithelium. During lipopolysaccharide-induced inflammation, the AMs remained sessile and attached to the alveoli, and they established intercommunication through synchronized Ca2+ waves, using the epithelium as the conducting pathway. The intercommunication was immunosuppressive, involving Ca2+-dependent activation of Akt, because AM-specific knockout of Cx43 enhanced alveolar neutrophil recruitment and secretion of proinflammatory cytokines in the bronchoalveolar lavage. A picture emerges of a novel immunomodulatory process in which a subset of alveolus-attached AMs intercommunicates immunosuppressive signals to reduce endotoxin-induced lung inflammation.

  1. Application of nerve stimulator in patients with operation of interscalene brachial plexus block anesthesia in elderly fracture of radius%神经刺激仪定位在老年桡骨骨折手术患者行肌间沟臂丛神经阻滞麻醉中的应用价值

    Institute of Scientific and Technical Information of China (English)

    汪东学; 金侃

    2015-01-01

    Objective To investigate the anesthetic effect of nerve stimulator method on patients with interscalene brachial plexus block in the elderly fracture of radius. Methods One hundred patients with elective upper limb operation of intermuscular groove brachial plexus block were chosen and randomly divided into 2 groups (n=50) including group S and group P. The patients in group S were treated with nerve stimulator interscalene brachial plexus block and those in group P with traditional paresthesia positioning method all by ropiva-caine. The the anesthetic effects and satisfaction of two groups were compared. Results The operation time, onset time and improving time of sensory nerve block of brachial plexus and the onset time of motor nerve block of brachial plexus of group S were significant shorter than those of group P. The anesthetic effects and satisfaction of group S were significantly better than those of group P. Conclusion The nerve stimulator can be safely and effectively applied in elderly patients with interscalene brachial plexus block.%目的 探讨神经刺激仪定位用于老年桡骨骨折患者行肌间沟臂丛神经阻滞麻醉效果.方法 选择行肌间沟臂丛神经阻滞老年桡骨骨折患者100例,随机分为S组(50例)和P组(50例),分别在神经刺激仪和传统异感法定位下予罗哌卡因行神经阻滞,比较两组患者麻醉效果及满意度.结果 S组操作,臂丛感觉神经阻滞起效、完善及运动神经阻滞起效时间均短于P组,差异有统计学意义(P<0.05);S组麻醉满意度优于P组,差异有统计学意义(P<0.05).结论 神经刺激仪定位应用于老年患者行肌间沟臂丛神经阻滞,安全有效.

  2. Cutaneous nerve entrapment syndrome

    Institute of Scientific and Technical Information of China (English)

    DongFuhui

    2004-01-01

    The cutaneous nerve entrapment syndrome is named that, the cutaneous nerve's functional disorder caused by some chronic entrapment, moreover appears a series of nerve's feeling obstacle,vegetative nerve function obstacle, nutrition obstacle, even motor function obstacle in various degree.

  3. Nerve biopsy (image)

    Science.gov (United States)

    Nerve biopsy is the removal of a small piece of nerve for examination. Through a small incision, a sample ... is removed and examined under a microscope. Nerve biopsy may be performed to identify nerve degeneration, identify ...

  4. Displasia alveolar congénita Congenital alveolar dysplasia

    OpenAIRE

    D.P. Sánchez Hernández; M.M. Suárez Galvis; M.T. García Vélez; A. Uribe Molina

    2012-01-01

    La displasia alveolar congénita es una patología congénita poco frecuente caracterizada por disminución de las unidades alveolares y anormalidades del desarrollo de la vasculatura pulmonar. Esta entidad produce hipertensión pulmonar severa e hipoxemia persistente con una evolución mortal en la mayoría de los casos. Afecta generalmente a recién nacidos a término, con un test de Apgar normal, que posteriormente desarrollan dificultad respiratoria, habitualmente en el primer día de vida. La enfe...

  5. ApplicationofEpiduralNerveBlockCombinedwithKetamineAnesthesiainPediatricAppendicitisOperation%硬膜外神经阻滞复合氯胺酮麻醉在小儿阑尾手术中的应用

    Institute of Scientific and Technical Information of China (English)

    王爱文

    2013-01-01

      目的观察罗哌卡因硬膜外阻滞复合氯胺酮-丙泊酚静脉麻醉在小儿阑尾手术中的应用,对呼吸循环功能以及术后恢复情况的影响。方法60例行阑尾手术患儿随机分为两组:氯胺酮基础麻醉后,硬膜外神经阻滞复合氯胺酮-丙泊酚静脉麻醉组(A组,n=30),硬膜外穿刺成功后注入0.375%罗哌卡因0.2mL/kg,术中以氯胺酮一丙泊酚持续静注;另一组氯胺酮基础麻醉后,单纯氯胺酮-丙泊酚静脉麻醉组(B组,n=30),术中氯胺酮一丙泊酚持续静注。结果术中A组循环,呼吸功能较B组稳定(P<0.05),肢体不良自主运动,喉痉挛等不良反应较B组少(P<0.05),A组氯胺酮用量明显少于B组(P<0.01),术后A组苏醒较快且平稳,恢复期精神症状少,与B组比较有显著差异(P<0.05)。结论硬膜外神经阻滞复合氯胺酮-丙泊酚静脉麻醉应用于小儿阑尾手术,可减少氯胺酮用量从而减少其不良反应,使患儿在麻醉手术期间呼吸循环更平稳,外科医师更满意,在小儿麻醉中是一种值得推广的麻醉方法。%Objective To observe the effect of ropivacaine epidural anesthesia combined with ketamine and propofol intravenous anesthesia used in pediatric appendicitis operation and the effect on the recovery of respiratory and circulatory function and postoperative. Methods 60 cases of appendix operations were randomly divided into two groups:ketamine basic anesthesia, epidural nerve block combined with ketamine and propofol intravenous anesthesia group (group A, n=30), epidural puncture success after injection of 0.375%ropivacaine 0.2mL/kg, intraoperative ketamine-propofol continuous infusion;another group of ketamine after basal anesthesia, ketamine and propofol intravenous anesthesia group (group B, n=30), intraoperative ketamine-propofol continuous infusion. Results The patients in group A than in group B stable circulatory and

  6. Effectiveness of femoral nerve block for postoperative analgesia after total knee arthroplasty: a Meta analysis%股神经阻滞用于全膝关节置换术患者术后镇痛的Meta分析

    Institute of Scientific and Technical Information of China (English)

    黄天丰; 张扬; 方向志; 王存金; 高巨

    2016-01-01

    目的 采用Meta分析的方法评价股神经阻滞(femoral nerve block,FNB)对全膝关节置换术(total knee arthroplasty,TKA)患者术后镇痛的效果. 方法 检索PubMed、OVID、EMBASE、Cochrane图书馆,检索时间从建库至2014年11月.收集在TKA术后使用FNB与患者自控静脉镇痛(patient-controlled intravenous analgesia,PCIA)或患者自控硬膜外镇痛(patient-controlled epidural analgesia,PCEA)的临床随机对照实验(randomized controlled trial,RCT).采用Cochrane协作网系统评价法评价纳入文献的质量,采用RevMan5.2软件进行Meta分析评价. 结果 共纳入14项研究,包括1 157例患者,其中FNB组616例,PCIA组380例,PCEA组161例.与PCIA组比较,FNB有效减少了患者术后24 h[加权均数差(weighted mean difference,WMD)=-17.93,95%置信区间(confidence interval,CI)=-27.38~-8.49]及48 h(WMD=-25.70,95%CI:-41.67~-9.74)的吗啡累计消耗量,降低患者术后24 h活动时VAS(WMD=-1.99,95%CI:-3.14~-0.85)(P<0.05);且FNB组患者术后恶心呕吐比值比(odds ratio,OR)(0.31,95%CI:0.22~0.44)、尿潴留(OR=0.24,95%CI:0.13~0.43,P<0.05)及头晕的发生率(OR=0.27,95%CI:0.14~0.52)都较低(P<0.05). 结论 比较PCIA及PCEA,FNB可能是TKA患者术后镇痛的一种更好的选择.%Objective To define the efficacy of femoral nerve block (FNB) with epidural and patient-controlled analgesia (PCA) for postoperative analgesia after total knee arthroplasty.Methods We searched the PubMed,OVID,EMBASE,and Cochrane library for all randomized controlled trials (RCTs) on the efficacy of FNB versus epidural or PCA in patients after total knee arthroplasty.The quality of the studies was evaluated by the method recommended by Cochrane Collaboration.Meta-analysis was conducted using the Cochrane Collaboration's RevMan 5.2 software.Results Fourteen RCTs with a total of 1 157 patients were included into the final analysis,616 patients received femoral nerve block,380 patients received PCA and

  7. Flank hernia secondary to phenol nerve block.

    LENUS (Irish Health Repository)

    Al-Hilli, Z

    2010-09-01

    The management of patients with chronic pain is challenging. The aim of treatment is alleviation of symptoms in an attempt to increase functional capacity. Interventional procedures, such as chemical neurolysis are adopted when other techniques fail to provide adequate pain control.

  8. What Are Nerve Blocks for Headache?

    Science.gov (United States)

    ... at the Montefiore Headache Center, Department of Neurology, Albert Einstein College of Medicine, Bronx, NY. Matthew S. Robbins, MD, ... is an assistant professor of neurology at the Albert Einstein College of Medicine, and the current chair of ...

  9. Pulmonary alveolar proteinosis in a cat

    OpenAIRE

    Szatmári, Viktor; Teske, Erik; Peter G. J. Nikkels; Griese, Matthias; de Jong, Pim A.; Grinwis, Guy; Theegarten, Dirk; Veraa, Stefanie; van Steenbeek, Frank G.; Drent, Marjolein; Bonella, Francesco

    2015-01-01

    BACKGROUND: Pulmonary alveolar proteinosis is an extremely rare lung disease in animals and humans. It is characterized by the deposition of a large amount of phospholipoproteinaceous material in the alveoli. There are several possible etiologies, both congenital and acquired. Alveolar macrophages play an important role in the clearance of surfactant. This is the first report of pulmonary alveolar proteinosis in the feline species. CASE PRESENTATION: Pulmonary alveolar proteinosis was diagnos...

  10. Pulmonary alveolar microlithiasis with calcified pleural plaques

    Directory of Open Access Journals (Sweden)

    Malhotra Balbir

    2010-01-01

    Full Text Available Pulmonary alveolar microlithiasis (PAM is a rare disease. Herein we report a case of pulmonary alveolar microlithiasis who was suspected to have the disease on chest X-ray and was confirmed on high resolution CT and transbronchial lung biopsy. These investigations showed characteristic features of pulmonary alveolar microlithiasis with diffuse interstitial pulmonary fibrosis.

  11. Pulmonary alveolar microlithiasis with calcified pleural plaques

    OpenAIRE

    Malhotra Balbir; Sabharwal Raghu; Singh Mandeep; Singh Amarjeet

    2010-01-01

    Pulmonary alveolar microlithiasis (PAM) is a rare disease. Herein we report a case of pulmonary alveolar microlithiasis who was suspected to have the disease on chest X-ray and was confirmed on high resolution CT and transbronchial lung biopsy. These investigations showed characteristic features of pulmonary alveolar microlithiasis with diffuse interstitial pulmonary fibrosis.

  12. Endothelial-monocyte activating polypeptide II disrupts alveolar epithelial type II to type I cell transdifferentiation

    Directory of Open Access Journals (Sweden)

    Chen Yao

    2012-01-01

    Full Text Available Abstract Background Distal alveolar morphogenesis is marked by differentiation of alveolar type (AT-II to AT-I cells that give rise to the primary site of gas exchange, the alveolar/vascular interface. Endothelial-Monocyte Activating Polypeptide (EMAP II, an endogenous protein with anti-angiogenic properties, profoundly disrupts distal lung neovascularization and alveolar formation during lung morphogenesis, and is robustly expressed in the dysplastic alveolar regions of infants with Bronchopulmonary dysplasia. Determination as to whether EMAP II has a direct or indirect affect on ATII→ATI trans-differentiation has not been explored. Method In a controlled nonvascular environment, an in vitro model of ATII→ATI cell trans-differentiation was utilized to demonstrate the contribution that one vascular mediator has on distal epithelial cell differentiation. Results Here, we show that EMAP II significantly blocked ATII→ATI cell transdifferentiation by increasing cellular apoptosis and inhibiting expression of ATI markers. Moreover, EMAP II-treated ATII cells displayed myofibroblast characteristics, including elevated cellular proliferation, increased actin cytoskeleton stress fibers and Rho-GTPase activity, and increased nuclear:cytoplasmic volume. However, EMAP II-treated cells did not express the myofibroblast markers desmin or αSMA. Conclusion Our findings demonstrate that EMAP II interferes with ATII → ATI transdifferentiation resulting in a proliferating non-myofibroblast cell. These data identify the transdifferentiating alveolar cell as a possible target for EMAP II's induction of alveolar dysplasia.

  13. Application of ultrasound-guided inguinal obturator nerve block in transurethral electric excision of bladder tumor%超声引导下腹股沟径路闭孔神经阻滞在经尿道膀胱肿瘤电切术中的应用

    Institute of Scientific and Technical Information of China (English)

    靳红绪; 王忠义; 张同军; 孙学飞; 王福朝; 刘志永; 徐志杰; 姚长青

    2013-01-01

    目的:比较超声引导下腹股沟径路闭孔神经阻滞和传统神经刺激器定位闭孔神经阻滞预防闭孔神经反射的效果。方法选取我院2011年7月-2012年11月经尿道膀胱肿瘤电切术的患者48例,美国麻醉医师协会(American Society of Anesthesiology,ASA)分级Ⅰ或Ⅱ级,采用随机数字表法,将其随机均分为两组:超声引导组(U组,n=24)和神经刺激器组(N组,n=24)。膀胱肿瘤位于单侧或双侧闭孔神经支配区域,其中17例需行双侧闭孔神经阻滞。闭孔神经阻滞前后分别测定阻滞侧大腿内收肌力量。记录每侧闭孔神经阻滞穿刺尝试次数、操作时间及两种闭孔神经阻滞方法成功率及并发症发生情况等。结果 U组均为1次尝试,N组有18侧为1次尝试,13侧为2次尝试以上,两组间差异有统计学意义(P<0.05);U组闭孔神经阻滞操作时间明显少于N组(P<0.05);两组闭孔神经阻滞前后测定的阻滞侧大腿内收肌力量及阻滞成功率比较无统计学意义(P>0.05);两组患者均未出现局麻药中毒、术后闭孔神经支配区域痛性感觉异常及闭孔神经损伤等情况。结论与传统神经刺激器定位比较,超声引导下闭孔神经阻滞定位准确,试穿次数少,操作时间短,安全有效。%Objective To compare the effects of ultrasound-guided inguinal obturator nerve block and traditional nerve stimulator on preventing obturator nerve reflex.Methods Forty-eight patients with (American Society of Anesthesiology, ASA)ⅠorⅡaged 37-81 years who underwent transurethral electric excision of bladder tumor in our hospital from July 2011 to November 2012 were randomly divided into ultrasound-guided group (group U, n=24) and nerve stimulator group (group N, n=24). The bladder tumor was located in unilateral or bilateral obturator nerve-innervated area. Bilateral obturator nerve was blocked in 17 patients. The thigh adductor muscle strength in

  14. TREATMENT OF COMPRESSION SYNDROME OF CERVICAL POSTERIOR BRANCH BY CERVICAL NERVE BLOCK OUTSIDE VERTEBRAL CANAL AND MANIPULATION%椎管外颈神经阻滞加手法治疗颈神经后支卡压综合症

    Institute of Scientific and Technical Information of China (English)

    王希; 袁君君

    2001-01-01

    为探讨评价颈神经后支卡压综合症的诊治方法,根据YabukiS等对颈神经解剖学的研究,结合临床回顾性地分析了89例颈神经后支卡压综合症患者椎管外颈神经阻滞及手法治疗的效果。经平均6个月随访,结果47例单纯行颈神经阻滞术者,治愈38例,占80.1%;42例配合手法治疗者,全部治愈,占100%。组间比较(P<0.05),两组治愈率有明显差异。提示对病因不明及无明显神经体征的头、颈肩痛患者,应诊断为颈神经后支卡压综合症,与颈神经后支在关节突出部位的卡压有关。椎管外颈神经阻滞配合手法治疗,是一种针对性强、有效的治疗方法。%To explore the diagnostic and therapeutic methods of compressionsyndrome of cervical posterior branch, according to Yabukis'research about anatomy of cervical nerve, analyze retrospectively the therapeutic effect of compression syndrome of cervical posterior branch(89 cases) with cervical nerve block outside vertebral canal and manipulation. The average follow-up time was half a year. 38 out of 47 patients were cured with cervical nerve block and the curative rate was 80%, but other 42 patients were all cured with cervical nerve block outside vertebral canal and manipulation, the curative rate was 100%. There was a significant difference(P<0.05) in two groups. For head-neck-shoulder pain patients without clear cause and obvious nervous signs, they should be diagnosed as compression syndrome of cervical posterior branch, which related to being compressed of cervical posterior branch at the articular process. It was suggested that cervical nerve block outside vertebral canal with manipulation was a pointed and effective therapeutic method.

  15. Readiness for surgery after axillary block

    DEFF Research Database (Denmark)

    Koscielniak-Nielsen, Z J; Stens-Pedersen, H L; Lippert, F K

    1997-01-01

    We have assessed prospectively the time to readiness for surgery following axillary block (sum of block performance and latency times) in 80 patients. The brachial plexus was identified using a nerve stimulator, and anaesthetized with 45 mL of mepivacaine 1% with adrenaline 5 micrograms mL-1....... In group 1 (single injection) the whole volume of mepivacaine was injected after locating only one of the plexus nerves. In group 2 (multiple injections) at least three plexus nerves were located, and the volume of mepivacaine was divided between them. Sensory block was assessed by a blinded observer every...

  16. Chloride-dependent secretion of alveolar wall liquid determined by optical-sectioning microscopy.

    Science.gov (United States)

    Lindert, Jens; Perlman, Carrie E; Parthasarathi, Kaushik; Bhattacharya, Jahar

    2007-06-01

    The liquid layer lining the pulmonary alveolar wall critically determines the lung's immune defense against inhaled pathogens, because it provides a liquid milieu in the air-filled alveolus for dispersal of immune cells and defensive surfactant proteins. However, mechanisms underlying formation of the liquid are unknown. We achieved visualization of the alveolar wall liquid (AWL) in situ in mouse lungs by means of optical-sectioning microscopy. Continuous liquid secretion was present in alveoli of wild-type (WT) mice under baseline conditions. This secretion was blocked by inhibitors of the cystic fibrosis transmembrane regulator (CFTR). The secretion was absent in Cftr(-/-) mice, and it was blocked when chloride was depleted from the perfusate of WT mice, providing the first evidence that CFTR-dependent chloride secretion causes AWL formation. Injected microparticles demonstrated flow of the AWL. The flow was blocked by CFTR inhibition and was absent in Cftr(-/-) mice. We conclude that CFTR-dependent liquid secretion is present in alveoli of the adult mouse. Defective alveolar secretion might impair alveolar immune defense and promote alveolar disease. PMID:17290033

  17. Systemic evaluation of femoral nerve block analgesia and patient controlled intravenous analgesia in pain control after total knee arthroplasty%全膝关节置换应用股神经阻滞镇痛与自控静脉镇痛的系统评价☆

    Institute of Scientific and Technical Information of China (English)

    张启栋; 刘朝晖; 程立明; 曹三利; 徐广春; 路玉峰; 郭万首

    2013-01-01

      背景:目前对全膝关节置换围手术期采用何种镇痛方法的效果差异存在争议。  目的:系统评价全膝关节置换术中应用股神经阻滞镇痛与患者自控静脉镇痛的疗效和安全性。  方法:全面搜索国内外关于全膝关节置换中应用股神经阻滞镇痛和患者自控静脉镇痛的随机对照研究资料,按照既定的纳入、排除标准,核定检出符合评价标准的文献,提取所需研究数据,采用RevMan 5.0.18软件进行Meta分析。评价指标包括术后24,48 h静息和活动时的目测类比评分、恶心呕吐胃肠道症状发生率、嗜睡等镇静过度发生率以及患者满意率。  结果与结论:纳入随机对照研究19篇,样本共计952膝,股神经阻滞组和患者自控静脉镇痛组分别为481膝和471膝。荟萃分析加权后,股神经阻滞与患者自控静脉镇痛相比,术后24,48 h静息和活动目测类比评分均较低(P OBJECTIVE:To assess the efficacy and safety of femoral nerve block analgesia and patient control ed intravenous analgesia in total knee arthroplasty. METHODS:Randomized control ed trials on the application of femoral nerve block analgesia and patient control ed intravenous analgesia in total knee arthroplasty, and the literatures that met the evaluation criteria were included according to the inclusion and exclusion criteria in order to extract the required research data. The Meta-analysis was performed with RevMan 5.0.18 software. The evaluation indicators included the visual analog scale during postoperative 24 hours, 48 hours resting and activities period, the incidence rate of nausea, vomiting and gastrointestinal symptoms, as wel as the incidence rate of lethargy and other excessive sedation and the satisfaction rate. RESULTS AND CONCLUSION:Nineteen randomized control ed trials with 952 knees were included. There were 481 knees in the femoral nerve block analgesia group and 471 knees in

  18. Vertical Ridge Augmentation of the Atrophic Posterior Mandible with Sandwich Technique: Bone Block from the Chin Area versus Corticocancellous Bone Block Allograft—Clinical and Histological Prospective Randomized Controlled Study

    Directory of Open Access Journals (Sweden)

    Luigi Laino

    2014-01-01

    Full Text Available The aim of the present study is to compare the histological aspects of bone formation in atrophic posterior mandibles augmented by autologous bone block from chin area with corticocancellous bone block allograft used as inlays with the sandwich technique. Materials and Methods. Sixteen patients with bilateral partial edentulism in the posterior mandible were selected. The residual bone height, preliminarily measured by computed tomography scans, ranged between 5 and 7 mm from the inferior alveolar nerve. All patients required regeneration procedure with autologous bone block from chin area (control group versus bone block allograft Puros (Zimmer Dental, 1900 Aston Avenue, Carlsbad, CA, USA (test group. Histological and histomorphometric samples were collected at the time of implant positioning in order to analyze the percentage of newly formed bone, the residual graft material, and marrow spaces/soft tissue. Results. No statistically significant differences between the two groups were found regarding the percentage of newly formed bone. The percentage of residual grafted material was significantly higher in the test group, whilst the percentage of marrow spaces was higher in control group. Conclusions. In conclusion, both procedures supported good results, although the use of bone blocks allograft was less invasive and preferable than harvesting bone from the mental symphysis.

  19. Bloqueo ciático continuo con catéter estimulador guiado mediante ecografía para tratamiento del miembro fantasma doloroso Ultrasound-guided continuous sciatic nerve block with stimulating catheter for the treatment of phantom limb pain

    Directory of Open Access Journals (Sweden)

    A. Martínez Navas

    2009-02-01

    Full Text Available Los bloqueos nerviosos periféricos pueden ser una alternativa a la analgesia intravenosa y epidural en el tratamiento del miembro fantasma doloroso. La dificultad en la localización del nervio ciático mediante neuroestimulación en pacientes con arteriopatía periférica y neuropatía puede verse aumentada por el hecho de presentar una amputación del miembro inferior, que imposibilita la observación de una respuesta motora en el pie coincidiendo con la localización del nervio. En estos casos, la ecografía puede convertirse en una técnica de localización nerviosa determinante del éxito de la analgesia ya que permite la identificación del nervio, así como la visualización en tiempo real de la posición relativa de la aguja y catéter respecto al nervio y la difusión del anestésico local administrado. Se presenta el caso de un paciente con miembro fantasma doloroso resistente al tratamiento convencional que se controló con un bloqueo ciático continuo con catéter estimulador guiado con ecografía.Peripheral nerve blocks can be an alternative to intravenous and epidural analgesia in the treatment of phantom limb pain. The difficulty of localizing the sciatic nerve through neurostimulation in patients with peripheral arteriopathy and neuropathy can be increased by lower limb amputation, making it impossible to observe a motor response in the foot coinciding with localization of the nerve. In these cases, ultrasonography can become a technique for nerve localization and determine the success of analgesic strategy, since it allows nerve identification, as well as visualization in real time of the relative position of the needle and catheter with respect to the nerve and the diffusion of the local anesthetic administered. We report the case of a patient with phantom limb pain refractory to conventional treatment, in whom pain control was achieved by ultrasound-guided continuous sciatic block with stimulating catheter.

  20. [Nerve injury following implant placement: prevention, diagnosis and treatment modalities].

    Science.gov (United States)

    Nazarian, Y; Eliav, E; Nahlieli, O

    2003-07-01

    Nerve injury is a well-known complication following oral and maxillofacial surgery. Direct trauma, inflammation and infection are postoperative neural disturbances main causes. The most inflicted nerves associated with endosseous implant placement are those innervating the mandible: the inferior alveolar nerve, the mental nerve and the lingual nerve. Evaluation of the nerve injury characteristics and severity as early as possible has always imposed a great challenge for clinicians. We demonstrate a reliable yet simple way of dealing with this kind of problem in conjunction with comparing preoperative and postoperative sensation of the chin, the tongue and the lower lip. On the other hand, it is considerably important to take preventive measures for such injuries by using appropriate radiographic images. If a nerve damage has occurred, best prognosis is to be expected by early and appropriate treatment. It is imperative to treat such injuries in four months following the injury, otherwise a permanent nerve damage may occur. Further investigation of nerve damage risks following implant placement should be performed in order to enable patient to decide whether having implants dependent rehabilitation or choosing an alternative. PMID:14515628

  1. Alveolar hypoventilation treated with medroxyprogesterone.

    OpenAIRE

    Milerad, J; Lagercrantz, H.; Löfgren, O

    1985-01-01

    Two children aged 1 and 20 months developed alveolar hypoventilation syndrome. They suffered severe apnoeic episodes and periodically required assisted ventilation. Their ventilatory response to carbon dioxide was lower than that of normal children and the transcutaneous oxygen tension during sleep was well below the normal range. Treatment with medroxyprogesterone acetate resulted in an improved response to carbon dioxide, and assisted ventilation was no longer needed. Oxygen and carbon diox...

  2. The effect of buffer molarity on the size, shape and sheath thickness of peripheral myelinated nerve fibres.

    OpenAIRE

    Holland, G R

    1982-01-01

    Nineteen rats were perfused intracardially with a 2% glutaraldehyde solution in cacodylate buffers adjusted in molarity from 0 to 0.4 M. Ultrathin sections of the inferior alveolar nerve were photographed in the electron microscope. The circumference, a shape factor, small diameter and myelin sheath thickness of each myelinated nerve fibre were measured using a semi-automatic image analysis system. Statistical analysis of the data revealed that the nerve profiles increasingly deviate from a t...

  3. 骶管阻滞对小儿喉罩拔除七氟烷最低肺泡有效浓度的影响%Caudal block reduces the minimum alveolar concentration of sevoflurane for laryngeal mask airway removal in children

    Institute of Scientific and Technical Information of China (English)

    鄢庆林; 易明亮; 姚玉笙

    2014-01-01

    目的:评价单次骶管阻滞对患儿拔除喉罩七氟烷最低肺泡有效浓度(MACLMA)的影响。方法选择2012年1~12月在四川省简阳市中医医院择期行单侧腹股沟斜疝手术患儿50例为研究对象,年龄2~5岁,美国麻醉医师协会分级为Ⅰ级,按照计算机生成的随机种子表将其随机分为七氟烷全身麻醉+骶管阻滞组(研究组)和七氟烷全身麻醉组(对照组),两组均为25例。研究组行单次骶管阻滞(0.25%罗哌卡因1 ml/kg);对照组未行骶管阻滞。两组患儿均采用七氟烷吸入诱导并维持,喉罩维持自主呼吸的麻醉方法。根据Dixon序贯法确定MACLMA。Probit概率单位法确定50%和95%患儿拔除喉罩七氟烷肺泡有效浓度(EC50和EC95)。结果两组患儿年龄、体质量等一般临床资料比较,差异无统计学意义(P>0.05)。研究组患儿拔除喉罩的七氟烷EC50值为1.21%(95%CI 1.14%~1.31%),EC95值为1.56%(95%CI 1.39%~2.14%);对照组患儿拔除喉罩的七氟烷EC50值为1.78%(95%CI 1.63%~1.87%),EC95值为2.21%(95%CI 1.96%~2.87%)。研究组患儿喉罩拔除七氟烷EC50和EC95均低于对照组,差异有统计学意义(P<0.001)。单次骶管阻滞后,患儿拔除喉罩的七氟烷EC50和EC95值分别下降了32.1%和29.4%。结论骶管阻滞可降低小儿喉罩拔除七氟烷最低肺泡有效浓度。%Objective The present study was designed to evaluate the minimum alveolar concentration of sevoflurane for Laryngeal mask airway removal (MACLMA) with and without caudal block in children. Methods A total of 50 subjects between 2 and 5 years old, American Society of Anesthesiologists physical statusⅠ, who were undergoing unilateral oblique inguinal hernia repair from January 2012 to December 2012 in Jianyang Integrated Traditional Chinese Medicine Hospital. Subjects were allocated to receive or not to receive caudal block according to random list

  4. [Alveolar sarcoma. Report of a case].

    Science.gov (United States)

    Devisme, L; Mensier, E; Bisiau, S; Bloget, F; Gosselin, B

    1996-01-01

    Alveolar soft part sarcoma occurs mostly in the deep soft tissues. An unusual case of primary pulmonary alveolar soft part sarcoma is reported. A 39-year-old woman presented with thoracic pain revealing the tumor. The left lower lobe was surgically resected. The microscopic features of this tumor, including characteristic alveolar pattern and the PAS-positive crystals were typical of alveolar soft part sarcoma. Immunohistochemically, granular cytoplasmic reactivities were observed with antibodies against vimentin, myoglobin, methionine-enkephalin, S100 protein and neuron-specific-enolase. Electron microscopic study demonstrated numerous crystallized structures in the tumor cell cytoplasm. This is the third case of pulmonary alveolar soft part sarcoma, one arising from the pulmonary vein. The histogenesis of alveolar soft part sarcoma is still debated. Our case does not allow distinction between myogenic or neural origin of this tumor.

  5. Alveolar septal pulmonary amyloidosis: a case report

    International Nuclear Information System (INIS)

    Primary pulmonary amyloidosis is a rare diesase, and is classified as either tracheobronchial or parenchymal; the latter is also divided into nodular and diffuse alveolar septal forms. The alveolar septal form is extremely rare and usually produces reticular and nodular opacities. We describe a case of alveolar septal pulmonary amyloidosis manifested as multiple small nodules on chest radiograph and disseminated micronodules mainly in centrilobular and subpleural location without reticular opacities, on HRCT

  6. [Pulmonary alveolar microlithiasis: Report of one case].

    Science.gov (United States)

    Fernández F, Cristina; Salinas F, Mauricio; de Grazia K, José Andrés; Díaz P, Juan Carlos

    2014-05-01

    Pulmonary alveolar microlithiasis is an extremely rare disease characterized by intra-alveolar accumulation of calcified spherical particles (called microliths), due to a mutation of the gene encoding a membrane transport protein of the alveolar surface. Most patients are asymptomatic at diagnosis. The course of the disease is slowly progressive, with development of pulmonary fibrosis and respiratory failure. The "sandstorm" pattern is the characteristic finding of this disease. We report a 39-year-old female presenting with progressive dyspnea. A chest X ray showed ground-glass opacities and a high resolution CT scan showed numerous calcified lung micronodules. A surgical lung biopsy confirmed the diagnosis of pulmonary alveolar microlithiasis. PMID:25427025

  7. Retrospective analysis of oral peripheral nerve sheath tumors in Brazilians

    Directory of Open Access Journals (Sweden)

    Juliana Tito Salla

    2009-03-01

    Full Text Available Traumatic neuroma, neurofibroma, neurilemmoma, palisaded encapsulated neuroma and malignant peripheral nerve sheath tumor (MPNST are peripheral nerve sheath tumors and present neural origin. The goal of this study was to describe the epidemiological data of oral peripheral nerve sheath tumors in a sample of the Brazilian population. Biopsies requested from the Oral Pathology Service, School of Dentistry, Federal University of Minas Gerais (MG, Brazil, between 1966 and 2006 were evaluated. Lesions diagnosed as peripheral nerve sheath tumors were submitted to morphologic and to immunohistochemical analyses. All cases were immunopositive to the S-100 protein. Thirty-five oral peripheral nerve sheath tumors were found, representing 0.16% of all lesions archived in the Oral Pathology Service. Traumatic neuroma (15 cases most frequently affected the mental foramen. Solitary neurofibroma (10 cases was more frequently observed in the palate. Neurofibroma associated with neurofibromatosis type I (2 cases was observed in the gingival and alveolar mucosa. Neurilemmoma (4 cases was more commonly observed in the buccal mucosa. Malignant peripheral nerve sheath tumors (3 cases occurred in the mandible, palate, and tongue. Palisaded encapsulated neuroma (1 case occurred in the buccal mucosa. The data confirmed that oral peripheral nerve sheath tumors are uncommon in the oral region, with some lesions presenting a predilection for a specific gender or site. This study may be useful in clinical dentistry and oral pathology practice and may be used as baseline data regarding oral peripheral nerve sheath tumors in other populations.

  8. Endodontic periapical lesion-induced mental nerve paresthesia

    Directory of Open Access Journals (Sweden)

    Elham Shadmehr

    2015-01-01

    Full Text Available Paresthesia is a burning or prickling sensation or partial numbness, resulting from neural injury. The symptoms can vary from mild neurosensory dysfunction to total loss of sensation in the innervated area. Only a few cases have described apical periodontitis to be the etiological factor of impaired sensation in the area innervated by the inferior alveolar and mental nerves. The aim of the present paper is to report a case of periapical lesion-induced paresthesia in the innervation area of the mental nerve, which was successfully treated with endodontic retreatment.

  9. Endodontic periapical lesion-induced mental nerve paresthesia.

    Science.gov (United States)

    Shadmehr, Elham; Shekarchizade, Neda

    2015-01-01

    Paresthesia is a burning or prickling sensation or partial numbness, resulting from neural injury. The symptoms can vary from mild neurosensory dysfunction to total loss of sensation in the innervated area. Only a few cases have described apical periodontitis to be the etiological factor of impaired sensation in the area innervated by the inferior alveolar and mental nerves. The aim of the present paper is to report a case of periapical lesion-induced paresthesia in the innervation area of the mental nerve, which was successfully treated with endodontic retreatment. PMID:25878687

  10. Effect of parecoxib sodium injection combined with scalp nerve block on postoperative analgesia after craniotomy%帕瑞昔布钠静脉注射联用头皮神经阻滞于开颅手术后镇痛的效果

    Institute of Scientific and Technical Information of China (English)

    马树勇

    2015-01-01

    Objective To evaluate the analgesic effect of parecoxib sodium injection combined with scalp nerve block in patient after craniotomy.Methods Fifty-eight patients undergoing selective craniotomy were randomly divided into block group (n=29) and combined group (n=29).All patients were treated with scalp nerve block before the operation in the block group.Patients in combined group received parecoxib sodium intravenous injection additionally before scalp nerve block.VAS was recorded at 0,1,2,4,8,12,24 h after the operation.The SBP,HR,RR,nausea vomiting score,sedation score were assessed at 0,1,2,4,12,24 h after the operation.Results There were no significant differences in the duration of analgesia,sedation,vital signs and other indices between the two groups (P > 0.05).There was statistically significant difference in respiratory rate between the two groups (P < 0.05),but no clinical significance.The time of first needed analgesics after the operation in combined group was significantly longer than that in block group (P < 0.05) and the patients needed additional analgesic drugs within 24 h after the operation were significantly lower in combined group than those in bock group (P =0.046).Conclusion Parecoxib sodium injection combined with scalp nerve block is an effective method for postoperative analgesia in patient after craniotomy.%目的 探讨帕瑞昔布钠静脉注射联合头皮神经阻滞用于开颅术后镇痛的持续时间和镇痛效果.方法 择期行开颅术患者58例,随机分为阻滞组(n=29)和联用组(n=29).前者术前行头皮神经阻滞术,后者麻醉前先静脉注射帕瑞昔布钠,后行头皮神经阻滞术.观察术后0、1、2、4、8、12、24 h各时点疼痛视觉模拟评分(VAS)与术后0、1、2、4、12、24 h收缩压(SBP)、心率(HR)、呼吸频率(RR)、恶心呕吐评分与镇静评分.结果 两种镇痛方法术后镇痛时间、镇静效果、生命体征等指标组间比较差异无统计学意义(P>0

  11. 鼻腔自主神经临床解剖研究——鼻内镜下高能量聚焦超声治疗变应性鼻炎的靶点选择%Clinical anatomical study of nasal autonomic nerve-obtaining target points for the treatment of allergic rhinitis by blocking nasal autonomic nerve with high intensity focused ultrasound under nasal endoscope

    Institute of Scientific and Technical Information of China (English)

    李强; 杨盈坡; 安伟

    2013-01-01

    Objective:To provide anatomical references for the treatment of allergic rhinitis by blocking nasal autonomic nerve with high intensity focused ultrasound under nasal endoscope.Methods:Ten (20 sides) adult head specimens sawn in midline sagittal were choosen,posterosuperior medial nasal branch and posterosuperior lateral nasal branch of sphenopalatine nerve as well as posteroinferior nasal nerve were anatomized under microscope to study and research their branches and ramification and to measure the distance from point of posterosuperior medial nasal branch started from nasal septum to superior border of choana and nasal bottom,the distance from posterosuperior lateral nasal branch in medial surface of middle turbinate to midpoint of inferior border of middle turbinate and the distance from point of posteroinferior nasal nerve reaching at inferior turbinate to posterior border of inferior turbinate.Results:(1)Posterosuperior medial nasal branch of sphenopalatine nerve disturbed on the nasal septum from backward and upward to forward and downward;the route approximated straight line and reverse-parabola line.The nerves in 10 sides disturbed on surface of nasal septum as a main never,all reaching the bottom of nasal septum from anterior-middle segment of nasal septum.The nerves in 8 sides disturbed on surface of nasal septum as two main never branches,the branch near nasal bottom(inferior branch) reaching the bottom of nasal septum from anterior-middle segment of nasal septum(two sides was destroyed when anatomized).The distances were (9.04 ± 1.51) mm(inferior branch) and (15.76 ±2.17) mm(superior branch) to superior border of choana,(18.95 ± 2.69)mm(inferior branch) and (23.39 ± 2.42) mm(superior branch)to nasal bottom.(2)Posterosuperior lateral nasal branch of spheno-palatine nerve distributed on medial surface of middle turbinate,and moved from posterior segment of superior border of middle turbinate,travelled slantingly and reached posterior segment of middle

  12. Carotid Brachial Plexus Nerve Block Anesthesia in the Clinical Application Effect of Operation of the Fracture of the Clavicle%颈臂丛联合神经阻滞麻醉在锁骨骨折手术中的临床应用效果

    Institute of Scientific and Technical Information of China (English)

    张彦东

    2014-01-01

    ObjectiveTo explore the clinical effect of anesthesia in the operation of cervical brachial plexus block of clavicle fracture.MethodsFrom January 2011 to June 2013 year to select 100 cases of clavicle fracture patients, randomly divided into observation group and control group, respectively, the implementation of brachial plexus block and brachial plexus block, block effect and adverse reactions were observed in 2 groups.ResultsThe observation group and the control group with excellent and good rate were 100%, 86% (P0.05). ConclusionCarotid brachial plexus nerve block for operation of clavicular fracture, clinical anesthesia effect is better than that of cervical plexus block, is worth the clinical promotion.%目的:探讨锁骨骨折手术中颈臂丛联合阻滞麻醉在临床应用效果。方法2011年1月至2013年6月选取100例锁骨骨折患者,随机分为对照组和观察组,分别实施臂丛神经阻滞以及颈臂丛联合阻滞,观察2组阻滞效果及不良反应。结果观察组及对照组患者的优良率分别为100%、86%(P0.05)。结论颈臂丛联合神经阻滞用于锁骨骨折手术,临床阻滞效果优于颈丛神经阻滞,值得临床推广。

  13. Anatomy of Mandibular Vital Structures. Part I: Mandibular Canal and Inferior Alveolar Neurovascular Bundle in Relation with Dental Implantology

    Directory of Open Access Journals (Sweden)

    Hom-Lay Wang

    Full Text Available Objectives: It is critical to determine the location and configuration of the mandibular canal and related vital structures during the implant treatment. The purpose of the present study was to review the literature concerning the mandibular canal and inferior alveolar neurovascular bundle anatomical variations related to the implant surgery.Material and Methods: Literature was selected through the search of PubMed, Embase and Cochrane electronic databases. The keywords used for search were mandibular canal, inferior alveolar nerve, and inferior alveolar neurovascular bundle. The search was restricted to English language articles, published from 1973 to November 2009. Additionally, a manual search in the major anatomy, dental implant, prosthetic and periodontal journals and books were performed.Results: In total, 46 literature sources were obtained and morphological aspects and variations of the anatomy related to implant treatment in posterior mandible were presented as two entities: intraosseous mandibular canal and associated inferior alveolar neurovascular bundle.Conclusions: A review of morphological aspects and variations of the anatomy related to mandibular canal and mandibular vital structures are very important especially in implant therapy since inferior alveolar neurovascular bundle exists in different locations and possesses many variations. Individual, gender, age, race, assessing technique used and degree of edentulous alveolar bone atrophy largely influence these variations. It suggests that osteotomies in implant dentistry should not be developed in the posterior mandible until the position of the mandibular canal is established.

  14. Computed tomographic imaging of pulmonary alveolar proteinosis

    International Nuclear Information System (INIS)

    Pulmonary alveolar proteinosis is a rare disease of uncertain etiology. The computed tomographic image is characterized by geographically sharply delineated alveolar infiltrates, faint, ground-glass-like parenchymal turbidity, with well bordered interstitial structures and recesses in the subpleural space. (orig.)

  15. CT quantification of pulmonary alveolar microlithiasis

    International Nuclear Information System (INIS)

    Pulmonary alveolar microlithiasis is a rare, familial disease with massive symmetrical intra-alveolar calcium deposition. Conventional CT findings and CT measurements with a dual energy technique were carried out in a 26-year-old patient suffering from this disease. The importance of the findings in the differential diagnosis and for estimating the progression and prognosis of the disease is discussed. (orig.)

  16. Pulmonary alveolar microlithiasis in children

    International Nuclear Information System (INIS)

    Two asymptomatic Turkish sibs are presented, a 4-year-old boy and his 7-year-old sister, with pulmonary alveolar microlithiasis (PAM) confirmed by transbronchial lung biopsy and bronchoalveolar lavage. Chest radiographs and high resolution CT demonstrated wide-spread intra-alveolar calcifications in both lungs. The lesions were sharply defined and less than 1 mm in diameter. CT documented a high concentration of microliths along the bronchovascular bundles, the intralobular fissue and the (sub)pleural lung parenchyma. The combination of bronchoalveolar lavage and roentgenographic appearance in high resolution CT are characteristic and pathognomonic, and can confirm the diagnosis. The more severe changes in the elder sib and the radiographic controls suggest that the pulmonary disease may be progressive in our patients. The described family of consanguineous, unaffected parents with two affected and one healthy child confirmed the autosomal recessive inheritance of PAM (McKusick 265100). In addition, the affected girl had autosomal recessive Waardenburg-anophthalmia syndrome (McKusick 206920), raising the question of whether this is a chance occurrence or possibly a contiguous gene syndrome. (orig.)

  17. Pulmonary alveolar microlithiasis in children

    Energy Technology Data Exchange (ETDEWEB)

    Schmidt, H. [Center of Diagnostic Radiology, Frankfurt Univ. (Germany); Loercher, U. [Center of Diagnostic Radiology, Frankfurt Univ. (Germany); Kitz, R. [Center of Pediatrics, Frankfurt Univ. (Germany); Zielen, S. [Center of Pediatrics, Frankfurt Univ. (Germany); Ahrens, P. [Center of Pediatrics, Frankfurt Univ. (Germany); Koenig, R. [Inst. of Human Genetics, Frankfurt Univ. (Germany)

    1996-01-01

    Two asymptomatic Turkish sibs are presented, a 4-year-old boy and his 7-year-old sister, with pulmonary alveolar microlithiasis (PAM) confirmed by transbronchial lung biopsy and bronchoalveolar lavage. Chest radiographs and high resolution CT demonstrated wide-spread intra-alveolar calcifications in both lungs. The lesions were sharply defined and less than 1 mm in diameter. CT documented a high concentration of microliths along the bronchovascular bundles, the intralobular fissue and the (sub)pleural lung parenchyma. The combination of bronchoalveolar lavage and roentgenographic appearance in high resolution CT are characteristic and pathognomonic, and can confirm the diagnosis. The more severe changes in the elder sib and the radiographic controls suggest that the pulmonary disease may be progressive in our patients. The described family of consanguineous, unaffected parents with two affected and one healthy child confirmed the autosomal recessive inheritance of PAM (McKusick 265100). In addition, the affected girl had autosomal recessive Waardenburg-anophthalmia syndrome (McKusick 206920), raising the question of whether this is a chance occurrence or possibly a contiguous gene syndrome. (orig.)

  18. Evaluation of Sensorimotor Nerve Damage in Patients with Maxillofacial Trauma; a Single Center Experience

    Directory of Open Access Journals (Sweden)

    Behnaz Poorian

    2016-04-01

    Full Text Available Objective: To evaluate sensorimotor nerve damage in patients with maxillofacial trauma referring to Taleghani hospital, Tehran, Iran Methods: This cross-sectional study was conducted during a 2-year period from 2014 to 2012 in Taleghani hospital of Tehran. We included a total number of 495 patients with maxillofacial trauma referring to our center during the study period. The demographic information, type of fracture, location of fracture and nerve injuries were assessed and recorded in each patients. The frequency of sensorimotor injuries in these patients was recorded. Data are presented as frequencies and proportions as appropriate. Results: Overall we included 495 patients with maxillofacial trauma with mean age of 31.5±13.8 years. There were 430 (86.9% men and in 65 (13.1% women among the patients. The frequency of nerve injuries was 67.7% (336 patients. The mean age of the patients with nerve injuries was 33.4 ± 3.7 years. Marginal mandibular branch of facial nerve was the most common involved nerve being involved in 5 patients (1%. Regarding trigeminal nerve, the inferior alveolar branch (194 patients 39.1% was the most common involved branch followed by infraorbital branch (135 patients 27.2%. Mandibular fracture was the most common injured bone being reported in 376 patient (75.9% patients followed by zygomatic bone in 100 patient (20%. Conclusion: The most frequent fracture occurred in mandible followed by zygoma and the most injured nerve was inferior alveolar nerve followed by infraorbital branch of trigeminal nerve. In facial nerve the marginal branch was the most involved nerve. The frequency of nerve injury and the male to female ratio was higher in the current study compared to the literature.

  19. Clinical study of ultrasound combined nerve stimulator guided brachial plexus block in elderly patients%超声联合神经刺激仪引导实施老年病人臂丛神经阻滞的临床研究

    Institute of Scientific and Technical Information of China (English)

    王俊安; 汪春英

    2011-01-01

    目的 评估超声联合神经刺激仪引导实施老年病人臂丛神经阻滞的优缺点及安全性.方法 75例ASAⅡ或Ⅲ级择期实施上肢手术的65岁以上老年病人,随机均分为三组:超声联合神经刺激仪定位组(US组);超声引导组(U组);神经刺激仪定位组(S组).记录各组臂丛神经阻滞的各项评价指标.结果 三组局麻药用量差异均无统计学意义.US组和U组阻滞操作时间、阻滞起效时间、阻滞完善时间均短于S组(P<0.05),辅助用药例数、并发症发生率均低于S组(P<0.05);US组阻滞起效时间、阻滞完善时间均短于U组(P<0.05),三组均无病人改全麻.结论 超声联合神经刺激仪引导实施肌间沟臂丛神经阻滞成功率高,并发症少,对病人影响小,用于老年病人安全有效.%Objective To evaluate the effect and safety of ultrasound combined nerve stimulator guided interscalene brachial plexus block in elderly patients. Methods Seventy-five ASA ? or ? patients over 65 years old scheduled for arm surgery were randomly divided into three groups:group US,ultrasound combined nerve stimulator group; group U, ultrasound group; group S, nerve stimulator group. Evaluating indices of brachial plexus block were recorded. Results The volumes of local anaesthetics of three groups showed no difference in statistics. In groups US and U manipulation time, onset time and maturity time of brachial plexus block became shorter than group S ( P < 0. 05); rates of using assistant medicine and complications were lower than group S (P<3. 05). Compare with group U,onset time and maturity time of brachial plexus block in group US were shorter(F<0. 05);other evaluating indices of brachial plexus block have no difference in statistics between groups US and U. Conclusion Ultrasound combined nerve stimulator guided interscalene brachial plexus block has advantages of raising success rate and reducing complications. It is effective and safe for elder patients.

  20. An anatomical evaluation of the serratus anterior plane block.

    Science.gov (United States)

    Mayes, J; Davison, E; Panahi, P; Patten, D; Eljelani, F; Womack, J; Varma, M

    2016-09-01

    The serratus anterior plane block has been described for analgesia of the hemithorax. This study was conducted to determine the spread of injectate and investigate the anatomical basis of the block. Ultrasound-guided serratus anterior plane block was performed on six soft-fix embalmed cadavers. All cadavers received bilateral injections, on one side performed with 20 ml latex and on the other with 20 ml methylene blue. Subsequent dissection explored the extent of spread and nerve involvement. Photographs were taken throughout dissection. The intercostal nerves were involved on three occasions with dye, but not with latex. The lateral cutaneous branches of the intercostal nerve contained dye and latex on all occasions. The serratus plane block appears to be mediated through blockade of the lateral cutaneous branches of the intercostal nerves. Anatomically, serratus plane block does not appear to be equivalent to paravertebral block for rib fracture analgesia. PMID:27440171

  1. A meta-analysis of countious femoral nerve block versus continuous epidural analgesia after total knee arthroplasty%全膝关节置换后持续股神经阻滞与持续硬膜外镇痛的Meta分析

    Institute of Scientific and Technical Information of China (English)

    袁志民; 魏建仝; 温景荣; 杨森; 全东和

    2015-01-01

    背景:疼痛是全膝关节置换后阻碍患者早期恢复的重要原因,持续硬膜外镇痛和持续股神经阻滞均是全膝关节置换后镇痛的有效方法,但哪种方法镇痛效果更好且并发症较少一直存在争议。  目的:比较全膝关节置换后持续硬膜外镇痛与持续股神经阻滞的临床疗效及安全性。  方法:计算机检索Cochrane-Library、PubMed、EMBASE、Web of Science、CBM、CNKI、VIP、WanFang等数据库,同时检索学位论文、会议论文等,检索时间为各数据库建库至2014-10-01,纳入全膝关节置换后持续硬膜外镇痛与持续股神经阻滞的随机对照试验。采用Cochrane系统评价的方法进行评价,用RevMan 5.0软件进行统计学分析。  结果与结论:共纳入12篇随机对照试验,4篇英文,8篇中文,共680例患者,其中持续股神经阻滞组患者343例,持续硬膜外镇痛组患者337例。Meta分析结果显示,持续股神经阻滞组与持续硬膜外镇痛组在全膝关节置换后6,12,24,48 h的目测类比评分差异均无显著性意义;但与持续硬膜外镇痛组相比,持续股神经阻滞可减少恶心/呕吐(RR=0.36,95%CI:0.21-0.63,P=0.003)、尿潴留(RR=0.08,95%CI:0.04-0.16, P <0.001)和头晕(RR=0.24,95%CI:0.06-0.99,P=0.05)的发生率。提示与硬膜外镇痛相比,全膝关节置换后持续股神经阻滞镇痛同样可以提供良好的镇痛效果,有利于患者早期功能恢复训练,且不良反应少,是一种安全、有效的镇痛方法。%BACKGROUND:Pain is the significant cause for patients with early rehabilitation after total knee arthroplasty. Continuous epidural analgesia and continuous femoral nerve block are effective analgesic methods after total knee arthroplasty, however, which method has better effects and less complications remains controversial. OBJECTIVE:To compare the efficacy and safety of countious femoral nerve block

  2. Cranial nerve injuries with supraglottic airway devices: a systematic review of published case reports and series.

    Science.gov (United States)

    Thiruvenkatarajan, V; Van Wijk, R M; Rajbhoj, A

    2015-03-01

    Cranial nerve injuries are unusual complications of supraglottic airway use. Branches of the trigeminal, glossopharyngeal, vagus and the hypoglossal nerve may all be injured. We performed a systematic review of published case reports and case series of cranial nerve injury from the use of supraglottic airway devices. Lingual nerve injury was the most commonly reported (22 patients), followed by recurrent laryngeal (17 patients), hypoglossal (11 patients), glossopharyngeal (three patients), inferior alveolar (two patients) and infra-orbital (one patient). Injury is generally thought to result from pressure neuropraxia. Contributing factors may include: an inappropriate size or misplacement of the device; patient position; overinflation of the device cuff; and poor technique. Injuries other than to the recurrent laryngeal nerve are usually mild and self-limiting. Understanding the diverse presentation of cranial nerve injuries helps to distinguish them from other complications and assists in their management. PMID:25376257

  3. Ultrasonographic evaluation of neck hematoma and block salvage after failed neurostimulation-guided interscalene block.

    Science.gov (United States)

    Howell, Stephen M; Unger, M W Todd; Colson, James D; Serafini, Mario

    2010-11-01

    Ultrasound-guided regional anesthetic techniques have shown some advantages over conventional paresthesia and neurostimulation techniques. We report the case of a neurostimulation-guided continuous interscalene block that would have ended in complication were it not for experience with ultrasound-guided regional anesthesia. Familiarity with ultrasound-guided block techniques permitted assessment of a neck hematoma during interscalene block and ultimately allowed successful peripheral nerve block.

  4. A Comparison of the Analgesic Efficacy of Femoral Nerve Block vs Intra-articular Injection for Anterior Cruciate Ligament Reconstruction-a Meta-analysis of Randomized Controlled Trials%股神经阻滞和关节内浸润控制前交叉韧带重建术后疼痛疗效比较的Meta分析

    Institute of Scientific and Technical Information of China (English)

    孙羽; 白希壮

    2012-01-01

    Objective To compare the efficacy of femoral nerve block and intraarticukr injection on relieving pain after anterior cruciate ligament reconstruction. Methods We searched electronic databases to identify randomized control trials,assessed methodological qualities and identified parameters for comparison. Mela-analysis was performed using Review Manager. Weighted mean difference was calculated for numerical data with 93% confidence interval. Heterogeneity was analyzed. Results 5 studies including 437 patients were identified. Meta-analysis of VAS with sensitivity analysis favored nerve block,WMD -5.50 (-9.897,-1.14). However,the effect may not be clinically significant. Conclusion Femoral nerve block might provide better pain relief, but the effect might not be clinically significant.%目的 比较股神经阻滞(FNB)和关节内浸润(IA)治疗前交叉韧带重建术后疼痛的疗效.方法 计算机检索MEDLINE(1966至2011.6)、EMBASE(1980至2011.6)、Cochrane图书馆以及ClinicalTrials.gov网站,检索相关随机对照研究,利用Detsky分级对纳入文献作方法学评估,对可合并结果行Meta分析,无法合并结果作描述分析.试构建倒漏斗图分析发表偏倚.结果 共纳入5项随机对照试验,计437例患者.术后疼痛视觉模拟量表(VAS)评分Meta分析显示FNB镇痛优于IA,WMD-5.50(-9.897,-1.14).未能构建有意义的倒漏斗图.结论 现有证据表明FNB镇痛优于IA,但优势程度难以体现出实际临床意义.本分析仅纳入5项研究,病例较少,尚需多中心、大样本随机对照研究验证.

  5. Heart Block

    Science.gov (United States)

    ... the signal causes the heart to contract and pump blood. Heart block occurs if the electrical signal is ... degree heart block limits the heart's ability to pump blood to the rest of the body. This type ...

  6. 神经刺激仪引导行肌间沟联合腋路臂丛神经阻滞用于高龄患者的临床观察%Clinical observation of interscalene joint axillary brachial plexus block guided by nerve stimulator in elderly patients

    Institute of Scientific and Technical Information of China (English)

    杨纲华; 卢增停; 马钧阳; 王立勋

    2014-01-01

    目的 比较常规异感法和神经刺激仪引导行肌间沟联合腋路臂丛神经阻滞用于高龄患者上肢手术的麻醉效果.方法 将60例ASA分级Ⅱ~Ⅲ级择期行上肢手术的高龄患者按随机数字表法分为神经刺激仪组和异感法组,每组30例.神经刺激仪组采用神经刺激仪引导行肌间沟联合腋路臂丛神经阻滞,异感法组按常规异感法行肌间沟联合腋路臂丛神经阻滞.两组所用局部麻醉药均为0.375%罗哌卡因,剂量为0.4 ml/kg.两组肌间沟、腋路臂丛神经阻滞麻醉药剂量各半.观察和记录两组患者操作时间、阻滞起效时间、镇痛持续时间、术中麻醉效果[采用疼痛视觉模拟量表(VAS)评分法]和不良反应.结果 神经刺激仪组操作时间和阻滞起效时间明显短于异感法组[(5.2±1.7) min比(8.6±2.2) min和(19.4±3.2) min比(29.0±3.9) min],术中VAS评分明显低于异感法组[(0.7±0.4)分比(2.3±0.8)分],差异均有统计学意义(P<0.01);神经刺激仪组和异感法组镇痛持续时间比较差异无统计学意义[(12.4±3.6)h比(13.1±3.8)h,P>0.05].神经刺激仪组无不良反应;异感法组有5例发生不良反应,其中局部血肿2例,喉返神经麻痹1例,霍纳综合征2例.结论 神经刺激仪引导行肌间沟联合腋路臂丛神经阻滞用于高龄患者定位准确,成功率高,麻醉效果好,不良反应少,值得在临床中推广.%Objective To compare the anesthetic effect of interscalene joint axillary brachial plexus block guided by nerve stimulator or conventional paresthesia in elderly patients with upper extremity surgery.Methods Sixty cases of ASA grade Ⅱ-Ⅲ elderly patients with upper extremity surgery were divided into two groups by random number table.Nerve stimulator group (30 cases) received interscalene joint axillary brachial plexus block guided by nerve stimulator.Paresthesia group (30 cases) received interscalene joint axillary brachial plexus block guided by

  7. [Peroneal nerve injury: anesthesia is not always to blame].

    Science.gov (United States)

    Curt Nuño, F; López Álvarez, S; Juncal Díaz, J; Domínguez Chaos, A; Llorca González, F; Pensado Castiñeiras, A

    2015-02-01

    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. PMID:25048997

  8. A case of pulmonary alveolar microlithiasis

    International Nuclear Information System (INIS)

    A case of pulmonary alveolar microlithiasis is reported. A 33-year-old male visited our clinic because of cough and sore throat. The chest X-ray showed granular micronodulation diffusely disseminated throughout the lung fields. On the eighth day since admission, cough and sore throat disappeared. Pulmonary alveolar microlithiasis was confirmed by transbronchial lung biopsy. Bronchoalveolar lavage (BAL) was performed, and the differential cell count of the BAL fluid showed 74.3 % eosinophilia. Furthermore, 67Ga-citrate scintigraphy revealed diffuse uptake throughout the lung fields. Whether these findings are common in pulmonary alveolar microlithiasis or not is considered to be an unanswered problem. (author)

  9. Cutaneous Sensory Block Area, Muscle-Relaxing Effect, and Block Duration of the Transversus Abdominis Plane Block

    DEFF Research Database (Denmark)

    Støving, Kion; Rothe, Christian; Rosenstock, Charlotte V;

    2015-01-01

    BACKGROUND AND OBJECTIVES: The transversus abdominis plane (TAP) block is a widely used nerve block. However, basic block characteristics are poorly described. The purpose of this study was to assess the cutaneous sensory block area, muscle-relaxing effect, and block duration. METHODS: Sixteen...... healthy volunteers were randomized to receive an ultrasound-guided unilateral TAP block with 20 mL 7.5 mg/mL ropivacaine and placebo on the contralateral side. Measurements were performed at baseline and 90 minutes after performing the block. Cutaneous sensory block area was mapped and separated into a...... medial and lateral part by a vertical line through the anterior superior iliac spine. We measured muscle thickness of the 3 lateral abdominal muscle layers with ultrasound in the relaxed state and during maximal voluntary muscle contraction. The volunteers reported the duration of the sensory block and...

  10. Population Blocks.

    Science.gov (United States)

    Smith, Martin H.

    1992-01-01

    Describes an educational game called "Population Blocks" that is designed to illustrate the concept of exponential growth of the human population and some potential effects of overpopulation. The game material consists of wooden blocks; 18 blocks are painted green (representing land), 7 are painted blue (representing water); and the remaining…

  11. Nerve conduction velocity

    Science.gov (United States)

    ... to measure the speed of the nerve signals. Electromyography (recording from needles placed into the muscles) is ... Often, the nerve conduction test is followed by electromyography (EMG). In this test, needles are placed into ...

  12. Common peroneal nerve dysfunction

    Science.gov (United States)

    ... toe-out movements Tests of nerve activity include: Electromyography (EMG, a test of electrical activity in muscles) Nerve ... Peroneal neuropathy. In: Preston DC, Shapiro BE, eds. Electromyography and Neuromuscular Disorders . 3rd ed. Philadelphia, PA: Elsevier; ...

  13. The Shamrock lumbar plexus block

    DEFF Research Database (Denmark)

    Sauter, Axel R; Ullensvang, Kyrre; Niemi, Geir;

    2015-01-01

    BACKGROUND: The Shamrock technique is a new method for ultrasound-guided lumbar plexus blockade. Data on the optimal local anaesthetic dose are not available. OBJECTIVE: The objective of this study is to estimate the effective dose of ropivacaine 0.5% for a Shamrock lumbar plexus block. DESIGN: A...... prospective dose-finding study using Dixon's up-and-down sequential method. SETTING: University Hospital Orthopaedic Anaesthesia Unit. INTERVENTION: Shamrock lumbar plexus block performance and block assessment were scheduled preoperatively. Ropivacaine 0.5% was titrated with the Dixon and Massey up......-and-down method using a stepwise change of 5 ml in each consecutive patient. Combined blocks of the femoral, the lateral femoral cutaneous and the obturator nerve were prerequisite for a successful lumbar plexus block. PATIENTS: Thirty patients scheduled for lower limb orthopaedic surgery completed the study...

  14. An alternative to nerve repair using an antioxidant compound: a histological study in rats.

    Science.gov (United States)

    Salles, Marcos B; Gehrke, Sergio A; Koo, Samuel; Allegrini, Sergio; Rogero, Sizue O; Ikeda, Tamiko I; Cruz, Áurea S; Shinohara, Elio H; Yoshimoto, Marcelo

    2015-01-01

    The fascicular composition and organisation of the inferior alveolar nerve (IAN) were determined to confirm the microarchitecture of the IAN bundles into each of the mandibular teeth, including the composition of the mental nerve. The aim of this study was to evaluate peripheral nerve repair after the application of an antioxidant compound to the damaged nerve tissue to elevate the concentration and bioavailability of elements capable of favouring tissue repair. Twenty-five Wistar rats were divided into groups: The Control 1 (Ctl 1) (n = 5) animals had the ischiatic nerve exposed with no suture injury and were sacrificed at 30 days post-operatively. The Control 2 (Ctl 2) (n = 10) animals had the ischiatic nerve exposed, and the nerve was injured using suture in three distinct regions. In the experimental (Exp) animals (n = 10), an antioxidant organic compound was applied to the nerve injury site. The animals with nerve injury (Ctl2 and Exp group) were sacrificed at 15 and 30 days post-operatively. The histological analysis showed less degeneration in the Exp group at 15 and 30 days post-operatively. Nerve neoformation forming a connection between the distal and proximal suture sites was observed in the experimental group. This study presented an alternative to nerve repair using an antioxidant compound. PMID:25578694

  15. Integrity of the alveolar-capillary barrier and alveolar surfactant system in smokers.

    OpenAIRE

    Schmekel, B; Bos, J.A.; A. R. Khan; Wohlfart, B; Lachmann, B.; Wollmer, P.

    1992-01-01

    BACKGROUND: The permeability of the alveolar-capillary barrier to technetium-99m labelled diethylenetriamine pentaacetate (99mTc DTPA) is known to be greatly increased in smokers, but the underlying mechanism is poorly understood. Abnormal permeability of the alveolar epithelium as well as impaired surfactant function has been suggested. The purpose of this study was to examine transudation of urea and albumin into the alveoli and alveolar surfactant function in smokers and non-smokers and to...

  16. Ulnar nerve palsy due to axillary crutch.

    Directory of Open Access Journals (Sweden)

    Veerendrakumar M

    2001-01-01

    Full Text Available A young lady with residual polio, using axillary crutch since early childhood, presented with tingling, numbness and weakness in ulnar nerve distribution of five months duration. Ulnar motor conduction study revealed proximal conduction block near the axilla, at the point of pressure by the crutch while walking. Distal ulnar sensory conduction studies were normal but proximal ulnar sensory conduction studies showed absence of Erb′s point potential. These findings suggested the presence of conduction block in sensory fibers as well. Proper use and change of axillary crutch resulted in clinical recovery and resolution of motor and sensory conduction block.

  17. 心理疗法在神经阻滞治疗在老年带状疱疹后遗神经痛中的疗效分析%Explore the efficacy of nerve blocking and psychotherapy in the combined treatment of senile post herpetic neuralgia

    Institute of Scientific and Technical Information of China (English)

    陈星玲; 宋世兰; 杨建平; 魏武洪; 陈晓玉; 周甜甜; 雷山川

    2013-01-01

    Objective :To explore the efficacy of nerve blocking and psychotherapy in the combined treatment of senile post herpetic neuralgia .Method Sixty senile patients with post -herpetic neuralgia were randomly divided into 2 groups(n = 30):nerve blocking combined with psychotherapy as a trial group and nerve blocking as a control group .Assess the pain degree 1 hours before and 35 days after the first treatment by Visual analog scale ,observe the efficacy and adverse reaction of two groups of patients ,and investigate the patient satisfaction for the treatment .Results :In the trial group 17 cases were cured ;10 cases were effective and the total effective rate was 90% .In the control group 12 cases were cured ;9 cases were effective and the total effective rate was 70% .The difference of total effective rate between two groups was statistically significant (P <0 .05) .Satisfaction with treatment of the trial group was 97% and the control group was 76% . The two groups on satisfaction with treatment difference was statistically significant (P < 0 .05 ) .Conclusions The treatment of senile post herpetic neuralgia is effective by Nerve blocking combined with psychotherapy .And the treatment should be widely applied ,since there are fewer complications and the high degree of patient satisfaction with the treatment .%目的:探讨神经阻滞联合心理治疗应用于老年带状疱疹后遗神经痛的疗效。方法:选择老年带状疱疹后遗神经痛60例,采用随机对照试验,随机分为两组(n=30):采用神经阻滞联合心理治疗作为试验组;采用神经阻滞作为对照组。采用视觉模拟评分法评估首次治疗前1h、首次治疗后35d时患者疼痛程度,观察两组患者的疗效及不良反应,调查患者对治疗的满意度评价。结果试验组基本治愈17例,显效10例,总有效率为90%,对照组基本治愈12例,显效9例,总有效率为70%,两组总有效率比较

  18. Clinical Observation on Combined Gabapentin and Nerve Block in the Treatment of Primary Trigeminal Neuralgia%加巴喷丁联合神经阻滞治疗原发性三叉神经痛的临床观察

    Institute of Scientific and Technical Information of China (English)

    黄云峰; 韦程瀚

    2013-01-01

    Objective To evaluate the efficacy and adverse reaction of combined gabapentin and nerve block in the treatment of primary trigeminal neuralgia. Methods 90 adult patients with trigeminal neuralgia were divided into gabapentin medical treatment group( A )and combined gabapentin and nerve block group ( B ),45 cases each group. Patients of group A were given gabapentin 1200 mg per day,treated for 4 weeks. The usage of gabapentin in group B was same as group A, and patients of group B were treated with nerve block once a week for 3 weeks. The numeric rating scales( NRS )changes, efficacy rate of relieving pain and the adverse reaction were observed after 4 weeks. Results The NRS scores of group A and group B were obviously decreased after treatment with pre-treatment( P 0.05 ). Conclusion The treatment of primary trigeminal neuralgia by combined gabapentin and nerve block has better efficacy and little adverse reactions,which is a good choice for the non-surgical treatment of trigeminal neuralgia.%目的 观察加巴喷丁联合神经阻滞治疗原发性三叉神经痛的临床疗效及不良反应.方法 将2010年3月至2011年12月南宁市红十字会医院收治的90例原发性三叉神经痛患者按随机数字表法分为单纯加巴喷丁药物治疗组(A组)和加巴喷丁联合神经阻滞治疗组(B组),各45例,A组每天口服加巴喷丁1200 mg,连服4周;B组加巴喷丁用法与A组相同,同时每周给予神经阻滞治疗1次,连续3周.4周后观察两组的疼痛强度(PI)、疼痛缓解度(PAR)、镇痛有效率及不良反应发生情况.结果 两组治疗后NRS评分明显低于治疗前(P<0.05),B组在治疗后3、7、14、21、28 d的NRS评分均明显低于A组(P<0.05);B组镇痛效率在治疗后3、7 d与A组无差别,在治疗后14、21、28 d高于A组(P<0.05);两组不良反应发生率比较差异无统计学意义(P>0.05).结论 加巴喷丁联合神经阻滞治疗原发性三叉神经痛临床效果好,不良反应少,是非手术疗法的较好选择.

  19. Optic Nerve Pit

    Science.gov (United States)

    ... Conditions Frequently Asked Questions Español Condiciones Chinese Conditions Optic Nerve Pit What is optic nerve pit? An optic nerve pit is a ... may be seen in both eyes. How is optic pit diagnosed? If the pit is not affecting ...

  20. CT引导下经皮穿刺胸交感链阻滞治疗手汗症的临床效果%Therapeutic feasibility of percutaneous puncture and chemical neurolysis of thoracic sympathetic nerve block in palmar hyperhidrosis under the guidance of computed tomograph

    Institute of Scientific and Technical Information of China (English)

    黄冰; 姚明; 周煦燕; 曹浩强; 祝则峰; 侯健; 陆雅萍; 孙建良; 胡奕

    2011-01-01

    Objective To explore the therapeutic feasibility of percutaneous puncture and neurolytic thoracic sympathetic nerve block under the guidance of computed tomograph (CT).Methods From September 2009 to August 2010,23 cases with primary palmar hyperhidrosis underwent percutaneous puncture and neurolytic thoracic sympathetic nerve block at our hospital.The puncture of thoracic sympathetic nerve was guided by CT through the gap of T3-4.The screen showed the direction of needle and the location of needle tip at the upper joint of costal head beside T3 body and outside of costal pleura.A mixed injection of 1% lidocaine and 30% iohexol was administered.On CT,lidocaine was found to cover the area where the thoracic sympathetic nerve was located.And after several minutes,the patient's palms turned warm and dry from cool and wet without the onset of Homer's syndrome.Then 2.5 ml of absolute alcohol was injected to block the thoracic sympathetic nerve.Results CT could guide the needle to the right position.And the injectate spreaded to the site of thoracic sympathetic nerve.At 5 min after anesthetic injection,the palmar temperature raised an average of 2.86 ℃ and the amplitude of pulse rose over 55%.Palmar hyperhidrosis was cured in 19 patients by one attempt and 4 patients required a second block with absolute alcohol.No complication occurred and there were 2 patients with tendency of recurrence during a follow-up period of 8 - 18 months.Conclusion The CT-guided therapy of percutaneous puncture and chemical neurolysis of thoracic sympathetic nerve block is both feasible and efficacious for palmar hyperhidrosis.%目的 探讨CT引导下经皮穿刺胸交感神经阻滞治疗手汗症的可行性.方法 2009年10月至2010年8月间在浙江省嘉兴市第一医院接受CT引导下经皮穿刺胸交感神经阻滞治疗的原发性手汗症患者23例,在CT引导下经胸3/4( T3/4)椎间隙穿刺,直至针尖解剖定位于第4肋骨小头上缘、第3椎体旁的壁胸

  1. Tension neuropathy of the superficial peroneal nerve: associated conditions and results of release.

    Science.gov (United States)

    Johnston, E C; Howell, S J

    1999-09-01

    We reviewed eight patients who sustained superficial peroneal nerve neuralgia after an inversion ankle sprain. Surgical exploration found anatomic abnormalities that tethered the nerve from movement during plantarflexion and inversion of the ankle. Most patients' pain improved dramatically after release and anterior transposition of the nerve. Seven joints also underwent arthroscopy, which showed intra-articular disease that was consistent with the original trauma. Five patients had reflex sympathetic dystrophy, three of which resolved after nerve release. Nerve conduction studies were not helpful. Careful physical examination and local nerve blocks were most important in making the diagnosis and prescribing treatment. All conservative measures should be exhausted before surgery is considered.

  2. Alveolar hydatid cyst: A case report

    Directory of Open Access Journals (Sweden)

    Behiye Zarif-Zakerian

    2010-06-01

    Full Text Available Alveolar hydatid cyst is a parasitic disease due to invasion of the Echinococcus multilocularis larva into the different tissues. The main host of this tape worms is Canidae family, especially foxes and jackals. Human beings are usually infected through eating contaminated vegetables and water with parasite eggs. In this article, one case of alveolar hydatid cyst has been reported in a 35 year-old woman

  3. Rare Lung Diseases II: Pulmonary Alveolar Proteinosis

    OpenAIRE

    Juvet, Stephen C; David Hwang; Waddell, Thomas K; Downey, Gregory P.

    2008-01-01

    The present article is the second in a series on rare lung diseases. It focuses on pulmonary alveolar proteinosis (PAP), a disorder in which lipoproteinaceous material accumulates in the alveolar space. PAP was first described in 1958, and for many years the nature of the material accumulating in the lungs was unknown. Major insights into PAP have been made in the past decade, and these have led to the notion that PAP is an autoimmume disorder in which autoantibodies interfere with signalling...

  4. The Molecular Basis of Pulmonary Alveolar Proteinosis

    OpenAIRE

    Carey, Brenna; Trapnell, Bruce C.

    2010-01-01

    Pulmonary alveolar proteinosis (PAP) comprises a heterogenous group of diseases characterized by abnormal surfactant accumulation resulting in respiratory insufficiency, and defects in alveolar macrophage- and neutrophil-mediated host defense. Basic, clinical and translational research over the past two decades have raised PAP from obscurity, identifying the molecular pathogenesis in over 90% of cases as a spectrum of diseases involving the disruption of GM-CSF signaling. Autoimmune PAP repre...

  5. Pulmonary alveolar proteinosis: diagnostic and therapeutic challenges

    OpenAIRE

    Campo Ilaria; Kadija Zamir; Mariani Francesca; Paracchini Elena; Rodi Giuseppe; Mojoli Francesco; Braschi Antonio; Luisetti Maurizio

    2012-01-01

    Abstract Pulmonary Alveolar Proteinosis (PAP) is a rare syndrome characterized by pulmonary surfactant accumulation within the alveolar spaces. It occurs with a reported prevalence of 0.1 per 100,000 individuals and in distinct clinical forms: autoimmune (previously referred to as the idiopathic form, represents the vast majority of PAP cases, and is associated with Granulocyte-Macrophage Colony Stimulating Factor (GM-CSF) auto-antibodies; GMAbs), secondary (is a consequence of underlying dis...

  6. A case report of pulmonary alveolar proteinosis

    OpenAIRE

    McDermott, Helen; Aitchison, Frances; Nathani, Nazim; Bhatnager, Anjali

    2009-01-01

    This is a case of pulmonary alveolar proteinosis that presented in an inner city hospital in Birmingham, UK. The patient was a previously well 42-year-old man, who went on to experience unusual cerebral complications of the disease. The presentation, imaging findings and diagnostic histology findings are described. Pulmonary alveolar proteinosis is a rare but important diagnosis. Characteristic high-resolution CT findings include diffuse ground glass density with superimposed interlobular sep...

  7. Toward Therapeutic Pulmonary Alveolar Regeneration in Humans

    OpenAIRE

    Massaro, Donald; Massaro, Gloria DeCarlo

    2006-01-01

    In humans, age results in loss of pulmonary alveoli; menopause accelerates loss of diffusing capacity, an index of alveolar surface area; and disease (e.g., chronic obstructive pulmonary disease) results in loss of alveoli. Thus, an important goal for investigators is to generate knowledge that allows induction of pulmonary alveolar regeneration in humans. Our enthusiasm for this goal and our assessment of its feasibility are based on work in several laboratories over the last decade that has...

  8. Lung Transplant Recipient with Pulmonary Alveolar Proteinosis

    OpenAIRE

    Tokman, Sofya; Hahn, M. Frances; Abdelrazek, Hesham; Panchabhai, Tanmay S.; Patel, Vipul J.; Walia, Rajat; Omar, Ashraf

    2016-01-01

    Pulmonary alveolar proteinosis (PAP) is a progressive lung disease characterized by accumulated surfactant-like lipoproteinaceous material in the alveoli and distal bronchioles. This accumulation is the result of impaired clearance by alveolar macrophages. PAP has been described in 11 solid organ transplant recipients, 9 of whom were treated with mammalian target of rapamycin inhibitors. We report a case of a lung transplant recipient treated with prednisone, mycophenolate mofetil (MMF), and ...

  9. Secondary Alveolar Bone Grafting and Iliac Cancellous Bone Harvesting for Patients With Alveolar Cleft.

    Science.gov (United States)

    Pan, Weiyi; Wu, Chenzhou; Yang, Zheng; Duan, Zexi; Su, Zhifei; Wang, Peiqi; Zheng, Qian; Li, Chunjie

    2016-06-01

    To assess the efficacy of present interventions optimizing the result of secondary alveolar bone grafting (SABG) and the interventions alleviating the donor site morbidity after iliac cancellous bone harvesting. Researches were identified by searching the electronic database of MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Chinese BioMedical Literature Database, and the China National Knowledge Infrastructure. In addition, relevant journals and references of the included studies were searched manually. The Oxford 2011 Levels of Evidence were applied to assess the methodological quality of selected studies, and the best evidence synthesis system was applied afterward to measure the strength of evidence. As a result, 42 studies were considered eligible and included, among which 4 were of high quality while 38 were of low quality. Thirty lines of evidences were acquired after the synthesis, among which 13 were rated as moderate while 17 were rated as insufficient. As for the interventions optimizing the result of SABG, moderate evidence confirmed the efficacy of preoperative orthodontic treatment, the superiority of performing SABG before the eruption of canine, and the accuracy of cone beam computed tomography in preoperative estimation of the cleft volume. As for the interventions alleviating the morbidity of iliac cancellous bone harvesting, moderate evidence confirmed the treatment benefit of the interventions below: minimally invasive technique, including trephine and Shepard osteotomy; preemptive analgesia, including continuous bupivacaine infusion or transversus abdominis plane block. As for the rest interventions, only insufficient evidence was found. PMID:27244214

  10. Remodeling of alveolar septa after murine pneumonectomy.

    Science.gov (United States)

    Ysasi, Alexandra B; Wagner, Willi L; Bennett, Robert D; Ackermann, Maximilian; Valenzuela, Cristian D; Belle, Janeil; Tsuda, Akira; Konerding, Moritz A; Mentzer, Steven J

    2015-06-15

    In most mammals, removing one lung (pneumonectomy) results in the compensatory growth of the remaining lung. In mice, stereological observations have demonstrated an increase in the number of mature alveoli; however, anatomic evidence of the early phases of alveolar growth has remained elusive. To identify changes in the lung microstructure associated with neoalveolarization, we used tissue histology, electron microscopy, and synchrotron imaging to examine the configuration of the alveolar duct after murine pneumonectomy. Systematic histological examination of the cardiac lobe demonstrated no change in the relative frequency of dihedral angle components (Ends, Bends, and Junctions) (P > 0.05), but a significant decrease in the length of a subset of septal ends ("E"). Septal retraction, observed in 20-30% of the alveolar ducts, was maximal on day 3 after pneumonectomy (P alveolar duct diameter ratio (Dout:Din) was significantly lower 3 days after pneumonectomy compared to all controls except for the detergent-treated lung (P surface tension within the alveolar duct, resulting in a new equilibrium at a higher total energy and lower surface area. The spatial and temporal association of these microstructural changes with postpneumonectomy lung growth suggests that these changes represent an early phase of alveolar duct remodeling. PMID:26078396

  11. Particulate concentrations in pulmonary alveolar proteinosis

    Energy Technology Data Exchange (ETDEWEB)

    McEuen, D.D.; Abraham, J.L. (Univ. of California, San Diego, La Jolla (USA))

    1978-12-01

    Quantitative birefringent particle counts per 10 high-power fields in lung tissue were correlated with age, sex, and occupational exposure in 37 cases of pulmonary alveolar proteinosis. Counts were significantly higher in pulmonary alveolar proteinosis cases in both regions of alveolar proteinosis (47 {plus minus} 11) and perivascular and peribronchiolar areas (dust retention areas) (275 {plus minus} 65) than in 13 controls (5 {plus minus} 3 and 79 {plus minus} 23, respectively). Of a total of 8619 particles, 4817 were less than 1 micron, and 3771 were 1 to 10 microns in diameter. Fifty-nine percent were round, 19% fibrous, and 22% irregular. When analyzed individually, 20 of 37 cases (78%) had alveolar particle counts significantly higher than controls, and 10 of 26 cases had dust-retention area counts greater than controls (P less than 0.050). Known or possible occupational exposure was ascertained in 13 cases. In the remaining 24 cases insufficient occupational information was available. The mean age of the pulmonary alveolar proteinosis patients was 33 {plus minus} 4 years, and of the controls, 40 {plus minus} 7 years, and there was a male-to-female ratio of approximately 3:1. We propose that many cases of pulmonary alveolar proteinosis will ultimately be shown to be associated with environmental exposures to fine dusts or fumes.

  12. Expression of TRPV1 channels after nerve injury provides an essential delivery tool for neuropathic pain attenuation.

    Directory of Open Access Journals (Sweden)

    Hossain Md Zakir

    Full Text Available Increased expression of the transient receptor potential vanilloid 1 (TRPV1 channels, following nerve injury, may facilitate the entry of QX-314 into nociceptive neurons in order to achieve effective and selective pain relief. In this study we hypothesized that the level of QX-314/capsaicin (QX-CAP--induced blockade of nocifensive behavior could be used as an indirect in-vivo measurement of functional expression of TRPV1 channels. We used the QX-CAP combination to monitor the functional expression of TRPV1 in regenerated neurons after inferior alveolar nerve (IAN transection in rats. We evaluated the effect of this combination on pain threshold at different time points after IAN transection by analyzing the escape thresholds to mechanical stimulation of lateral mental skin. At 2 weeks after IAN transection, there was no QX-CAP mediated block of mechanical hyperalgesia, implying that there was no functional expression of TRPV1 channels. These results were confirmed immunohistochemically by staining of regenerated trigeminal ganglion (TG neurons. This suggests that TRPV1 channel expression is an essential necessity for the QX-CAP mediated blockade. Furthermore, we show that 3 and 4 weeks after IAN transection, application of QX-CAP produced a gradual increase in escape threshold, which paralleled the increased levels of TRPV1 channels that were detected in regenerated TG neurons. Immunohistochemical analysis also revealed that non-myelinated neurons regenerated slowly compared to myelinated neurons following IAN transection. We also show that TRPV1 expression shifted towards myelinated neurons. Our findings suggest that nerve injury modulates the TRPV1 expression pattern in regenerated neurons and that the effectiveness of QX-CAP induced blockade depends on the availability of functional TRPV1 receptors in regenerated neurons. The results of this study also suggest that the QX-CAP based approach can be used as a new behavioral tool to detect

  13. Optic nerve oxygenation

    DEFF Research Database (Denmark)

    Stefánsson, Einar; Pedersen, Daniella Bach; Jensen, Peter Koch;

    2005-01-01

    at similar levels of perfusion pressure. The levels of perfusion pressure that lead to optic nerve hypoxia in the laboratory correspond remarkably well to the levels that increase the risk of glaucomatous optic nerve atrophy in human glaucoma patients. The risk for progressive optic nerve atrophy in human...... glaucoma patients is six times higher at a perfusion pressure of 30 mmHg, which corresponds to a level where the optic nerve is hypoxic in experimental animals, as compared to perfusion pressure levels above 50 mmHg where the optic nerve is normoxic. Medical intervention can affect optic nerve oxygen......-oxygenase inhibitor, indomethacin, which indicates that prostaglandin metabolism plays a role. Laboratory studies suggest that carbonic anhydrase inhibitors might be useful for medical treatment of optic nerve and retinal ischemia, potentially in diseases such as glaucoma and diabetic retinopathy. However, clinical...

  14. Optic nerve oxygenation

    DEFF Research Database (Denmark)

    Stefánsson, Einar; Pedersen, Daniella Bach; Jensen, Peter Koch;

    2005-01-01

    at similar levels of perfusion pressure. The levels of perfusion pressure that lead to optic nerve hypoxia in the laboratory correspond remarkably well to the levels that increase the risk of glaucomatous optic nerve atrophy in human glaucoma patients. The risk for progressive optic nerve atrophy in human......The oxygen tension of the optic nerve is regulated by the intraocular pressure and systemic blood pressure, the resistance in the blood vessels and oxygen consumption of the tissue. The oxygen tension is autoregulated and moderate changes in intraocular pressure or blood pressure do not affect...... glaucoma patients is six times higher at a perfusion pressure of 30 mmHg, which corresponds to a level where the optic nerve is hypoxic in experimental animals, as compared to perfusion pressure levels above 50 mmHg where the optic nerve is normoxic. Medical intervention can affect optic nerve oxygen...

  15. 颈2背根神经节脉冲射频联合神经阻滞治疗颈源性头痛的疗效观察%Pulsed radio-frequency stimulation combined with nerve block for cervicogenic headache

    Institute of Scientific and Technical Information of China (English)

    李波; 储辉; 黄洪; 俞航; 徐志久

    2012-01-01

    Objective To observe the clinical effect on cervicogenic headache (CEH) of pulsed radiofrequency stimulation (PRF) applied to the C2 dorsal root ganglion combined with nerve block.Methods A total of 78 cases diagnosed as CEH were randomly divided into a combined treatment group,a PRF treatment group and a nerve block group.The combined treatment group was given both PRF applied to the C2 dorsal root ganglion and blocking therapy.The other two groups were given only one treatment or the other.All the treatments were once weekly for 3 weeks.Before treatment and 1,3 and 6 months after treatment,all of the patients' headaches were evaluated using a visual analogue scale (VAS).Results At 1,3 and 6 months after treatment,the average VAS scores of all three groups had decreased significantly.The VAS ratings dropped the most in the combined treatment group,followed by the PRF group and then the nerve block group.All the intergroup differences were statistically significant.The combined treatment group's cure rate (88%) was significantly better than that of the PRF group (81%),which was significantly better than that of the nerve block group (54%).Conclusion Combining PRF applied to the C2dorsal root ganglion with nerve block therapy has a synergistic effect on CEH.The curative effect of the combined treatment was better than either PRF or blocking alone.%目的 观察C2背根神经节脉冲射频(PRF)联合神经阻滞治疗颈源性头痛(CEH)的临床疗效.方法 采用随机数字表法将78例CEH患者分成联合治疗组、PRF治疗组及神经阻滞组.联合治疗组给予C2背根神经节PRF及神经阻滞治疗,PRF治疗组及神经阻滞组则分别给予C2背根神经节PRF治疗或C2背根神经节阻滞治疗.神经阻滞治疗每周1次,连续治疗3周.于治疗前及治疗后1,3,6个月时采用视觉模拟评分法(VAS)对3组患者疼痛改善情况进行评定.结果 3组患者治疗后1,3,6个月时其疼痛VAS评分

  16. Structure-activity relationship of nerve-highlighting fluorophores.

    Directory of Open Access Journals (Sweden)

    Summer L Gibbs

    Full Text Available Nerve damage is a major morbidity associated with numerous surgical interventions. Yet, nerve visualization continues to challenge even the most experienced surgeons. A nerve-specific fluorescent contrast agent, especially one with near-infrared (NIR absorption and emission, would be of immediate benefit to patients and surgeons. Currently, there are only three classes of small molecule organic fluorophores that penetrate the blood nerve barrier and bind to nerve tissue when administered systemically. Of these three classes, the distyrylbenzenes (DSBs are particularly attractive for further study. Although not presently in the NIR range, DSB fluorophores highlight all nerve tissue in mice, rats, and pigs after intravenous administration. The purpose of the current study was to define the pharmacophore responsible for nerve-specific uptake and retention, which would enable future molecules to be optimized for NIR optical properties. Structural analogs of the DSB class of small molecules were synthesized using combinatorial solid phase synthesis and commercially available building blocks, which yielded more than 200 unique DSB fluorophores. The nerve-specific properties of all DSB analogs were quantified using an ex vivo nerve-specific fluorescence assay on pig and human sciatic nerve. Results were used to perform quantitative structure-activity relationship (QSAR modeling and to define the nerve-specific pharmacophore. All DSB analogs with positive ex vivo fluorescence were tested for in vivo nerve specificity in mice to assess the effect of biodistribution and clearance on nerve fluorescence signal. Two new DSB fluorophores with the highest nerve to muscle ratio were tested in pigs to confirm scalability.

  17. Microtomography of the human tooth-alveolar bone complex

    Science.gov (United States)

    Dalstra, Michel; Cattaneo, Paolo M.; Beckmann, Felix; Sakima, Maurício T.; Lemor, Carsten; Laursen, Morten G.; Melsen, Birte

    2006-08-01

    In this study the structure of the adult human dentoalveolar process is examined using conventional and synchrotron radiation-based microtomography (SRμCT). Mandibular and maxillary segments containing two to five adjacent teeth were harvested at autopsy from 49 adult donors. These segments were embedded in blocks of methylmetacrylate and scanned using a conventional table-top μCT-scanner at a pixel size and slice thickness of 35 μm. A few segments were also scanned at a synchrotron facility at an initial pixel size of 16.4 μm, which was binned by a factor 2 to result in an effective voxel size of almost 32.8 μm. The three-dimensional reconstructions revealed how intricately the teeth are supported by the alveolar bone. Furthermore, this support is highly inhomogeneous with respect to the buccal, mesial, lingual and distal quadrants. Reflecting their various degrees of mineralization, tissues like bone, dentine, enamel and cementum, could well be identified, especially in the scans made with SRμCT. Despite comparable voxel sizes, the reconstructed data-sets obtained with conventional μCT were less detailed and somewhat fuzzy in appearance compared to the data-sets of SRμCT. However, for quantification of macroscopical features like the thickness of the alveolar wall or the presence of dehiscences/fenestrations this seemed sufficient.

  18. Imaging the trigeminal nerve

    Energy Technology Data Exchange (ETDEWEB)

    Borges, Alexandra [Radiology Department, Instituto Portugues de Oncologia Francisco Gentil, Centro de Lisboa, Rua Prof. Lima Basto, 1093, Lisboa (Portugal)], E-mail: borgalexandra@gmail.com; Casselman, Jan [Department of Radiology, A. Z. St Jan Brugge and A. Z. St Augustinus Antwerpen Hospitals (Belgium)

    2010-05-15

    Of all cranial nerves, the trigeminal nerve is the largest and the most widely distributed in the supra-hyoid neck. It provides sensory input from the face and motor innervation to the muscles of mastication. In order to adequately image the full course of the trigeminal nerve and its main branches a detailed knowledge of neuroanatomy and imaging technique is required. Although the main trunk of the trigeminal nerve is consistently seen on conventional brain studies, high-resolution tailored imaging is mandatory to depict smaller nerve branches and subtle pathologic processes. Increasing developments in imaging technique made possible isotropic sub-milimetric images and curved reconstructions of cranial nerves and their branches and led to an increasing recognition of symptomatic trigeminal neuropathies. Whereas MRI has a higher diagnostic yield in patients with trigeminal neuropathy, CT is still required to demonstrate the bony anatomy of the skull base and is the modality of choice in the context of traumatic injury to the nerve. Imaging of the trigeminal nerve is particularly cumbersome as its long course from the brainstem nuclei to the peripheral branches and its rich anastomotic network impede, in most cases, a topographic approach. Therefore, except in cases of classic trigeminal neuralgia, in which imaging studies can be tailored to the root entry zone, the full course of the trigeminal nerve has to be imaged. This article provides an update in the most recent advances on MR imaging technique and a segmental imaging approach to the most common pathologic processes affecting the trigeminal nerve.

  19. Imaging the trigeminal nerve

    International Nuclear Information System (INIS)

    Of all cranial nerves, the trigeminal nerve is the largest and the most widely distributed in the supra-hyoid neck. It provides sensory input from the face and motor innervation to the muscles of mastication. In order to adequately image the full course of the trigeminal nerve and its main branches a detailed knowledge of neuroanatomy and imaging technique is required. Although the main trunk of the trigeminal nerve is consistently seen on conventional brain studies, high-resolution tailored imaging is mandatory to depict smaller nerve branches and subtle pathologic processes. Increasing developments in imaging technique made possible isotropic sub-milimetric images and curved reconstructions of cranial nerves and their branches and led to an increasing recognition of symptomatic trigeminal neuropathies. Whereas MRI has a higher diagnostic yield in patients with trigeminal neuropathy, CT is still required to demonstrate the bony anatomy of the skull base and is the modality of choice in the context of traumatic injury to the nerve. Imaging of the trigeminal nerve is particularly cumbersome as its long course from the brainstem nuclei to the peripheral branches and its rich anastomotic network impede, in most cases, a topographic approach. Therefore, except in cases of classic trigeminal neuralgia, in which imaging studies can be tailored to the root entry zone, the full course of the trigeminal nerve has to be imaged. This article provides an update in the most recent advances on MR imaging technique and a segmental imaging approach to the most common pathologic processes affecting the trigeminal nerve.

  20. Perawatan Ortodontik Gigi Anterior Berjejal dengan Tulang Alveolar yang Tipis

    Directory of Open Access Journals (Sweden)

    Miesje K. Purwanegara

    2015-09-01

    Full Text Available Anterior teeth movement in orthodontic treatment is limited to labiolingual direction by very thin alveolar bone. An uncontrolled anterior tooth movement to labiolingual direction can cause alveolar bone perforation at its root segment. This case report is to remind us that alveolar bone thickness limits orthodontc tooth movement. A case of crowded anterior teeth with thin alveolar bone in malocclusion I is reported. This case is treated using adgewise orthodontic appliance. Protraction of anterior teeth is anticipated due to thin alveolar bone on the anterior surface. The conclusion is although the alveolar bone surrounding the crowded anterior teeth is thin, by controlling the movement the teeth reposition is allowed.

  1. Expression of hNav1.8 sodium channel protein in affected nerves of patients with trigeminal neuralgia

    Institute of Scientific and Technical Information of China (English)

    ZHU Ling-lan; JIANG Xiao-zhong; ZHAO Yun-fu; LI Yu-li; HE Jin

    2004-01-01

    Objective: To explore the pathogenesis of trigeminal neuralgia (TN) and to provide a new target for the drug treatment of TN by studying the expression of tetrodotoxin-resistant hNavl. 8 sodium channel protein in affected nerves of patients with TN. Methods: Twelve affected inferior alveolar nerves were obtained from patients with idiopathic TN, to whom the drug therapy was not effective. As negative control, one normal inferior alveolar nerve was obtained from patients who accepted the combined radical neck dissection with glossectomy and mandibulectomy. One muscle sample was obtained as normal control. One dorsal root ganglion from rat was as positive control. These tissues and prepared hNav1.8 antibody were conducted immunohistochemistry response. Results: hNavl. 8 channel protein was expresses in all the 12 specimens of the affected nerves of patients with TN, but not in the muscle sample and the normal inferior alveolar nerve. Conclusion:The abnormal expression of hNavl. 8 channel protein in the affected nerves of patients with TN may play an impo~nt role in the pathogenesis of TN.

  2. The Isolated Effect of Adductor Canal Block on Quadriceps Femoris Muscle Strength After Total Knee Arthroplasty

    DEFF Research Database (Denmark)

    Sørensen, Johan Kløvgaard; Jæger, Pia; Dahl, Jørgen Berg;

    2016-01-01

    BACKGROUND: Using peripheral nerve block after total knee arthroplasty (TKA), without impeding mobility, is challenging. We hypothesized that the analgesic effect of adductor canal block (ACB) could increase the maximum voluntary isometric contraction (MVIC) of the quadriceps femoris muscle after...

  3. Bloqueio do nervo maxilar para redução de fraturas do osso zigomático e assoalho da órbita Bloqueo del nervio maxilar para reducción de fracturas del hueso zigomático y suelo de la órbita Maxillary nerve block for zygoma and orbital floor fractures reduction

    Directory of Open Access Journals (Sweden)

    Karl Otto Geier

    2003-08-01

    fracturas del hueso zigomático y del suelo de la órbita. MÉTODO: Quince pacientes fueron sometidos al bloqueo del nervio maxilar por la técnica de Moore (abordaje infrazigomática para reducción de fracturas aisladas del arco zigomático (ocho pacientes y asociadas al suelo de la órbita (siete pacientes. Ningún paciente recibió medicación pre-anestésica. Después de sedación y anestesia local con 2 ml de lidocaína a 1,5% con adrenalina a 1:300.000, el nervio maxilar fue abordado con 8 ml de la misma solución anestésica a través de una aguja 22G, 10 cm de largo de punta romba. Fueron evaluados: el tiempo de bloqueo, la latencia, el tiempo de analgesia, la incidencia de fallas, la necesidad de anestesia general y las complicaciones. RESULTADOS: Los primeros tres bloqueos fueron difíciles, resultando en dos bloqueos parciales y una falla. Los restantes fueron efectivos y los pacientes no mencionaron ninguna incomodidad o dolor durante el bloqueo y la cirugía. El tiempo para la realización del bloqueo varió de 5 a 20 minutos, en cuanto la latencia anestésica quedó entre 3 y 10 minutos. Fueron registradas 7 ocurrencias de punción vascular, sin embargo, sin relatos de formación de hematomas. CONCLUSIONES: Reducción de fracturas zigomáticas son factibles bajo bloqueo del nervio maxilar, cuando realizadas en la fosa ptérigo palatina, permitiendo anestesia de sus dos ramos distales, nervio zigomático-temporal y nervio zigomático-frontal.BACKGROUND AND OBJECTIVES: There are few reports of zygomatic orbital floor or zygomatic arch fractures reduction under regional anesthesia. This study aimed at evaluating extraoral maxillary nerve block for zygoma and orbital floor fractures reduction. METHODS: Participated in this study 15 patients submitted to maxillary block according to Moore’s technique (lateral approach of the pterygoid plate for reduction of isolated zygomatic arch fractures (8 patients or orbit floor fractures associated to zygomatic arch

  4. Facial Nerve Neuroma Management

    OpenAIRE

    Weber, Peter C; Osguthorpe, J. David

    1998-01-01

    Three facial nerve neuromas were identified in the academic year 1994-1995. Each case illustrates different management dilemmas. One patient with a grade III facial nerve palsy had a small geniculate ganglion neuroma with the dilemma of decompression versus resection clear nerve section margins. The second patient underwent facial neuroma resection with cable graft reconstruction, but the permanent sections were positive. The last patient had a massive neuroma in which grafting versus other f...

  5. 高位颈神经阻滞联合臭氧注射治疗颈源性头痛的疗效分析%Clinical study of upper cervical nerve block combined with injection of ozone for the treatment of cervicogenic headache

    Institute of Scientific and Technical Information of China (English)

    何明伟; 于密生; 郭玉娜; 王琦; 李玄英; 刘京杰; 岳建宁; 马骏; 倪家骧

    2013-01-01

    目的 探讨高位颈神经阻滞联合臭氧注射治疗颈源性头痛的效果.方法 60例颈源性头痛患者完全随机分为A组(31例)和B组(29例).A组接受颈2、3神经阻滞联合臭氧注射治疗,B组仅接受颈2、3神经阻滞治疗.分别于治疗后1周和3、6个月进行疗效评价.结果 治疗后1周、3个月和6个月的视觉模拟评分法(VAS)评分A组分别为(1.3±0.4)、(1.8±1.2)和(2.3+1.4)分,B组分别为(1.5±1.1)、(3.4±1.3)和(4.3±2.2)分,A组治疗后3、6个月VAS评分均明显低于B组,差异均有统计学意义(均P<0.05).治疗后1周及3、6个月A组优良率分别为100.0%(31例)、87.1%(27例)、80.6%(25例),B组分别为100.0%(29例)、72.4%(21例)、62.1%(18例),A组治疗后3、6个月优良率均高于B组,差异均有统计学意义(均P<0.05).各组无明显并发症发生.结论 高位颈神经阻滞联合臭氧注射治疗颈源性头痛疗效优于单纯高位颈椎旁神经阻滞治疗,但其远期疗效有待于进一步探讨.%Objective To study the effect of the upper cervical nerve block combined with injection of ozone for the treatment of cervicogenic headache.Methods Sixty patients suffering from cervicogenic headache were randomly divided into group A(n =31)and group B(n =29).Group A received C2,3 nerve block combined with injection of ozone;group B received upper cervical nerve block.The efficacy and improvement of pain were compared.Results For group A,at 1 week,1 month and 3 months after opeartaion,the visual analogue scale(VAS) scores were (1.3 ± 0.4),(1.8 ± 1.2) and (3.1 ± 1.4) scores ; the excellent and good rate was 100.0% (31/31),87.1% (27/31),80.6% (25/31) respectively.For group B,the VAS scores were (1.5 ± 1.1),(3.4 ± 1.3) and (4.3 ± 2.2) scores ; the excellent and good rate was 100.0% (29/29),72.4% (21/29),62.1% (18/29),respectively.Compared with group B,3 months and 6 months after treatment,the VAS in group A were significantly reduced

  6. Local infiltration analgesia and femoral nerve block for pain control after total knee arthroplasty:a meta-analysis%全膝关节置换后局部浸润麻醉与股神经阻滞镇痛的Meta分析

    Institute of Scientific and Technical Information of China (English)

    邢梅利; 许彬; 辛颖

    2016-01-01

    BACKGROUND:Both local infiltration analgesia and femoral nerve block are used for the pain management after total knee arthroplasty. Controversy stil remains regarding the optimal technique for pain relief. OBJECTIVE:To systematical y evaluate analgesic effects of local infiltration analgesia and femoral nerve block after total knee arthroplasty. METHODS:Databases including PubMed, EMBASE, the Cochrane Library, Web of Science and CBM, were comprehensively searched to identify randomized control ed studies comparing local infiltration analgesia with femoral nerve block. Two reviewers independently selected trials, included literatures, extracted data, and assessed the methodological qualities of included studies according to Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0. When there were different opinions, it was decided by the third author. Data were analyzed by RevMan 5.3 software. RESULTS AND CONCLUSION:(1) Eleven randomized control ed trials involving 566 patients were included. (2) At 24 and 48 hours (h) after surgery, there were no significant differences between the local infiltration analgesia and femoral nerve block groups, in Visual Analog Scale scores [MD24 h=0.15, 95%CI (-0.26, 1.28), P>0.05;MD48 h=0.19, 95%CI (-0.06, 0.44), P>0.05] in the resting state, and [MD24 h=-0.01, 95%CI (-0.51, 0.48), P>0.05;MD48h=0.18, 95%CI (-0.45, 0.82), P>0.05] in the active state, amount of analgesic drug use [MD24 h=-2.23, 95%CI (-5.63, 1.16), P>0.05;MD48 h=2.44, 95%CI (-1.08, 5.95), P>0.05], hospital stay [MD=0.05, 95%CI (-0.40, 0.50), P>0.05], postoperative nausea and vomiting [OR=1.09, 95%CI (0.39, 3.04), P>0.05] and postoperative infection [OR=0.99, 95%CI (0.44, 2.59), P>0.05]. (3) These results indicated that the analgesic effect of local infiltration analgesia was identical to that of femoral nerve block after total knee arthroplasty. Due to its simple operation, local infiltration analgesia can be used as a standard analgesia method after

  7. Zitongxi Block

    Institute of Scientific and Technical Information of China (English)

    1996-01-01

    @@ Zitongxi Block (Western Zitong Block), is located in Zitong County, northwest of Sichuan Province (as shown on Fig. 8 ). Geologically. it is situated in the Zitong Depression, southwest of the middle Longmenshan faulted and folded belt, covering an area of 1 830 km2. Transportation is very convenient. A crisscross network of highways run through the block and the Baocheng railway is nearby. The climate is moderate. Most area belongs to hilly land with the elevation of 500-600 m.The Tongjiang River runs across the area.

  8. Whole lung lavage for pulmonary alveolar proteinosis

    Directory of Open Access Journals (Sweden)

    Jayaraman S

    2010-01-01

    Full Text Available A 26-year-old male presented with complaints of dry cough of six months and progressive breathlessness of three months duration. He was coughing out milky white sputum for two months and had lost 12 kg weight in two months. He had an evening rise in temperature of one month duration. Clinically, the patient was in respiratory distress and the respiratory system examination revealed bilateral velcro crackles. High resolution computed tomography chest showed bilateral diffuse reticulonodular opacities and "Crazy Paving" pattern suggestive of alveolar proteinosis. Broncho alveolar lavage showed eosinophilic granular material, which was periodic acid-Schiff positive. Open lung biopsy was done to confirm the diagnosis and the histopathologic examination revealed eosinophilic secretions with granular appearance suggestive of pulmonary alveolar proteinosis. Subsequently, patient underwent bilateral sequential whole lung lavage under general anesthesia. Patient showed marked clinical and radiological improvement after sequential whole lung lavage.

  9. Anatomical Relationship of Lingual Nerve to the Region of Mandibular Third Molar

    Directory of Open Access Journals (Sweden)

    Marcelo Breno Meneses Mendes

    2014-01-01

    Full Text Available Objectives: This study evaluated the relationship of the lingual nerve with the adjacent anatomical structures of the mandibular third molar region, influencing the dentist to be aware of the variability of these relationships. Material and Methods: Samples of 24 human corpse half-heads were selected and divided according with the presence or absence of the mandibular third molars. The lingual nerve (LN was explored, showing its run from the oblique line until its crossing with the submandibular gland duct. The measurements along the LN and the adjacent anatomical structures were taken at the retromolar, molar and sublingual region with the use of a digital caliper. Results: The distance from the LN and the third molar socket, which represents the horizontal distance of the lingual plate to the nerve, on average, was 4.4 mm (SD 2.4 mm. The distance from the LN and the lingual alveolar rim, which represents the vertical relationship between the nerve and the lingual alveolar rim of the third molar socket, on average, was 16.8 mm (SD 5.7 mm. The LN has a varied topography that leaves it very vulnerable during any procedure executed in this region. Conclusions: Unless adequate protection of the lingual nerve is acquired by following an adequate surgical technique, the lingual nerve will always be vulnerable to damage during surgical intervention or manipulation in this region.

  10. Bloqueio seletivo dos nervos supraescapular e axilar promove analgesia satisfatória e menor grau de bloqueio motor: comparação com o bloqueio interescalênico El bloqueo selectivo de los nervios supraescapular y axilar promueve una analgesia satisfactoria y un menor grado de bloqueo motor: comparación con el bloqueo interescalénico Selective suprascapular and axillary nerve block provides adequate analgesia and minimal motor block: comparison with interscalene block

    Directory of Open Access Journals (Sweden)

    Patrícia Falcão Pitombo

    2013-02-01

    and axillary nerve blocks in shoulder arthroscopy using the interscalene approach to brachial ple

  11. Impairment of Alveolar Macrophage Transcription in Idiopathic Pulmonary Fibrosis

    OpenAIRE

    Ren, Ping; Rosas, Ivan O.; MacDonald, Sandra D.; Wu, Hai-Ping; Billings, Eric M; Gochuico, Bernadette R.

    2007-01-01

    Rationale: Alveolar macrophages are inflammatory cells that may contribute to the pathogenesis of idiopathic pulmonary fibrosis (IPF), which is characterized by excessive alveolar aggregation of cells and extracellular matrix proteins.

  12. CT引导下臭氧消融术联合神经根阻滞治疗腰椎间盘突出症%The therapeutic effect analysis of lumbar intervertebral disc protrusion using ozone ablation and selected nerve root block by CT

    Institute of Scientific and Technical Information of China (English)

    李荣春; 郭睛晴; 周外平

    2009-01-01

    Objective To explore the clinical effect of ozone ablation and nerve root block in the treatment of lumbar intervertebral disc protrusion. Methods Two hundred patients with lumbar disc herniation were divided into two groups:100 patients in group A were treated with ozone ablation; 100 patients in group B were treated with ozone ablation combined with nerve root block. The therapeutic effect was evaluated by comparing the value of VAS and total effective rate of therapy at the first day before treatment, and at the 3rd day ,3rd month and 6th month after treatment. Results The values of VAS in two groups at the 3rd day,3rd month and 6th month after treatment were remarkably lower than those at the first day before treatment (P<0.05 or P<0.01). The values of VAS in B group at the 3rd day ,3rd month and 6th month after treatment were lower significantly than those in group A (P<0.05 or P<0.01). The total effective rate of therapy at the 3rd day,3rd month and 6th month after treatment was 90% ,85% and 79% in group A,and 100% ,90% and 85% in group B respectively. The total effective rate of therapy at the 3rd day ,3rd month and 6th month after treatment in group B was higher than in group A. Conclusion The total effective rate of therapy by ozone ablation combined with nerve root block treating lumbar intervertebral disc protrusion under CT at the 3rd day after treatment was 100% , and that at the 3rd month and 6th month after treatment was increased.%目的 探讨CT引导下臭氧消融术联合神经根阻滞治疗腰椎间盘突出症的穿刺的准确性、治疗的安全性以及疗效.方法 选择200例腰椎问盘突出症患者,随机分为2组:A组100例,单纯行臭氧消融术,B组:100例,臭氧消融术联合神经阻滞治疗,治疗前1d、治疗后3d、3、6个月测定疼痛视觉模拟评分(VAS),治疗总有效率来评估治疗效果(比较常用的是MacNab法评价疗效).结果 两组患者治疗后3d、3、6个月VAS值较治疗前1 d

  13. 喙突入路锁骨下臂丛神经阻滞——改良法与经典法的比较%Infraclavicular brachial plexus nerve block via a coracoid approach: comparison of the anesthestic effects between the classic method and the modified method

    Institute of Scientific and Technical Information of China (English)

    焦微; 车薛华; 徐振东; 张洁

    2013-01-01

    目的 探讨改良(或修正)喙突入路和经典喙突入路定位对锁骨下臂丛神经阻滞的影响.方法 对80例择期行臂丛神经阻滞手术的患者,随机分为2组,采用神经刺激器定位臂丛神经:A组以喙突内下2 cm为穿刺点(经典组);B组穿刺点参考喙突内下2 cm,并用臂丛神经体表的 投影对该穿刺点进行修正(改良组).记录两组患者操作时间、穿刺次数、阻滞成功率、并发症及患者的满意度.结果 改良组的操作时间明显少于经典组(P<0.01),且改良组无需调整阻滞针即可定位到臂丛神经的比例明显高于经典组(P<0.05).结论 改良喙突入路可以明显提高单次穿刺定位到神经的概率,且可减少操作时间,提高了穿刺点体表定位的准确性.%Objective To investigate the impact of the modified and classic coracoid approach for localization in the infraclavicular brachial plexus nerve block.Methods Eighty patients schedtded for elective surgical procedures under infraclavicular brachial plexus block were randomly divided into two groups.The puncture point of Group A was the classic Wilson's approach via the point 2 cm medial and caudal to the coracoid process.The puncture point of Group B was modified by surface projection of the brachial plexus.Peripheral nerve stimulator was used to confirm the proper localization of the plexus.The performance time,the number of puncture,the anesthesia success rate,the incidence of complications and patient satisfaction were recorded.Results The performance time of the modified group was less than that of the classic group (P < 0.01).The chance of locating the bmchial plexus in a single puncture without adjusting the block needle was significantly higher in the modified group (P < 0.05).Conclusion The modified coracoid approach can significantly improve the probability of locating the nerve in one puncture that reduces the performance time.It improves the accuracy of puncture point

  14. Effects of nerve block combined with antiviral drug on patients with herpes zoster pain and sleep quality%神经阻滞联合抗病毒药物对带状疱疹患者疼痛及睡眠质量影响

    Institute of Scientific and Technical Information of China (English)

    陈慧

    2015-01-01

    Objective To explore the nerve block combined with antiviral drug on patients with herpes zoster treatment effect,and provide the basis for clinical pain relief and improve the quality of sleep.Methods The 90 cases of herpes zoster patients in our hospital in the Department of Dermatology for treatment,30 cases were randomly divided into a,B,C 30 cases 30 cases,group A with simple antiviral therapy,group B with antiviral joint pain relieving antiphlogistic drug therapy,group C treated with nerve block combined with antiviral therapy,recording three groups of visual score (VAS) and sleep quality score (QS),analysis and improvement in three groups of pain and sleep quality.Results The pain scores before and after treatment,in group A had no obvious change for the better,after 2 weeks,will be obviously significant differences (t =4.329,5.424,P < 0.05),C B two groups in 1 weeks after treatment there were significant differences (P < 0.05).In sleep quality,sleep quality has not improved significantly in group A (P >0.05),after 1 weeks,the sleep quality improvement (P < 0.05) before and after treatment in the two groups of ethylene and propylene,there was significant difference (P < 0.05),ethylene propylene no obvious differences between the two groups (P > 0.05).Conclusions The nerve block combined with antiviral drug with good pain relief and improve the role of sleep in patients with herpes zoster,can be used in clinical treatment.%目的 探究神经阻滞联合抗病毒药物对带状疱疹患者治疗效果,为临床疼痛缓解和改善睡眠质量提供依据.方法 选用来我院神经内科就诊带状疱疹患者90例,随机分为甲30例、乙30例、丙30例,甲组采用单纯抗病毒治疗,乙组采用抗病毒联合镇痛消炎药治疗,丙组采用神经阻滞联合抗病毒治疗,记录三组视觉评分(VAS)和睡眠质量评分(QS),分析三组疼痛和睡眠质量改善情况.结果 疼痛评分上,甲组治疗前后未见明显好转,2

  15. Tobacco smoke and the pulmonary alveolar macrophage.

    Science.gov (United States)

    Drath, D B; Davies, P; Karnovsky, M L; Huber, G L

    1979-01-01

    Our results indicate that tobacco smoke exposure to varying duration causes morphological, biochemical and functional alterations in pulmonary alveolar macrophages. The results of these changes is a population of alveolar macrophages made up of larger cells, with a reduced nucleus-cytoplasmic ratio, which are heavily loaded with heterolysosomes containing lipid. Though their fractional complement of mitochondria remains the same, an increase in the inner mitochondrial membrane surface area may be related to an enhanced oxidative metabolism. The cell is biochemically activated particularly following chronic exposure and is functionally impaired with respect to phagocytosis. PMID:232822

  16. Alveolar proteinosis: case report and literature review

    Directory of Open Access Journals (Sweden)

    2013-07-01

    Full Text Available Alveolar proteinosis is a rare disease. Its etiology, pathology, and manifestations are becoming increasingly more apparent. Few cases have been reported, which highlights the importance of reporting this case and reviewing current literature. New therapeutic options are being introduced with adequate outcomes thereby making it possible to manage patients who were previously unresponsive to conventional treatment. 25% of cases resolve spontaneously, while most patients require conventional treatment with total lung lavage that often does not improve prognosis. The case reported in this article was associated to Mycobacterium tuberculosis infection and diabetes. Primary alveolar proteinosis can have a direct relationship to these concomitant conditions.

  17. Lung Transplant Recipient with Pulmonary Alveolar Proteinosis

    Directory of Open Access Journals (Sweden)

    Sofya Tokman

    2016-01-01

    Full Text Available Pulmonary alveolar proteinosis (PAP is a progressive lung disease characterized by accumulated surfactant-like lipoproteinaceous material in the alveoli and distal bronchioles. This accumulation is the result of impaired clearance by alveolar macrophages. PAP has been described in 11 solid organ transplant recipients, 9 of whom were treated with mammalian target of rapamycin inhibitors. We report a case of a lung transplant recipient treated with prednisone, mycophenolate mofetil (MMF, and tacrolimus who ultimately developed PAP, which worsened when MMF was replaced with everolimus.

  18. Lung Transplant Recipient with Pulmonary Alveolar Proteinosis.

    Science.gov (United States)

    Tokman, Sofya; Hahn, M Frances; Abdelrazek, Hesham; Panchabhai, Tanmay S; Patel, Vipul J; Walia, Rajat; Omar, Ashraf

    2016-01-01

    Pulmonary alveolar proteinosis (PAP) is a progressive lung disease characterized by accumulated surfactant-like lipoproteinaceous material in the alveoli and distal bronchioles. This accumulation is the result of impaired clearance by alveolar macrophages. PAP has been described in 11 solid organ transplant recipients, 9 of whom were treated with mammalian target of rapamycin inhibitors. We report a case of a lung transplant recipient treated with prednisone, mycophenolate mofetil (MMF), and tacrolimus who ultimately developed PAP, which worsened when MMF was replaced with everolimus. PMID:27213073

  19. PERIPHERAL BLOCK ANESTHESIA OF UPPER EXTREMITY AND ITS COMPLICATIONS

    OpenAIRE

    Tapar, Hakan; SÜREN, Mustafa; Kaya, Ziya; Arıcı, Semih; Karaman, Serkan; Kahveci, Mürsel

    2012-01-01

    Successful peripheral blocks and selection of appropriate technique according to surgery is possible with a good knowledge of anatomy. Regional peripheral block anesthesia of upper extremity which applied by single injection to plexus brachialis is the most recommended method of anesthesia in daily surgical procedures. The most important advantages of peripheral nerve blocks which are type of regional anesthesia according to general anesthesia and central blocks are less effect to...

  20. Peripheral nerve disease

    Institute of Scientific and Technical Information of China (English)

    1992-01-01

    920745 Experimental reconstruction of in-trinsic hand muscle function by anteriorinterosseous nerve transference. HUANGGang(黄钢), et al. Dept Orthopaedics, GeneralHosp, PLA, Beijing, 100853. Natl, Med J Chin1992; 72(5): 269-272. The anterior interosseous nerve was transferred

  1. Odontoma localizado dentro del conducto dentario inferior: diagnóstico radiográfico y tratamiento quirúrgico de un caso clínico Odontoma located within the inferior alveolar nerve: radiographic diagnosis and surgical management of a clinical case

    Directory of Open Access Journals (Sweden)

    J. Vázquez Diego

    2009-08-01

    Full Text Available Se presenta un caso clínico de odontoma localizado dentro del conducto dentario inferior. El paciente de 54 años de edad es de sexo femenino. Se utiliza la técnica radiográfica panorámica para poder localizar y diagnosticar la afección. Posteriormente se realizó la intervención quirúrgica para extirpar la lesión y se realizó un seguimiento a corto y largo plazo para evaluar la recuperación de la sensibilidad de la zona afectada. El estudio histopatológico confirmó el diagnóstico de odontoma. Basado en lo expuesto se analiza al odontoma según ubicación, sexo y edad habiendo realizado una revisión de la literatura representada en tablas y gráficos.A clinical case of odontoma, located within the inferior dental nerve in a 54-year-old female patient, is reported. The lesion was situated and diagnosed by means of a conventional panoramic radiography technique. Then, a surgical approach was carried out to remove the pathological entity, and a short- and long-term follow-up control was done to evaluate sensitive recovery of the involved area. Later on, a histo-pathological study confirmed our previous diagnosis of odontoma. Based on our findings, odontoma is analyzed according to its location, sex and age of patients, as well as radiographic appearance. This analysis is presented through tables and graphics, after reviewing the scientific literature on this subject published over the last decade.

  2. Biological and artificial nerve conduit for repairing peripheral nerve defect

    Institute of Scientific and Technical Information of China (English)

    Xuetao Xie; Changqing Zhang

    2006-01-01

    OBJECTIVE: Recently, with the development of biological and artificial materials, the experimental and clinical studies on application of this new material-type nerve conduit for treatment of peripheral nerve defect have become the hotspot topics for professorial physicians.DATA SOURCES: Using the terms "nerve conduits, peripheral nerve, nerve regeneration and nerve transplantation" in English, we searched Pubmed database, which was published during January 2000 to June 2006, for the literatures related to repairing peripheral nerve defect with various materials. At the same time, we also searched Chinese Technical Scientific Periodical Database at the same time period by inputting" peripheral nerve defect, nerve repair, nerve regeneration and nerve graft" in Chinese.STUDY SELECTION: The materials were firstly selected, and literatures about study on various materials for repairing peripheral nerve defect and their full texts were also searched. Inclusive criteria: nerve conduits related animal experiments and clinical studies. Exclusive criteria: review or repetitive studies.DATA EXTRACTION: Seventy-nine relevant literatures were collected and 30 of them met inclusive criteria and were cited.DATA SYNTHESTS: Peripheral nerve defect, a commonly seen problem in clinic, is difficult to be solved. Autogenous nerve grafting is still the gold standard for repairing peripheral nerve defect, but because of its application limitation and possible complications, people studied nerve conduits to repair nerve defect. Nerve conduits consist of biological and artificial materials.CONCLUSION: There have been numerous reports about animal experimental and clinical studies of various nerve conduits, but nerve conduit, which is more ideal than autogenous nerve grafting, needs further clinical observation and investigation.

  3. Selective alveolar corticotomy to intrude overerupted molars.

    Science.gov (United States)

    Oliveira, Dauro Douglas; de Oliveira, Bruno Franco; de Araújo Brito, Helio Henrique; de Souza, Margareth Maria Gomes; Medeiros, Paulo José

    2008-06-01

    Orthodontic intrusion of overerupted molars in adults is challenging for most clinicians. Efficient intrusion can be achieved by combining selective alveolar corticotomies with a modified full-coverage maxillary splint to reduce surgical risks, treatment time, and costs for both orthodontists and patients. PMID:18538256

  4. Rituximab therapy in pulmonary alveolar proteinosis improves alveolar macrophage lipid homeostasis

    OpenAIRE

    Malur Anagha; Kavuru Mani S; Marshall Irene; Barna Barbara P; Huizar Isham; Karnekar Reema; Thomassen Mary

    2012-01-01

    Abstract Rationale Pulmonary Alveolar Proteinosis (PAP) patients exhibit an acquired deficiency of biologically active granulocyte-macrophage colony stimulating factor (GM-CSF) attributable to GM-CSF specific autoantibodies. PAP alveolar macrophages are foamy, lipid-filled cells with impaired surfactant clearance and markedly reduced expression of the transcription factor peroxisome proliferator-activated receptor gamma (PPARγ) and the PPARγ-regulated ATP binding cassette (ABC) lipid transpor...

  5. Clinical Effect of Nerve Stimulator Assisted by Ropivacaine Block Anesthesia in Senior Patients Undergoing Lower Limb Surgery%神经刺激仪辅助罗哌卡因阻滞麻醉用于老年下肢手术的效果

    Institute of Scientific and Technical Information of China (English)

    范勇涛

    2012-01-01

    目的 观察神经刺激仪辅助罗哌卡因阻滞麻醉用于老年下肢手术的临床效果.方法 将我院拟行单侧下肢手术的老年患者58例随机分为试验组30例和对照组28例.试验组在神经刺激仪引导下采用0.50%罗哌卡因和1.00%利多卡因行腰丛神经联合坐骨神经阻滞麻醉;对照组采用2.00%利多卡因和0.75%罗哌卡因行硬膜外麻醉.比较两组一般情况、麻醉情况、术后禁食及并发症情况.结果 两组手术时间及使用止血带时间比较差异无统计学意义(P>0.05).术中试验组平均动脉压保持在稳定的状态,无明显波动.手术开始时、术中不同时点及术后1h平均动脉压两组比较差异有统计学意义(P<0.01).麻醉开始起效时间、维持时间两组比较差异亦有统计学意义(P<0.05).试验组麻醉后不同时点神经阻滞完善率均高于对照组,但差异无统计学意义(P>0.05).术后禁食时间及尿潴留发生率两组比较差异有统计学意义(P<0.05).结论 在神经刺激仪定位下0.50%罗哌卡因用于老年下肢手术腰丛神经联合坐骨神经阻滞麻醉效果满意且安全性好.%Objective To investigate the clinical efficacy of nerve stimulator assisted by Ropivacaine block anesthesia in senior patients undergoing lower limb surgery. Methods 58 senior patients undergoing elective unilateral lower limb surgery were randomly di vided into experimental group (30 cases) and control group (28 cases). In experimental group, lumbar plexus combined with sciatic nerve block anesthesia was performed by a nerve stimulator with 0.50% of Ropivacaine and 1.00% of Lidocaine. In control group, epi dural anesthesia was performed with 2.00% of Lidocaine and 0.75% of Ropivacaine. The general situation, anestesia situation, absolute diet time and complications were compared. Results There was statistically significant difference in the surgery time and tourniquet time between the two groups (P > 0

  6. Bloqueio dos nervos femoral e isquiático guiados por ultrassom em paciente anticoagulado: case reports Bloqueo de los nervios femoral e isquiático guiados por ultrasonido en paciente anticoagulado Ultrasound-guided femoral and sciatic nerve blocks in an anticoagulated patient: relato de casos

    Directory of Open Access Journals (Sweden)

    Leonardo Henrique Cunha Ferraro

    2010-08-01

    cada vez más en una práctica frecuente. Con la menor probabilidad de promover lesiones vasculares, el ultrasonido se convierte en un instrumento interesante en la realización de bloqueos periféricos, especialmente en los pacientes que usan anticoagulantes o con disturbios de la coagulación. El objetivo de este estudio fue relatar dos casos en que se realizaron los bloqueos isquiático y femoral guiados por ultrasonido en pacientes anticoagulados. RELATO DE LOS CASOS: En el primer caso, la cirugía realizada consistió en la amputación del pie anterior izquierdo en función de una necrosis y de señales de infección. El segundo caso, fue una limpieza quirúrgica de la rodilla izquierda. Los pacientes presentaron disturbios de coagulación con una actividad de protrombina y tiempo de tromboplastina activado por encima de los valores normales. Los dos pacientes se sometieron al bloqueo femoral e isquiático guiado por ultrasonido, evolucionando sin alteración motora o sensitiva en los territorios de esos nervios y sin hematoma en la región local de la punción. CONCLUSIONES: La anticoagulación impone ciertas restricciones a la aplicación de las técnicas anestésicas regionales clásicas. Con el avance de los equipos y métodos de ultrasonido, hoy por hoy se puede identificar con alta precisión las estructuras vasculares y neurales. Eso posibilita que la punción guiada por ultrasonido sea más exacta, tanto para alcanzar el área de interés como para minimizar los riesgos de lesión vascular accidental. Hasta el presente momento, no se recomienda la realización de bloqueo periférico en pacientes anticoagulados o portadores de coagulopatías. Sin embargo, considerando que existen pocos relatos sobre bloqueos regionales con ultrasonido en situaciones de coagulopatías, la seguridad de tal técnica en esas condiciones todavía no se ha establecido.BACKGROUND AND OBJECTIVES: The use of the ultrasound to guide the puncture in peripheral nerve blocks has become

  7. Anatomical basis for nerve block of the brachial plexus via superomedial to midpoint of the clavicle%锁骨中点内上方阻滞臂丛神经的解剖学

    Institute of Scientific and Technical Information of China (English)

    董西安; 李光宗; 郭荣奎; 刘宝梅; 孙静; 鞠晓华; 张志玉

    2011-01-01

    Objective: To provide the morphological basis for blocking the brachial plexus via superomedial to midpoint of the clavicle. Methods:Length of the brachial plexus, diameter of the junction of three cords of the brachial plexus above the first rib were measured on sixteen fixed cadavers, in order to identify the optimal point, direction, angle and depth of needling on account that the subclavian artery was prevented. Results: The length of the brachial plexus was 108. 09 mm±12. 49 mm. The diameter of the junction of three cords of the brachial plexus above the first rib was 16. 40 mm±2. 10 mm. The distance of needling pathway was 25. 45 mm± 0. 42 mm. The optimal angle that could protect the subclavian artery was 12. 85°±0. 59°. Conclusion: The needle can be inserted at the point that 10 mm inwards and 23 mm upwards to the midpoint of the clavicle, and run inferolaterally (meaning at 140° that identify as the angle between the vertical line through the needling point and the needling pathway) toward superior border of the midpoint of the clavicle. The angle is 12. 85° to protect the subclavian artery. This approach is effective to complete block the brachial plexus without complications such as pneumothorax and hemothorax.%目的:为临床麻醉工作者提供锁骨中点上方阻滞人路方法.方法:在经10%甲醛溶液固定的60侧头颈、上肢标本及锁骨中点矢状切断面标本上测量臂丛的长度、第1肋上面臂丛神经3束汇合处的直径,确定臂丛阻滞进针点、进针方向、进针角度、进针深度、确定锁骨下动脉的保护角度.结果:臂丛神经的长度为108.09mm±12.49 mm;第1肋上面臂丛神经3束汇合处的直径为16.40 mm±2.10 mm;进针路径(即进针点至锁骨中点上缘)距离为25.45mm±0.42 mm;保护锁骨下动脉的夹角为12.85°±0.59°.结论:锁骨中点向内10 mm向上23 mm处即为进针点,以140°(即进针点的垂线与进针路径呈的夹角)斜向外下至

  8. Secondary pulmonary alveolar proteinosis in hematologic malignancies.

    Science.gov (United States)

    Chaulagain, Chakra P; Pilichowska, Monika; Brinckerhoff, Laurence; Tabba, Maher; Erban, John K

    2014-12-01

    Pulmonary alveolar proteinosis (PAP), characterized by deposition of intra-alveolar PAS positive protein and lipid rich material, is a rare cause of progressive respiratory failure first described by Rosen et al. in 1958. The intra-alveolar lipoproteinaceous material was subsequently proven to have been derived from pulmonary surfactant in 1980 by Singh et al. Levinson et al. also reported in 1958 the case of 19-year-old female with panmyelosis afflicted with a diffuse pulmonary disease characterized by filling of the alveoli with amorphous material described as "intra-alveolar coagulum". This is probably the first reported case of PAP in relation to hematologic malignancy. Much progress has been made on PAP first described by Rosen which is currently classified as idiopathic or primary or autoimmune PAP. Idiopathic PAP occurs as a result of auto-antibodies directed against granulocyte-macrophage colony stimulating factor (GM-CSF) impeding the surfactant clearing function of alveolar macrophages leading to progressive respiratory failure. Whole lung lavage and GM-CSF therapy has improved outcomes in patients with idiopathic PAP. Despite major advancement in the management of hematologic malignancy and its complications, little is known about the type of PAP first described by Levinson and now known as secondary PAP; a term also used when PAP occurs due to other causes such as occupational dusts. In this article we review and analyze the limited literature available in secondary PAP due to hematologic malignancies and present a case of PAP associated with chronic lymphocytic leukemia successfully treated with bendamustine and rituximab. PMID:25300566

  9. Ghost Block

    OpenAIRE

    Webb, Neil

    2011-01-01

    Filmed on the English south coast 'Ghost Block' depicts the uncanny and eerie atmosphere at the site of a WW2 coastal defence line. The concrete cubes were used as an anti-invasion blockade against potential landing forces. This protection line now slowly decaying and becoming enmeshed into the environment still acts as a defence to repel unwanted visitors. The area is a natural reserve to nesting birds that often lay eggs directly onto the beach surface. The blocks act as a final barrier ...

  10. 奥卡西平联合神经阻滞治疗原发性三叉神经痛的随机对照试验%RANDOMIZED CONTROLLED TRIAL OF OXCARBAZEPINE COMBINED WITH NERVE BLOCK IN TREATMENT OF PRIMARY TRIGEMINAL NEURALGIA

    Institute of Scientific and Technical Information of China (English)

    苏芳; 盖成林; 袁源; 张倩

    2013-01-01

    目的:评估奥卡西平联合神经阻滞是否可以提高治疗原发性三叉神经痛的临床效果.方法:选择原发性三叉神经痛患者60例,随机分为3组:奥卡西平治疗组(O组)、神经阻滞组(B组)和奥卡西平联合神经阻滞组(OB组).采用视觉模拟评分(visual analogue scale,VAS)评估3组患者治疗前及治疗后第1、2、4周的疼痛分值以及睡眠、生活质量、MPQ总评分、患者自我评价等指标,同时观察患者的不良反应.结果:O组患者口服奥卡西平起效缓慢,但能有效缓解疼痛,治疗后第4周与治疗前VAS疼痛评分比较差异有显著性(P<0.01);B组治疗后第1、2、4周疼痛缓解效果与O组比较,差异有显著性(P<0.05);B组治疗后第4周与治疗前VAS疼痛评分比较有显著性差异(P<0.01); OB组奥卡西平联合神经阻滞组患者,治疗后第4周与治疗前VAS疼痛评分比较差异有显著性(P<0.01);且OB组较其他两组治疗后各时间点疼痛评分统计学差异显著(P<0.05).患者评价显示OB组较其他两组总体效果更让人满意(P<0.05).3组均有不良反应发生,其中O组不良反应发生例数最多;OB组不良反应发生例数最少,差异有显著性(P<0.05).结论:奥卡西平联合神经阻滞治疗原发性三叉神经痛有效且安全;其疗效优于单独服药和单独神经阻滞治疗.%Objective:To study the efficacy of Oxcarbazepine combined with nerve block in the treatment of primary trigeminal neuralgia.Methods:Sixty primary trigeminal neuralgia patients were randomly divided into three groups:group O (Oxcarbazepine),group B (nerve block) and group OB (Oxcarbazepine combined with nerve block).We evaluated the degree of the patients' pain of pre-therapy and post-therapy after the first week,the second week and the fourth week by visual analogue scale (VAS).Results:The pain of group O relieve slowly,while have an effective relief after therapy; and there was a significant difference between the

  11. 选择性神经根封闭术在多节段腰椎管狭窄症诊治中的应用%The Value of Selective Diagnostic Nerve Root Block in the Treatment of Multilevel Degenerated Lumbar Spinal Stenosis

    Institute of Scientific and Technical Information of China (English)

    陈志明; 马华松; 吴继功; 邵燕翔; 谭荣; 张乐乐

    2012-01-01

    目的 探讨选择性神经根封闭术在多节段腰椎管狭窄症定位诊断及术式选择中的作用.方法 自2008年7月至2010年4月收治多节段腰椎管狭窄症患者共53例,男20例,女33例;年龄57~85岁,平均68岁.所有患者均采用选择性神经根封闭术明确责任节段.根据责任节段行手术治疗.A组采用开窗减压、间盘摘除术;B组采用椎板减压、椎间植骨融合、椎弓根螺钉固定术.术前、术后均采用视觉模拟评分法(visual analogue scale,VAS)及日本骨科协会(Japanese orthopaedic association,JOA)评分进行疗效评估.结果 选择性神经根封闭术明确单节段责任间隙40例,两节段11例,有2例在神经根封闭后症状缓解不到30%,未再行手术治疗.A组(18例)手术前、后及最后随访时JOA评分分别为(5.8±2.3)分、(12.3±1.6)分、(11.9±1.3)分,VAS评分分别为(7.6±1.6)分、(2.3±1.5)分、(1.8±1.1)分.B组(33例)进行单节段融合29例,两节段融合4例,手术前、后及最后随访时JOA评分分别为(5.5±2.1)分、(11.8±1.8)分、(11.6±1.5)分.VAS评分分别为(7.4±2.3)分、(2.5±1.2)分、(2.1±1.5)分.术后及最后随访时JOA、VAS评分与术前比较差异有统计学意义(P<O.001),A组与B组术前、术后JOA、VAS评分差异无统计学意义(P>0.05).结论 在腰椎管狭窄症的定位诊断中,选择性神经根封闭是明确责任节段准确而有效的方法,有助于减小手术范围,提高手术疗效.%Objective To explore the value of selective diagnostic nerve root block in the treatment of multilevel degenerated lumbar spinal stenosis. Methods 53 cases of multilevel degenerated lumbar spinal stenosis were treated between July 2008 and April 2010. There were 20 males and 33 females with the mean age of 68 years old. Selective diagnostic nerve root block was used in all cases to identify 'the responsible segments'. Based on the results,surgical treatment was divided into two group. In Group A

  12. Cigarette Smoke Extract Inhibits the Proliferation of Alveolar Epithelial Cells and Augments the Expression of P21WAF1

    Institute of Scientific and Technical Information of China (English)

    Zongxian JIAO; Qilin AO; Xiaona GE; Mi XIONG

    2008-01-01

    Cigarette smoking is intimately related with the development of chronic obstructive pulmonary diseases, and alveolar epithelium is a major target for the exposure of cigarette smoke ex- tract. In order to investigate the effect of cigarette smoke extract on the proliferation of alveolar epithelial cell type Ⅱand its relationship with P21WAF1, the alveolar epithelial type Ⅱ cell line (A549) cells were chosen as surrogate cells to represent alveolar epithelial type Ⅱ cells. MTT assay was used to detect cell viability after interfered with different concentrations of cigarette smoke ex-tract. It was observed cigarette smoke extract inhibited the growth of A549 cells in a dose- and time-dependent manner. The morphological changes, involving the condensation and margination of nuclear chromatin, even karyorrhexis, were observed by both Hoechst staining and electronic mi-croscopy. Flow cytometry analysis demonstrated the increased cell percentages in G1 and subG1phases after the cells were incubated with cigarette smoke extract. The expression of p21WAF1 protein and mRNA was also significantly increased as detected by the methods of Western blot or reverse transcription-polymerase chain reaction respectively. In conclusion, cigarette smoke extract inhibits the proliferation of alveolar epithelial cell type Ⅱ and blocks them in G1/S phase. The intracellular accumulation of P21WAF1 may be one of the mechanisms which contribute to cigarette smoke ex-tract-induced inhibition of cell proliferation.

  13. Neurophysiological approach to disorders of peripheral nerve

    DEFF Research Database (Denmark)

    Crone, Clarissa; Krarup, Christian

    2013-01-01

    Disorders of the peripheral nerve system (PNS) are heterogeneous and may involve motor fibers, sensory fibers, small myelinated and unmyelinated fibers and autonomic nerve fibers, with variable anatomical distribution (single nerves, several different nerves, symmetrical affection of all nerves...

  14. Radial Nerve Tendon Transfers.

    Science.gov (United States)

    Cheah, Andre Eu-Jin; Etcheson, Jennifer; Yao, Jeffrey

    2016-08-01

    Radial nerve palsy typically occurs as a result of trauma or iatrogenic injury and leads to the loss of wrist extension, finger extension, thumb extension, and a reduction in grip strength. In the absence of nerve recovery, reconstruction of motor function involves tendon transfer surgery. The most common donor tendons include the pronator teres, wrist flexors, and finger flexors. The type of tendon transfer is classified based on the donor for the extensor digitorum communis. Good outcomes have been reported for most methods of radial nerve tendon transfers as is typical for positional tendon transfers not requiring significant power. PMID:27387076

  15. Changes in nerve microcirculation following peripheral nerve compression

    Institute of Scientific and Technical Information of China (English)

    Yueming Gao; Changshui Weng; Xinglin Wang

    2013-01-01

    Following peripheral nerve compression, peripheral nerve microcirculation plays important roles in regulating the nerve microenvironment and neurotrophic substances, supplying blood and oxygen and maintaining neural conduction and axonal transport. This paper has retrospectively analyzed the articles published in the past 10 years that addressed the relationship between peripheral nerve compression and changes in intraneural microcirculation. In addition, we describe changes in different peripheral nerves, with the aim of providing help for further studies in peripheral nerve microcirculation and understanding its protective mechanism, and exploring new clinical methods for treating peripheral nerve compression from the perspective of neural microcirculation.

  16. Epidural block

    Science.gov (United States)

    ... Drugs & Supplements Videos & Tools Español You Are Here: Home ... It numbs or causes a loss of feeling in the lower half your body. This lessens the pain of contractions during childbirth. An epidural block may also be used to ...

  17. High Ulnar Nerve Injuries: Nerve Transfers to Restore Function.

    Science.gov (United States)

    Patterson, Jennifer Megan M

    2016-05-01

    Peripheral nerve injuries are challenging problems. Nerve transfers are one of many options available to surgeons caring for these patients, although they do not replace tendon transfers, nerve graft, or primary repair in all patients. Distal nerve transfers for the treatment of high ulnar nerve injuries allow for a shorter reinnervation period and improved ulnar intrinsic recovery, which are critical to function of the hand. PMID:27094893

  18. A Practical Surgical Technique to Expose the Mental Nerve in Narrowing Genioplasty.

    Science.gov (United States)

    Wang, Chenglong; Gui, Lai; Liu, Jianfeng

    2015-11-01

    In this article, the authors present a practical surgical technique using the anatomical character of the inferior alveolar nerve to fully expose the mental nerve (MN) in narrowing genioplasty. During the procedure, a rectangular mandibular outer cortex adjacent to the mental foramen is removed before the osteotomy. The objective is to avoid the injury of the MN from the reciprocating saw or bur and offer abundant space for the surgical operation. The technique has a minimal learning curve and will be useful to plastic surgeons to minimize unintentional cutting or pulling injury to the MN in narrowing genioplasty. PMID:26893979

  19. The quantitative sensory testing is an efficient objective method for assessment of nerve injury

    OpenAIRE

    Kim, Young-Kyun; Yun, Pil-Young; Kim, Jong-Hwa; Lee, Ji-Young; Lee, Won

    2015-01-01

    Background This study evaluated Somatosensory evoked potentials (SEP), Quantitative sensory testing (QST), and thermography as diagnostic methods for nerve injury. Methods From 2006 through 2011, 17 patients (mean age: 50.1 years) from OOOO Hospital who sought care for altered sensation after dental implant treatment were identified. The mean time of objective assessment was 15.2 months after onset. Results SEP of Inferior alveolar nerve(IAN) was 15.87 ± 0.87 ms on the normal side and 16.18 ±...

  20. Diabetic Nerve Problems

    Science.gov (United States)

    ... at the wrong times. This damage is called diabetic neuropathy. Over half of people with diabetes get ... you change positions quickly Your doctor will diagnose diabetic neuropathy with a physical exam and nerve tests. ...

  1. Damaged axillary nerve (image)

    Science.gov (United States)

    Conditions associated with axillary nerve dysfunction include fracture of the humerus (upper arm bone), pressure from casts or splints, and improper use of crutches. Other causes include systemic disorders that cause neuritis (inflammation of ...

  2. Sacral nerve stimulation.

    Science.gov (United States)

    Matzel, K E; Stadelmaier, U; Besendörfer, M

    2004-01-01

    The current concept of recruiting residual function of an inadequate pelvic organ by electrostimulation involves stimulation of the sacral spinal nerves at the level of the sacral canal. The rationale for applying SNS to fecal incontinence was based on clinical observations of its effect on bowel habits and anorectal continence function in urologic patients (increased anorectal angulation and anal canal closure pressure) and on anatomic considerations: dissection demonstrated a dual peripheral nerve supply of the striated pelvic floor muscles that govern these functions. Because the sacral spinal nerve site is the most distal common location of this dual nerve supply, stimulating here can elicit both functions. Since the first application of SNS in fecal incontinence in 1994, this technique has been improved, the patient selection process modified, and the spectrum of indications expanded. At present SNS has been applied in more than 1300 patients with fecal incontinence limited.

  3. Diabetes and nerve damage

    Science.gov (United States)

    Diabetic neuropathy; Diabetes - neuropathy; Diabetes - peripheral neuropathy ... In people with diabetes, the body's nerves can be damaged by decreased blood flow and a high blood sugar level. This condition is ...

  4. Degenerative Nerve Diseases

    Science.gov (United States)

    Degenerative nerve diseases affect many of your body's activities, such as balance, movement, talking, breathing, and heart function. Many of these diseases are genetic. Sometimes the cause is a medical ...

  5. Iatrogenic damage to the mandibular nerves as assessed by the masseter inhibitory reflex

    OpenAIRE

    Biasiotta, A.; Cascone, P.; Cecchi, R; Cruccu, G.; IANNETTI, G.; A. Mariani; Spota, A.; Truini, A.

    2011-01-01

    Iatrogenic injury of the inferior alveolar or lingual nerves frequently leads to legal actions for damage and compensation for personal suffering. The masseter inhibitory reflex (MIR) is the most used neurophysiological tool for the functional assessment of the trigeminal mandibular division. Aiming at measuring the MIR sensitivity and specificity, we recorded this reflex after mental and tongue stimulations in a controlled, blinded study in 160 consecutive patients with sensory disturbances ...

  6. Optic nerve oxygen tension

    DEFF Research Database (Denmark)

    la Cour, M; Kiilgaard, Jens Folke; Eysteinsson, T;

    2000-01-01

    To investigate the influence of acute changes in intraocular pressure on the oxygen tension in the vicinity of the optic nerve head under control conditions and after intravenous administration of 500 mg of the carbonic anhydrase inhibitor dorzolamide.......To investigate the influence of acute changes in intraocular pressure on the oxygen tension in the vicinity of the optic nerve head under control conditions and after intravenous administration of 500 mg of the carbonic anhydrase inhibitor dorzolamide....

  7. Huhe Block

    Institute of Scientific and Technical Information of China (English)

    1996-01-01

    @@ Huhe Block is located in the mid-west part of Inner Mogolia Autonomous Region, covering an area of 15 079km2, in the range of 109°40'-112°00'E and 39°23()-40°40'N. Topographically. the Fengzhen hill is to the east, the Yinshan Mounts is to the north, the Hetao Plain and Ordos Plateau are respectively in its west and south.The Yellow River flows across this block. The elevation is 1 000 m in the flat area and in the range of 1 000-1 300m. in the plateau area, good for the development of agriculture and industry as well as husbandry. It belongs to inland plateau climate with annually averaged temperature of 8℃, the minimum being -12℃ in winter and the maximum 22℃ in summer.

  8. Rare Lung Diseases II: Pulmonary Alveolar Proteinosis

    Directory of Open Access Journals (Sweden)

    Stephen C Juvet

    2008-01-01

    Full Text Available The present article is the second in a series on rare lung diseases. It focuses on pulmonary alveolar proteinosis (PAP, a disorder in which lipoproteinaceous material accumulates in the alveolar space. PAP was first described in 1958, and for many years the nature of the material accumulating in the lungs was unknown. Major insights into PAP have been made in the past decade, and these have led to the notion that PAP is an autoimmume disorder in which autoantibodies interfere with signalling through the granulocyte-macrophage colony-stimulating factor receptor, leading to macrophage and neutrophil dysfunction. This has spurred new therapeutic approaches to this disorder. The discussion of PAP will begin with a case report, then will highlight the classification of PAP and review recent insights into the pathogenesis of PAP. The approach to therapy and the prognosis of PAP will also be discussed.

  9. Pulmonary alveolar proteinosis and aluminum dust exposure

    Energy Technology Data Exchange (ETDEWEB)

    Miller, R.R.; Churg, A.M.; Hutcheon, M.; Lom, S.

    1984-08-01

    A 44-yr-old male presented shortness of breath, diffuse X-ray infiltrates, and physiologic evidence of a restrictive lung disease. Biopsy revealed pulmonary alveolar proteinosis. The patient had worked for the previous 6 yr as an aluminum rail grinder in a very dusty environment. Analysis of his lung tissue revealed greater than 300 X 10(6) particles of aluminum/g dry lung; all of the particles appeared as spheres of less than 1 mu diameter. We believe that this case represents an example of pulmonary alveolar proteinosis induced by inhalation of aluminum particles; this finding confirms animal studies which suggest that proteinosis can be produced by very large doses of many types of finely divided mineral dust.

  10. Treatment of Adult Primary Alveolar Proteinosis.

    Science.gov (United States)

    Rodríguez Portal, José Antonio

    2015-07-01

    Pulmonary alveolar proteinosis (PAP) is a rare disease characterized by the accumulation of surfactant-like lipoproteinaceous material in the distal air spaces and terminal bronchi, which may lead to impaired gas exchange. This accumulation of surfactant is due to decreased clearance by the alveolar macrophages. Its primary, most common form, is currently considered an autoimmune disease. Better knowledge of the causes of PAP have led to the emergence of alternatives to whole lung lavage, although this is still considered the treatment of choice. Most studies are case series, often with limited patient numbers, so the level of evidence is low. Since the severity of presentation and clinical course are variable, not all patients will require treatment. Due to the low level of evidence, some objective criteria based on expert opinion have been arbitrarily proposed in an attempt to define in which patients it is best to initiate treatment. PMID:25896950

  11. Silver Nanoparticles in Alveolar Bone Surgery Devices

    Directory of Open Access Journals (Sweden)

    Stefano Sivolella

    2012-01-01

    Full Text Available Silver (Ag ions have well-known antimicrobial properties and have been applied as nanostrategies in many medical and surgical fields, including dentistry. The use of silver nanoparticles (Ag NPs may be an option for reducing bacterial adhesion to dental implant surfaces and preventing biofilm formation, containing the risk of peri-implant infections. Modifying the structure or surface of bone grafts and membranes with Ag NPs may also prevent the risk of contamination and infection that are common when alveolar bone augmentation techniques are used. On the other hand, Ag NPs have revealed some toxic effects on cells in vitro and in vivo in animal studies. In this setting, the aim of the present paper is to summarize the principle behind Ag NP-based devices and their clinical applications in alveolar bone and dental implant surgery.

  12. Bilateral stony lung: pulmonary alveolar microlithiasis.

    Science.gov (United States)

    Chandra, Subhash; Mohan, Anant; Guleria, Randeep; Das, Prasenjit; Sarkar, Chitra

    2009-01-01

    A 40-year-old male paddy field worker was referred for exertional shortness of breath and non-productive cough for 4 years. He had been treated for pulmonary tuberculosis twice. Chest radiograph showed extensive bilateral nodular opacities ("sandstorm-like") in the middle and lower lobe. Pulmonary function tests revealed a restrictive ventilatory defect. High resolution CT showed widespread nodular infiltration with "crazy paving" appearance and interrupted black pleura sign. This was confirmed as pulmonary alveolar microlithiasis (PAM) by trans-bronchial lung biopsy, which showed normal respiratory lining epithelium with dilated alveolar spaces containing many calcific bodies, some of which showed concentric calcification. The possibilities of silicosis (due to exposure to husk) and tuberculosis, both of which can mimic PAM clinically and radiologically, made this case a diagnostic challenge. PMID:21686505

  13. Bmp2 and Bmp4 accelerate alveolar bone development.

    Science.gov (United States)

    Ou, Mingming; Zhao, Yibing; Zhang, Fangming; Huang, Xiaofeng

    2015-06-01

    Alveolar bone remodeling is a continuous process that takes place during development and in response to various physiological and pathological stimuli. However, detailed knowledge regarding the underlying mechanisms involved in alveolar bone development is still lacking. This study aims at improving our understanding of alveolar bone formation and the role of bone morphogenetic proteins (Bmps) in this process. Mice at embryonic (E) day 13.5 to postnatal (PN) day 15.5 were selected to observe the process of alveolar bone development. Alveolar bone development was found to be morphologically observable at E14.5. Molar teeth isolated from mice at PN7.5 were pretreated with Bmp2, Bmp4, Noggin, or BSA, and grafted subcutaneously into mice. The subcutaneously implanted tooth germs formed alveolar bone indicating the role of the dental follicle in alveolar bone development. Alveolar bone formation was increased after pretreatment with Bmp2 and Bmp4, but not with Noggin. Gene expression levels in dental follicle cells from murine molars were also determined by real-time RT-PCR. The expression levels of Runx2, Bsp, and Ocn were significantly higher in dental follicle cells cultured with Bmp2 or Bmp4, and significantly lower in those cultured with Noggin when compared with that of the BSA controls. Our results suggest that the dental follicle participates in alveolar bone formation and Bmp2/4 appears to accelerate alveolar bone development.

  14. 麻醉学监护下的局部麻醉胸腔镜胸交感神经阻断术114例%Thoracoscopic sympathetic nerve blocking under local anesthesia with MAC: 114 cases report

    Institute of Scientific and Technical Information of China (English)

    郭绍红; 王晶晶

    2012-01-01

    目的 大样本研究麻醉学监护下的局麻一期双侧胸腔镜胸交感神经阻断术的优缺点.方法 用于回顾性研究的患者共有205例,其中采用麻醉学监护下的局部浸润麻醉的共有114例(局麻组),采用单腔管插管全麻的共有91例(全麻组).局麻组用(0.5%利多卡因+0.0625%布比卡因浸润麻醉每个手术切口,术中使用瑞芬太尼辅助镇痛,麻醉学全程监护(MAC).每侧切2个长约7mm的皮肤切口.穿入穿刺套管,进行常规的胸腔镜胸交感神经阻断术.结果 局麻组患者整个手术过程中神智清醒,完全自主呼吸.局麻组和全麻组的入手术室至手术开始时间分别为(31.18±10.84)和(35.49±10.22)min(P <0.01);手术时间分别为(60.79±12.77)和(44.67±13.06)min(P <0.001);术毕至出手术室时间分别为(7.83±4.23)和(24.40±8.78)min(P <0.001);进出手术室时间分别为(100.32±17.34)和(104.34±17.45)min(P >0.05).住院日两组分别为(3.48±0.91)和(3.80±0.81)d(P <0.01),局麻组和全麻组的住院费分别为(6382.41±935.91)和(7 010.91±1 009.83)元(P<0.001);麻醉药物费用分别为(168.72±59.29)和(534.54±121.46)元(P<(0.001);麻醉费分别为(438.07±99.03)和(353.85±46.09)元(P<0.001);麻醉材料费分别为(32.64±54.99)和(225.23±82.23)元(P<0.001);麻醉总费用分别为(639.95±147.05)和(1 111.54±139.75)元(P<0.001).结论 一期双侧胸腔镜胸交感神经阻断术可以在瑞芬太尼强化的局部浸润庥下完成,虽然手术时间延长,但显著缩短了手术前的准备和手术后的时间.与全麻手术相比,消除了全身麻醉的各种风险,手术安全、更为微创、显著减少了总费用、麻醉药物费用和麻醉材料费用、术后恢复加快、住院日显著缩短.%[Objective] To investigate the advantages and disadvantages of the operation of one stage bilateral thoracoscopic sympathetic blocking (OSBTSB) under local infiltration anesthesia and

  15. 三点法腋路臂丛神经阻滞--神经刺激器法和异感法的比较%Triple-injection Axillary Brachial Plexus Block:a Comparison of Two Nerve-localization Techniques, Nerve Stimulation Versus Paresthesia

    Institute of Scientific and Technical Information of China (English)

    车薛华; 梁伟民; 陈佳瑶

    2005-01-01

    目的采用随机对照的方法对神经刺激器法和异感法这两种定位方法在三点腋路臂丛阻滞中的效果进行比较.方法45名拟行前臂和手部手术的病人被随机分入异感定位组(paresthesia,PAR组n=23)和周围神经刺激器定位组(peripheral nerve stimulator,PNS组n=22),分别采用异感定位法和神经刺激器定位法定位支配上肢的4支混合神经中的3支(肌皮神经、正中神经、桡神经或尺神经),将等量的2%利多卡因和0.5%布比卡因混合液40 mL分别注射于3支神经周围,其中肌皮神经5 mL,正中神经15 mL,桡神经或尺神经15 mL,另5 mL侵润上臂内侧的皮神经.臂丛阻滞成功被定义为注射30 min后,肘部远端5支神经(肌皮神经、桡神经、正中神经、尺神经和前臂内侧皮神经)支配区域的感觉阻滞完全,比较2组在臂丛阻滞成功率、时效和并发症等方面的差异.结果PNS组的阻滞成功率要高于PAR组(95.5%对54.5%,P<0.01),两组间差异主要由于PAR组的肌皮神经和桡神经阻滞率较低(P<0.05).PNS组的麻醉起效时间短于PAR组(19 min对29 min,P<0.01).两组中共有3例病人(6.6%)发生术后短暂的神经功能障碍,3周内均获完全恢复.结论PNS法是一种良好的定位手段.将该方法应用于三点法腋路臂丛神经阻滞,可获得优于传统异感定位法的效果.臂丛阻滞后神经功能障碍并不少见,应引起足够重视.

  16. Aberrant Dual Origin of the Dorsal Scapular Nerve and Its Communication with Long Thoracic Nerve: An Unusual Variation of the Brachial Plexus.

    Science.gov (United States)

    Shilal, Poonam; Sarda, Rohit Kumar; Chhetri, Kalpana; Lama, Polly; Tamang, Binod Kumar

    2015-06-01

    Pre and post-fixed variations at roots of the brachial plexus have been well documented, however little is known about the variations that exist in the branches which arise from the brachial plexus. In this paper, we describe about one such rare variation related to the dorsal scapular and the long thoracic nerve, which are the branches arising from the roots of the brachial plexus. The variation was found during routine dissection. The dorsal scapular nerve, which routinely arises from the fifth cervical nerve root (C5), was seen to receive contributions from C5 as well as sixth cervical nerve (C6), while the long thoracic nerve arose from C6 and seventh cervical nerves (C7) only. Furthermore along with variations in origin of the dorsal scapular and long thoracic nerves, the brachial plexus was seen to exist as a prefixed plexus receiving a contribution from C4 nerve root. An aberrant communicating branch between the dorsal scapular and long thoracic nerve was also identified. Knowledge about the course and anatomy of such variations can be vital for understanding the aetiology of various conditions such as winging of scapula, interscapular pain, administration of cervical nerve blocks, surgeries and for effective management of regions and muscles supplied by dorsal scapular and long thoracic nerve.

  17. Bloqueio do nervo frênico após realização de bloqueio do plexo braquial pela via interescalênica: relato de caso A bloqueo del nervio frénico después de la realización de bloqueo del plexo braquial por la vía interescalénica: relato de caso Phrenic nerve block after interscalene brachial plexus block: case report

    Directory of Open Access Journals (Sweden)

    Luis Henrique Cangiani

    2008-04-01

    embargo, en su mayoría, sin repercusiones clínicas importantes. El objetivo de este relato fue presentar un caso en que ocurrió bloqueo del nervio frénico, con comprometimiento ventilatorio en paciente con insuficiencia renal crónica, sometido a la instalación de fístula arterio-venosa extensa, bajo bloqueo del plexo braquial por la vía perivascular interescalénica. RELATO DEL CASO: Paciente del sexo masculino, 50 años, tabaquista, portador de insuficiencia renal crónica en régimen de hemodiálisis, hipertensión arterial, hepatitis C, diabetes melito, enfermedad pulmonar obstructiva crónica, sometido a la instalación de fístula arterio-venosa extensa en el miembro superior derecho bajo bloqueo de plexo braquial por la vía interescalénica. El plexo braquial fue localizado con la utilización del estimulador de nervio periférico. Se inyectaron 35 mL de una solución de anestésico local constituida de una mezcla de lidocaína a 2% con epinefrina a 1:200.000 y ropivacaína a 0,75% en partes iguales. Al final de la inyección el paciente estaba lúcido, pero sin embargo con disnea y predominio de incursión respiratoria intercostal ipsilateral al bloqueo. No había murmullo vesicular en la base del hemitórax derecho. La SpO2 se mantuvo en un 95%, con catéter nasal de oxígeno. No fue necesaria la instalación de métodos de auxilio ventilatorio invasivo. La radiografía del tórax reveló que el hemidiafragma derecho ocupaba el 5° espacio intercostal. El cuadro clínico se revirtió en tres horas. CONCLUSIONES: El caso mostró que hubo parálisis total del nervio frénico con síntomas respiratorios. A pesar de no haber sido necesaria la terapéutica invasiva para el tratamiento, queda el aviso aquí para la restricción de la indicación de la técnica en esos casos.BACKGROUND AND OBJECTIVES: Phrenic nerve block is a common adverse event of brachial plexus block. However, in most cases it does not have any important clinical repercussion. The objective

  18. Alveolar ridge augmentation by osteoinduction in rats

    DEFF Research Database (Denmark)

    Pinholt, E M; Bang, G; Haanaes, H R

    1990-01-01

    The purpose of this study was to evaluate bone substitutes for alveolar ridge augmentation by osteoinduction. Allogenic, demineralized, and lyophilized dentin and bone was tested for osteoinductive properties in order to establish an experimental model for further studies. Implantations were...... performed subperiosteally on the premaxilla and heterotopically in the abdominal muscles of rats. Light microscopic evaluations revealed that all allogenic, demineralized, and lyophilized dentin and bone implants induced new bone formation. No inflammatory or foreign body reactions were observed....

  19. Phagocytic properties of lung alveolar wall cells

    Directory of Open Access Journals (Sweden)

    Tanaka,Akisuke

    1974-04-01

    Full Text Available For the purpose to define the mechanism of heavy metal intoxication by inhalation, morphologic observations were made on rat lungs after nasal instillation of iron colloid particles of positive and negative electric charges. Histochemical observation was also made on the liver and spleen of these animals. The instilled iron colloid particles reach the alveolar cavity easily, as can be seen in the tissue sections stained by Prussian blue reaction. Alveolar macrophages do take up them avidly both of positive and negative charges, though much less the positive particles than negative ones. In contrast, the alveolar epithelial cells take up solely positive particles by phagocytosis but not negative ones. Electron microscope observation revealed that the positive particles are ingested by Type I epithelial cells by pinocytosis and by Type II cells by phagocytosis as well. Then the iron colloid particles are transferred into the basement membrane by exocytosis. Travelling through the basement membrane they are again taken up by capillary endothelial cells by phagocytosis. Some particles were found in the intercellular clefts of capillary endothelial cells but not any iron colloid particles in the intercellular spaces of epithelial cells and in the capillary lumen. However, the liver and spleen tissues of the animals given iron colloid showed a strong positive iron reaction. On the basis of these observations, the mechanism of acute intoxication by inhaling heavy metal dusts like lead fume is discussed from the view point of selective uptake of alveolar epithelial and capillary endothelial cells for the particles of the positive electric cha'rge.

  20. In situ methods for assessing alveolar mechanics.

    Science.gov (United States)

    Wu, You; Perlman, Carrie E

    2012-02-01

    Lung mechanics are an important determinant of physiological and pathophysiological lung function. Recent light microscopy studies of the intact lung have furthered the understanding of lung mechanics but used methodologies that may have introduced artifacts. To address this concern, we employed a short working distance water immersion objective to capture confocal images of a fluorescently labeled alveolar field on the costal surface of the isolated, perfused rat lung. Surface tension held a saline drop between the objective tip and the lung surface, such that the lung surface was unconstrained. For comparison, we also imaged with O-ring and coverslip; with O-ring, coverslip, and vacuum pressure; and without perfusion. Under each condition, we ventilated the lung and imaged the same region at the endpoints of ventilation. We found use of a coverslip caused a minimal enlargement of the alveolar field; additional use of vacuum pressure caused no further dimensional change; and absence of perfusion did not affect alveolar field dimension. Inflation-induced expansion was unaltered by methodology. In response to inflation, percent expansion was the same as recorded by all four alternative methods. PMID:22074721

  1. Pulmonary alveolar proteinosis: time to shift?

    Science.gov (United States)

    Papiris, Spyros A; Tsirigotis, Panagiotis; Kolilekas, Likurgos; Papadaki, Georgia; Papaioannou, Andriana I; Triantafillidou, Christina; Papaporfyriou, Anastasia; Karakatsani, Anna; Kagouridis, Konstantinos; Griese, Matthias; Manali, Effrosyni D

    2015-06-01

    Pulmonary alveolar proteinosis (PAP) is categorized into hereditary, secondary and autoimmune PAP (aPAP) types. The common pathogenesis is the ability of the alveolar macrophages to catabolize phagocytized surfactant is affected. Hereditary PAP is caused by mutations involving the GM-CSF signaling, particularly in genes for the GM-CSF receptor and sometimes by GATA2 mutations. Secondary PAP occurs in hematologic malignancies, other hematologic disorders, miscellaneous malignancies, fume and dust inhalation, drugs, autoimmune disorders and immunodeficiencies. aPAP is related to the production of GM-CSF autoantibodies. PAP is characterized morphologically by the inappropriate and progressive 'occupation' of the alveolar spaces by an excessive amount of unprocessed surfactant, limiting gas exchange and gradually exhausting the respiratory reserve. Myeloid cells' immunity deteriorates, increasing the risk of infections. Treatment of PAP is based on its etiology. In aPAP, recent therapeutic advances might shift the treatment option from the whole lung lavage procedure under general anesthesia to the inhalation of GM-CSF 'as needed'. PMID:25864717

  2. High-resolution measurement of electrically-evoked vagus nerve activity in the anesthetized dog

    Science.gov (United States)

    Yoo, Paul B.; Lubock, Nathan B.; Hincapie, Juan G.; Ruble, Stephen B.; Hamann, Jason J.; Grill, Warren M.

    2013-04-01

    Objective. Not fully understanding the type of axons activated during vagus nerve stimulation (VNS) is one of several factors that limit the clinical efficacy of VNS therapies. The main goal of this study was to characterize the electrical recruitment of both myelinated and unmyelinated fibers within the cervical vagus nerve. Approach. In anesthetized dogs, recording nerve cuff electrodes were implanted on the vagus nerve following surgical excision of the epineurium. Both the vagal electroneurogram (ENG) and laryngeal muscle activity were recorded in response to stimulation of the right vagus nerve. Main results. Desheathing the nerve significantly increased the signal-to-noise ratio of the ENG by 1.2 to 9.9 dB, depending on the nerve fiber type. Repeated VNS following nerve transection or neuromuscular block (1) enabled the characterization of A-fibers, two sub-types of B-fibers, and unmyelinated C-fibers, (2) confirmed the absence of stimulation-evoked reflex compound nerve action potentials in both the ipsilateral and contralateral vagus nerves, and (3) provided evidence of stimulus spillover into muscle tissue surrounding the stimulating electrode. Significance. Given the anatomical similarities between the canine and human vagus nerves, the results of this study provide a template for better understanding the nerve fiber recruitment patterns associated with VNS therapies.

  3. [Biophysics of nerve excitation].

    Science.gov (United States)

    Kol'e, O R; Maksimov, G V

    2010-01-01

    The studies testifying to the presence of the interrelation between the physiological functions of the organism and physical and chemical processes in nerves are discussed. Changes in some physical and chemical parameters observed both upon elicited rhythmic exaltation of nerves and during the spontaneous rhythmic activity of neurons are analyzed. Upon rhythmic exaltation, a complex of physical and chemical processes is triggered, and reversible structural and metabolic rearrangements at the subcellular and molecular levels occur that do not take place during the generation of a single action potential. Thus, only in conditions of rhythmic exaltation of a nerve, it is possible to reveal those processes that provide exaltation of nerves in the organism. The future possibilities of the investigations combining the biophysical and physiological approaches are substantiated. Characteristic changes in physicochemical parameters are observed in nerves during the generation of a series of action potentials of different frequency and duration ("frequency dependence") under normal physiological conditions, as well as in extreme situations and in nerve pathology. The structural and metabolic rearrangements are directly related to the mode of rhythmic exaltation and proceed both in the course of rhythmic exaltation and after its termination. Participation and the basic components of the nervous fulcrum (an axon, Shwan cell, myelin, subcellular organelles) in the realization of rhythmic exaltation is shown. In the coordination of all processes involved in rhythmic exaltation, the main role is played by the systems of redistribution and transport of intercellular and endocellular calcium. The idea is put forward that myelin of nerve fibers is not only an isolator, but also an "intercellular depot" of calcium and participates in the redistribution of different ions. Thus, the rhythmic excitation is of great importance in the realization of some physiological functions, the

  4. 右美托咪定联合心理干预对神经阻滞下单侧全膝关节置换术患者心理应激反应的影响%Influence on mental stress reaction of dexmedetomidine uniting psycholog-ical intervention of the patients with unilateral total knee replacement un-der nerve block

    Institute of Scientific and Technical Information of China (English)

    周强

    2015-01-01

    Objective To explore the influence on mental stress reaction of dexmedetomidine uniting psychological in-tervention of the patients with unilateral total knee replacement under nerve block. Methods 60 patients with one sided total knee replacement under nerve block from October 2014 to march 2015 in our hospital were choosed,they were di-vided into study group (30 cases) and control group (30 cases) by random number table method,the two groups were all given psychological intervention,Study group was given dexmedetomidine,control group was given 0.9% saline solution. Before and after operation,the difference of HR、MAP、serum cortisol, ATII between two groups was compared respec-tively.At the same time,the mental condition between two groups were compared using S-AI,HAD,AVAT. Results Be-fore operation,the score of S-AI,HAD,AVAT,and HR、MAP、serum cortisol、ATII between two groups was no statistical differenc(P>0.05).After operation,HR、MAP、serum cortisol、ATII of study group was[(80±5) mm Hg、(80±8)/min、(308±116)nmol/L、(15±5)ng/L] lower than [(86±6)mm Hg、(84±9)/min、(356±136)nmol/L、(21±7)ng/L] in control group respec-tively,with statistical difference(P0.05);术后,研究组MAP、HR、血清皮质醇、ATⅡ分别为(80±5)mm Hg、(80±8)/min、(308±116) nmol/L、(15±5) ng/L,低于对照组的(86±6)mm Hg、(84±9)/min、(356±136)nmol/L、(21±7)ng/L,差异有统计学意义(P<0.05);术后研究组S-AI、HAD、AVAT评分分别为(9±4)、(9±3)、(53±5)分,低于对照组的(12±5)、(12±4)、(60±5)分,差异有统计学意义(P<0.05)。结论右美托咪定联合心理干预能减少腰丛与坐骨神经联合阻滞下行单侧全膝关节置换术患者的心理应激反应,明显减轻患者心理压力,保障血流动力学平稳。

  5. Perioperative Nerve Blockade: Clues from the Bench

    Directory of Open Access Journals (Sweden)

    M. R. Suter

    2011-01-01

    Full Text Available Peripheral and neuraxial nerve blockades are widely used in the perioperative period. Their values to diminish acute postoperative pain are established but other important outcomes such as chronic postoperative pain, or newly, cancer recurrence, or infections could also be influenced. The long-term effects of perioperative nerve blockade are still controversial. We will review current knowledge of the effects of blocking peripheral electrical activity in different animal models of pain. We will first go over the mechanisms of pain development and evaluate which types of fibers are activated after an injury. In the light of experimental results, we will propose some hypotheses explaining the mitigated results obtained in clinical studies on chronic postoperative pain. Finally, we will discuss three major disadvantages of the current blockade: the absence of blockade of myelinated fibers, the inappropriate duration of blockade, and the existence of activity-independent mechanisms.

  6. Dog sciatic nerve gap repaired by artificial tissue nerve graft

    Institute of Scientific and Technical Information of China (English)

    GU Xiaosong; ZHANG Peiyun; WANG Xiaodong; DING Fei; PENG Luping; CHENG Hongbing

    2003-01-01

    The feasibility of repairing dog sciatic nerve damage by using a biodegradable artificial tissue nerve graft enriched with neuroregenerating factors is investigated. The artificial nerve graft was implanted to a 30 mm gap of the sciatic nerve damage in 7 dogs. The dogs with the same nerve damage that were repaired by interposition of the autologous nerve or were given no treatment served as control group 1 or 2, respectively. The observations include gross and morphological observations, immune reaction, electrophysiological examination, fluorescence tracing of the neuron formation and the number of the neurons at the experimental sites, etc. Results showed that 6 months after the implantation of the graft, the regenerated nerve repaired the damage of the sciatic nerve without occurrence of rejection and obvious inflammatory reaction in all 7 dogs, and the function of the sciatic nerve recovered with the nerve conduction velocity of (23.91±11.35)m/s. The regenerated neurons and the forming of axon could be observed under an electron microscope. This proves that artificial tissue nerve graft transplantation can bridge the damaged nerve ends and promote the nerve regeneration.

  7. Cleaning and decompression of inferior alveolar canal to treat dysesthesia and paresthesia following endodontic treatment of a third molar.

    Science.gov (United States)

    Scala, Rudy; Cucchi, Alessandro; Cappellina, Luca; Ghensi, Paolo

    2014-01-01

    Endodontic overfilling involving the mandibular canal may cause an injury of the inferior alveolar nerve (IAN). We report a case of disabling dysesthesia and paresthesia of a 70-year-old man after endodontic treatment of his mandibular left third molar that caused leakage of root canal filling material into the mandibular canal. After radiographic evaluation, extraction of the third molar and distal osteotomy, a surgical exploration was performed and followed by removal of the material and decompression of the IAN. The patient reported an improvement in sensation and immediate disappearance of dysesthesia already from the first postoperative day. PMID:25099006

  8. Cleaning and decompression of inferior alveolar canal to treat dysesthesia and paresthesia following endodontic treatment of a third molar

    Directory of Open Access Journals (Sweden)

    Rudy Scala

    2014-01-01

    Full Text Available Endodontic overfilling involving the mandibular canal may cause an injury of the inferior alveolar nerve (IAN. We report a case of disabling dysesthesia and paresthesia of a 70-year-old man after endodontic treatment of his mandibular left third molar that caused leakage of root canal filling material into the mandibular canal. After radiographic evaluation, extraction of the third molar and distal osteotomy, a surgical exploration was performed and followed by removal of the material and decompression of the IAN. The patient reported an improvement in sensation and immediate disappearance of dysesthesia already from the first postoperative day.

  9. Claudins and alveolar epithelial barrier function in the lung

    OpenAIRE

    Frank, James A.

    2012-01-01

    The alveolar epithelium of the lung constitutes a unique interface with the outside environment. This thin barrier must maintain a surface for gas transfer while being continuously exposed to potentially hazardous environmental stimuli. Small differences in alveolar epithelial barrier properties could therefore have a large impact on disease susceptibility or outcome. Moreover, recent work has focused attention on the alveolar epithelium as central to several lung diseases, including acute lu...

  10. Pulmonary Surfactant Surface Tension Influences Alveolar Capillary Shape and Oxygenation

    OpenAIRE

    Ikegami, Machiko; Weaver, Timothy E.; Grant, Shawn N.; Whitsett, Jeffrey A.

    2009-01-01

    Alveolar capillaries are located in close proximity to the alveolar epithelium and beneath the surfactant film. We hypothesized that the shape of alveolar capillaries and accompanying oxygenation are influenced by surfactant surface tension in the alveolus. To prove our hypothesis, surfactant surface tension was regulated by conditional expression of surfactant protein (SP)-B in Sftpb−/− mice, thereby inhibiting surface tension–lowering properties of surfactant in vivo within 24 hours after d...

  11. Alveolar epithelial type II cell: defender of the alveolus revisited

    OpenAIRE

    Fehrenbach Heinz

    2001-01-01

    Abstract In 1977, Mason and Williams developed the concept of the alveolar epithelial type II (AE2) cell as a defender of the alveolus. It is well known that AE2 cells synthesise, secrete, and recycle all components of the surfactant that regulates alveolar surface tension in mammalian lungs. AE2 cells influence extracellular surfactant transformation by regulating, for example, pH and [Ca2+] of the hypophase. AE2 cells play various roles in alveolar fluid balance, coagulation/fibrinolysis, a...

  12. Alveolar pressure during high-frequency jet ventilation

    OpenAIRE

    Vught, Adrianus; Versprille, Adrian; Jansen, Jos

    1990-01-01

    textabstractWe studied the influence of ventilatory frequency (1-5 Hz), tidal volume, lung volume and body position on the end-expiratory alveolar-to-tracheal pressure difference during high-frequency jet ventilation (HFJV) in Yorkshire piglets. The animals were anesthetized and paralysed. Alveolar pressure was estimated with the clamp off method, which was performed by a computer controlled ventilator and which had been extensively tested on its feasibility. The alveolar-to-tracheal pressure...

  13. Pulmonary Alveolar Proteinosis in Children: A case series

    OpenAIRE

    seyyed Ahmad Tabatabaei; abdollah karimi; Sedigheh Rafiee Tabatabaei; B Radpay; Farzaneh Jadali

    2010-01-01

    Pulmonary Alveolar Proteinosis(PAP) is a rare disease of unknown etiology, characterized by the accumulation of proteinoceous material in the alveoli that is rich in lipid and is positive on periodic acid-Schiff(PAS) stain. PAP is rare in children. Two forms are encountered in pediatric practice: congenital alveolar proteinosis (CAP) and a later–onset form that is generally less severe. Broncho-alveolar lavage is the key to diagnosis. Therapeutic lung lavages are the only effective treatment ...

  14. 针刺复合星状神经节阻滞治疗外伤性上肢截肢术后幻肢痛效果观察%The effect of combination therapy of nerve block and acupuncture for phantom limb pain by amputation of upper extremity after surgery

    Institute of Scientific and Technical Information of China (English)

    龚琴; 刘莱莉; 罗富荣; 廖荣宗; 高俊青; 陈浩宇

    2014-01-01

    Objective To investigate the effect of combination therapy of nerve block and acupuncture to phantom limb pain of upper extremity after amputation.Methods Eighty patients with phantom limb pain of upper limb were randomly divided into four groups (n=20):20 patients received basic treatment (A group),which included Medications and Psychotherapy,20 patients recieved acupuncture and basic treatment (B group),20 patients recieved nerve block and basic treatment (C group),20 patients recieved nerve block,acupuncture and basic treatment (D group).Scores of VAS,SR-36 and comprehensive comparison of efficacy were used to assess before and after treatment among the four groups.Results visual analogue scales (VAS) scores and SF-36 scores of four groups of patients were significant differences after treatment compared with before treatment (P<0.05).VAS scores decreased after treatment,while SF-36 scores were significantly increased.When compared with A group (52±6),VAS scores of B group (42±8),C group (42±8) and D group (32±6) after treatment decreased significantly,and the differences were statistically significant(P<0.05).Compared with A group(Mental:58±9,Physical:36±5),SF-36 scores of B group(Mental:67±9,Physical:43± 4),C group(Mental:66±6,Physical:43±5) and D group(Mental:77±10,Physical:50±6) after treatment increased significantly,and the differences were statistically significant (P<0.05).When compared with B group and C group,VAS scores of D group decreased significantly after treatment,and SF-36 scores were significantly increased(P<0.05).Comprehensive comparison of efficacy of four groups of patients:After treatment for 5 weeks,compared with A group (70%),there was significant difference in comprehensive comparison of efficacy of B group(85%),C group(85%) and D group(100%) (P<0.05).The results suggest that the treatment effect of B group,C group and D group is better than A group,the treatment effect of D group is best among four groups

  15. 经喉罩七氟醚吸入麻醉联合神经阻滞在小儿腹股沟疝手术中的应用%Application of combined nerves block-sevoflurane used inhalation anesthesia with laryngeal mask ventilation on the stress response in patients suffering from pedo-inguinal hernia operation

    Institute of Scientific and Technical Information of China (English)

    娄锋

    2011-01-01

    Objective To investigate the influence of combined nerves block-sevnflurane used inhalation anesthesia with laryngeal mask ventilation on the stress response to pedo-inguinal hernia operation,and the effects of analgesia after operation. Methods Ninety patients aged 1-8 years and scheduled for inguinal hernia operation were randomly divided into 3 groups, group A under combined nerves block-sevoflurane, group B sevoflurane used inhalation anesthesia,and group C used ketamine.To observe HR,BP,SpO2, PETCO2 of the 3 groups before anesthesia induction(T1),at consciousness lost(T2), operation beginning (T3), deligating hernial sac(T4), sewing skin after operation(T5).To observe induction time, analepsia time,and ex-oecium time of the 3 groups,and to compare adverse effects of the 3 groups,such as introducing compliance, hyperkinesis laryngis and etc. Results Group C's HR,BP were higher than that in group A and group B at T3, T4, T5(P<0.05), The induction time, analepsia time,and ex-oecium time in group A and group B were shorter than that in group C(P<0.05). The induction cooperation and body moving at operation in group A and group B were better than that in group C(P<0.05). Restlessness at analepsia time and effects of analgesia after operation in group A were better than that in group B(P<0.05). Conclusions Combined nerves block-sevnflurane possesses anesthesia induction, fast analepsia, vital signs stable, few adverse effects and good effects of analgesia after operation, especialy used in pedo-inguinal hernia operation.%目的 研究七氟醚联合神经阻滞在小儿斜疝手术中的麻醉及术后镇痛效果.方法 选择90例年龄1~8岁择期行斜疝手术的患儿,随机分为三组,七氟醚复合神经阻滞组(A组),七氟醚吸入组(B组)和氯胺酮组(C组).观察三组患儿麻醉诱导前(T1)、意识消失时(T2)、手术开始时(T3)、结扎疝囊时(T4)、手术结束缝皮时(T5)的心率(HR)、血压(BP)

  16. Neuromuscular ultrasound of cranial nerves.

    Science.gov (United States)

    Tawfik, Eman A; Walker, Francis O; Cartwright, Michael S

    2015-04-01

    Ultrasound of cranial nerves is a novel subdomain of neuromuscular ultrasound (NMUS) which may provide additional value in the assessment of cranial nerves in different neuromuscular disorders. Whilst NMUS of peripheral nerves has been studied, NMUS of cranial nerves is considered in its initial stage of research, thus, there is a need to summarize the research results achieved to date. Detailed scanning protocols, which assist in mastery of the techniques, are briefly mentioned in the few reference textbooks available in the field. This review article focuses on ultrasound scanning techniques of the 4 accessible cranial nerves: optic, facial, vagus and spinal accessory nerves. The relevant literatures and potential future applications are discussed.

  17. Isolation and Culture of Human Alveolar Type II Pneumocytes.

    Science.gov (United States)

    Witherden, I R; Tetley, T D

    2001-01-01

    Alveolar type II pneumocytes (alveolar type II cells; TII cells) play an important role in the homeostasis of the alveolar unit. They are the progenitor cells to the type I pneumocyte and are therefore responsible for regeneration of alveolar epithelium following alveolar epithelial cell damage. The type I cell covers over 90% of the alveolar surface, reflecting its capacity to stretch into a flattened cell with very little depth (approx. 0.1 µm), but with a large surface area, to facilitate gas exchange. Nevertheless, the type II cell outnumbers type I cells, estimated to be by 2:1 in rodents. Most of the type II cell lies buried in the interstitium of the alveolus, with only the apical tip of the cell reaching into the airspace, through which another crucial function, provision of alveolar surfactant, occurs. Surfactant synthesis and secretion is a unique feature of type II cells; surfactant consists of a high proportion of phospholipids (approx. 90%) and a small proportion of protein (approx. 10%), which contains surfactant apoprotein (SP), of which four have so far been described, SP-A, SP-B, SP-C, and SP-D (1,2). Surfactant is highly surface active and is essential to prevent alveolar collapse. In addition, surfactant has many other roles, including pulmonary host defense. Compromised surfactant synthesis and function are believed to be a feature of numerous disease states (1,2), including infant respiratory distress syndrome, adult respiratory distress syndrome, alveolar proteinosis, and microbial infection. PMID:21336897

  18. Computed tomography of the alveolar bone; Computertomographie des Alveolarkammes

    Energy Technology Data Exchange (ETDEWEB)

    Schueller, H. [Bonn Univ. (Germany). Radiologische Klinik

    1996-03-01

    In addition to the conventional radiological methods used in odontology, computed tomography (CT) provides superposition-free images of the mandible and maxilla. Its value has been proved not only in cases of malignancy but also in many other problems. If an examination is performed with a slice thickness of less than 1.5 mm, the form and position of retained teeth in the alveolar bone, as well as subsequent lesions of neighboring permanent teeth, can be visualized so that early treatment can be planned. If the parodontal space of a retained tooth is visible, orthodontic intervention is possible. Precise assessment of horizontal or vertical bone loss is essential in inflammatory dental diseases. The morphology and extent of benign cystic lesions are also shown by CT. With CT surgical strategy of an intended implant therapy can take into account the remaining bone substance and the exact position of nerves and foramina. If such therapy is possible, the location, form and number of implants are easily defined. (orig.) [Deutsch] Die Computertomographie ermoeglicht in Ergaenzung zu den in der Zahnheilkunde gebraeuchlichen radiologischen Untersuchungsverfahren eine ueberlagerungsfreie Darstellung von Ober- und Unterkiefer. Neben der bereits etablierten Anwendung der CT bei malignen Erkrankungen hat sich ihr Einsatz bei weiteren Fragestellungen bewaehrt. Wird die Untersuchung mit einer Schichtdicke von weniger als 1,5 mm durchgefuehrt, lassen sich Form und Lage retinierter Zaehne im Kieferknochen und die durch die retinierten Zaehne verursachten Schaeden an bleibenden Zaehnen beurteilen, so dass eine fruehzeitige Therapie moeglich ist. Laesst sich der Parodontalspalt des retinierten Zahnes abgrenzen, ist eine kieferorthopaedische Einordnung moeglich. Bei entzuendlichen Zahnerkrankungen ist der horizontale und vertikale Knochenabbau genau zu bestimmen. Die Morphologie und Ausdehnung von benignen zystischen Raumforderungen ist mit der CT erfassbar. Vor einer beabsichtigten

  19. Regional anesthesia in transurethral resection of prostate (TURP) surgery: A comparative study between saddle block and subarachnoid block

    OpenAIRE

    Susmita Bhattacharyya; Subrata Bisai; Hirak Biswas; Mandeep Kumar Tiwary; Suchismita Mallik; Swarna Mukul Saha

    2015-01-01

    Background: Spinal anesthesia is the technique of choice in transurethral resection of prostate (TURP). The major complication of spinal technique is risk of hypotension. Saddle block paralyzed pelvic muscles and sacral nerve roots and hemodynamic derangement is less. Aims and objectives: To compare the hemodynamic changes and adequate surgical condition between saddle block and subarachnoid block for TURP. Material and methods: Ninety patients of aged between 50 to 70 years of ASA-PS I, II s...

  20. Role of dexamethasone in brachial plexus block

    International Nuclear Information System (INIS)

    To evaluate the effect of dexamethasone added to (lignocaine) on the onset and duration of axillary brachial plexus block. Study Design: Randomized controlled trial. Place and Duration of Study: Combined Military Hospital Rawalpindi, from September 2009 to March 2010. Patients and Methods: A total of 100 patients, who were scheduled for elective hand and forearm surgery under axillary brachial plexus block, were randomly allocated to group A in which patients received 40 ml 1.5% lidocaine with 2 ml of isotonic saline (0.9%) and group B in which patients received 40 ml 1.5% lidocaine with 2 ml of dexamethasone (8 mg). Nerve stimulator with insulated needle for multiple stimulations technique was used to locate the brachial plexus nerves. After the injection onset of action and duration of sensory blockade of brachial plexus were recorded at 5 minutes and 15 minutes interval. Results: Group A showed the onset of action of 21.64 ± 2.30 min and in group B it was 15.42 ± 1.44 min (p< 0.001). Duration of nerve block was 115.08 ± 10.92 min in group A and 265.42 ± 16.56 min in group B (p < 0.001). Conclusion: The addition of dexamethasone to 1.5% lignocaine solution in axillary brachial plexus block prolongs the duration of sensory blockade significantly. (author)

  1. Characteristic aspects of alveolar proteinosis diagnosis Aspectos característicos do diagnóstico da proteinose alveolar

    OpenAIRE

    Thiago Prudente Bártholo; José Gustavo Pugliese; Luiz Carlos Aguiar Vaz; Cláudia Henrique da Costa; Rogério Rufino

    2012-01-01

    Alveolar proteinosis is an uncommon pulmonary disease characterized by an accumulation of surfactant in terminal airway and alveoli, thereby impairing gas exchange and engendering respiratory insufficiency in some cases. Three clinically and etiologically distinct forms of pulmonary alveolar proteinosis are recognized: congenital, secondary and idiopathic, the latter corresponding to 90% of the cases. In this case report we present a young male patient that was diagnosed with alveolar protein...

  2. A comparison of ultrasound-guided supraclavicular and infraclavicular blocks for upper extremity surgery

    DEFF Research Database (Denmark)

    Koscielniak-Nielsen, Z J; Frederiksen, B S; Rasmussen, H;

    2009-01-01

    -guided supraclavicular or infraclavicular blocks. We hypothesized that the supraclavicular approach, being more superficial and easier to visualize using a 10 MHz transducer, will produce a faster and a more extensive sensory block. METHODS: One hundred and twenty patients were randomized to two equal groups......BACKGROUND: Ultrasound (US)-guided supraclavicular or infraclavicular blocks are commonly used for upper extremity surgery. The aims of this randomized study were to compare the block performance and onset times, effectiveness, incidence of adverse events and patient's acceptance of US......) of the seven terminal nerves was assessed every 10 min. Patients were declared ready for surgery when they had an effective surgical block--anaesthesia or analgesia of the five nerves below the elbow. Thirty minutes after the block, the unblocked nerves were supplemented. The block performance and...

  3. Evidence of peripheral nerve blocks for cancer-related pain

    DEFF Research Database (Denmark)

    Klepstad, P; Kurita, G P; Mercadante, S;

    2015-01-01

    The European Association for Palliative Care has initiated a comprehensive program to achieve an over-all review of the evidence of multiple cancer pain management strategies in order to extend the current guideline for treatment of cancer pain. The present systematic review analyzed the existing...

  4. Propofol’s effect on the sciatic nerve Harmful or protective?

    Institute of Scientific and Technical Information of China (English)

    Yi Sun; Xizhe Zhang; Qi Zhou; Yong’an Wang; Yiwen Jiang; Jian Cao

    2013-01-01

    Propofol can inhibit the inflammatory response and reduce the secretion and harmful effects of as-trocyte-derived proinflammatory cytokines. In this study, after propofol was injected into the injured sciatic nerve of mice, nuclear factor kappa B expression in the L 4-6 segments of the spinal cord in the injured side was reduced, apoptosis was decreased, nerve myelin defects were al eviated, and the nerve conduction block was lessened. The experimental findings indicate that propofol inhibits the inflammatory and immune responses, decreases the expression of nuclear factor kappa B, and reduces apoptosis. These effects of propofol promote regeneration fol owing sciatic nerve injury.

  5. Tumors of the optic nerve

    DEFF Research Database (Denmark)

    Lindegaard, Jens; Heegaard, Steffen

    2009-01-01

    A variety of lesions may involve the optic nerve. Mainly, these lesions are inflammatory or vascular lesions that rarely necessitate surgery but may induce significant visual morbidity. Orbital tumors may induce proptosis, visual loss, relative afferent pupillary defect, disc edema and optic...... atrophy, but less than one-tenth of these tumors are confined to the optic nerve or its sheaths. No signs or symptoms are pathognomonic for tumors of the optic nerve. The tumors of the optic nerve may originate from the optic nerve itself (primary tumors) as a proliferation of cells normally present...... in the nerve (e.g., astrocytes and meningothelial cells). The optic nerve may also be invaded from tumors originating elsewhere (secondary tumors), invading the nerve from adjacent structures (e.g., choroidal melanoma and retinoblastoma) or from distant sites (e.g., lymphocytic infiltration and distant...

  6. Segment distraction to reduce a wide alveolar cleft before alveolar bone grafting.

    NARCIS (Netherlands)

    Binger, T.; Katsaros, C.; Rucker, M.; Spitzer, W.J.

    2003-01-01

    OBJECTIVE: To demonstrate a method for reduction of wide alveolar clefts prior to bone grafting. This method aims to facilitate bone grafting and achieve adequate soft tissue coverage of the graft with attached gingiva. CASE REPORT: Treatment of a patient with bilateral cleft lip and palate with a s

  7. Nostril Base Augmentation Effect of Alveolar Bone Graft

    Directory of Open Access Journals (Sweden)

    Woojin Lee

    2013-09-01

    Full Text Available Background The aims of alveolar bone grafting are closure of the fistula, stabilization ofthe maxillary arch, support for the roots of the teeth adjacent to the cleft on each side.We observed nostril base augmentation in patients with alveolar clefts after alveolar bonegrafting. The purpose of this study was to evaluate the nostril base augmentation effect ofsecondary alveolar bone grafting in patients with unilateral alveolar cleft.Methods Records of 15 children with alveolar clefts who underwent secondary alveolar bonegrafting with autogenous iliac cancellous bone between March of 2011 and May of 2012 werereviewed. Preoperative and postoperative worm’s-eye view photographs and reconstructedthree-dimensional computed tomography (CT scans were used for photogrammetry. Thedepression of the nostril base and thickness of the philtrum on the cleft side were measuredin comparison to the normal side. The depression of the cleft side pyriform aperture wasmeasured in comparison to the normal side on reconstructed three-dimensional CT.Results Significant changes were seen in the nostril base (P=0.005, the philtrum length(P=0.013, and the angle (P=0.006. The CT measurements showed significant changes in thepyriform aperture (P<0.001 and the angle (P<0.001.Conclusions An alveolar bone graft not only fills the gap in the alveolar process but alsoaugments the nostril base after surgery. In this study, only an alveolar bone graft was performedto prevent bias from other procedures. Nostril base augmentation can be achieved byperforming alveolar bone grafts in children, in whom invasive methods are not advised.

  8. An estimation of mechanical stress on alveolar walls during repetitive alveolar reopening and closure.

    Science.gov (United States)

    Chen, Zheng-Long; Song, Yuan-Lin; Hu, Zhao-Yan; Zhang, Su; Chen, Ya-Zhu

    2015-08-01

    Alveolar overdistension and mechanical stresses generated by repetitive opening and closing of small airways and alveoli have been widely recognized as two primary mechanistic factors that may contribute to the development of ventilator-induced lung injury. A long-duration exposure of alveolar epithelial cells to even small, shear stresses could lead to the changes in cytoskeleton and the production of inflammatory mediators. In this paper, we have made an attempt to estimate in situ the magnitudes of mechanical stresses exerted on the alveolar walls during repetitive alveolar reopening by using a tape-peeling model of McEwan and Taylor (35). To this end, we first speculate the possible ranges of capillary number (Ca) ≡ μU/γ (a dimensionless combination of surface tension γ, fluid viscosity μ, and alveolar opening velocity U) during in vivo alveolar opening. Subsequent calculations show that increasing respiratory rate or inflation rate serves to increase the values of mechanical stresses. For a normal lung, the predicted maximum shear stresses are surface tension or viscosity, the maximum shear stress will notably increase, even at a slow respiratory rate. Similarly, the increased pressure gradients in the case of elevated surface or viscosity may lead to a pressure drop >300 dyn/cm(2) across a cell, possibly inducing epithelial hydraulic cracks. In addition, we have conceived of a geometrical model of alveolar opening to make a prediction of the positive end-expiratory pressure (PEEP) required to splint open a collapsed alveolus, which as shown by our results, covers a wide range of pressures, from several centimeters to dozens of centimeters of water, strongly depending on the underlying pulmonary conditions. The establishment of adequate regional ventilation-to-perfusion ratios may prevent recruited alveoli from reabsorption atelectasis and accordingly, reduce the required levels of PEEP. The present study and several recent animal experiments likewise

  9. Ganglion block. When and how?

    International Nuclear Information System (INIS)

    Increasing understanding of the anatomy and physiology of neural structures has led to the development of surgical and percutaneous neurodestructive methods in order to target and destroy various components of afferent nociceptive pathways. The dorsal root ganglia and in particular the ganglia of the autonomous nervous system are targets for radiological interventions. The autonomous nervous system is responsible for the regulation of organ functions, sweating, visceral and blood vessel-associated pain. Ganglia of the sympathetic chain and non-myelinized autonomous nerves can be irreversibly destroyed by chemical and thermal ablation. Computed tomography (CT)-guided sympathetic nerve blocks are well established interventional radiological procedures which lead to vasodilatation, reduction of sweating and reduction of pain associated with the autonomous nervous system. Sympathetic blocks are applied for the treatment of various vascular diseases including critical limb ischemia. Other indications for thoracic and lumbar sympathectomy include complex regional pain syndrome (CRPS), chronic tumor associated pain and hyperhidrosis. Neurolysis of the celiac plexus is an effective palliative pain treatment particularly in patients suffering from pancreatic cancer. Percutaneous dorsal root ganglion rhizotomy can be performed in selected patients with radicular pain that is resistant to conventional pharmacological and interventional treatment. (orig.)

  10. Optic nerve oxygen tension

    DEFF Research Database (Denmark)

    Kiilgaard, Jens Folke; Pedersen, D B; Eysteinsson, T;

    2004-01-01

    The authors have previously reported that carbonic anhydrase inhibitors such as acetazolamide and dorzolamide raise optic nerve oxygen tension (ONPO(2)) in pigs. The purpose of the present study was to investigate whether timolol, which belongs to another group of glaucoma drugs called beta...

  11. Progress of peripheral nerve repair

    Institute of Scientific and Technical Information of China (English)

    陈峥嵘

    2002-01-01

    Study on repair of peripheral nerve injury has been proceeding over a long period of time. With the use of microsurgery technique since 1960s,the quality of nerve repair has been greatly improved. In the past 40 years, with the continuous increase of surgical repair methods, more progress has been made on the basic research of peripheral nerve repair.

  12. The level of the sciatic nerve division and its relations to the piriform muscle

    Directory of Open Access Journals (Sweden)

    Ugrenović Slađana Z.

    2005-01-01

    Full Text Available Background. The sciatic nerve, as the terminal branch of the sacral plexus, leaves the pelvis through the greater sciatic foramen beneath the piriform muscle. Afterwards, it separates into the tibial and the common peroneal nerve, most frequently at the level of the upper angle of the popliteal fossa. Higher level of the sciatic nerve division is a relatively frequent phenomenom and it may be the cause of an incomplete block of the sciatic nerve during the popliteal block anesthesia. There is a possibility of different anatomic relations between the sciatic nerve or its terminal branches and the piriform muscle (piriformis syndrome. The aim of this research was to investigate the level of the sciatic nerve division and its relations to the piriform muscle. It was performed on 100 human fetuses (200 lower extremities which were in various gestational periods and of various sex, using microdissection method. Characteristic cases were photographed. Results. Sciatic nerve separated into the tibial and common peroneal nerve in popliteal fossa in 72.5% of the cases (bilaterally in the 66% of the cases. In the remainder of the cases the sciatic nerve division was high (27.5% of the cases in the posteror femoral or in the gluteal region. Sciatic nerve left the pelvis through the infrapiriform foramen in 192 lower extremities (96% of the cases, while in 8 lower extremities (4% of the cases the variable relations between sciatic nerve and piriform muscle were detected. The common peroneal nerve penetrated the piriform muscle and left the pelvis in 5 lower extremities (2.5% of the cases and the tibial nerve in those cases left the pelvis through the infrapiriform foramen. In 3 lower extremities (1.5% of the cases common peroneal nerve left the pelvis through suprapiriform, and the tibial nerve through the infrapiriform foramen. The high terminal division of sciatic nerve (detected in 1/3 of the cases, must be kept in mind during the performing of popliteal

  13. Multispectral photoacoustic imaging of nerves with a clinical ultrasound system

    Science.gov (United States)

    Mari, Jean Martial; West, Simeon; Beard, Paul C.; Desjardins, Adrien E.

    2014-03-01

    Accurate and efficient identification of nerves is of great importance during many ultrasound-guided clinical procedures, including nerve blocks and prostate biopsies. It can be challenging to visualise nerves with conventional ultrasound imaging, however. One of the challenges is that nerves can have very similar appearances to nearby structures such as tendons. Several recent studies have highlighted the potential of near-infrared optical spectroscopy for differentiating nerves and adjacent tissues, as this modality can be sensitive to optical absorption of lipids that are present in intra- and extra-neural adipose tissue and in the myelin sheaths. These studies were limited to point measurements, however. In this pilot study, a custom photoacoustic system with a clinical ultrasound imaging probe was used to acquire multi-spectral photoacoustic images of nerves and tendons from swine ex vivo, across the wavelength range of 1100 to 1300 nm. Photoacoustic images were processed and overlaid in colour onto co-registered conventional ultrasound images that were acquired with the same imaging probe. A pronounced optical absorption peak centred at 1210 nm was observed in the photoacoustic signals obtained from nerves, and it was absent in those obtained from tendons. This absorption peak, which is consistent with the presence of lipids, provides a novel image contrast mechanism to significantly enhance the visualization of nerves. In particular, image contrast for nerves was up to 5.5 times greater with photoacoustic imaging (0.82 +/- 0.15) than with conventional ultrasound imaging (0.148 +/- 0.002), with a maximum contrast of 0.95 +/- 0.02 obtained in photoacoustic mode. This pilot study demonstrates the potential of photoacoustic imaging to improve clinical outcomes in ultrasound-guided interventions in regional anaesthesia and interventional oncology.

  14. Perawatan Pulpa Gigi Sulung Disertai Abses Dento Alveolar

    OpenAIRE

    Nasution, Nurasiah Adita

    2008-01-01

    Abses dento alveolar adalah kumputan pus yang berada pada tulang alveolar sekitar apeks gigi akibat kematian pulpa. Matinya pulpa dapat disebabkan bakteri, trauma, iritasi mekanis, termis maupun kimiawi. Pengaruh bakteri merupakan penyebab kerusakan jaringan pulpa yang terbesar. Perluasan infeksi ke dalam jaringan periapikal dapat melalui foramen apikalke jaringan periodontal sehingga terjadi inflarnasi. Bila virulensi bakteri meningkat disertai rendahnya pertahanan tubuh penderita dapat ...

  15. Alveolar pressure during high-frequency jet ventilation

    NARCIS (Netherlands)

    A.J. van Vught (Adrianus); A. Versprille (Adrian); J.R.C. Jansen (Jos)

    1990-01-01

    textabstractWe studied the influence of ventilatory frequency (1-5 Hz), tidal volume, lung volume and body position on the end-expiratory alveolar-to-tracheal pressure difference during high-frequency jet ventilation (HFJV) in Yorkshire piglets. The animals were anesthetized and paralysed. Alveolar

  16. Post-neonatal drop in alveolar SP-A expression

    DEFF Research Database (Denmark)

    Stray-Pedersen, Arne; Vege, Ashild; Stray-Pedersen, Asbjorg;

    2008-01-01

    was developed enabling semi-quantitative estimation of staining intensity and distribution. RESULTS: SP-A was detected in the terminal bronchioles and alveolar spaces of fetuses >35 weeks gestation. The intra-alveolar SP-A expression increased in the perinatal period followed by a marked drop in infants aged...

  17. Anaesthetic management of bilateral alveolar proteinosis for bronchopulmonary lavage.

    OpenAIRE

    Dixit R; Chaudhari L; Mahashur A

    1998-01-01

    The most hazardous manifestation of pulmonary alveolar proteinosis is progressive hypoxia for which bronchopulmonary lavage (BPL) is the single most effective treatment. Unfortunately this procedure under general anesthesia itself increases the risk of hypoxia due to the need for one lung ventilation. It was therefore considered interesting to report the successful anaesthetic management of a patient with pulmonary alveolar proteinosis for Bronchopulmonary lavage.

  18. Tongue-Palate Contact of Perceptually Acceptable Alveolar Stops

    Science.gov (United States)

    Lee, Alice; Gibbon, Fiona E.; O'Donovan, Cliona

    2013-01-01

    Increased tongue-palate contact for perceptually acceptable alveolar stops has been observed in children with speech sound disorders (SSD). This is a retrospective study that further investigated this issue by using quantitative measures to compare the target alveolar stops /t/, /d/ and /n/ produced in words by nine children with SSD (20 tokens of…

  19. Coronectomy of mandibular third molars: A clinical protocol to avoid inferior alveolar nerve injury.

    Science.gov (United States)

    Monaco, Giuseppe; Vignudelli, Elisabetta; Diazzi, Michele; Marchetti, Claudio; Corinaldesi, Giuseppe

    2015-10-01

    Coronectomy is a surgical procedure for the treatment of mandibular third molars in close proximity to the mandibular canal. Unfortunately, often the surgical protocol is not described step by step and it is difficult for the clinician to assess the key factors that are important for the success of this procedure. The aim of this paper is to propose and describe a standardized surgical protocol to improve the success of the technique. The treatment approach, for the most common types of third molars impaction is analysed. Each step of the surgical procedure is described in details and a new type of crown section is proposed. The presented protocol is proposed in order to define a clinical practitioner's guide that could help the surgeon who approaches coronectomy for the first times. PMID:26321069

  20. Pulmonary alveolar proteinosis: diagnostic and therapeutic challenges

    Directory of Open Access Journals (Sweden)

    Campo Ilaria

    2012-06-01

    Full Text Available Abstract Pulmonary Alveolar Proteinosis (PAP is a rare syndrome characterized by pulmonary surfactant accumulation within the alveolar spaces. It occurs with a reported prevalence of 0.1 per 100,000 individuals and in distinct clinical forms: autoimmune (previously referred to as the idiopathic form, represents the vast majority of PAP cases, and is associated with Granulocyte-Macrophage Colony Stimulating Factor (GM-CSF auto-antibodies; GMAbs, secondary (is a consequence of underlying disorders, congenital (caused by mutations in the genes encoding for the GM-CSF receptor, and PAP-like syndromes (disorders associated with surfactant gene mutations. The clinical course of PAP is variable, ranging from spontaneous remission to respiratory failure. Whole lung lavage (WLL is the current standard treatment for PAP patients and although it is effective in the majority of cases, disease persistence is not an unusual outcome, even if disease is well controlled by WLL. In this paper we review the therapeutic strategies which have been proposed for the treatment of PAP patients and the progress which has been made in the understanding of the disease pathogenesis.