WorldWideScience

Sample records for autonomic nerve block

  1. 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.

  2. Cardiac autonomic nerve distribution and arrhythmia

    Institute of Scientific and Technical Information of China (English)

    Quan Liu; Dongmei Chen; Yonggang Wang; Xin Zhao; Yang Zheng

    2012-01-01

    OBJECTIVE: To analyze the distribution characteristics of cardiac autonomic nerves and to explore the correlation between cardiac autonomic nerve distribution and arrhythmia.DATA RETRIEVAL: A computer-based retrieval was performed for papers examining the distribution of cardiac autonomic nerves, using "heart, autonomic nerve, sympathetic nerve, vagus nerve, nerve distribution, rhythm and atrial fibrillation" as the key words.SELECTION CRITERIA: A total of 165 studies examining the distribution of cardiac autonomic nerve were screened, and 46 of them were eventually included.MAIN OUTCOME MEASURES: The distribution and characteristics of cardiac autonomic nerves were observed, and immunohistochemical staining was applied to determine the levels of tyrosine hydroxylase and acetylcholine transferase (main markers of cardiac autonomic nerve distribution). In addition, the correlation between cardiac autonomic nerve distribution and cardiac arrhythmia was investigated.RESULTS: Cardiac autonomic nerves were reported to exhibit a disordered distribution in different sites, mainly at the surface of the cardiac atrium and pulmonary vein, forming a ganglia plexus. The distribution of the pulmonary vein autonomic nerve was prominent at the proximal end rather than the distal end, at the upper left rather than the lower right, at the epicardial membrane rather than the endocardial membrane, at the left atrium rather than the right atrium, and at the posterior wall rather than the anterior wall. The main markers used for cardiac autonomic nerves were tyrosine hydroxylase and acetylcholine transferase. Protein gene product 9.5 was used to label the immunoreactive nerve distribution, and the distribution density of autonomic nerves was determined using a computer-aided morphometric analysis system.CONCLUSION: The uneven distribution of the cardiac autonomic nerves is the leading cause of the occurrence of arrhythmia, and the cardiac autonomic nerves play an important role in the

  3. [Influence of beta block and autonomic nerve block on the recovery time of the sinus node in sick sinus syndrome and carotid sinus syndrome].

    Science.gov (United States)

    Brignole, M; Sartore, B; Barra, M; Menozzi, C; Monducci, I; Bertulla, A

    1984-10-01

    In order to evaluate the relative role of the automatic nervus system and of the intrinsic electrophysiologic properties on the sinus node function, we measured the corrected sinus node recovery time before and after autonomic nervous system blockade in 24 patients. Fourteen had a sick sinus syndrome, five had a carotid sinus syncope, two had syncope of unknown origin associated with bradycardia. Beta blockade was obtained by infusing metoprolol intravenously at a dosage of 0.2 mg/kg; complete automatic blockade was achieved by further i.v. administration of atropine at a dosage of 0.04 mg/kg. After beta blockade, the corrected sinus node recovery time increased in patients with sick sinus syndrome and intrinsic slow heart rate, whereas it decreased in patients with carotid sinus syncope or with syncope and bradycardia. In patients with sick sinus syndrome and normal intrinsic heart rate the response was variable. A positive direct correlation was found between the changes of the corrected sinus node recovery time induced by beta blockade and those induced by autonomic blockade; that is, both either prolonged or shortened the corrected sinus node recovery time. The changes of the corrected sinus node recovery time after beta blockade alone were inversely correlated with the intrinsic heart rate. We conclude that patients with intrinsic depression of the sinus node have an increased sympathetic tone.

  4. Morphologic Changes in Autonomic Nerves in Diabetic Autonomic Neuropathy

    Directory of Open Access Journals (Sweden)

    Heung Yong Jin

    2015-12-01

    Full Text Available Diabetic neuropathy is one of the major complications of diabetes, and it increases morbidity and mortality in patients with both type 1 diabetes mellitus (T1DM and type 2 diabetes mellitus (T2DM. Because the autonomic nervous system, for example, parasympathetic axons, has a diffuse and wide distribution, we do not know the morphological changes that occur in autonomic neural control and their exact mechanisms in diabetic patients with diabetic autonomic neuropathy (DAN. Although the prevalence of sympathetic and parasympathetic neuropathy is similar in T1DM versus T2DM patients, sympathetic nerve function correlates with parasympathetic neuropathy only in T1DM patients. The explanation for these discrepancies might be that parasympathetic nerve function was more severely affected among T2DM patients. As parasympathetic nerve damage seems to be more advanced than sympathetic nerve damage, it might be that parasympathetic neuropathy precedes sympathetic neuropathy in T2DM, which was Ewing's concept. This could be explained by the intrinsic morphologic difference. Therefore, the morphological changes in the sympathetic and parasympathetic nerves of involved organs in T1DM and T2DM patients who have DAN should be evaluated. In this review, evaluation methods for morphological changes in the epidermal nerves of skin, and the intrinsic nerves of the stomach will be discussed.

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

    Science.gov (United States)

    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.

  6. Nerve injury caused by mandibular block analgesia

    DEFF Research Database (Denmark)

    Hillerup, S; Jensen, Rigmor H

    2006-01-01

    Fifty-four injection injuries in 52 patients were caused by mandibular block analgesia affecting the lingual nerve (n=42) and/or the inferior alveolar nerve (n=12). All patients were examined with a standardized test of neurosensory functions. The perception of the following stimuli was assessed......: 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...

  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. 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).

  9. Cardiac Autonomic Nerve Stimulation in the Treatment of Heart Failure

    OpenAIRE

    Kobayashi, Mariko; Massiello, Alex; Karimov, Jamshid H.; Van Wagoner, David R.; Fukamachi, Kiyotaka

    2013-01-01

    Research on the therapeutic modulation of cardiac autonomic tone by electrical stimulation has yielded encouraging early clinical results. Vagus nerve stimulation has reduced the rates of morbidity and sudden death from heart failure, but therapeutic vagus nerve stimulation is limited by side effects of hypotension and bradycardia. Sympathetic nerve stimulation that has been implemented in the experiment may exacerbate the sympathetic-dominated autonomic imbalance. In contrast, concurrent sti...

  10. Pudendal nerve block for vaginal birth.

    Science.gov (United States)

    Anderson, Deborah

    2014-01-01

    Pudendal nerve block is a safe and effective pain relief method for vaginal birth. Providing analgesia to the vulva and anus, it is used for operative vaginal birth and subsequent repair, late second stage pain relief with spontaneous vaginal birth, repair of complex lacerations, or repair of lacerations in women who are unable to achieve adequate or satisfactory pain relief during perineal repair with local anesthesia. Key to its efficacy is the knowledge of pudendal nerve anatomy, the optimal point of infiltration of local anesthetic, and an understanding of the amount of time necessary to effect adequate analgesia.

  11. Combined KHFAC + DC nerve block without onset or reduced nerve conductivity after block

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    Franke, Manfred; Vrabec, Tina; Wainright, Jesse; Bhadra, Niloy; Bhadra, Narendra; Kilgore, Kevin

    2014-10-01

    Objective. Kilohertz frequency alternating current (KHFAC) waveforms have been shown to provide peripheral nerve conductivity block in many acute and chronic animal models. KHFAC nerve block could be used to address multiple disorders caused by neural over-activity, including blocking pain and spasticity. However, one drawback of KHFAC block is a transient activation of nerve fibers during the initiation of the nerve block, called the onset response. The objective of this study is to evaluate the feasibility of using charge balanced direct current (CBDC) waveforms to temporarily block motor nerve conductivity distally to the KHFAC electrodes to mitigate the block onset-response. Approach. A total of eight animals were used in this study. A set of four animals were used to assess feasibility and reproducibility of a combined KHFAC + CBDC block. A following randomized study, conducted on a second set of four animals, compared the onset response resulting from KHFAC alone and combined KHFAC + CBDC waveforms. To quantify the onset, peak forces and the force-time integral were measured during KHFAC block initiation. Nerve conductivity was monitored throughout the study by comparing muscle twitch forces evoked by supra-maximal stimulation proximal and distal to the block electrodes. Each animal of the randomized study received at least 300 s (range: 318-1563 s) of cumulative dc to investigate the impact of combined KHFAC + CBDC on nerve viability. Main results. The peak onset force was reduced significantly from 20.73 N (range: 18.6-26.5 N) with KHFAC alone to 0.45 N (range: 0.2-0.7 N) with the combined CBDC and KHFAC block waveform (p < 0.001). The area under the force curve was reduced from 6.8 Ns (range: 3.5-21.9 Ns) to 0.54 Ns (range: 0.18-0.86 Ns) (p < 0.01). No change in nerve conductivity was observed after application of the combined KHFAC + CBDC block relative to KHFAC waveforms. Significance. The distal application of CBDC can significantly reduce or even

  12. Autonomic and sensory nerve dysfunction in primary biliary cirrhosis

    Institute of Scientific and Technical Information of China (English)

    Katalin Keresztes; Ildikó Istenes; Aniko Folhoffer; Peter L Lakatos; Andrea Horvath; Timea Csak; Peter Varga; Peter Kempler; Ferenc Szalay

    2004-01-01

    AIM: Cardiovascular autonomic and peripheral sensory neuropathy is a known complication of chronic alcoholic and non-alcoholic liver diseases. We aimed to assess the prevalence and risk factors for peripheral sensory nerve and autonomic dysfunction using sensitive methods in patients with primary biliary cirrhosis (PBC).METHODS: Twenty-four AMA M2 positive female patients with clinical, biochemical and histological evidence of PBC and 20 age matched healthy female subjects were studied.Five standard cardiovascular reflex tests and 24-h heart rate variability (HRV) analysis were performed to define autonomic function. Peripheral sensory nerve function on median and peroneal nerves was characterized by current perception threshold (CPT), measured by a neuroselective diagnostic stimulator (Neurotron, Baltimore, MD).RESULTS: Fourteen of 24 patients (58%) had at least one abnormal cardiovascular reflex test and thirteen (54%)had peripheral sensory neuropathy. Lower heart rate response to deep breathing (P = 0.001), standing (P = 0.03)and Valsalva manoeuvre (P = 0.01), and more profound decrease of blood pressure after standing (P = 0.03) was found in PBC patients than in controls. As a novel finding we proved that both time domain and frequency domain parameters of 24-h HRV were significantly reduced in PBC patients compared to controls. Each patient had at least one abnormal parameter of HRV. Lower CPT values indicated hyperaesthesia as a characteristic feature at peroneal nerve testing at three frequencies (2000 Hz: P = 0.005;250 Hz: P = 0.002; 5 Hz: P = 0.004) in PBC compared to controls. Correlation of autonomic dysfunction with the severity and duration of the disease was observed. Lower total power of HRV correlated with lower CPT values at median nerve testing at 250 Hz (P = 0.0001) and at 5 Hz (P = 0.002), as well as with those at peroneal nerve testing at 2000 Hz (P = 0.01).CONCLUSION: Autonomic and sensory nerve dysfunctions are frequent in PBC. Twenty

  13. 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

  14. Gastrointestinal autonomic nerve tumors:A surgical point of view

    Institute of Scientific and Technical Information of China (English)

    Anton Stift; Josef Friedl; Michael Gnant; Friedrich Herbst; Raimund Jakesz; Etienne Wenzl

    2004-01-01

    AIM: Gastrointestinal autonomic nerve tumors are uncommon stromal tumors of the intestinal tract. Their histological appearance is similar to that of other gastrointestinal stromal tumors. We report two cases and performed an analysis of the literature by comparing our findings with the available case reports in the medical literature.METHODS: Two patients were admitted with abdominal tumor masses. One occurred in the stomach with large multiple liver metastases and the second originated in Meckel's diverticulum. The latter site has never been reported previously. Both patients underwent surgery. In one patient gastrectomy, right liver resection and colon transversum resection were performed to achieve aggressive tumor debulking. In the other patient the tumor bearing diverticulum was removed.RESULTS: Postoperative recovery of both patients was uneventful. Histological examination, immunohistochemical analysis and electron microscopy revealed the diagnosis of a gastrointestinal autonomic nerve tumor. The patient with the tumor in Meckel's diverticulum died 6 mo after surgery because of pneumonia. The patient with liver metastases have been alive 13 years after initial tumor diagnosis and 7 years after surgery with no evidence of tumor progression. In light of our results, we performed a thorough comparison with available literature reports.CONCLUSION: Radical surgical resection of gastrointestinal autonomic nerve tumors seems to be the only available curative approach to date, and long term survival is possible even in large metastasized tumors.ACKNOWLEDGMENTWe thank Christine Brostjan, PhD for critical review of the manuscript.

  15. Essential regional nerve blocks for the dermatologist: Part 2.

    Science.gov (United States)

    Davies, T; Karanovic, S; Shergill, B

    2014-12-01

    Following on from Part 1 of the series (regional nerve blocks for the face and scalp), we guide the clinician through the anatomy and cutaneous innervation of the digits, wrist and ankle, providing a practical step-by-step guide to regional nerve blockade of these areas.

  16. Essential regional nerve blocks for the dermatologist: part 1.

    Science.gov (United States)

    Davies, T; Karanovic, S; Shergill, B

    2014-10-01

    The aim of this two-part series is to provide an up-to-date review of essential regional nerve blocks for dermatological practice. In Part 1, we give a concise overview of local anaesthetics and their potential complications, as well as the relevant anatomy and cutaneous innervation of the face and scalp. This culminates in a step-by-step practical guide to performing each nerve block.

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

    DEFF Research Database (Denmark)

    Nielsen, Zbigniew Jerzy Koscielniak

    2008-01-01

    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......, the concomitant use of nerve stimulation offers no further advantage. However, several studies reported problems with obtaining satisfactory images in some patients. Ultrasound guidance significantly shortened the block performance time and/or reduced the number of needle passes to reach the target in all...

  18. Lateral femoral cutaneous nerve block after total hip arthroplasty

    DEFF Research Database (Denmark)

    Thybo, K H; Mathiesen, O; Dahl, J B;

    2016-01-01

    BACKGROUND: Peripheral regional nerve blocks are commonly used for pain management after lower extremity surgery, but motor blockade can be a significant concern. The lateral femoral cutaneous nerve (LFCN) is a purely sensory nerve from the lumbar plexus. We hypothesised that an LFCN block would...... reduce movement-related pain after total hip arthroplasty (THA) in patients with moderate-to-severe pain. METHODS: Sixty patients with visual analogue scale (VAS) score > 40 mm during 30-degree active flexion of the hip on either the first or second postoperative day after THA were included...

  19. 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....

  20. 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

  1. 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...

  2. Suprascapular nerve block for the treatment of frozen shoulder

    Directory of Open Access Journals (Sweden)

    Korhan Ozkan

    2012-01-01

    Full Text Available Aims: The aim of our study was to compare the effects of suprascapular nerve block in patients with frozen shoulder and diabetes mellitus unresponsive to intraarticular steroid injections. Settings and Design: Ten patients without improvement of sign and symptoms after intraarticular injections were made a suprascapular nerve block. Methods: Pain levels and active range of movement of patients were recorded at initial attendance and after 1, 4, and 12 weeks. All patients′ simple pain scores, total pain scores, and range of motion of their shoulders were improved significantly after suprascapular nerve block. Statistical Analysis: In this study, the statistical analyses were performed by using the SPSS 8.0 program (SPSS Software, SPSS Inc., USA. To compare pre- and post-injection results of simple pain score, total pain score, shoulder abduction and external rotation, Wilcoxon test was used. Results: Patient′s simple pain scores, total pain scores also abduction, external rotation and internal rotation angles were improved significantly after suprascapular nerve block. Conclusion: Effective results after suprascapular nerve blockage was obtained for the treatment of refractory frozen shoulder cases.

  3. PHRENIC NERVE PALSY AFTER SUPRACLAVICULAR BRACHIAL PLEXUS BLOCK

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    Gupta A K

    2009-09-01

    Full Text Available A 67 year old male patient was scheduled for implant removal from right upper limb under supraclavicular block. During procedure patient develops right phrenic nerve palsy & complains of dyspnea which was managed conservatively and no intervention done except chest x-ray for confirming the diagnosis. Surgeons completed the implant removal without any invasive intervention or interruption.

  4. Ultrasound-guided nerve block for inguinal hernia repair

    DEFF Research Database (Denmark)

    Bærentzen, Finn; Maschmann, Christian; Jensen, Kenneth;

    2012-01-01

    Open inguinal hernia repair in adults is considered a minor surgical procedure but can be associated with significant pain. We aimed to evaluate acute postoperative pain management in male adults randomized to receive an ultrasound-guided ilioinguinal and iliohypogastric nerve block administered...

  5. An unusual delayed complication of inferior alveolar nerve block.

    Science.gov (United States)

    Smyth, Joanna; Marley, John

    2010-01-01

    Systemic and localised complications after administration of local anaesthetic for dental procedures are well recognised. We present two cases of patients with trismus and sensory deficit that arose during resolution of trismus as a delayed complication of inferior alveolar nerve block.

  6. Use of digital nerve blocks to provide anaesthetic relief.

    Science.gov (United States)

    Summers, Anthony

    2011-09-01

    This article discusses the various techniques that nurses can use to perform digital nerve blocks, which are some of the most common procedures undertaken by emergency practitioners treating patients with finger injuries. In covering the advantages and disadvantages of each technique, it focuses primarily on the digits of the hand, but the techniques can also be performed on toes.

  7. Ventricular Pneumocephalus with Meningitis after Lumbar Nerve Root Block

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    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.

  8. TRPM8 mechanism of autonomic nerve response to cold in respiratory airway

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    Wang Cong-Yi

    2008-06-01

    Full Text Available Abstract Breathing cold air without proper temperature exchange can induce strong respiratory autonomic responses including cough, airway constriction and mucosal secretion, and can exacerbate existing asthma conditions and even directly trigger an asthma attack. Vagal afferent fiber is thought to be involved in the cold-induced respiratory responses through autonomic nerve reflex. However, molecular mechanisms by which vagal afferent fibers are excited by cold remain unknown. Using retrograde labeling, immunostaining, calcium imaging, and electrophysiological recordings, here we show that a subpopulation of airway vagal afferent nerves express TRPM8 receptors and that activation of TRPM8 receptors by cold excites these airway autonomic nerves. Thus activation of TRPM8 receptors may provoke autonomic nerve reflex to increase airway resistance. This putative autonomic response may be associated with cold-induced exacerbation of asthma and other pulmonary disorders, making TRPM8 receptors a possible target for prevention of cold-associated respiratory disorders.

  9. Simulation of spinal nerve blocks for training anesthesiology residents

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    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.

  10. INGUINAL NERVE BLOCK FOR PATIENTS UNDERGOING INGUINAL HERNIOPLASTY

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    Amirthagadeswar

    2015-02-01

    Full Text Available Inguinal hernia repair is the most common elective surgical procedure performed under general, regional or local anesthesia. The advantages of day case surgery include greater patient satisfaction and reduced financial costs to the health service. Inguinal nerve b locks may be particularly helpful for patients with cardiovascular or respiratory disease, for whom there may be advantages in avoiding general anesthesia. The absence of post - operative sedation or drowsiness allows early ambulation and diminishes the requirement for recovery facilities with inguinal nerve block.

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

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    Schneider-Kolsky, M.E.; Pike, J.; Connell, D.A. [Department of Medical Imaging, Victoria House Private Hospital, 316 Malvern Road, Prahran 3181, Melbourne, Victoria (Australia)

    2004-05-01

    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.)

  12. 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

  13. Permanent neurologic deficit after inferior alveolar nerve block: a case report.

    Science.gov (United States)

    Shenkman, Z; Findler, M; Lossos, A; Barak, S; Katz, J

    1996-10-01

    Permanent neurologic damage after an inferior dental nerve block is reported. Clinical manifestations included hemisensory syndrome, facial nerve palsy, hearing impairment, and ataxia. Possible mechanisms and preventive measures are discussed.

  14. Evaluation of effects of sciatic and femoral nerve blocks in sheep undergoing stifle surgery.

    Science.gov (United States)

    Wagner, Ann E; Mama, Khursheed R; Ruehlman, Dana L; Pelkey, Sheila; Turner, A Simon

    2011-04-01

    The authors evaluated the effects of locally anesthetizing the sciatic and femoral nerves in sheep undergoing stifle (femorotibial) surgery (16 sheep received nerve blocks; 16 sheep underwent a nerve localization procedure but received no nerve blocks). Heart rate, mean arterial blood pressure and end-tidal isoflurane were recorded every 5 min while sheep were anesthetized. At some of the observed time points, the mean heart rate in the sheep that had received no nerve blocks was significantly higher than in the sheep that had received the nerve blocks. Postoperatively, each sheep was assigned scores for comfort and attitude, movement, flock behavior, feeding behavior and appetite and respiratory rate (based on predefined descriptions). Though the authors found no undesirable effects of this local anesthesia, beneficial effects of the nerve blocks were minimal or not readily apparent under the conditions of this study.

  15. Autonomic nerve development contributes to prostate cancer progression.

    Science.gov (United States)

    Bauman, John; McVary, Kevin

    2013-11-01

    In a significant translational study, Magnon et al. investigated the role that the autonomic nervous system plays in the development and spread of prostate cancer in both mice and human models. The study shows different roles for both branches of the autonomic nervous system, with the sympathetic system promoting early stages of tumorigenesis, and the parasympathetic system promoting cancer dissemination. This information could lead to important new foundations for treatment, therapies and management of prostate cancer.

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

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    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.

  17. 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.

  18. [Techniques of autonomic nerve preservation in laparoscopic radical resection for rectal cancer].

    Science.gov (United States)

    Wei, Hongbo; Zheng, Zongheng

    2015-06-01

    Pelvic autonomic nerve is a three-dimensional structure surrounding the rectum. There are several key points related to nerve injury during laparoscopic radical resection for rectal cancer. Hypogastric nerve has close relation with the upper and middle part of the rectum. Combined with S2-S4 pelvic splanchnic nerve, hypogastric nerve forms pelvic plexus. Incorrect operation in pelvic parietal peritoneum during dissection of upper rectum will lead to nerve injury. When performing dissection of inferior mesenteric artery, bilateral nerve tracts should be pushed to posterior abdominal wall and anterior fascia of the abdominal aorta should be well protected to avoid nerve injury. Pelvic plexus fibers located lateral to the rectum of pelvic floor, as well as neurovascular bundle closed to Denonvillier's fascia, also have close relations with nerve injury. Dissection of either lateral or anterior wall of rectum should be performed behind the Denonvillier's fascia and in front of the proper fascia of rectum. Sharp dissection should be performed closed to the mesorectum to protect branches of pelvic plexus.

  19. 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.

  20. Magnetic resonance neurography-guided nerve blocks for the diagnosis and treatment of chronic pelvic pain syndrome.

    Science.gov (United States)

    Fritz, Jan; Chhabra, Avneesh; Wang, Kenneth C; Carrino, John A

    2014-02-01

    Magnetic resonance (MR) neurography - guided nerve blocks and injections describe a techniques for selective percutaneous drug delivery, in which limited MR neurography and interventional MR imaging are used jointly to map and target specific pelvic nerves or muscles, navigate needles to the target, visualize the injected drug and detect spread to confounding structures. The procedures described, specifically include nerve blocks of the obturator nerve, lateral femoral cutaneous nerve, pudendal nerve, posterior femoral cutaneous nerve, sciatic nerve, ganglion impar, sacral spinal nerve, and injection into the piriformis muscle.

  1. A Novel CT-Guided Transpsoas Approach to Diagnostic Genitofemoral Nerve Block and Ablation

    Science.gov (United States)

    Parris, David; Fischbein, Nancy; Mackey, Sean; Carroll, Ian

    2010-01-01

    Background Inguinal hernia repair is associated with a high incidence of chronic postsurgical pain. This pain may be caused by injury to the iliohypogastric, ilioinguinal, or genitofemoral nerves. It is often difficult to identify the specific source of the pain, in part, because these nerves are derived from overlapping nerve roots and closely colocalize in the area of surgery. It is therefore technically difficult to selectively block these nerves individually proximal to the site of surgical injury. In particular, the genitofemoral nerve is retroperitoneal before entering the inguinal canal, a position that puts anterior approaches to the proximal nerve at risk of transgressing into the peritoneum. We report a computed tomography (CT)-guided transpsoas technique to selectively block the genitofemoral nerve for both diagnostic and therapeutic purposes while avoiding injury to the nearby ureter and intestines. Case A 39-year-old woman with chronic lancinating right groin pain after inguinal hernia repair underwent multiple pharmacologic interventions and invasive procedures without relief. Using CT and Stimuplex nerve stimulator guidance, the genitofemoral nerve was localized on the anterior surface of the psoas muscle and a diagnostic block with local anesthetic block was performed. The patient had immediate relief of her symptoms for 36 hours, confirming the diagnosis of genitofemoral neuralgia. She subsequently underwent CT-guided radiofrequency and phenol ablation of the genitofemoral nerve but has not achieved long-term analgesia. Conclusion CT-guided transpsoas genitofemoral nerve block is a viable option for safely and selectively blocking the genitofemoral nerve for diagnostic or therapeutic purposes proximal to injury caused by inguinal surgery. PMID:20546515

  2. The subdiaphragmatic part of the phrenic nerve - morphometry and connections to autonomic ganglia.

    Science.gov (United States)

    Loukas, Marios; Du Plessis, Maira; Louis, Robert G; Tubbs, R Shane; Wartmann, Christopher T; Apaydin, Nihal

    2016-01-01

    Few anatomical textbooks offer much information concerning the anatomy and distribution of the phrenic nerve inferior to the diaphragm. The aim of this study was to identify the subdiaphragmatic distribution of the phrenic nerve, the presence of phrenic ganglia, and possible connections to the celiac plexus. One hundred and thirty formalin-fixed adult cadavers were studied. The right phrenic nerve was found inferior to the diaphragm in 98% with 49.1% displaying a right phrenic ganglion. In 22.8% there was an additional smaller ganglion (right accessory phrenic ganglion). The remaining 50.9% had no grossly identifiable right phrenic ganglion. Most (65.5% of specimens) exhibited plexiform communications with the celiac ganglion, aorticorenal ganglion, and suprarenal gland. The left phrenic nerve inferior to the diaphragm was observed in 60% of specimens with 19% containing a left phrenic ganglion. No accessory left phrenic ganglia were observed. The left phrenic ganglion exhibited plexiform communications to several ganglia in 71.4% of specimens. Histologically, the right phrenic and left phrenic ganglia contained large soma concentrated in their peripheries. Both phrenic nerves and ganglia were closely related to the diaphragmatic crura. Surgically, sutures to approximate the crura for repair of hiatal hernias must be placed above the ganglia in order to avoid iatrogenic injuries to the autonomic supply to the diaphragm and abdomen. These findings could also provide a better understanding of the anatomy and distribution of the fibers of that autonomic supply.

  3. Femoral versus Multiple Nerve Blocks for Analgesia after Total Knee Arthroplasty

    Science.gov (United States)

    Stav, Anatoli; Reytman, Leonid; Sevi, Roger; Stav, Michael Yohay; Powell, Devorah; Dor, Yanai; Dudkiewicz, Mickey; Bayadse, Fuaz; Sternberg, Ahud; Soudry, Michael

    2017-01-01

    Background The PROSPECT (Procedure-Specific Postoperative Pain Management) Group recommended a single injection femoral nerve block in 2008 as a guideline for analgesia after total knee arthroplasty. Other authors have recommended the addition of sciatic and obturator nerve blocks. The lateral femoral cutaneous nerve is also involved in pain syndrome following total knee arthroplasty. We hypothesized that preoperative blocking of all four nerves would offer superior analgesia to femoral nerve block alone. Methods This is a prospective, randomized, controlled, and observer-blinded clinical study. A total of 107 patients were randomly assigned to one of three groups: a femoral nerve block group, a multiple nerve block group, and a control group. All patients were treated postoperatively using patient-controlled intravenous analgesia with morphine. Pain intensity at rest, during flexion and extension, and morphine consumption were compared between groups over three days. Results A total of 90 patients completed the study protocol. Patients who received multiple nerve blocks experienced superior analgesia and had reduced morphine consumption during the postoperative period compared to the other two groups. Pain intensity during flexion was significantly lower in the “blocks” groups versus the control group. Morphine consumption was significantly higher in the control group. Conclusions Pain relief after total knee arthroplasty immediately after surgery and on the first postoperative day was significantly superior in patients who received multiple blocks preoperatively, with morphine consumption significantly lower during this period. A preoperative femoral nerve block alone produced partial and insufficient analgesia immediately after surgery and on the first postoperative day. (Clinical trial registration number (NIH): NCT01303120) PMID:28178436

  4. 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.

  5. Effects of expression ways and traits of anger emotion on autonomic nerve in the emotion recovery stage

    Institute of Scientific and Technical Information of China (English)

    詹向红

    2013-01-01

    Objective To explore the effects of expression ways and traits of anger emotion on autonomic nerve in the emotion recovery stage.Methods The 48 healthy undergraduate students were recruited as subjects,who were

  6. The Anticonvulsant Effect of Transcutaneous Auricular Vagus Nerve Stimulation is Associated with Balancing the Autonomic Dysfunction in Rats

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    Wei He

    2016-11-01

    Full Text Available Objective: The present study aims to investigate whether the anticonvulsant effect of transcutaneous auricular vagus nerve stimulation is associated with balancing the autonomic dysfunction in rats.

  7. 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.

  8. Direct Interaction between Autonomic Nerves and the Immune System

    Science.gov (United States)

    1987-11-15

    enhancement, propranolol for beta-adrenergic blockade, and phentolamine for alpha- adrenergic blockade. Cholinergic agents were not examined due to the...Table III), The alpha blocker phentolamine also caused partial inhibition of the agonist response, and in the case of NE, was additive with propranolol...effect which was blocked by propranolol (beta blocker) but not phentolamine (alpha blocker). "Further analysis showed that beta2-stimulation with

  9. 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.

  10. The Effect of Levetiracetam Therapy on the Autonomous Nerve System in Epilepsy Patients

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    Kazim Ekmekci

    2013-10-01

    Full Text Available Aim: It was aimed to research the effects of levetiracetam on some autonomic functions by comparing autonomous nerve system tests in epilepsy patients using levetiracetam monotherapy with the tests of the healthy volunteers who don’t use drug.   Material and Method: Fourty-one patients diagnosed with partial epilepsy using levetiracetam were included in this study. Control group was selected from 35 healthy volunteers who don’t have epilepsy. RR interval variation (RRIV, valsalva, and tilt tests were applied to patient and control groups in order to assess the autonomous nerve system functions. Results: No statistically-significant differences were found in the results of RRIV, valsalva, and tilt tests in patients in comparison with the control group (p>0.05. No statistical significances weren’t also observed when the results of upright position and the postural blood pressure changes were compared with the control group (p>0.05. Discussion: Our findings had shown that using levetiracetam therapy had no effect on the responses of heart rate and blood pressure in epilepsy patients.

  11. 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

    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....

  12. 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....

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

    Directory of Open Access Journals (Sweden)

    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

  14. Role of suprascapular nerve block in chronic shoulder pain: A comparative study of 60 cases

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    Anil Salgia

    2014-01-01

    Full Text Available Background: Suprascapular nerve block using anatomical landmark has been shown to be a safe and effective treatment for chronic shoulder pain from rheumatoid and degenerative arthritis. This can be performed as an outpatient procedure that reduces pain and disability. Aims and Objectives: To access efficacy of suprascapular nerve block in chronic shoulder pain. To compare results between placebo and use of methyl prednisolone with bupivacaine for nerve block . Materials and Methods: 60 patients with chronic shoulder pain were taken up for the trial. In the study group, all patients received the block through the anatomical landmark approach, with a single sitting suprascapular nerve block. On randomized basis, 30 patients were given 10 ml of 0.5% bupivacaine and 40 mg of methyl prednisolone acetate (depo medrol to block the suprascapular nerve. Another 30 patients were injected with 11 ml of 0.9% saline. Patients were followed up on 2 nd day, 7 th day, and 21 st day and 3 months for the status of relief of pain and improvement of movement of joint. Results: Evaluation of the efficacy of the block was achieved by comparing verbal pain scores and improvement in range of movements at 2, 7, 21 days and 3 months after the injection. Significant pain relief is defined as improvement of more than 70% on verbal and visual analog pain scale scores. Results were consistent with VAS score of pain. Maximum improvement was noted in the bupivacaine+methyl prednisolone mixed group. Conclusion: The result of this study shows a clear benefit of methyl prednisolone + bupivacaine for suprascapular nerve block in cases of chronic shoulder pain. There was statistically and clinically significant reduction in pain and improvement in range of movements.

  15. Skin and mucosal ischemia as a complication after inferior alveolar nerve block

    Science.gov (United States)

    Aravena, Pedro Christian; Valeria, Camila; Nuñez, Nicolás; Perez-Rojas, Francisco; Coronado, Cesar

    2016-01-01

    The anesthetic block of the inferior alveolar nerve (IAN) is one of the most common techniques used in dental practice. The local complications are due to the failures on the anesthetic block or to anatomic variations in the tap site such as intravascular injection, skin ischemia and ocular problems. The aim of this article is to present a case and discuss the causes of itching and burning sensation, blanching, pain and face ischemia in the oral cavity during the IAN block.

  16. INGUINAL NERVE BLOCK FOR PATIENTS UNDERGOING INGUINAL HERNIOPLASTY

    OpenAIRE

    2015-01-01

    Inguinal hernia repair is the most common elective surgical procedure performed under general, regional or local anesthesia. The advantages of day case surgery include greater patient satisfaction and reduced financial costs to the health service. Inguinal nerve b locks may be particularly helpful for patients with cardiovascular or respiratory dis...

  17. 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.

  18. A case report of complex auricular neuralgia treated with the great auricular nerve and facet blocks

    Science.gov (United States)

    Eghtesadi, Marzieh; Leroux, Elizabeth; Vargas-Schaffer, Grisell

    2017-01-01

    Background The great auricular nerve is a cutaneous branch of the cervical plexus originating from the C2 and C3 spinal nerves. It innervates the skin over the external ear, the angle of the mandible and the parotid gland. It communicates with the ansa cervicalis. Great auricular neuralgia is rarely diagnosed in clinical practice and can be refractory. We present a new approach using ultrasound-guided nerve blocks. Case We present a case of a 41-year-old female with paroxysmal ear pain accompanied by dysautonomia, tingling in the tongue, dysphagia, dysarthria and abdominal symptoms. No significant findings were found on cervical and brain imaging. The patient responded partially to a great auricular nerve block. A combined approach using this block with facet block of C2 and C3 induced a more pronounced and prolonged benefit. Conclusion Great auricular neuralgia is not often encountered in practice and can be accompanied by symptoms originating from the ansa cervicalis network. A combined approach of nerve blocks can be considered in refractory cases. PMID:28255253

  19. RESULTS OF TREATMENT OF ACUTE LUMBAR DISC HERNIATION WITH TRANSFORAMINAL NERVE ROOT BLOCK

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    EMILIANO NEVES VIALLE

    Full Text Available ABSTRACT Objective: To determine the efficacy of anesthetic transforaminal nerve root block in patients with sciatica secondary to lumbar disc herniation through a prospective observational study. Methods: The study included 176 patients from a private clinic undergoing transforaminal injection performed by a single spinal surgeon. The patients were assessed after two weeks, three months and six months regarding to the improvement of the pain radiating to the lower limbs. In case of persistent symptoms, patients could choose to perform a new nerve root block and maintenance of physical therapy or be submitted to conventional microdiscectomy. Results: By the end of six-month follow-up of the 176 patients, 116 had a favorable outcome (95 after one block and 21 after two blocks, and only 43 required surgery. Conclusion: The results of our study suggest a positive effect of transforaminal block for the treatment of sciatica in patients with lumbar disc herniation.

  20. Dexmedetomidine and propofol infusion on sedation characteristics in patients undergoing sciatic nerve block in combination with femoral nerve block via anterior approach

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    Abdulkadir Yektaş

    2015-10-01

    Full Text Available ABSTRACTOBJECTIVE: Dexmedetomidine is an a-2 adrenergic agonist having wide range of effects including sedation in mammalian brain, and has analgesic as well as sympatholytic properties. This study aimed to compare the effects of dexmedetomidine and propofol infusion on sedation characteristics in patients undergoing combined sciatic nerve and femoral nerve block via anterior approach for lower limb orthopedic procedure.METHODS: Forty patients, who were between 18 and 65 years old, this study was made at anesthesiology clinic of Bagcilar training and research hospital in 08 September 2011 to 07 June 2012, and underwent surgical procedure due to fractures lateral and medial malleol, were included. Sciatic nerve and femoral nerve block were conducted with an anterior approach on all patients included in the study, with an ultrasonography. The patients were randomly divided into dexmedetomidine [Group D (n = 20; 0.5 µg kg-1 h-1] and propofol [Group P (n = 20; 3 mg kg-1 h-1] infusion groups.RESULTS: The vital findings and intra-operative Ramsay sedation scale values were similar in both groups. Time taken for sedation to start and time required for sedation to become over of Group D were significantly higher than those of Group P (p < 0.001 for each.CONCLUSIONS: Substitution of dexmedetomidine instead of propofol prolongs the times to start of sedation, the times to end of sedation and duration of sedation.

  1. Occipital nerve blocks in postconcussive headaches: a retrospective review and report of ten patients.

    Science.gov (United States)

    Hecht, Jeffrey S

    2004-01-01

    Headaches are common following traumatic brain injuries of all severities. Pain generators may be in the head itself or the neck. Headache assessment is discussed. Diagnosis and treatment of cervical headaches syndromes and, in particular, occipital neuralgia are reviewed. Finally, a retrospective study of 10 postconcussive patients with headaches who were treated with greater occipital nerve blocks is presented. Following the injection(s), 80% had a "good" response and 20% had a "partial" response. Occipital nerve block is a useful diagnostic and treatment modality in the setting of postconcussive headaches.

  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. TRANSFORAMINAL CERVICAL NERVE ROOT BLOCK: OUTCOMES AND COMPLICATIONS

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    EMILIANO NEVES VIALLE

    Full Text Available ABSTRACT Objectives: To investigate the effect and complications after transforaminal injection for cervicobrachialgia caused by cervical disc herniation. Methods: We retrospectively reviewed all patients undergoing fluoroscopy-guided transforaminal injection for radiculopathy caused by cervical disc herniation. During the last seven years, 57 patients (39 female, 18 male, mean age 45.6 years experiencing cervical radiculopathy underwent cervical foraminal block guided by fluoroscopy by postero-lateral approach. The position of the needle was verified after injection of a small amount of contrast. A glucocorticosteroid was injected after 0.5 ml of 2% lidocaine. Results: The local with the highest prevalence of procedures was C6 root (31 procedures; 14 patients underwent C7 block, 7 had C5 block, and 5 in C4. Eight patients (14% had complications (3 syncopes, 3 transient hoarseness, one patient had worsening of symptoms and one patient had soft tissue hematoma. In total, 42.1% were asymptomatic after the procedure and therefore did not require surgery after the procedure. Other 57.9% had transient improvement, became asymptomatic for at least 2 months but required surgery due to the recurrence of symptoms. Conclusion: Cervical foraminal block for cervical disc herniation is a safe way to avoid surgery. Some patients still need surgery after the procedure, but the temporary improvement in symptoms gives the patient some relief while awaiting surgery.

  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

    . Furthermore, QST assessments demonstrated significantly decreased suprathreshold heat pain perception in the groin after lidocaine versus placebo blocks (95% confidence interval = -3.5 to -0.5, P = 0.008).Conclusion:Ultrasound-guided lidocaine blocks of the ilioinguinal and iliohypogastric nerves......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...... ratings under standardized conditions with numerical rating scale (0-10), sensory mapping to a cool roller, and quantitative sensory testing (QST), in the groin regions, before and after each ultrasound-guided block. A needle approach of 1 to 2 cm superior and medial to the anterior superior iliac spine...

  5. 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.

  6. A conduction block in sciatic nerves can be detected by magnetic motor root stimulation.

    Science.gov (United States)

    Matsumoto, Hideyuki; Konoma, Yuko; Fujii, Kengo; Hanajima, Ritsuko; Terao, Yasuo; Ugawa, Yoshikazu

    2013-08-15

    Useful diagnostic techniques for the acute phase of sciatic nerve palsy, an entrapment neuropathy, are not well established. The aim of this paper is to demonstrate the diagnostic utility of magnetic sacral motor root stimulation for sciatic nerve palsy. We analyzed the peripheral nerves innervating the abductor hallucis muscle using both electrical stimulations at the ankle and knee and magnetic stimulations at the neuro-foramina and conus medullaris levels in a patient with sciatic nerve palsy at the level of the piriformis muscle due to gluteal compression related to alcohol consumption. On the fourth day after onset, magnetic sacral motor root stimulation using a MATS coil (the MATS coil stimulation method) clearly revealed a conduction block between the knee and the sacral neuro-foramina. Two weeks after onset, needle electromyography supported the existence of the focal lesion. The MATS coil stimulation method clearly revealed a conduction block in the sciatic nerve and is therefore a useful diagnostic tool for the abnormal neurophysiological findings associated with sciatic nerve palsy even at the acute phase.

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

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    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.

  8. 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

  9. Magnesium sulfate in femoral nerve block, does postoperative analgesia differ? A comparative study

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    Hossam A. ELShamaa

    2014-04-01

    Conclusion: The current study concluded that the admixture of magnesium to bupivacaine provides a profound prolongation of the femoral nerve block, in addition to a significant decrease in postoperative pain scores and total dose of rescue analgesia, with a longer bearable pain periods in the first postoperative day.

  10. Ultrasound-guided proximal and distal sciatic nerve blocks in children.

    NARCIS (Netherlands)

    Geffen, G.J. van; Pirotte, T.; Gielen, M.J.M.; Scheffer, G.; Bruhn, J.

    2010-01-01

    STUDY OBJECTIVE: To present the use of ultrasonography for the performance of proximal subgluteal and distal sciatic nerve blocks in children. DESIGN: Prospective descriptive study. SETTING: University hospital. PATIENTS: 45 ASA physical status I, II, and III patients, aged between 8 months and 16 y

  11. 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.

  12. Skin and mucosal ischemia as a complication after inferior alveolar nerve block

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    Pedro Christian Aravena

    2016-01-01

    Full Text Available The anesthetic block of the inferior alveolar nerve (IAN is one of the most common techniques used in dental practice. The local complications are due to the failures on the anesthetic block or to anatomic variations in the tap site such as intravascular injection, skin ischemia and ocular problems. The aim of this article is to present a case and discuss the causes of itching and burning sensation, blanching, pain and face ischemia in the oral cavity during the IAN block.

  13. 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....

  14. Prolonged vertigo and ataxia after mandibular nerve block for treatment of trigeminal neuralgia

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    Arvind Chaturvedi

    2011-01-01

    Full Text Available Common complications of neurolytic mandibular nerve block are hypoesthesia, dysesthesia, and chemical neuritis. We report a rare complication, prolonged severe vertigo and ataxia, after neurolytic mandibular blockade in a patient suffering from trigeminal neuralgia. Coronoid approach was used for right sided mandibular block. After successful test injection with local anesthetic, absolute alcohol was given for neurolytic block. Immediately after alcohol injection, patient developed nausea and vomiting along with severe vertigo, ataxia and hypertension. Neurological evaluation was normal except for the presence of vertigo and ataxia. Computerised tomography scan brain was also normal. Patient was admitted for observation and symptomatic treatment was given. Vertigo and ataxia gradually improved over 24 hours.

  15. Uterine autonomic nerve innervation plays a crucial role in regulating rat uterine mast cell functions during embryo implantation.

    Science.gov (United States)

    Yuan, Xue-Jun; Huang, Li-Bo; Qiao, Hui-Li; Deng, Ze-Pei; Fa, Jing-Jing

    2009-12-01

    To explore the potential mechanism of how uterine innervations would affect the uterine mast cell (MC) population and functions during the periimplantation. We herein first examined the consequence of uterine neurectomy on embryo implantation events. We observed that amputation of autonomic nerves innervating the uterus led to on-time implantation failure in rats. Exploiting MC culture and ELISA approaches, we then further analyzed the effect of neurectomy on cellular histamine levels and its release from uterine MCs, to elucidate the relation of the autonomic nerves and local cellular immunity in the uterine during early pregnancy. We observed that disconnection of autonomic nerve innervation significantly increased the population of uterine MCs. Most interestingly, these increased number of uterine MCs in neuroectomized rats contained a much reduced cellular level of histamine. Our subsequent challenge experiments revealed that uterine MCs in nerve amputated rats exhibited enhanced histamine releasing rate in response to substance P and antiIgE, suggesting loss of nerve innervation in the uterus not only increases the population of uterine MCs, but also facilitates the release of histamine from MCs, thus subsequently interfere with the normal implantation process. Collectively, our findings provide a new line of evidence supporting the concept that immune-neuro-endocrine network plays important role during pregnancy establishment and maintenance.

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

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    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 peripheral nerve stimulator versus ultrasonography guided axillary block using multiple injection technique

    Science.gov (United States)

    Kumar, Alok; Sharma, DK; Sibi, Maj. E; Datta, Barun; Gogoi, Biraj

    2014-01-01

    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. PMID:25624532

  18. Cancer Pain Control for Advanced Cancer Patients by Using Autonomic Nerve Pharmacopuncture

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    Hwi-joong Kang

    2014-09-01

    Full Text Available Objectives: The purpose of this study is to report a case series of advanced cancer patients whose cancer pain was relieved by using autonomic nerve pharmacopuncture (ANP treatment. ANP is a subcutaneous injection therapy of mountain ginseng pharmacopuncture (MGP along the acupoints on the spine (Hua-Tuo-Jia-Ji-Xue; 0.5 cun lateral to the lower border of the spinous processes of vertebrae to enhance the immune system and to balance autonomic nerve function. Methods: Patients with three different types of cancer (gastric cancer, lung cancer, colon cancer with distant metastases with cancer pain were treated with ANP. 1 mL of MGP was injected into the bilateral Hua-Tuo-Jia-Ji-Xue on the T1-L5 sites (total 12 ─ 20 mL injection of each patient’s dorsum by using the principle of symptom differentiation. During ANP treatment, the visual analogue scale (VAS for pain was used to assess their levels of cancer pain; also, the dosage and the frequency of analgesic use were measured. Results: The cancer pain levels of all three patients improved with treatment using ANP. The VAS scores of the three patients decreased as the treatment progressed. The dosage and the frequency of analgesics also gradually decreased during the treatment period. Significantly, no related adverse events were found. Conclusion: ANP has shown benefit in controlling cancer pain for the three different types of cancer investigated in this study and in reducing the dosage and the frequency of analgesics. ANP is expected to be beneficial for reducing cancer pain and, thus, to be a promising new treatment for cancer pain.

  19. Histological modifications of the rat prostate following transection of somatic and autonomic nerves

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    Rosaura Diaz

    2010-06-01

    Full Text Available It is known that hormones influence significantly the prostate tissue. However, we reported that mating induces an increase in androgen receptors, revealing a neural influence on the gland. These data suggested that somatic afferents (scrotal and genitofemoral nerves and autonomic efferents (pelvic and hypogastric nerves could regulate the structure of the prostate. Here we assessed the role of these nerves in maintaining the histology of the gland. Hence, afferent or efferent nerves of male rats were transected. Then, the ventral and dorsolateral regions of the prostate were processed for histology. Results showed that afferent transection affects prostate histology. The alveoli area decreased and increased in the ventral and dorsolateral prostate, respectively. The epithelial cell height increased in both regions. Efferent denervation produced dramatic changes in the prostate gland. The tissue lost its configuration, and the epithelium became scattered and almost vanished. Thus, afferent nerves are responsible for spinal processes pertaining to the trophic control of the prostate, activating its autonomic innervation. Hence, our data imply that innervation seems to be synergic with hormones for the healthy maintenance of the prostate. Thus, it is suggested that some prostate pathologies could be due to the failure of the autonomic neural pathways regulating the gland.Sabe-se que os hormônios influenciam significativamente o tecido prostático. Entretanto, nós demonstramos que o acasalamento induz um aumento nos receptores androgênicos, revelando uma influência neural sobre a glândula. Esses dados sugerem que os aferentes somáticos (nervos escrotal e genito-femural e os eferentes autonômicos (nervos pélvicos e hipo-gástricos poderiam regular a estrutura da próstata. Neste trabalho, avaliou-se a função destes nervos na manutenção da histologia da glândula. Dessa forma, os nervos aferentes e eferentes de ratos machos foram

  20. Effect of intracranial hypertension on cerebral hemorrhage induced autonomic nerve imbalance

    Institute of Scientific and Technical Information of China (English)

    Xuelong Jin; Wenli Jing; Fengxia Yan; Zhaoqiang Zhang; Fengjun Lü; Shuiqing Jing; Na Sun; Kazushige Mizoguchi

    2007-01-01

    BACKGROUND: Cerebral hemorrhage can cause the imbalance of nerve function, whereas its mechanism and main impact factors are still not quite clear.OBJECTIVE: To explore the rules about the changes of intracranial pressure in brainstem hemorrhage and internal capsule hemorrhage, and analyze the role of intracranial hypertension in the changes of nerve function caused by cerebral hemorrhage.DESIGN: A self-controlled trial.SETTING: Department of Physiology, Tianjin Medical University.MATERIALS: Sixty-five healthy male Japanese white rabbits with long ears (1.5-1.8 kg) were supplied and fed by the Department of Animal Experiment of Tianjin Medical University. The RM6240B biological signal collecting and processing system was used.METHODS: The experiments were conducted in the Department of Physiology, Tianjin Medical University from August 2001 to May 2006. ① The rabbits were anesthetized, then fixed onto the brain stereotaxic apparatus, and afterwards fenestration on skull and intubation to lateral ventricle were performed. The dynamic changes of intracranial pressure were monitored continuously. Rabbits were infused with autologous arterial blood (0.3 mL) into midbrain corpora quadrigemina inferior colliculus to induce model of acute brainstem hemorrhage; models of internal capsule hemorrhage were established by infusing autologous arterial blood into internal capsule. ② The dynamic intracranial pressures under the above conditions were recorded continuously with the RM6240B biological signal collecting and processing system. ③ An animal model of persistent intracranial hypertension was established by infusion of physiologic saline into lateral ventricle. ④ The changes of the intensity of autonomic nerve discharge were analyzed, using the biological signal collecting and processing system before and after hemorrhage and under persistent intracranial hypertension. ⑤ Ten animal models of internal capsule hemorrhage and 10 of brainstem hemorrhage were selected

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

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    Bjarne Skjødt Worm

    Full Text Available PURPOSE: 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. MATERIALS AND METHODS: We undertook a clinical study to quantify the maximal gross visibility or ultrastructure of seven peripheral nerves identified by either real time ultrasound (clinical cohort, n = 635 or by still picture ultrasonograms (clinical cohort, n = 112. In addition, we undertook a study on test subjects (n = 4 to quantify interobserver variations and potential bias among expert and trainee observers. RESULTS: When comparing real time ultrasound and interpretation of still picture sonograms, gross identification of large nerves was reduced by 15% and 40% by expert and trainee observers, respectively, while gross identification of small nerves was reduced by 29% and 66%. Identification of within-nerve ultrastructure was even less. For all nerve sizes, trainees were unable to identify any anatomical structure in 24 to 34%, while experts were unable to identify anything in 9 to 10%. CONCLUSION: Exhaustive ultrasonography experience and real time ultrasound measurements seem to be keystones in obtaining optimal nerve identification. In contrast the use of still pictures appears to be insufficient for documentation as well as educational purposes. Alternatives such as video clips or enhanced picture technology are encouraged

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

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    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.

  3. Effect of autonomic blocking agents and structurally related substances on the “salt arousal of drinking”

    NARCIS (Netherlands)

    Wied, D. de

    1966-01-01

    The effect of autonomic blocking agents and structurally related substances was studied in rats in which thirst was produced by the administration of a hypertonic sodium chloride solution. Scopolamine, methamphetamine, amphetamine, chlorpromazine, atropine, mecamylamine, hexamethonium, nethalide, in

  4. 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.

  5. Biphasic effects of orexin-A on autonomic nerve activity and lipolysis.

    Science.gov (United States)

    Shen, Jiao; Tanida, Mamoru; Yao, Jia-Fei; Niijima, Akira; Nagai, Katsuya

    2008-10-24

    Previously, we showed that orexin-A, a 33-aa peptide, influences renal sympathetic nerve activity. Because the autonomic nervous system plays an important role in the regulation of lipid metabolism, we investigated the in vivo effects of orexin-A on the sympathetic nerve activity innervating white adipose tissue (WAT-SNA) and lipolysis. We found that intracerebroventricular (icv) administration of orexin-A at doses of 1 microg/rat and 10 ng/rat elevated and suppressed WAT-SNA, respectively. The effect of the high dose of orexin-A (1 microg/rat) was eliminated by pretreatment with diphenhydramine hydrochloride, a histamine H(1) receptor antagonist. In contrast, the effect of the low dose of orexin-A (10 ng/rat) was suppressed by thioperamide maleate salt, a histamine H(3) receptor antagonist. Moreover, icv administration of 1 microg/rat and 10 ng/rat of orexin-A increased and decreased the levels of plasma free fatty acids (FFAs), respectively. The effect of 1 microg/rat of orexin-A on plasma FFA was eliminated by propranolol hydrochloride, a beta-adrenergic receptor blocker, and also by diphenhydramine. The effect of orexin-A at dose of 10 ng/rat disappeared by pretreatment with atropine sulfate, a muscarinic receptor blocker, and thioperamide maleate salt. Our results suggest that high doses of orexin-A may regulate the lipolytic processes in adipose tissue through facilitation of the sympathetic nervous system, which is driven by histamine neurons through the H(1) receptor, and that the beta(3)-receptor may be involved in this enhanced lipolytic response. Low doses of orexin-A, on the other hand, may lower lipolysis by suppressing sympathetic nerve activity via the H(3)-receptor, and the muscarinic receptor may be related to this response.

  6. A comparative evaluation of anesthetic efficacy of articaine 4% and lidocaine 2% with anterior middle superior alveolar nerve block and infraorbital nerve block: An in vivo study

    Science.gov (United States)

    Saraf, Suma Prahlad; Saraf, Prahlad Annappa; Kamatagi, Laxmikant; Hugar, Santosh; Tamgond, Shridevi; Patil, Jayakumar

    2016-01-01

    Background: The ideal maxillary injection should produce a rapid onset of profound pulpal anesthesia for multiple teeth from a single needle penetration. The main objective is to compare the efficacy of articaine 4% and lidocaine 2% and to compare anterior middle superior alveolar nerve block (AMSANB) and infraorbital nerve block (IONB) for anesthesia of maxillary teeth. Materials and Methods: Forty patients undergoing root canal treatment of maxillary anteriors and premolars were included and randomly divided into four groups of ten each. Group I: patients receiving AMSANB with articaine, Group II: Patients receiving IONB with articaine, Group III: Patients receiving AMSANB with lidocaine, Group IV: Patients receiving IONB with lidocaine. The scores of onset of anesthesia and pain perception were statistically analyzed. Results: Onset of action was fastest for articaine with AMSANB and slowest for lidocaine with IONB by Tukey's test. A significant change was observed in the electrical pulp test readings at onset and at 30 min by paired t-test. All patients experienced mild pain during the procedure recorded by visual analog scale. Conclusion: Articaine 4% proved to be more efficacious than lidocaine 2%, and AMSANB was more advantageous than IONB in securing anesthesia of maxillary anteriors and premolars. PMID:27994313

  7. Femoral nerve block versus intravenous fentanyl in adult patients with hip fractures - a systematic review

    Directory of Open Access Journals (Sweden)

    Flávia Vieira Guimarães Hartmann

    Full Text Available Abstract Background: Hip fractures configure an important public health issue and are associated with high mortality taxes and lose of functionality. Hip fractures refer to a fracture occurring between the edge of the femoral head and 5 cm below the lesser trochanter. They are common in orthopedic emergencies. The number of proximal femoral fractures is likely to increase as the population ages. The average cost of care during the initial hospitalization for hip fracture can be estimated about US$ 7,000 per patient. Femoral fractures are painful and need immediate adequate analgesia. Treating pain femoral fractures is difficult because there are limited numbers of analgesics available, many of which have side effects that can limit their use. Opiates are the most used drugs, but they can bring some complications. In this context, femoral nerve blocks can be a safe alternative. It is a specific regional anesthetic technique used by doctors in emergency medicine to provide anesthesia and analgesia of the affected leg. Objective: To compare the analgesic efficacy of intravenous fentanyl versus femoral nerve block before positioning to perform spinal anesthesia in patients with femoral fractures assessed by Pain Scales. Methods: A systematic review of scientific literature was conducted. Studies described as randomized controlled trials comparing femoral nerve block and traditional fentanyl are included. Two reviewers (MR and FH independently assessed potentially eligible trials for inclusion. The methodology assessment was based on the tool developed by the Cochrane Collaboration for assessment of bias for randomized controlled trials. The Cochrane Library, Pubmed, Medline and Lilacs were searched for all articles published, without restriction of language or time. Results: Two studies were included in this review. Nerve blockade seemed to be more effective than intravenous fentanyl for preventing pain in patients suffering from a femoral fracture

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

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    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. Effect of Arm Positioning on Entrapment of Infraclavicular Nerve Block Catheter

    Science.gov (United States)

    Reddy, Rahul; Kendall, Mark C.; Nader, Antoun; Weeks, Jessica J.

    2017-01-01

    Continuous brachial plexus nerve block catheters are commonly inserted for postoperative analgesia after upper extremity surgery. Modifications of the insertion technique have been described to improve the safety of placing an infraclavicular brachial plexus catheter. Rarely, these catheters may become damaged or entrapped, complicating their removal. We describe a case of infraclavicular brachial plexus catheter entrapment related to differences in arm positioning during catheter placement and removal. Written authorization to obtain, use, and disclose information and images was obtained from the patient.

  10. Anterior and middle superior alveolar nerve block for anesthesia of maxillary teeth using conventional syringe

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    Ignacio Velasco

    2012-01-01

    Full Text Available Background: Dental procedures in the maxilla typically require multiple injections and may inadvertently anesthetize facial structures and affect the smile line. To minimize these inconveniences and reduce the number of total injections, a relatively new injection technique has been proposed for maxillary procedures, the anterior and middle superior alveolar (AMSA nerve block, which achieves pulpal anesthesia from the central incisor to second premolar through palatal approach with a single injection. The purpose of this article is to provide background information on the anterior and middle superior alveolar nerve block and demonstrate its success rates of pulpal anesthesia using the conventional syringe. Materials and Methods: Thirty Caucasian patients (16 men and 14 women with an average age of 22 years-old, belonging to the School of Dentistry of Los Andes University, were selected. All the patients received an AMSA nerve block on one side of the maxilla using the conventional syringe, 1 ml of lidocaine 2% with epinephrine 1:100.000 was injected to all the patients. Results: The AMSA nerve block obtained a 66% anesthetic success in the second premolar, 40% in the first premolar, 60% in the canine, 23.3% in the lateral incisor, and 16.7% in the central incisor. Conclusions: Because of the unpredictable anesthetic success of the experimental teeth and variable anesthesia duration, the technique is disadvantageous for clinical application as the first choice, counting with other techniques that have greater efficacy in the maxilla. Although, anesthetizing the teeth without numbing the facial muscles may be useful in restorative dentistry.

  11. Occipital nerve block is effective in craniofacial neuralgias but not in idiopathic persistent facial pain

    OpenAIRE

    Jürgens, T. P.; Müller, P.; Seedorf, H; Regelsberger, J; May, A

    2012-01-01

    Occipital nerve block (ONB) has been used in several primary headache syndromes with good results. Information on its effects in facial pain is sparse. In this chart review, the efficacy of ONB using lidocaine and dexamethasone was evaluated in 20 patients with craniofacial pain syndromes comprising 8 patients with trigeminal neuralgia, 6 with trigeminal neuropathic pain, 5 with persistent idiopathic facial pain and 1 with occipital neuralgia. Response was defined as an at least 50% reduction...

  12. Vagus nerve stimulation: state of the art of stimulation and recording strategies to address autonomic function neuromodulation

    Science.gov (United States)

    Guiraud, David; Andreu, David; Bonnet, Stéphane; Carrault, Guy; Couderc, Pascal; Hagège, Albert; Henry, Christine; Hernandez, Alfredo; Karam, Nicole; Le Rolle, Virginie; Mabo, Philippe; Maciejasz, Paweł; Malbert, Charles-Henri; Marijon, Eloi; Maubert, Sandrine; Picq, Chloé; Rossel, Olivier; Bonnet, Jean-Luc

    2016-08-01

    Objective. Neural signals along the vagus nerve (VN) drive many somatic and autonomic functions. The clinical interest of VN stimulation (VNS) is thus potentially huge and has already been demonstrated in epilepsy. However, side effects are often elicited, in addition to the targeted neuromodulation. Approach. This review examines the state of the art of VNS applied to two emerging modulations of autonomic function: heart failure and obesity, especially morbid obesity. Main results. We report that VNS may benefit from improved stimulation delivery using very advanced technologies. However, most of the results from fundamental animal studies still need to be demonstrated in humans.

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

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    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.

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

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    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.

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

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    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.

  16. 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.

  17. Evaluation of distal symmetric polyneuropathy: the role of autonomic testing, nerve biopsy, and skin biopsy (an evidence-based review).

    Science.gov (United States)

    England, J D; Gronseth, G S; Franklin, G; Carter, G T; Kinsella, L J; Cohen, J A; Asbury, A K; Szigeti, K; Lupski, J R; Latov, N; Lewis, R A; Low, P A; Fisher, M A; Herrmann, D; Howard, J F; Lauria, G; Miller, R G; Polydefkis, M; Sumner, A J

    2009-01-01

    Distal symmetric polyneuropathy (DSP) is the most common variety of neuropathy. Since the evaluation of this disorder is not standardized, the available literature was reviewed to provide evidence-based guidelines regarding the role of autonomic testing, nerve biopsy, and skin biopsy for the assessment of polyneuropathy. A literature review using MEDLINE, EMBASE, Science Citation Index, and Current Contents was performed to identify the best evidence regarding the evaluation of polyneuropathy published between 1980 and March 2007. Articles were classified according to a four-tiered level of evidence scheme and recommendations were based on the level of evidence. (1) Autonomic testing may be considered in the evaluation of patients with polyneuropathy to document autonomic nervous system dysfunction (Level B). Such testing should be considered especially for the evaluation of suspected autonomic neuropathy (Level B) and distal small fiber sensory polyneuropathy (SFSN) (Level C). A battery of validated tests is recommended to achieve the highest diagnostic accuracy (Level B). (2) Nerve biopsy is generally accepted as useful in the evaluation of certain neuropathies as in patients with suspected amyloid neuropathy, mononeuropathy multiplex due to vasculitis, or with atypical forms of chronic inflammatory demyelinating polyneuropathy (CIDP). However, the literature is insufficient to provide a recommendation regarding when a nerve biopsy may be useful in the evaluation of DSP (Level U). (3) Skin biopsy is a validated technique for determining intraepidermal nerve fiber (IENF) density and may be considered for the diagnosis of DSP, particularly SFSN (Level C). There is a need for additional prospective studies to define more exact guidelines for the evaluation of polyneuropathy.

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

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    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. 

  19. Ultrasound-guided bilateral continuous sciatic nerve blocks with stimulating catheters for postoperative pain relief after bilateral lower limb amputations*.

    NARCIS (Netherlands)

    Geffen, G.J. van; Scheuer, M.; Müller, A.; Garderniers, J.; Gielen, M.J.M.

    2006-01-01

    The performance of continuous bilateral sciatic nerve blocks under ultrasonographic control using stimulating catheters is described in a 4-year-old child with VACTERL syndrome. Ultrasound showed an abnormal vascular and nerve supply to the lower limbs. The use of ultrasound guidance made successful

  20. Cancer-related Fatigue in Patients with Advanced Cancer Treated with Autonomic Nerve Pharmacopuncture.

    Science.gov (United States)

    Park, Ji-hye; Jeon, Hyung-jun; Kang, Hwi-joong; Jeong, In-Sook; Cho, Chong-kwan; Yoo, Hwa-seung

    2015-06-01

    The purpose of this study was to observe the effects of autonomic nerve pharmacopuncture (ANP) treatment on cancer-related fatigue (CRF) in patients with advanced cancer. This observational case study was conducted at the East West Cancer Center of Daejeon University's Dunsan Korean Medical Hospital. Two patients were observed. One patient was diagnosed with left thymic cancer metastatic to the left pleura. The other patient had terminal-stage cervical cancer with iliac bone and lumbar 5 metastases. We injected mountain ginseng pharmacopuncture (MGP) into acupoints alongside the spine (Hua-Tuo-Jia-Ji-Xue, EX B2). We examined the patients for CRF using the Korean version of the Revised Piper Fatigue Scale (RPFS-K), which is a self-assessment tool. The scores on the RPFS-K for both patients tended to decrease during the treatment. Laboratory findings, including hematological changes, were also checked. Liver and renal function tests showed that the treatment was safe. Although further large-population studies are necessary, this case study suggests that ANP has a favorable effect on CRF in patients with advanced cancer.

  1. Clinical Analysis of Motor Nerve and Sensory Nerve Block in Brachial Plexus Block Guided by Nerve Stimulator%神经刺激仪对臂丛神经运动与感觉阻滞的临床分析

    Institute of Scientific and Technical Information of China (English)

    王辉; 王玲

    2013-01-01

    Objective To evaluate the clinical outcomes of motor nerve and sensory nerve separate block in interscalene brachial plexus block guided performed by nerve stimulator. Methods Eighty patients with upper extremity surgery were randomly divided into 2 groups with 40 cases each. The interscalene brachial plexus block was performed with the conventional technique in control group,and with a reformed method guided by the nerve stimulator in observation group. The sensory and motor block, VAS score and recovery of motor function were compared between the two groups at different time point after anesthesia. Results ①There were no significant differences in the outcomes of ulnar and medial nerve block. The success rate of musculo-cutaneous verve and radial nerve block was significantly higher in observation group than that in control group(P <0.05). ②The VAS score of observation group was higher than control group at 6h after anesthesia( P < 0.05). And the cases of myodynamia ≥ 2 in observation group were marked higher that in control group at 1h and 2h after giving drugs (P < 0.05 ). Conclusion Brachial plexus block guided by the nerve stimulator is better than conventional technique with a higher block rate and lesser local anesthetic dosage and faster recovery.%目的 比较传统异感法与神经刺激仪辅助定位法在臂丛神经阻滞中对运动与感觉阻滞的临床效果.方法 选取行上肢手术的80例患者,随机分为对照组和观察组各40例,对照组采用传统异感法进行肌间沟臂丛阻滞,观察组在神经刺激仪引导下行肌间沟臂丛阻滞.比较两组患者麻醉后不同时间感觉和运动阻滞的情况.结果 ①观察组对于尺神经、桡神经、正中神经及肌皮神经组织效果均较好,两组患者在尺神经和正中神经阻滞效果上差异不明显,但观察组对桡神经和肌皮神经的阻滞效果明显优于对照组(P<0.05).②两组患者麻醉后0.5h、1h、2h、24h

  2. 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.

  3. 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

  4. Effects of Continuous Sciatic Nerve Block by Tetrodotoxin on Growth Associated Protein-43 Expression in Dorsal Root Ganglions of Normal and Sciatic Nerve Injury Rats

    Institute of Scientific and Technical Information of China (English)

    Chen Wang; Yong-fa Zhang; Xiao-yu Huang

    2007-01-01

    @@ Growth associated protein-43 (GAP-43) is considered to be one of the most useful molecular markers for the neural development, nerve regeneration, and neuroplasticity. In most mature neurons, the expression of GAP-43 is at very low or negative level; its expression is triggered in response to the interruption of axonal transport. The purpose of this study was to examine whether continuous sciatic nerve block by tetrodotoxin (TTX) affects GAP-43 expression in the dorsal root ganglion (DRG) of normal and sciatic nerve injury rats.

  5. Cerebellar and brainstem infarction as a complication of CT-guided transforaminal cervical nerve root block

    Energy Technology Data Exchange (ETDEWEB)

    Suresh, S. [The Royal National Orthopaedic Hospital NHS Trust, London (United Kingdom); Berman, J. [The Royal National Orthopaedic Hospital NHS Trust, Anaesthetic Department, London (United Kingdom); Connell, David A. [The Royal National Orthopaedic Hospital NHS Trust, Department of Radiology, London (United Kingdom)

    2007-05-15

    A 60-year-old man with a 4-year history of intractable neck pain and radicular pain in the C5 nerve root distribution presented to our department for a CT-guided transforaminal left C5 nerve root block. He had had a similar procedure on the right 2 months previously, and had significant improvement of his symptoms with considerable pain relief. On this occasion he was again accepted for the procedure after the risks and potential complications had been explained. Under CT guidance, a 25G spinal needle was introduced and after confirmation of the position of the needle, steroid was injected. Immediately the patient became unresponsive, and later developed a MR-proven infarct affecting the left vertebral artery (VA) territory. This is the first report of a major complication of a cervical root injection under CT guidance reported in the literature. We present this case report and the literature review of the potential complications of this procedure. (orig.)

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

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    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.

  7. Anatomical Study of The Sacum for Transsacral Block of Sacral Nerves

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    D S Patil

    2012-08-01

    Full Text Available Inroduction: For transsacral block of sacral nerves in analgesia and anesthesia of the rectal, anal or urethral region the dorsal sacral foramina are used.To find solution of this by identifying additional anatomical landmarks and measurements of dorsal sacral foramina for transsacral nerve block. Materials & Method: Total 100 complete and undamaged adult, dry sacrums were measured with a vernier caliper (accurate to 0.1 mm. Dorsal sacral foramina of the sacrum were taken as points. Calculations and analyses were expressed as mean (SD, median and range using Open Office 3.2.0 spreadsheet version for Linux (Ubuntu 10.04. Results: The average distance between the two superolateral sacral crests was 60.61 (SD 6.71 mm. Distance between dorsal sacral foramina vertical right side 1st to 2nd 14.05 (SD 2.35mm, 2nd to 3rd 12.33 (SD 1.84mm, 3rd to 4th 11.26 (SD 2.35mm and vertical left side 1st to 2nd 14.18 (SD 2.61mm, 2nd to 3rd 12.18 (SD 1.95mm, 3rd to 4th 10.78 (SD2.42mm. Transverse distance between dorsal sacral foramina 1st to 1st 34.72 (SD 3.97mm, 2nd to 2nd 29.43 (SD 3.51mm, 3rd to 3rd 25.58 (SD 3.46mm, 4th to 4th 24.63 (SD 3.22mm. Conclusion: Measurements of dorsal sacral foramina can be used for transsacral nerve block. [Natl J of Med Res 2012; 2(4.000: 501-503

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

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    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

  9. Adductor canal block versus femoral nerve block for total knee arthroplasty: a meta-analysis of randomized controlled trials

    Science.gov (United States)

    Wang, Duan; Yang, Yang; Li, Qi; Tang, Shen-Li; Zeng, Wei-Nan; Xu, Jin; Xie, Tian-Hang; Pei, Fu-Xing; Yang, Liu; Li, Ling-Li; Zhou, Zong-Ke

    2017-01-01

    Femoral nerve blocks (FNB) can provide effective pain relief but result in quadriceps weakness with increased risk of falls following total knee arthroplasty (TKA). Adductor canal block (ACB) is a relatively new alternative providing pure sensory blockade with minimal effect on quadriceps strength. The meta-analysis was designed to evaluate whether ACB exhibited better outcomes with respect to quadriceps strength, pain control, ambulation ability, and complications. PubMed, Embase, Web of Science, Wan Fang, China National Knowledge Internet (CNKI) and the Cochrane Database were searched for RCTs comparing ACB with FNB after TKAs. Of 309 citations identified by our search strategy, 12 RCTs met the inclusion criteria. Compared to FNB, quadriceps maximum voluntary isometric contraction (MVIC) was significantly higher for ACB, which was consistent with the results regarding quadriceps strength assessed with manual muscle strength scale. Moreover, ACB had significantly higher risk of falling versus FNB. At any follow-up time, ACB was not inferior to FNB regarding pain control or opioid consumption, and showed better range of motion in comparison with FNB. ACB is superior to the FNB regarding sparing of quadriceps strength and faster knee function recovery. It provides pain relief and opioid consumption comparable to FNB and is associated with decreased risk of falls. PMID:28079176

  10. 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

  11. 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

  12. 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

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

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    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

  14. Skin temperature measured by infrared thermography after specific ultrasound-guided blocking of the musculocutaneous, radial, ulnar, and median nerves in the upper extremity

    DEFF Research Database (Denmark)

    Lange, K H W; Jansen, T; Asghar, S

    2011-01-01

    Sympathetic block causes vasodilatation and increases in skin temperature (T(s)). However, the T(s) response after specific nerve blocking is unknown. In this study, we hypothesized that T(s) would increase after specific blocking of the nerve innervating that area....

  15. Development of rat tibia innervation: colocalization of autonomic nerve fiber markers with growth-associated protein 43.

    Science.gov (United States)

    Gajda, Mariusz; Litwin, Jan A; Tabarowski, Zbigniew; Zagólski, Olaf; Cichocki, Tadeusz; Timmermans, Jean-Pierre; Adriaensen, Dirk

    2010-01-01

    Development of autonomic innervation of the tibia was investigated in rat fetuses on gestational days (GD) 17-21 and in juvenile animals on postnatal days (PD) 1-28. Double immunofluorescence combined with confocal microscopy was applied to study colocalization of neuronal growth- associated protein 43 (GAP-43) and panneuronal marker protein gene product 9.5 (PGP) with markers of the autonomic nervous system: neuropeptide Y (NPY) and dopamine beta-hydroxylase (DbetaH) for adrenergic, as well as vasoactive intestinal polypeptide (VIP) and vesicular acetylcholine transporter (VAChT) for cholinergic fibers. The first GAP-43-immunoreactive (GAP-IR) nerve fibers were seen on GD17 in the perichondrium of the proximal epiphysis. Further GAP- and PGP-IR innervation appeared in the perichondrium/periosteum of the diaphysis and in the distal epiphysis (GD19), then in the bone marrow and in the intercondylar eminence (GD21). On PD1, NPY-IR and DbetaH-IR fibers appeared within the diaphyseal periosteum and on PD4 within the bone marrow. From PD14, GAP-43 immunoreactivity of NPY-positive fibers decreased. From PD7 on, NPY-IR fibers were observed in cartilage canals of both epiphyses and in the intercondylar eminence. In secondary ossification centers, NPY-IR fibers were seen from PD10, and in the bone marrow of the epiphyses from PD14. First VIP-IR and VAChT-IR fibers were observed on PD4 within the periosteum, bone marrow and patellar ligament. From PD10 on, VIP-positive fibers were seen in the intercondylar eminence, and from PD14 in secondary ossification centers. GAP-43 proved to be superior to PGP 9.5 as marker of growing nerve fibers, mostly due to its earlier appearance. The presence of specific nerve fibers may suggest possible involvement of autonomic innervation in regulation of bone development.

  16. Autonomic markers of emotional processing: skin sympathetic nerve activity in humans during exposure to emotionally-charged images

    Directory of Open Access Journals (Sweden)

    Rachael eBrown

    2012-10-01

    Full Text Available The sympathetic innervation of the skin primarily subserves thermoregulation, but the system has also been commandeered as a means of expressing emotion. While it is known that the level of skin sympathetic nerve activity (SSNA is affected by anxiety, the majority of emotional studies have utilized the galvanic skin response as a means of inferring increases in SSNA. The purpose of the present study was to characterize the changes in SSNA when showing subjects neutral or emotionally-charged images from the International Affective Picture System. Skin sympathetic nerve activity was recorded via tungsten microelectrodes inserted into cutaneous fascicles of the common peroneal nerve in ten subjects. Neutral images, positively-charged images (erotica or negatively-charged images (mutilation were presented in blocks of fifteen images of a specific type, each block lasting two minutes. Images of erotica or mutilation were presented in a quasi-random fashion, each block following a block of neutral images. Both images of erotica or images of mutilation caused significant increases in SSNA, but the increases in SSNA were greater for mutilation. The increases in SSNA were often coupled with sweat release and cutaneous vasoconstriction, however, these markers were not always consistent with the SSNA increases. We conclude that SSNA, comprising cutaneous vasoconstrictor and sudomotor activity, increases with both positively-charged and negatively-charged emotional images. Measurement of SSNA provides a more comprehensive assessment of sympathetic outflow to the skin than does the use of sweat release alone as a marker of emotional processing.

  17. Population pharmacokinetics of bupivacaine in combined lumbar and sciatic nerve block

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    Hanene Eljebari

    2014-01-01

    Full Text Available Objectives: The primary aim of this study was to establish the population pharmacokinetic (PPK model of bupivacaine after combined lumbar plexus and sciatic nerve blocks and secondary aim is to assess the effect of patient′s characteristics including age, body weight and sex on pharmacokinetic parameters. Materials and Methods: A total of 31 patients scheduled for elective lower extremity surgery with combined lumbar and sciatic nerve block using plain bupivacaine 0.5% were included. The total bupivacaine plasma concentrations were measured before injection and after two blocks placement and at selected time points. Monitoring of bupivacaine was made by high performance liquid chromatography (HPLC with ultraviolet detection. Non-linear mixed effects modeling was used to analyze the PPK of bupivacaine. Results: One compartment model with first order absorption, two input compartments and a central elimination was selected. The Shapiro-Wilks test of normality for normalized prediction distribution errors for this model (P = 0.156 showed this as a valid model. The selected model predicts a population clearance of 930 ml/min (residual standard error [RSE] = 15.48%, IC 95% = 930 ± 282.24 with inter individual variability of 75.29%. The central volume of distribution was 134 l (RSE = 12.76%, IC = 134 ± 33.51 L with inter individual variability of 63.40%. The absorption of bupivacaine in two sites Ka1 and Ka2 were 0.00462/min for the lumbar site and 0.292/min for the sciatic site. Age, body weight and sex have no effect on the bupivacaine pharmacokinetics in this studied population. Conclusion: The developed model helps us to assess the systemic absorption of bupivacaine at two injections sites.

  18. Comparison of Periodontal Ligament Injection and Inferior Alveolar Nerve Block in Mandibular Primary Molars Pulpotomy: A Randomized Control Trial

    Science.gov (United States)

    Haghgoo, Roza; Taleghani, Ferial

    2015-01-01

    Background: Inferior alveolar nerve block is a common technique for anesthesia of the primary mandibular molars. A number of disadvantages have been shown to be associated with this technique. Periodontal ligament (PDL) injection could be considered as an alternative to inferior alveolar nerve block. The aim of this study was to evaluate the effectiveness of PDL injection in the anesthesia of primary molar pulpotomy with mandibular block. Methods: This study was performed using a sequential double-blind randomized trial design. 80 children aged 3-7 years old who required pulpotomy in symmetrical mandibular primary molars were selected. The teeth of these children were anesthetized with periodontal injection on one side of the mandible and block on the other. Pulpotomy was performed on each patient during the same appointment. Signs of discomfort, including hand and body tension and eye movement, the verbal complaint and crying (SEM scale), were evaluated by a dental assistant who was blinded to the treatment allocation of the patients. Finally, the data were analyzed using the exact Fisher test and Pearson Chi-squared exact test. Results: Success rate was 88/75 and 91/25 in the PDL injection and nerve block groups, respectively. There was no statistically significant difference between the two techniques (P = 0.250). Conclusion: Results showed that PDL injection can be used as an alternative to nerve block in pulpotomy of the mandibular primary molars. PMID:26028895

  19. General anesthesia plus ilioinguinal nerve block versus spinal anesthesia for ambulatory inguinal herniorrhapy

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    Lucía Vizcaíno-Martínez

    2014-01-01

    Full Text Available Objective: The aim was to evaluate general anesthesia (GA plus ilioinguinal nerve block (IIB versus spinal anesthesia (SA in patients scheduled for ambulatory inguinal hernia repair regarding pain management, anesthesia recovery and reducing potential complications. Materials and Methods: A double-blind, prospective, randomized, controlled study in patients American Society of Anesthesiologists I-III randomized into two groups: GA plus IIB group, induction of anesthesia with propofol, maintenance with sevoflurane, airway management with laryngeal mask allowing spontaneous ventilation and ultrasound-guided IIB; SA group, patients who underwent spinal block with 2% mepivacaine. The study variables were pain intensity, assessed by visual analog scale, analgesic requirements until hospital discharge, time to ambulation and discharge, postoperative complications-related to both techniques and satisfaction experienced. Results: Thirty-two patients were enrolled; 16 patients in each group. The differences regarding pain were statistically significant at 2 h of admission (P < 0.001 and at discharge (P < 0.001 in favor of the GA plus ilioinguinal block group. In addition in this group, analgesic requirements were lower than SA group (P < 0.001, with times of ambulation and discharge significantly shorter. The SA group had a higher tendency to develop complications and less satisfaction. Conclusion: General anesthesia plus IIB is better than SA regarding postoperative analgesia, time to mobilization and discharge, side-effect profile and satisfaction experienced by the patients.

  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. 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.

  2. Thermal hyperalgesia after sciatic nerve block in rat is transient and clinically insignificant.

    Science.gov (United States)

    Janda, Allison; Lydic, Ralph; Welch, Kathleen B; Brummett, Chad M

    2013-01-01

    Ropivacaine has been associated with transient heat hyperalgesia in sciatic nerve blocks in rat. The goal of the present study was to evaluate the hypothesized presence of transient heat hyperalgesia after perineural injection of ropivacaine with a secondary subanalysis of 2 published studies. Paw withdrawal latency was used to assess the duration of sensory blockade and presence of heat hyperalgesia at 210, 240, 270, and 300 minutes and 24 hours after injection. The analysis revealed hyperalgesia at a single time point (240 minutes after injection; mean difference, -0.60 seconds; P = 0.012) that resolved within 30 minutes, and there was no other significant hyperalgesia at other time points. Although statistically significant, the single time point measurement represented only an 11% change from baseline and was no longer present 30 minutes later. These data support the need for a reevaluation of the interpretation that pain can be worsened by perineural ropivacaine injection.

  3. 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.

  4. The Anticonvulsant Effect of Transcutaneous Auricular Vagus Nerve Stimulation is Associated with Balancing the Autonomic Dysfunction in Rats

    Institute of Scientific and Technical Information of China (English)

    Wei He; Xiao-Yu Wang; Hong Shi; Yang-Shuai Su; Xiang-Hong Jing; Bing Zhu

    2016-01-01

    Objective: The present study aims to investigate whether the anticonvulsant effect of transcutaneous auricular vagus nerve stimulation is associated with balancing the autonomic dysfunction in rats. Methods: Healthy adult male Sprague-Dawley rats were anesthetized with an intraperitoneal injection of 10%urethane. Seizures were evoked by intraperitoneal injection of pentylenetetrazol (PTZ, 60 mg/kg). Femoral vein catheterization was performed for injection of sympathetic agonist and antagonists. Bipolar globe silver electrodes were utilized for epidural EEG recording. Three needles were inserted separately in subcutaneous muscles of left anterior limb, right anterior limb, and left hind limb to record ECG signals. ta-VNS was performed at auricular concha. Results: In comparison with preictal state, the mean heart rate (HR) increased slightly during epileptic seizures (P<0.05). In comparison with ictal state, the mean HR decreased a little at postictal state (P<0.05). When continuous epileptic seizures in EEG traces occurred (in ictal state), vein injection of propranolol hydrochloride (sympathetic antagonist) suppressed the epileptic seizures. When epileptic seizures occurred rarely (in postictal state), vein injection of adrenaline hydrochloride (sympathetic agonist) exacerbated the epileptic seizures. In comparison with pre-stimulation, the integral of EEG traces after ta-VNS decreased (P<0.05), the mean HR decreased (P<0.05), and the high power (HF) of HRV increased (P<0.05) after ta-VNS. Conclusion: The results showed that autonomic dysfunction occurred in epileptic rats characterized by enhanced sympathetic nerve activity. Epileptic seizures in EEG traces decreased, HR decreased and HF increased after ta-VNS, which indicated that ta-VNS may suppress epileptic seizures via balancing the autonomic dysfunction.

  5. Effect of Shensong Yangxin on the Progression of Paroxysmal Atrial Fibrillation is Correlated with Regulation of Autonomic Nerve Activity

    Science.gov (United States)

    Zhao, Hong-Yi; Zhang, Shu-Di; Zhang, Kai; Wang, Xi; Zhao, Qing-Yan; Zhang, Shu-Juan; Dai, Zi-Xuan; Qian, Yong-Sheng; Zhang, You-Jing; Wei, Hao-Tian; Tang, Yan-Hong; Huang, Cong-Xin

    2017-01-01

    Background: Shensong Yangxin (SSYX), a traditional Chinese herbal medicine, has long been used clinically to treat arrhythmias in China. However, the mechanism of SSYX on atrial fibrillation (AF) is unknown. In this study, we tested the hypothesis that the effect of SSYX on the progression of paroxysmal AF is correlated with the regulation of autonomic nerve activity. Methods: Eighteen mongrel dogs were randomly divided into control group (n = 6), pacing group (n = 6), and pacing + SSYX group (n = 6). The control group was implanted with pacemakers without pacing; the pacing group was implanted with pacemakers with long-term intermittent atrial pacing; the pacing + SSYX group underwent long-term intermittent atrial pacing and SSYX oral administration. Results: Compared to the pacing group, the parameters of heart rate variability were lower after 8 weeks in the pacing + SSYX group (low-frequency [LF] component: 20.85 ± 3.14 vs. 15.3 ± 1.89 ms2, P = 0.004; LF component/high-frequency component: 1.34 ± 0.33 vs. 0.77 ± 0.15, P dogs in the pacing group had more episodes and longer durations of AF than that in the pacing + SSYX group. SSYX markedly inhibited the increase in sympathetic nerves and upregulation of tumor necrosis factor-alpha and interleukin-6 expression in the pacing + SSYX group. Furthermore, SSYX suppressed the decrease of acetylcholine and α7 nicotinic acetylcholine receptor protein induced by long-term intermittent atrial pacing. Conclusions: SSYX substantially prevents atrial electrical remodeling and the progression of AF. These effects of SSYX may have association with regulating the imbalance of autonomic nerve activity and the cholinergic anti-inflammatory pathway. PMID:28091409

  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. 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.

  9. 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.

  10. 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

    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...

  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. Comparative Study of Greater Palatine Nerve Block and Intravenous Pethidine for Postoperative Analgesia in Children Undergoing Palatoplasty

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    Manjunath R Kamath

    2009-01-01

    Full Text Available Greater palatine nerve block anaesthetizes posterior portions of the hard palate and its overlying soft tissues. This study compared the efficacy, safety, and ease of the nerve block for cleft palate surgeries in children with i.v. pethidine for postoperative pain management. A prospective, double blind, randomized trial, enrolled 50 children aged below 10 years scheduled for palatoplasty and were alternatively allocated to two groups. Group A received intravenous pethidine 1mg.kg-1, whereas Group B, bilateral greater palatine nerve block with bupivacaine 0.25%, 1ml on each side, before the surgical stimulation. Modified Aldrete Scoring System, Children′s Hospital Eastern Ontario Pain Scale (CHEOPS and Brussels Sedation Score were employed to assess recovery, quality of analgesia and sedation respectively, by the nursing staff. Whenever pain score was> 8, 0.5mg.kg-1 of pethidine was given intravenously for rescue analgesia in both groups. Recovery scores were better in Group B (p=0.007. In the immediate postoperative period, pain score was more in Group A (number of patients with pain score> 8, 44% v/s 12%, p= .0117. Requirement for rescue analgesia was more in Group A (60 times v/s 7. The average sedation scores were similar. There was a higher incidence of agitation in Group A (66 vs. 30. The incidence of deep sedation was nearly half in Group B (34 Vs 63. Greater palatine nerve block was considered successful in 88% of cases. Greater palatine nerve block produces more effective, consistent and prolonged analgesia than pethidine.

  13. Intra-SA-nodal pacemaker shifts induced by autonomic nerve stimulation in the dog.

    Science.gov (United States)

    Goldberg, J M

    1975-10-01

    Pacemaker shifts in the canine heart were inferred during stimulation of thoracic cardiac nerves and following norepinephrine from changes in the initial site of activation of bipolar electrodes sutured over the rostral, middle, and caudal regions of the sinus node, over the internodal pathways, and His bundle. During control periods, pacemaker activity was localized within the sinoatrial (SA) node 87% of the time, with the middle electrode most frequently showing initial activation. Stimulation of the right-sympathetic nerves enhanced sinus node pacemaker dominance, shifting it rostrally within the node. Right-vagal stimulation shifted the pacemaker caudally within the SA node, to nonnodal sites, and to the lower atrioventricular node and His bundle. Left-sympathetic stimulation shifted the pacemaker caudally within the sinus node and enhanced pacemaker activity in the vicinity of the internodal pathway electrodes and His bundle. Dispersion of pacemaker activity was particularly apparent during stimulation of the ventrolateral cervical cardiac nerve. Stimulation of the left-vagal nerves produced effects similar to those of the left-sympathetic nerves. Norepinephrine enhanced pacemaker activity particularly in the rostral region of the sinus node. Slight shifts in pacemaker activity within the sinus node produced changes in pattern of atrial excitation.

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

    Science.gov (United States)

    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

  17. Early-onset multisystem degeneration with central motor, autonomic and optic nerve disturbances: unusual Riley-Day syndrome or new clinical entity?

    Science.gov (United States)

    Schnitzler, A; Witte, O W; Kunesch, E; Freund, H J; Benecke, R

    1998-02-05

    We report a 21-year-old woman presenting with a slowly progressive tetraparesis, optic nerve atrophy on both sides, and autonomic disturbances since early childhood. The patient has been carefully followed up for 5 years with clinical and ancillary investigations. The results and the time course strongly suggest an underlying degenerative syndrome affecting parts of three major systems: autonomic, motor and visual. Some symptoms resemble familial dysautonomia (FD, Riley-Day syndrome), however, hallmarks of FD, such as absence of fungiform papillae of the tongue, abnormal reaction on intradermal histamine injection, absent tendon reflexes, are missing, and central motor disturbances have not been described in FD. We consider this syndrome a slowly progressive multisystemic degeneration with two unusual hitherto unreported features: the combination of affected systems (autonomic and motor systems, optic nerves), and the early onset.

  18. [Autonomic neuropathies].

    Science.gov (United States)

    Siepmann, T; Penzlin, A I; Illigens, B M W

    2013-07-01

    Autonomic neuropathies are a heterogeneous group of diseases that involve damage of small peripheral autonomic Aδ- and C-fibers. Causes of autonomic nerve fiber damage are disorders such as diabetes mellitus and HIV-infection. Predominant symptoms of autonomic neuropathy are orthostatic hypotension, gastro-intestinal problems, urogenital dysfunction, and cardiac arrhythmia, which can severely impair the quality of life in affected patients. Furthermore, autonomic neuropathies can be induced by autoimmune diseases such as acute inflammatory demyelinating polyneuropathy, hereditary disorders such as the lysosomal storage disorder Fabry disease and hereditary sensory and autonomic neuropathies, as well as certain toxins and drugs.

  19. Alternative to the inferior alveolar nerve block anesthesia when placing mandibular dental implants posterior to the mental foramen.

    Science.gov (United States)

    Heller, A A; Shankland, W E

    2001-01-01

    Local anesthesia block of the inferior alveolar nerve is routinely taught throughout dental education. This commonly used technique eliminates all somatosensory perception of the mandible, mandibular teeth, floor of the mouth, ipsilateral tongue, and all but the lateral (buccal) gingivae. Generally, the dentist or surgeon desires these structures to be anesthetized. However, in the placement of mandibular implants, it may be useful for the patient to be able to sense when the inferior alveolar nerve is in danger of being damaged, possibly producing permanent paresthesia. In this article, the technique of mandibular infiltration prior to mandibular implant placement in the mandible is discussed.

  20. 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.

  1. NERVE BLOCKING (PAIN CONTROL AFTER THORACOTOMY WITH BUPIVACAINE:EPIDURAL VS INTERCOSTAL

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    A GHAFOURI

    2001-09-01

    Full Text Available Introduction. Use of analgesics is an evitable and necessary part of thoracic surgery. This study was designed to compare analgesic effects of persistent thoracic epidural anesthesia versus persistent intercostal nerve block and determine their role in opioid need after thoracotomy. Methods. 116 patients above 20 years old who were candidate for thoracotomy through either posterolateral or thoracoabdominal incision were situatedin one of three group for pain relief. For the first group, pain relieved by petidine and pentazosin. In 2nd group, pain relived by thoracic epidural anesthesia with bupivacaine catheters which were inserted between costal and plural space. In 3rd group, bupivacaine was introduced through 3rd and 4th intercostal space by catheter (2 mg/kg in devided doses. Pain was meseared by visual analogue scale and quantified by surgical residents through a method bupivacaine was injected. If Bupivacaine did not relieve pain, then opioid was used as adjuvant. Results. The study showed that epidural group needed less opioids and had more cooperation in comparison with two other group. The intercostal group complained of pain at chest tube site. Discussion. In thoracotomized patients, pain control is more effective via epidural anesthesia in turns of opioid side effects, expenses and patient comfort.

  2. Liposomal Bupivacaine vs Interscalene Nerve Block for Pain Control After Shoulder Arthroplasty: A Retrospective Cohort Analysis.

    Science.gov (United States)

    Hannan, Casey V; Albrecht, Matthew J; Petersen, Steve A; Srikumaran, Uma

    The aim of this study was to compare liposomal bupivacaine and interscalene nerve block (ISNB) for analgesia after shoulder arthroplasty. We compared 37 patients who received liposomal bupivacaine vs 21 who received ISNB after shoulder arthroplasty by length of hospital stay (LOS), opioid consumption, and postoperative pain. Pain was the same in both groups for time intervals of 1 hour and 8 to 14 hours postoperatively. Compared with ISNB patients, liposomal bupivacaine patients reported less pain at 18 to 24 hours (P = .001) and 27 to 36 hours (P = .029) and had lower opioid consumption on postoperative days 2 (P = .001) and 3 (P = .002). Mean LOS for liposomal bupivacaine patients was 46 ± 20 hours vs 57 ± 14 hours for ISNB patients (P = .012). Sixteen of 37 liposomal bupivacaine patients vs 2 of 21 ISNB patients were discharged on the first postoperative day (P = .010). Liposomal bupivacaine was associated with less pain, less opioid consumption, and shorter hospital stays after shoulder arthroplasty compared with ISNB.

  3. Occipital nerve block is effective in craniofacial neuralgias but not in idiopathic persistent facial pain.

    Science.gov (United States)

    Jürgens, T P; Müller, P; Seedorf, H; Regelsberger, J; May, A

    2012-04-01

    Occipital nerve block (ONB) has been used in several primary headache syndromes with good results. Information on its effects in facial pain is sparse. In this chart review, the efficacy of ONB using lidocaine and dexamethasone was evaluated in 20 patients with craniofacial pain syndromes comprising 8 patients with trigeminal neuralgia, 6 with trigeminal neuropathic pain, 5 with persistent idiopathic facial pain and 1 with occipital neuralgia. Response was defined as an at least 50% reduction of original pain. Mean response rate was 55% with greatest efficacy in trigeminal (75%) and occipital neuralgia (100%) and less efficacy in trigeminal neuropathic pain (50%) and persistent idiopathic facial pain (20%). The effects lasted for an average of 27 days with sustained benefits for 69, 77 and 107 days in three patients. Side effects were reported in 50%, albeit transient and mild in nature. ONBs are effective in trigeminal pain involving the second and third branch and seem to be most effective in craniofacial neuralgias. They should be considered in facial pain before more invasive approaches, such as thermocoagulation or vascular decompression, are performed, given that side effects are mild and the procedure is minimally invasive.

  4. Management of pudendal neuralgia using ultrasound-guided pulsed radiofrequency: a report of two cases and discussion of pudendal nerve block techniques.

    Science.gov (United States)

    Hong, Myong-Joo; Kim, Yeon-Dong; Park, Jeong-Ki; Hong, Hyon-Joo

    2016-04-01

    Pudendal neuralgia is characterized by chronic pain or discomfort in the area innervated by the pudendal nerve, with no obvious cause. A successful pudendal nerve block is crucial for the diagnosis of pudendal neuralgia. Blind or fluoroscopy-guided pudendal nerve blocks have been conventionally used for diagnosis and treatment; however, ultrasound-guided pudendal nerve blocks were also reported recently. With regard to the achievement of long-term effects, although pulsed radiofrequency performed under fluoroscopic guidance has been reported, that performed under ultrasound guidance is not well reported. This report describes two cases of pudendal neuralgia that were successfully managed using ultrasound-guided pulsed radiofrequency and presents a literature review of pudendal nerve block techniques. However, in the management of chronic neuropathic pain, physicians should keep in mind that the placebo effect related to invasive approaches must not be neglected.

  5. Autonomic nerves versus prostaglandins in the control of rat and rabbit testicular capsular contractions in vivo and in vitro

    Energy Technology Data Exchange (ETDEWEB)

    Hargrove, J.L.; Ellis, L.C.

    1976-06-01

    The tonus and rate of spontaneous contractions measured in vivo from the tunica albuginea of rabbit testes were augmented by epinephrine, acetylcholine and prostaglandin (PG)F/sub 2 alpha/. Neither reserpine, dibenamine nor atropine decreased autorhythmic contractility. Indomethacin injections ip significantly decreased the mean amplitude of testicular contractions. This treatment effaced motility in two of eleven preparations. Injections of 5,8,11,14-eicosatetraynoic acid (TYA) did not significantly decrease the amplitude of contraction. Electrical stimulation of the spermatic artery (site of the spermatic nerve) in rabbits and in rats failed to alter testicular tonus or motility. The above evidence suggests that local factors such as PGs may contribute more to smooth muscle activity in the tunica albuginea of rabbit testes than do autonomic nerves. The rhythmical contractions observed in vivo, however, continued in the presence of indomethacin in the bathing medium, and may not require stimulation by PGs for their origination. Rat testes, unlike rabbit testes, did not contract rhythmically in vivo. Isolated rat testes contracted in response to administered PGF/2 alpha/, while PGE/sub 1/ abolished the induced contraction. Such modulators of muscular tonus feasibly could alter intratesticular pressure for the intact animal.

  6. Self-consistent analyses for potential conduction block in nerves by an ultrashort high-intensity electric pulse

    Science.gov (United States)

    Joshi, R. P.; Mishra, A.; Hu, Q.; Schoenbach, K. H.; Pakhomov, A.

    2007-06-01

    Simulation studies are presented that probe the possibility of using high-field (>100kV/cm) , short-duration (˜50ns) electrical pulses for nonthermal and reversible cessation of biological electrical signaling pathways. This would have obvious applications in neurophysiology, clinical research, neuromuscular stimulation therapies, and even nonlethal bioweapons development. The concept is based on the creation of a sufficiently high density of pores on the nerve membrane by an electric pulse. This modulates membrane conductance and presents an effective “electrical short” to an incident voltage wave traveling across a nerve. Net blocking of action potential propagation can then result. A continuum approach based on the Smoluchowski equation is used to treat electroporation. This is self-consistently coupled with a distributed circuit representation of the nerve dynamics. Our results indicate that poration at a single neural segment would be sufficient to produce an observable, yet reversible, effect.

  7. Ultrasound-guided femoral nerve block for pain control in an infant with a femur fracture due to nonaccidental trauma.

    Science.gov (United States)

    Frenkel, Oron; Mansour, Karim; Fischer, Jason W J

    2012-02-01

    A 3-month-old infant girl was transferred to our emergency department (ED) with a subtrochanteric femoral neck fracture due to nonaccidental trauma. She received multiple doses of parenteral analgesics both before arrival and in our ED. We performed an ultrasound-guided femoral nerve block using 2.0 mL of 0.25% bupivicaine (approximately 1.25 mg/kg) before placing the patient in a Pavlik harness. Successful pain control was achieved within 15 minutes of the procedure allowing pain-free manipulation of the affected extremity. The patient required only a single dose of parenteral narcotics during the ensuing 18 hours. To our knowledge, this is the first report of an ultrasound-guided femoral nerve block used in the ED for pain control in a pediatric patient.

  8. 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.

  9. 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....... CONCLUSION: Adductor canal block provides a clinically relevant and statistically significant increase in quadriceps muscle strength for patients in severe pain after TKA....

  10. 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.

  11. 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

    to the sciatic nerve in the popliteal fossa. Circumferential spread of 3-ml isotonic saline around the sciatic nerve was observed on ultrasound images in both conditions. CONCLUSION: Preliminary proof of concept of this novel method demonstrates that precise in-plane ultrasound-guided initial placement...

  12. Perivascular nerve fiber α-synuclein regulates contractility of mouse aorta: a link to autonomic dysfunction in Parkinson's disease.

    Science.gov (United States)

    Marrachelli, Vannina G; Miranda, Francisco J; Alabadí, José A; Milán, Miguel; Cano-Jaimez, Marifé; Kirstein, Martina; Alborch, Enrique; Fariñas, Isabel; Pérez-Sánchez, Francisco

    2010-07-01

    Parkinson's disease and other neurodegenerative disorders associated to changes in alpha-synuclein often result in autonomic dysfunction, most of the time accompanied by abundant expression of this synaptic protein in peripheral autonomic neurons. Given that expression of alpha-synuclein in vascular elements has been previously reported, the present study was undertaken to determine whether alpha-synuclein directly participates in the regulation of vascular responsiveness. We detected by immunohistochemistry perivascular nerve fibers containing alpha-synuclein in the aorta of mice while aortic endothelial cells and muscular fibers themselves did not exhibit detectable levels of this protein. To assess the effect of alpha-synuclein on vascular reactivity, aortic ring preparations obtained from alpha-synuclein-deficient knockout mice and from transgenic mice overexpressing human wild-type alpha-synuclein under the control of the tyrosine hydroxylase-promoter were mounted and equilibrated in organ baths for isometric tension recording. Lack of alpha-synuclein did not modify the relaxant responses to the endothelium-dependent (acetylcholine) and -independent (sodium nitroprusside) vasodilators, but resulted in a greater than normal norepinephrine-induced vasoconstriction along with a lowered response to dopamine, suggesting potential presynaptic changes in dopamine and norepinephrine releases in knockout mice. Overexpression of alpha-synuclein in TH-positive fibers resulted in complex abnormal responses, characterized by lowered acetylcholine-induced relaxation and lowered norepinephrin-induced contraction. Taken together, our data show for the first time that alpha-synuclein is present in sympathetic fibers supplying the murine aorta and provide evidence that changes in alpha-synuclein levels in perivascular fibers play a physiological role in the regulation of vascular function.

  13. 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.

  14. Autonomic neuropathy

    DEFF Research Database (Denmark)

    Hilsted, J

    1983-01-01

    The diagnosis of autonomic neuropathy is often difficult to establish, since clinical symptoms generally appear late in the course of the disease, and may be non-specific. A number of recently developed quantifiable and reproducible autonomic nerve function tests are reviewed, with emphasis on th...

  15. Iliohypogastric/ilioinguinal nerve block in inguinal hernia repair for postoperative pain management: comparison of the anatomical landmark and ultrasound guided techniques

    OpenAIRE

    Abdurrahman Demirci; Esra Mercanoglu Efe; Gürkan Türker; Alp Gurbet; Fatma Nur Kaya; Ali Anil; İlker Çimen

    2014-01-01

    Objectives: The purpose of this study is to compare the efficacy of iliohypogastric/ilioinguinal nerve blocks performed with the ultrasound guided and the anatomical landmark techniques for postoperative pain management in cases of adult inguinal herniorrhaphy. Methods: 40 patients, ASA I-II status were randomized into two groups equally: in Group AN (anatomical landmark technique) and in Group ultrasound (ultrasound guided technique), iliohypogastric/ilioinguinal nerve block was performed w...

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

    Directory of Open Access Journals (Sweden)

    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

  17. 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.

  18. 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.

  19. 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.

  20. 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

  1. Gross anatomical study on the human myocardial bridges with special reference to the spatial relationship among coronary arteries, cardiac veins, and autonomic nerves.

    Science.gov (United States)

    Watanabe, Yuko; Arakawa, Takamitsu; Kageyama, Ikuo; Aizawa, Yukio; Kumaki, Katsuji; Miki, Akinori; Terashima, Toshio

    2016-04-01

    Coronary arteries are frequently covered by cardiac muscles. This arrangement is termed a myocardial bridge. Previous studies have shown that myocardial bridges can cause myocardial ischemic diseases or cardiac arrhythmia, but the relevant pathogenic mechanisms remain unknown. We examined 60 hearts from Japanese cadavers macroscopically to clarify the spatial relationships among coronary arteries, cardiac veins and autonomic nerves. We found 86 myocardial bridges in 47 hearts from the 60 cadavers examined (78.3%). Next, we dissected out nine hearts with myocardial bridges in detail under the operating microscope. We found no additional branches of coronary arteries on the myocardial bridge surfaces. However, the cardiac veins, which usually accompany the coronary arteries, ran independently on the myocardial bridge surfaces in the same region. Cardiac autonomic nerves comprised two rami: one was associated with the coronary artery under the myocardial bridge and the other ran on the surface of the bridge. Such spatial relationships among the coronary arteries, cardiac veins and cardiac autonomic nerves at the myocardial bridges are quite similar to those in mouse embryo hearts.

  2. 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.

  3. Evaluation of cardiac autonomic nerves by iodine-123 metaiodobenzylguanidine scintigraphy and ambulatory electrocardiography in patients after arterial switch operations

    Energy Technology Data Exchange (ETDEWEB)

    Sakurai, Hajime; Maeda, Masanobu; Miyahara, Ken [Shakaihoken Chukyo Hospital, Nagoya (Japan)] [and others

    2000-05-01

    The autonomic cardiac nerves reach the heart after passing through the vicinity of the aortic root and the pulmonary trunk. The arterial switch operation (ASO) completely transects the ascending aorta and the pulmonary trunk. Therefore, this surgical procedure virtually denerves the heart. Cardiac sympathetic denervation and reinnervation were evaluated in patients after ASO using iodine-123 metaiodobenzylguanidine (MIBG) myocardial scintigraphy and parasympathetic denervation and reinnervation using ambulatory electrocardiography [Holter electrocardiogram (ECG)]. MIBG scintigraphy was performed in 14 patients who underwent ASO (ASO group) and 3 patients who underwent other open heart surgery (control group). All patients in the ASO group underwent the operation in the neonatal or infantile period. Planar and single photon emission computed tomography (SPECT) images of the myocardium were obtained. Defect score was determined by the SPECT images as a semi-quantitative index. The mean interval between ASO and MIBG scintigraphy was 25.6{+-}14.6 months. Holter ECG was also performed in 14 patients in the ASO group and 19 age-matched normal children. The Holter ECGs were plotted on a Lorenz plot. The H index, which is related to vagal tone for the cardiovascular system, was calculated from the R-R intervals. The mean interval between the ASO and Holter ECG was 8.3{+-}9.7 months. MIBG scintigraphy in the control group demonstrated an almost normal homogeneous tracer uptake, but showed extremely reduced tracer uptake and significantly higher defect score in the ASO group. The extent and degree of the reduction of MIBG uptake improved with time after the ASO. The heart-to-mediastinum MIBG count ratio tended to increase with time. The H index of the ASO group was lower than that of normal children (<12 months: Control group 0.0280{+-}0.0068 vs ASO group 0.0219{+-}0.0083), and gradually increased with time (1-3 years: 0.0470{+-}0.0157 vs 0.0314{+-}0.0124). (author)

  4. 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.

  5. Peripheral injury of pelvic visceral sensory nerves alters GFRa (GDNF family receptor alpha localization in sensory and autonomic pathways of the sacral spinal cord

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    Shelley Lynne Forrest

    2015-04-01

    Full Text Available GDNF (glial cell line-derived neurotrophic factor, neurturin and artemin use their co-receptors (GFRα1, GFRα2 and GFRα3, respectively and the tyrosine kinase Ret for downstream signalling. In rodent dorsal root ganglia (DRG most of the unmyelinated and some myelinated sensory afferents express at least one GFRα. The adult function of these receptors is not completely elucidated but their activity after peripheral nerve injury can facilitate peripheral and central axonal regeneration, recovery of sensation, and sensory hypersensitivity that contributes to pain. Our previous immunohistochemical studies of spinal cord and sciatic nerve injuries in adult rodents have identified characteristic changes in GFRα1, GFRα2 or GFRα3 in central spinal cord axons of sensory neurons located in dorsal root ganglia. Here we extend and contrast this analysis by studying injuries of the pelvic and hypogastric nerves that contain the majority of sensory axons projecting to the pelvic viscera (e.g., bladder and lower bowel. At 7 d, we detected some effects of pelvic but not hypogastric nerve transection on the ipsilateral spinal cord. In sacral (L6-S1 cord ipsilateral to nerve injury, GFRα1-immunoreactivity (IR was increased in medial dorsal horn and CGRP-IR was decreased in lateral dorsal horn. Pelvic nerve injury also upregulated GFRα1- and GFRα3-IR terminals and GFRα1-IR neuronal cell bodies in the sacral parasympathetic nucleus that provides the spinal parasympathetic preganglionic output to the pelvic nerve. This evidence suggests peripheral axotomy has different effects on somatic and visceral sensory input to the spinal cord, and identifies sensory-autonomic interactions as a possible site of post-injury regulation.

  6. Scaffolds from block polyurethanes based on poly(ɛ-caprolactone) (PCL) and poly(ethylene glycol) (PEG) for peripheral nerve regeneration.

    Science.gov (United States)

    Niu, Yuqing; Chen, Kevin C; He, Tao; Yu, Wenying; Huang, Shuiwen; Xu, Kaitian

    2014-05-01

    Nerve guide scaffolds from block polyurethanes without any additional growth factors or protein were prepared using a particle leaching method. The scaffolds of block polyurethanes (abbreviated as PUCL-ran-EG) based on poly(ɛ-caprolactone) (PCL-diol) and poly(ethylene glycol) (PEG) possess highly surface-area porous for cell attachment, and can provide biochemical and topographic cues to enhance tissue regeneration. The nerve guide scaffolds have pore size 1-5 μm and porosity 88%. Mechanical tests showed that the polyurethane nerve guide scaffolds have maximum loads of 4.98 ± 0.35 N and maximum stresses of 6.372 ± 0.5 MPa. The histocompatibility efficacy of these nerve guide scaffolds was tested in a rat model for peripheral nerve injury treatment. Four types of guides including PUCL-ran-EG scaffolds, autograft, PCL scaffolds and silicone tubes were compared in the rat model. After 14 weeks, bridging of a 10 mm defect gap by the regenerated nerve was observed in all rats. The nerve regeneration was systematically characterized by sciatic function index (SFI), histological assessment including HE staining, immunohistochemistry, ammonia silver staining, Masson's trichrome staining and TEM observation. Results revealed that polyurethane nerve guide scaffolds exhibit much better regeneration behavior than PCL, silicone tube groups and comparable to autograft. Electrophysiological recovery was also seen in 36%, 76%, and 87% of rats in the PCL, PUCL-ran-EG, and autograft groups respectively, whilst 29.8% was observed in the silicone tube groups. Biodegradation in vitro and in vivo show proper degradation of the PUCL-ran-EG nerve guide scaffolds. This study has demonstrated that without further modification, plain PUCL-ran-EG nerve guide scaffolds can help peripheral nerve regeneration excellently.

  7. 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.

  8. 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.

  9. Heart Rate Changes in Response to Mechanical Pressure Stimulation of Skeletal Muscles Are Mediated by Cardiac Sympathetic Nerve Activity

    Science.gov (United States)

    Watanabe, Nobuhiro; Hotta, Harumi

    2017-01-01

    Stimulation of mechanoreceptors in skeletal muscles such as contraction and stretch elicits reflexive autonomic nervous system changes which impact cardiovascular control. There are pressure-sensitive mechanoreceptors in skeletal muscles. Mechanical pressure stimulation of skeletal muscles can induce reflex changes in heart rate (HR) and blood pressure, although the neural mechanisms underlying this effect are unclear. We examined the contribution of cardiac autonomic nerves to HR responses induced by mechanical pressure stimulation (30 s, ~10 N/cm2) of calf muscles in isoflurane-anesthetized rats. Animals were artificially ventilated and kept warm using a heating pad and lamp, and respiration and core body temperature were maintained within physiological ranges. Mechanical stimulation was applied using a stimulation probe 6 mm in diameter with a flat surface. Cardiac sympathetic and vagus nerves were blocked to test the contribution of the autonomic nerves. For sympathetic nerve block, bilateral stellate ganglia, and cervical sympathetic nerves were surgically sectioned, and for vagus nerve block, the nerve was bilaterally severed. In addition, mass discharges of cardiac sympathetic efferent nerve were electrophysiologically recorded. Mechanical stimulation increased or decreased HR in autonomic nerve-intact rats (range: −56 to +10 bpm), and the responses were negatively correlated with pre-stimulus HR (r = −0.65, p = 0.001). Stimulation-induced HR responses were markedly attenuated by blocking the cardiac sympathetic nerve (range: −9 to +3 bpm, p mechanical stimulation increased, or decreased the frequency of sympathetic nerve activity in parallel with HR (r = 0.77, p = 0.0004). Furthermore, the changes in sympathetic nerve activity were negatively correlated with its tonic level (r = −0.62, p = 0.0066). These results suggest that cardiac sympathetic nerve activity regulates HR responses to muscle mechanical pressure stimulation and the direction of HR

  10. Adding dexmedetomidine to ropivacaine for lumbar plexus and sciatic nerve block for amputation of lower limb in high-risk patient-a case report.

    Science.gov (United States)

    Wang, Chun-Guang; Ding, Yan-Ling; Han, Ai-Ping; Hu, Chang-Qing; Hao, Shi; Zhang, Fang-Fang; Li, Yong-Wang; Liu, Hu; Han, Zhe; Guo, De-Li; Zhang, Zhi-Qiang

    2015-01-01

    The ischemia necrosis of limb frequently requires surgery of amputation. Lumbar plexus and sciatic nerve block is an ideal intra-operative anesthetic and post-operative antalgic technique for patients of amputation, especially for high-risk patients who have severe cardio-cerebrovascular diseases. However, the duration of analgesia of peripheral nerve block is hardly sufficient to avoid the postoperative pain and the usage of opioids. In this case, a 79-year-old man, with multiple cerebral infarcts, congestive heart failure, atrial flutter and syncope, was treated with an above knee amputation because of ischemia necrosis of his left lower limb. Dexmedetomidine 1 μg/kg was added to 0.33% ropivacaine for lumbar plexus and sciatic nerve block in this case for intra-operative anesthesia and post-operative analgesia. The sensory function was blocked fully for surgery and the duration of analgesia maintained 26 hours with haemodynamic stability and moderate sedation. The patient did not complain pain and require any supplementary analgesics after surgery. This case showed that adding 1 μg/kg dexmedetomidine to ropivacaine for lumbar plexus and sciatic nerve block may be a feasible and safe technique for high-risk patients for lower limb surgery of amputation.

  11. Trigeminal nerve block with alcohol for medically intractable classic trigeminal neuralgia: long-term clinical effectiveness on pain

    Science.gov (United States)

    Han, Kyung Ream; Chae, Yun Jeong; Lee, Jung Dong; Kim, Chan

    2017-01-01

    Background: Trigeminal nerve block (Tnb) with alcohol for trigeminal neuralgia (TN) may not be used widely as a percutaneous procedure for medically intractable TN in recent clinical work, because it has been considered having a limited duration of pain relief, a decrease in success rate and increase in complications on repeated blocks. Objectives: To evaluate the clinical outcome of the Tnb with alcohol in the treatment of medically intractable TN. Methods: Six hundred thirty-two patients were diagnosed with TN between March 2000 and February 2010. Four hundred sixty-five out of 632 underwent Tnb with alcohol under a fluoroscope. Pain relief duration were analyzed and compared in the individual branch blocks. Outcomes were compared between patients with and without a previous Tnb with alcohol. Results: Tnb with alcohol were performed in a total 710 (1st-465, 2nd-155, 3rd-55, 4th-23, 5th-8, 6th-4) cases for a series of consecutive 465 patients during the study period. Forty hundred sixty two out of the 465 patients experienced immediate complete pain relief (99%) at the first Tnb. Of the 465 patients, 218 patients (46.9%) did not require any further treatment after the first Tnb with alcohol during an entire study period. One hundred fifty nine (34.2 %) out of the 465 patients experienced recurring pain after the first block, among whom 155 patients received subsequent blocks, and the remaining 4 patients decided to take medication. According to the Kaplan-Meier analysis, the probabilities of remaining pain relief for 1, 2, 3, and 5 years after the procedures were 86.2%, 65.5%, 52.5%, and 33.4%, respectively. There was no significant difference in the probability of pain relief duration between patients with and without previous Tnb with alcohol. Median (95% CI) pain relief durations of the first and repeated blocks were 39 (36-51) and 37 (28-54) months, respectively. There was no significant difference in occurrence of complications between patients with and

  12. Successful treatment of Raynaud's syndrome in a lupus patient with continuous bilateral popliteal sciatic nerve blocks: a case report.

    Science.gov (United States)

    Dao, Thuan; Amaro-Driedger, David; Mehta, Jaideep

    2016-01-01

    Raynaud's syndrome has been treated medically and invasively, sometimes with regional anesthesia leading up to sympathectomy. We demonstrate that regional anesthesia was in this case a useful technique that can allow some patients to find temporary but significant relief from symptoms of Raynaud's syndrome exacerbation. We present a 43-year-old woman with Raynaud's syndrome secondary to lupus who was treated with bilateral popliteal nerve block catheters for ischemic pain and necrosis of her feet; this led to almost immediate resolution of her pain and return of color and function of her feet. While medical management should continue to be a front-line treatment for Raynaud's syndrome, regional anesthesia can be useful in providing rapid dissipation of symptoms and may thus serve as a viable option for short-term management of this syndrome.

  13. 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

  14. 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

    BACKGROUND: Postoperative pain relief may be improved by reducing sensitization of nociceptive pathways caused by surgical trauma. Such a reduction may depend on the timing and efficacy of analgesia and the duration of the nociceptive block versus the duration of the nociceptive input. We examine...

  15. [Peripheral nerve block. An overview of new developments in an old technique].

    Science.gov (United States)

    Graf, B M; Martin, E

    2001-05-01

    General anaesthesia and peripheral neuronal blockade are techniques which were introduced into clinical practice at the same time. Although general anaesthesia was accepted significantly faster due to effective new drugs and apparent ease of handling, neuronal blockade has recently gained great importance. The reasons are in particular newer aids such as industrially produced catheter sets, nerve stimulators and ultrasound guidance which have facilitated that these economical techniques can be used not only for intraoperative anaesthesia but also for perioperative analgesia without any major risks for the patients. In parallel to epidural anaesthesia a change of paradigms has recently taken place using catheter instead of single-shot techniques. This allows the loading dose of the local anaesthetics to be installed in a safe way, to reload the dose when intraoperatively required and to extend the analgesia perioperatively by this technique using lower concentrations of the same drugs or drug combinations. A great number of short, middle or long acting local anaesthetics are available to choose the right drug for any particular case. Short and middle acting drugs are characterised by a faster onset compared to long acting drugs, but toxic plasma levels are seen during long time application causing seizures or drowsiness or by using prilocaine methemoglobin. Therefore long acting local anaesthetics such as bupivacaine, ropivacaine or levobupivacaine are the first choice drugs for long time application via peripheral nerve catheters for perioperative anaesthesia and analgesia. By using low concentrations of these potent drugs even for a longer period of time, no toxic plasma levels are seen with the exception of artificial intravasal injections. Additives such as opioids and alpha 2-sympathomimetics are also used. While the use of opioids is controversial, alpha 2-sympathomimetics are able to accelerate the onset and to extend the duration of regional anaesthesia and

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

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    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.

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

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    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.

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

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    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.

  19. 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

  20. Subperiosteal hematoma from peribulbar block during cataract surgery leading to optic nerve compression in a patient with parahemophilia

    Directory of Open Access Journals (Sweden)

    Khokhar S

    2015-12-01

    Full Text Available Sudarshan Khokhar,1 Bhagabat Nayak,1 Bharat Patil,1 Milind Devidas Changole,1 Gautam Sinha,1 Reetika Sharma,1 Lipika Nayak2 1Dr RP Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India; 2Department of Pediatrics, Loknayak Hospital, Maulana Azad Medical College, Delhi, India Abstract: A 17-year-old male presented with gradual painless diminution of vision since childhood. Slit lamp examination revealed both eyes having congenital cataract. Right eye lens aspiration was performed but was uneventful, and he prepared for left eye surgery after 7 days. Immediately after giving a peribulbar block, a complete akinesia, tight eyelids, and stony hard eyeball was noted. An abaxial proptosis of 7 mm was noted. Lateral canthotomy and inferior cantholysis were done and proptosis reduced to 5 mm. Bleeding time–clotting time was normal. Proptosis worsened to 8 mm the next day. Contrast-enhanced computed tomography scan showed inferolateral subperiosteal hematoma, but drainage could not be performed due to prolonged prothrombin time and activated prothrombin time. Fresh frozen plasma was transfused. Tarsorrhaphy was performed for exposure keratopathy after his coagulation profile became normal. Hematology evaluation after 2 weeks detected factor V deficiency, and was diagnosed as Owren's disease or parahemophilia. Keywords: peribulbar block, hematoma, subperiosteal, parahemophilia, optic nerve compression

  1. 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

    to receive an ultrasound-guided supraclavicular phrenic nerve block with 10 ml ropivacaine or 10 ml saline (placebo) immediately following surgery. A nerve catheter was subsequently inserted and treatment continued for 3 days. The study drug was pharmaceutically pre-packed in sequentially numbered identical......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...... that ultrasound-guided supraclavicular phrenic nerve block is an effective technique for reducing the incidence of ipsilateral shoulder pain after thoracic surgery....

  2. Effect of Perineural Dexamethasone on the Duration of Single Injection Saphenous Nerve Block for Analgesia After Major Ankle Surgery. A Randomized, Controlled Study

    DEFF Research Database (Denmark)

    Bjørn, Siska; Linde, Frank; Nielsen, Kristian Kibak;

    2016-01-01

    prolongs the duration of analgesia and postpones as well as reduces opioid-requiring pain. METHODS: Forty patients were included in this prospective, randomized, controlled study. All patients received a continuous sciatic catheter and were randomized to receive a single-injection saphenous nerve block...

  3. Lumbar segmental nerve blocks with local anesthetics, pain relief, and motor function: a prospective double-blind study between lidocaine and ropivacaine.

    Science.gov (United States)

    Wolff, André P; Wilder Smith, Oliver H G; Crul, Ben J P; van de Heijden, Marc P; Groen, Gerbrand J

    2004-08-01

    Selective segmental nerve blocks with local anesthetics are applied for diagnostic purposes in patients with chronic back pain to determine the segmental level of the pain. We performed this study to establish myotomal motor effects after L4 spinal nerve blocks by lidocaine and ropivacaine and to evaluate the relationship with pain. Therefore, 20 patients, of which 19 finished the complete protocol, with chronic lumbosacral radicular pain without neurological deficits underwent segmental nerve blocks at L4 with both lidocaine and ropivacaine. Pain intensity scores (verbal numeric rating scale; VNRS) and the maximum voluntary muscle force (MVMF; using a dynamometer expressed in newtons) of the tibialis anterior and quadriceps femoris muscles were measured on the painful side and on the control side. The median VNRS decrease was 4.0 (P control side (P = 0.016; Tukey test). Multiple regression revealed a significant negative correlation for change in VNRS score versus change in median MVMF (Spearman R = -0.48: P = 0.00001). This study demonstrates that in patients with unilateral chronic low back pain radiating to the leg, pain reduction induced by local anesthetic segmental nerve (L4) block is associated with increased quadriceps femoris and tibialis anterior MVMF, without differences for lidocaine and ropivacaine.

  4. Iliohypogastric/ilioinguinal nerve block in inguinal hernia repair for postoperative pain management: comparison of the anatomical landmark and ultrasound guided techniques

    Directory of Open Access Journals (Sweden)

    Abdurrahman Demirci

    2014-09-01

    Full Text Available Objectives: The purpose of this study is to compare the efficacy of iliohypogastric/ilioinguinal nerve blocks performed with the ultrasound guided and the anatomical landmark techniques for postoperative pain management in cases of adult inguinal herniorrhaphy. Methods: 40 patients, ASA I-II status were randomized into two groups equally: in Group AN (anatomical landmark technique and in Group ultrasound (ultrasound guided technique, iliohypogastric/ilioinguinal nerve block was performed with 20 ml of 0.5% levobupivacaine prior to surgery with the specified techniques. Pain score in postoperative assessment, first mobilization time, duration of hospital stay, score of postoperative analgesia satisfaction, opioid induced side effects and complications related to block were assessed for 24 h postoperatively. Results: VAS scores at rest in the recovery room and all the clinical follow-up points were found significantly less in Group ultrasound (p < 0.01 or p < 0.001. VAS scores at movement in the recovery room and all the clinical follow-up points were found significantly less in Group ultrasound (p < 0.001 in all time points. While duration of hospital stay and the first mobilization time were being found significantly shorter, analgesia satisfaction scores were found significantly higher in ultrasound Group (p < 0.05, p < 0.001, p < 0.001 respectively. Conclusion: According to our study, US guided iliohypogastric/ilioinguinal nerve block in adult inguinal herniorrhaphies provides a more effective analgesia and higher satisfaction of analgesia than iliohypogastric/ilioinguinal nerve block with the anatomical landmark technique. Moreover, it may be suggested that the observation of anatomical structures with the US may increase the success of the block, and minimize the block-related complications.

  5. 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

  6. The autonomic laboratory

    Science.gov (United States)

    Low, P. A.; Opfer-Gehrking, T. L.

    1999-01-01

    The autonomic nervous system can now be studied quantitatively, noninvasively, and reproducibly in a clinical autonomic laboratory. The approach at the Mayo Clinic is to study the postganglionic sympathetic nerve fibers of peripheral nerve (using the quantitative sudomotor axon reflex test [QSART]), the parasympathetic nerves to the heart (cardiovagal tests), and the regulation of blood pressure by the baroreflexes (adrenergic tests). Patient preparation is extremely important, since the state of the patient influences the results of autonomic function tests. The autonomic technologist in this evolving field needs to have a solid core of knowledge of autonomic physiology and autonomic function tests, followed by training in the performance of these tests in a standardized fashion. The range and utilization of tests of autonomic function will likely continue to evolve.

  7. Calretinin-immunoreactive nerves in the uterus, pelvic autonomic ganglia, lumbosacral dorsal root ganglia and lumbosacral spinal cord.

    Science.gov (United States)

    Papka, R E; Collins, J; Copelin, T; Wilson, K

    1999-10-01

    Nerves containing the calcium-binding protein calretinin have been reported in several organs but not in female reproductive organs and associated ganglia. This study was undertaken to determine if nerves associated with the uterus contain calretinin and the source(s) of calretinin-synthesizing nerves in the rat (are they sensory, efferent, or both?). Calretinin-immunoreactive nerves were present in the uterine horns and cervix where they were associated with arteries, uterine smooth muscle, glands, and the epithelium. Calretinin-immunoreactive terminals were apposed to neurons in the paracervical ganglia; in addition, some postganglionic neurons in this ganglion were calretinin positive. Calretinin perikarya were present in the lumbosacral dorsal root ganglia, no-dose ganglia, and lumbosacral spinal cord. Retrograde axonal tracing, utilizing Fluorogold injected into the uterus or paracervical parasympathetic ganglia, revealed calretinin-positive/Fluorogold-labeled neurons in the dorsal root and nodose ganglia. Also, capsaicin treatment substantially reduced the calretinin-positive fibers in the uterus and pelvic ganglia, thus indicating the sensory nature of these fibers. The presence of calretinin immunoreactivity identifies a subset of nerves that are involved in innervation of the pelvic viscera and have origins from lumbosacral dorsal root ganglia and vagal nodose ganglia. Though the exact function of calretinin in these nerves is not currently known, calretinin is likely to play a role in calcium regulation and their function.

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

    Directory of Open Access Journals (Sweden)

    Szucs Szilard

    2012-06-01

    Full Text Available Abstract Background Peripheral 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. Methods Following 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. Results Of 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

  9. 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

  10. A population pharmacokinetic model for the complex systemic absorption of ropivacaine after femoral nerve block in patients undergoing knee surgery.

    Science.gov (United States)

    Gaudreault, François; Drolet, Pierre; Fallaha, Michel; Varin, France

    2012-12-01

    Because of its slow systemic absorption and flip-flop kinetics, ropivacaine's pharmacokinetics after a peripheral nerve block has never been thoroughly characterized. The purpose of this study was to develop a population pharmacokinetic model for ropivacaine after loco-regional administration and to identify patient characteristics that may influence the drug's absorption and disposition. Frequent plasma samples were taken up to 93 h after a 100 mg dose given as femoral block for postoperative analgesia in 15 orthopedic patients. Ropivacaine plasma concentration-time data were analyzed using a nonlinear mixed effects modeling method. A one-compartment model with parallel inverse Gaussian and time-dependent inputs best described ropivacaine plasma concentration-time curves. Ropivacaine systemic absorption was characterized by a rapid phase (mean absorption time of 25 ± 4.8 min) followed by a much slower phase (half-life of 3.9 ± 0.65 h). Interindividual variability (IIV) for these parameters, 58 and 9 %, indicated that the initial absorption phase was more variable. The apparent volume of distribution (V/F = 77.2 ± 11.5 L, IIV = 26 %) was influenced by body weight (Δ 1.49 % per kg change) whereas the absorption rate constant (slower phase) of ropivacaine was affected by age (Δ 2.25 % per year change). No covariate effects were identified for the apparent clearance of the drug (CL/F =10.8 ± 1.0 L/h, 34  IIV = 34 %). These findings support our hypothesis that modeling a complex systemic absorption directly from plasma concentration-time curves exhibiting flip-flop kinetics is possible. Only the age-effect was considered as relevant for possible dosing adjustments.

  11. 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

  12. Combination Therapy with Continuous Three-in-One Femoral Nerve Block and Periarticular Multimodal Drug Infiltration after Total Hip Arthroplasty

    Directory of Open Access Journals (Sweden)

    Tomonori Tetsunaga

    2016-01-01

    Full Text Available Background. Various postoperative pain relief modalities, including continuous femoral nerve block (CFNB, local infiltration analgesia (LIA, and combination therapy, have been reported for total knee arthroplasty. However, no studies have compared CFNB with LIA for total hip arthroplasty (THA. The aim of this study was to compare the efficacy of CFNB versus LIA after THA. Methods. We retrospectively reviewed the postoperative outcomes of 93 THA patients (20 men, 73 women; mean age 69.2 years. Patients were divided into three groups according to postoperative analgesic technique: CFNB, LIA, or combined CFNB+LIA. We measured the following postoperative outcome parameters: visual analog scale (VAS for pain at rest, supplemental analgesia, side effects, mobilization, length of hospital stay, and Harris Hip Score (HHS. Results. The CFNB+LIA group had significantly lower VAS pain scores than the CFNB and LIA groups on postoperative day 1. There were no significant differences among the three groups in use of supplemental analgesia, side effects, mobilization, length of hospital stay, or HHS at 3 months after THA. Conclusions. Although there were no clinically significant differences in outcomes among the three groups, combination therapy with CFNB and LIA provided better pain relief after THA than CFNB or LIA alone, with few side effects.

  13. Understanding the surgical pitfalls in total mesorectal excision : Investigating the histology of the perirectal fascia and the pelvic autonomic nerves

    NARCIS (Netherlands)

    Kraima, A. C.; West, N. P.; Treanor, D.; Magee, D. R.; Bleys, R. L A W; Rutten, H. J T; Van De Velde, C. J H; Quirke, P.; Deruiter, M. C.

    2015-01-01

    Aim Excellent understanding of fasciae and nerves surrounding the rectum is necessary for total mesorectal excision (TME). However, fasciae anterolateral to the rectum and surrounding the low rectum are still poorly understood. We studied the perirectal fascia enfolding the extraperitoneally located

  14. [Changes in autonomic nerve function during the normal menstrual cycle measured by the coefficient of variation of R-R intervals].

    Science.gov (United States)

    Kondo, M; Hirano, T; Okamura, Y

    1989-05-01

    The purpose of this study was to determine if there is a change in autonomic nerve function during the menstrual cycle. The subjects were 20 females (average age 26.1 years +/- 4.6) with a normal menstrual cycle. The coefficient of variation of R-R intervals (CV R.R) was measured to investigate autonomic function in the menstrual, follicular, ovulatory, luteal, and premenstrual phases. Average CV R-R for all phases was 5.2 +/- 1.9%. And the CV R-R tended to be lower in those in their 30s than in those in their 20s. And no noticeable difference was seen in the CV R-R among the 5 phases of the menstrual cycle. On the other hand, the CV R-R of 11 females with premenstrual syndrome was low in the ovulatory, luteal and premenstrual phases. These results, which provide basic data for clinical use, suggest the following. (1) The age of subjects should be taken into consideration. (2) Changes in the CV R-R during the menstrual cycle are negligible. (3) However, in those showing symptoms associated with the menstrual cycle such as premenstrual syndrome, changes during the menstrual cycle should be taken into account. At the same time psychological changes in the subjects were evaluated by the following tests: Cornell Medical Index, Taylor's manifest anxiety scale, and Zung's self-rating depression scale. The results of these tests did not vary significantly during the menstrual cycle.

  15. Dimethylsulfoxide potentiates the nerve conduction-blocking effect of lidocaine without augmentation of the intracellular lidocaine concentration in the giant axon of crayfish in vitro.

    Science.gov (United States)

    Yano, Takeshi; Ibusuki, Shoichiro; Takasaki, Mayumi; Tsuneyoshi, Isao

    2013-08-01

    The purpose of this study was to investigate how dimethylsulfoxide (DMSO) potentiates the blocking action of lidocaine. A giant axon removed from a crayfish was used to investigate nerve conduction and intracellular lidocaine concentration. The maximum values of the differential waveform (dV/dt max) calculated from evoked action potentials were used for evaluating an inhibition of nerve conduction. The inhibition of the dV/dt max in low-frequency stimulation (tonic block) and high-frequency stimulation (phasic block) after perfusion of 1 mm lidocaine with or without 0.2 vol % DMSO, in which the concentration of DMSO alone had no anesthetic effect, was measured to evaluate the potentiating action of DMSO. The intracellular lidocaine concentration was measured via a lidocaine-sensitive glass microelectrode during 30 min of perfusion of 1 mm lidocaine alone or in combination with DMSO. When applied without lidocaine, DMSO caused a dose-dependent nerve conduction block when used at concentrations >1 vol %. The dV/dt max in the tonic block was significantly decreased when 0.2 vol % DMSO was added to the lidocaine solution (P = 0.004). In the phasic block, there was no significant potentiating action of DMSO. There were no significant differences in the intracellular lidocaine concentrations with or without DMSO. The potentiating effects of DMSO were observed only in the condition of low-frequency stimulation and were not related to the intracellular lidocaine concentration in the giant axon of crayfish in vitro.

  16. 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.)

  17. Prostate cancer progression attributed to autonomic nerve development: Potential for therapeutic prevention of localized and metastatic disease

    OpenAIRE

    2013-01-01

    In a study recently published in Science, Magnon et al. show that both the sympathetic and parasympathetic components of the autonomic nervous system play an integral part in the development and dissemination of prostate cancer (PCa). Inhibition of the sympathetic nervous system (SNS) and disruption of the adrenergic receptors, specifically Ardβ2, resulted in the prevention of primary PCa tumor development in mice. The authors found that inhibition of the SNS is only successful in preventing ...

  18. Analysis of Operation Technique of Nerve Block Anesthesia%浅谈神经阻滞麻醉的实施技术分析

    Institute of Scientific and Technical Information of China (English)

    高连凤

    2014-01-01

    Objective The treatment methods of patients with nerve block anesthesia to be investigated. Methods Analyzing the operation technique of local nerve block anesthesia. Results Anesthesiologists take good care of the patients with aseptic operation on the anesthesia area in order to prevent from infection and reduce the infectious risk. Conclusion The basic and elementary operation technique and peripheral nerve localization is required for puncture operation. In addition, whether the block planar diffusion is rather extensive or not and whether complications occur or not should be reminded.%目的:探讨神经阻滞中对患者处理。方法对局部麻醉中神经阻滞的实施方法进行分析。结果麻醉科医师认真地处理患者,对麻醉区无菌操作防止感染发生的作用,在降低感染危险。结论穿刺操作时做好基本操作技术,周围神经定位。提醒阻滞平面扩散是否过度广泛及是否会发生并发症。

  19. 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.

  20. 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.

  1. Anatomical basis for pelvic autonomic nerve preservation in total mesorectal excision of adult male%全直肠系膜切除术中保留男性盆腔自主神经的解剖基础

    Institute of Scientific and Technical Information of China (English)

    刘念; 林谋斌; 张浩波; 陆兴生; 吕克之; 尹路

    2012-01-01

    Objective To study the pelvic fascia related to pelvic autonomic nerve and detect the anatomical localization of pelvic autonomic nerve by marker in adult male.Methods Twelve pelvises of adult male harvested from cadavers were studied by dissection.Results Hypogastric nerve was embedded in the posterior leaf of the visceral pelvic fascia.Pelvic plexus was situated between vesicohypogastric fascia and visceral fascia.Pelvic nerve branch of seminal vesicle and prostate was located at the anterolateral part of Denonvilliers fascia.Sacral promontory,ureter,junction of Denonvilliers fascia,visceral fascia and seminal vesicle could be regarded as anatomical markers for pelvic autonomic nerve.Conclusion The anatomical characteristics of pelvic autonomic nerve can be used for protecting and isolating pelvic autonomic nerve in total mesorectal excision of adult male.%目的 探讨成年男性盆腔自主神经的筋膜层次及其解剖标记,明确全直肠系膜切除术中保留男性盆腔自主神经的解剖基础.方法 对12具男性尸体盆腔(24侧半盆腔)进行解剖.结果 盆腔自主神经走行筋膜层次为:腹下神经走行于脏筋膜后叶内,盆丛位于膀胱腹下筋膜与脏筋膜间,精囊前列腺分支位于Denonvilliers筋膜前侧方.骶骨岬、输尿管、Denonvilliers筋膜与脏筋膜交汇处、精囊腺等都可作为男性盆腔自主神经定位标记.结论 男性盆腔自主神经的筋膜层次和解剖标记可用于男性全直肠系膜切除术中盆腔自主神经的定位和保护.

  2. Prostate cancer progression attributed to autonomic nerve development: potential for therapeutic prevention of localized and metastatic disease.

    Science.gov (United States)

    Fernández, Elena V; Price, Douglas K; Figg, William D

    2013-11-01

    In a study recently published in Science, Magnon et al. show that both the sympathetic and parasympathetic components of the autonomic nervous system play an integral part in the development and dissemination of prostate cancer (PCa). Inhibition of the sympathetic nervous system (SNS) and disruption of the adrenergic receptors, specifically Ardβ 2, resulted in the prevention of primary PCa tumor development in mice. The authors found that inhibition of the SNS is only successful in preventing murine tumor development if completed early enough, and the parasympathetic nervous system (PNS) predominates in later stages of PCa. Inhibition of the PNS by way of the cholinergic receptor, muscarinic 1 (Chrm1), caused mice to develop less metastases to the pelvic lymph nodes, intestines, and bones. A PCa progression scheme has been outlined where initial tumor engraftment is controlled by the SNS but then becomes less prominent than the PNS, which promotes metastasis. The investigators showed the dependence of the autonomic nervous system on development of PCa and present opportunities for prevention; further studies are needed to confirm these results in humans.

  3. Origin and central projections of rat dorsal penile nerve: possible direct projection to autonomic and somatic neurons by primary afferents of nonmuscle origin.

    Science.gov (United States)

    Núñez, R; Gross, G H; Sachs, B D

    1986-05-22

    Cell number, size, and somatotopic arrangement within the spinal ganglia of the cells of origin of the rat dorsal penile nerve (DPN), and their spinal cord projections, were studied by loading the proximal stump of the severed DPN with horseradish peroxidase (HRP). The DPN sensory cells were located entirely in the sixth lumbar (L6) dorsal root ganglia (DRG), in which a mean of 468 +/- 78 cells per side were observed, measuring 26.7 +/- 0.8 microns in their longest axis (range 10-65 microns) and distributed apparently randomly within the ganglia. Within the spinal cord, no retrograde label was found, i.e., no motoneurons were labeled, indicating that in the rat the DPN is formed exclusively of sensory nerve fibers. Although labeled fibers entered the cord only through L6, transganglionically transported HRP was evident in all spinal segments examined, i.e., T13-S2. Labeled fibers projected along the inner edge of the dorsal horn (medial pathway) throughout their extensive craniosacral distribution. However, laminar distribution varied with spinal segment. In the dorsal horn, terminals or preterminal axons were found in the dorsal horn marginal zone (lamina I), the substantia gelatinosa (lamina II), the nucleus proprius (laminae III and IV--the most consistent projection), Clarke's column (lamina VI), and the dorsal gray commissure. In the ventral horn, terminals were found in lamina VII and lamina IX. Label apposed to cell somas and dendrites in lamina VII may represent direct primary afferent projections onto sympathetic autonomic neurons. In lamina IX, labeled terminals delineated the somas and dendrites of cells that appeared to be motoneurons. This is the first description of an apparently monosynaptic contact onto motoneurons by a primary afferent of nonmuscle origin.

  4. 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.

  5. Progress on obesity mediated by vagus nerve simulation and vagal blocking%迷走神经调控治疗肥胖的研究进展

    Institute of Scientific and Technical Information of China (English)

    于亭亭; 范志宁

    2010-01-01

    肥胖症的流行已受到广泛关注,但目前仍未获得最佳治疗手段.新近对肥胖的研究主要集中在中枢神经系统对能量平衡的调控等方面,而迷走神经是其重要通路.本文就近年来迷走神经调控治疗肥胖的研究进展作一综述.%The optimal bariatric surgery is still not acquired although the obesity epidemic has become a worldwide problem. The recentness studies on obesity focused on mass balance regulated by central nervous system, in which an important circuit is vagus nerve. This review provides progress on obesity mediated by vagus nerve simulation and vagal blocking.

  6. The effect of end-to-side nerve anastomosis of autonomic nerve to somatic nerve on the donor nerve and its functions%内脏神经-体神经端侧吻合对供体神经及其功能的影响

    Institute of Scientific and Technical Information of China (English)

    董传江; 谢宗兰; 张路生; 范哲奇; 吴朝; 董自强

    2016-01-01

    Objective Using neural morphology and electromyography technology to study the effect of end-to-side nerve anastomosis of autonomic nerve to somatic nerve on the donor nerve and its functions.Methods Twenty-four young adult male Sprague-Dawley rats [mean weight (230 ± 28) g] were randomly divided into 2 groups:group A,control group (n =12);group B,end-to-side anastomosis group (n =12).In group A only a L3-L6 laminectomy was performed,and in group B the distal end of left L6 ventral root (L6VR) was sutured in an end-to-side fashion to Left L4 ventral root (L6VR).All rats' left tibialis anterior muscle electromyogram (EMG) was recorded at 4th,12th,and 24th week after operation.At 24th week after operation,the rats were sacrificed.The left L4 nerve segment In control group,and the left L4 nerve segment distal to the anastomosis site in end-to-side anastomosis group were resected and stained with toluidine blue for nerve fiber count.The L4 nerve innervated tibialis anterior muscle wet weight was measured,and hematoxylin and eosin (HE) staining was used to observe muscle morphology.Results At 4th and 12th week after operation,the denervation EMG changes to varying degrees were observed,and returned to normal at 24th week.The average number of myelinated axons of the left L4VR at 24th week after operation in end-to-side anastomosis group and control group was 1 043 ± 212 and 1 039 ± 205,respectively.At 24th week there were no significant differences in muscle morphology between the two groups (P > 0.05).The muscle wet weights in two groups were (0.666 ± 0.043) g and (0.670 ± 0.050) g respectively with the difference being not significant between the two groups (P > 0.05).Conclusion End-to-side anastomosis shows no adverse effect on the donor nerve and donor nerve innervated muscle function.%目的 利用神经形态学、肌电图技术检测内脏神经-体神经端侧吻合对供体神经及其功能影响.方法 选用24只成年雄性SD大鼠(230~250 g)

  7. 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

  8. 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.

  9. Effect of different anesthesia methods in laparoscopic pelvic autonomic nerve reserved surgery on the sexual function of patients with colorectal cancer%不同麻醉方法对腹腔镜盆腔植物神经保留术直肠癌患者性功能影响的临床研究

    Institute of Scientific and Technical Information of China (English)

    余叶挺; 陈天勇; 丁可峰; 关天容

    2014-01-01

    目的:对不同麻醉方法对腹腔镜盆腔植物神经保留术直肠癌患者性功能影响进行分析。方法:选取2010年11月至2013年11月在我院进行腹腔镜盆腔植物神经保留术直肠癌手术男性患者62例,随机进行分组,单纯组患者30例,单纯进行气管插管全麻;联合组患者32例,在常规气管插管全麻基础上联合硬膜外神经阻滞麻醉,观察两组患者术后性功能情况进行分析。结果:联合组患者阴茎勃起功能障碍发生比例、排尿功能障碍及射精功能障碍发生比例均明显优于单纯组患者,差异性显著,具有统计学意义(P<0.05)。62例患者无一例因麻醉操作导致发生严重不良反应和全脊髓麻醉等严重不良后果。结论:腹腔镜盆腔植物神经保留术直肠癌患者在全麻基础上联合硬膜外神经阻滞麻醉可有效的降低术后射精功能障碍、排尿困难及勃起功能障碍等情况的发生,改善患者的生活质量,安全性较高,可依据患者进行应用和开展。%Objectives:To analyze the effect of different anesthesia methods in laparoscopic pelvic autonom-ic nerve reserved surgery on the sexual function of patients with colorectal cancer.Methods:The 62 colorectal cancer patients having received laparoscopic pelvic autonomic nerve reserved surgery in our hospital from November 2010 to November 2013 were randomly divided into two groups:simple group of 30 patients to receive simple endo-tracheal intubation;joint group of 32 patients to receive epidural nerve block anesthesia on the basis of conventional general anesthesia.The postoperative sexual functions of the two groups were compared.Results:The incidence rates of erectile dysfunction,voiding dysfunction and ejaculatory dysfunction in the joint group were significantly bet-ter than that of the signal group,with a statistically significant difference (P<0.05 ).There was no case of serious adverse consequences caused

  10. Differential Patterns and Determinants of Cardiac Autonomic Nerve Dysfunction during Endotoxemia and Oral Fat Load in Humans.

    Directory of Open Access Journals (Sweden)

    Dan Ziegler

    Full Text Available The autonomic nervous system (ANS plays an important role in regulating the metabolic homeostasis and controlling immune function. ANS alterations can be detected by reduced heart rate variability (HRV in conditions like diabetes and sepsis. We determined the effects of experimental conditions mimicking inflammation and hyperlipidemia on HRV and heart rate (HR in relation to the immune, metabolic, and hormonal responses resulting from these interventions. Sixteen lean healthy subjects received intravenous (i.v. low-dose endotoxin (lipopolysaccharide [LPS], i.v. fat, oral fat, and i.v. glycerol (control for 6 hours, during which immune, metabolic, hormonal, and five HRV parameters (pNN50, RMSSD, low-frequency (LF and high-frequency (HF power, and LF/HF ratio were monitored and energy metabolism and insulin sensitivity (M-value were assessed. LPS infusion induced an increase (AUC in HR and LF/HF ratio and decline in pNN50 and RMSSD, while oral fat resulted in elevated HR and a transient (hours 1-2 decrease in pNN50, RMSSD, and HF power. During LPS infusion, ΔIL-1ra levels and ΔIL-1ra and ΔIL-1ß gene expression correlated positively with ΔLF/HF ratio and inversely with ΔRMSSD. During oral fat intake, ΔGLP-1 tended to correlate positively with ΔHR and inversely with ΔpNN50 and ΔRMSSD. Following LPS infusion, lipid oxidation correlated positively with HR and inversely with pNN50 and RMSSD, whereas HRV was not related to M-value. In conclusion, suppression of vagal tone and sympathetic predominance during endotoxemia are linked to anti-inflammatory processes and lipid oxidation but not to insulin resistance, while weaker HRV changes in relation to the GLP-1 response are noted during oral fat load.ClinicalTrials.gov NCT01054989.

  11. Differential Patterns and Determinants of Cardiac Autonomic Nerve Dysfunction during Endotoxemia and Oral Fat Load in Humans

    Science.gov (United States)

    Ziegler, Dan; Strom, Alexander; Strassburger, Klaus; Nowotny, Bettina; Zahiragic, Lejla; Nowotny, Peter J.; Carstensen-Kirberg, Maren; Herder, Christian; Szendroedi, Julia; Roden, Michael

    2015-01-01

    The autonomic nervous system (ANS) plays an important role in regulating the metabolic homeostasis and controlling immune function. ANS alterations can be detected by reduced heart rate variability (HRV) in conditions like diabetes and sepsis. We determined the effects of experimental conditions mimicking inflammation and hyperlipidemia on HRV and heart rate (HR) in relation to the immune, metabolic, and hormonal responses resulting from these interventions. Sixteen lean healthy subjects received intravenous (i.v.) low-dose endotoxin (lipopolysaccharide [LPS]), i.v. fat, oral fat, and i.v. glycerol (control) for 6 hours, during which immune, metabolic, hormonal, and five HRV parameters (pNN50, RMSSD, low-frequency (LF) and high-frequency (HF) power, and LF/HF ratio) were monitored and energy metabolism and insulin sensitivity (M-value) were assessed. LPS infusion induced an increase (AUC) in HR and LF/HF ratio and decline in pNN50 and RMSSD, while oral fat resulted in elevated HR and a transient (hours 1-2) decrease in pNN50, RMSSD, and HF power. During LPS infusion, ΔIL-1ra levels and ΔIL-1ra and ΔIL-1ß gene expression correlated positively with ΔLF/HF ratio and inversely with ΔRMSSD. During oral fat intake, ΔGLP-1 tended to correlate positively with ΔHR and inversely with ΔpNN50 and ΔRMSSD. Following LPS infusion, lipid oxidation correlated positively with HR and inversely with pNN50 and RMSSD, whereas HRV was not related to M-value. In conclusion, suppression of vagal tone and sympathetic predominance during endotoxemia are linked to anti-inflammatory processes and lipid oxidation but not to insulin resistance, while weaker HRV changes in relation to the GLP-1 response are noted during oral fat load. Trial Registration ClinicalTrials.gov NCT01054989 PMID:25893426

  12. Autoimmune autonomic disorders.

    Science.gov (United States)

    Mckeon, Andrew; Benarroch, Eduardo E

    2016-01-01

    Autoimmune autonomic disorders occur because of an immune response directed against sympathetic, parasympathetic, and enteric ganglia, autonomic nerves, or central autonomic pathways. In general, peripheral autoimmune disorders manifest with either generalized or restricted autonomic failure, whereas central autoimmune disorders manifest primarily with autonomic hyperactivity. Some autonomic disorders are generalized, and others are limited in their anatomic extent, e.g., isolated gastrointestinal dysmotility. Historically, these disorders were poorly recognized, and thought to be neurodegenerative. Over the last 20 years a number of autoantibody biomarkers have been discovered that have enabled the identification of certain patients as having an autoimmune basis for either autonomic failure or hyperactivity. Peripheral autoimmune autonomic disorders include autoimmune autonomic ganglionopathy (AAG), paraneoplastic autonomic neuropathy, and acute autonomic and sensory neuropathy. AAG manifests with acute or subacute onset of generalized or selective autonomic failure. Antibody targeting the α3 subunit of the ganglionic-type nicotinic acetylcholine receptor (α3gAChR) is detected in approximately 50% of cases of AAG. Some other disorders are characterized immunologically by paraneoplastic antibodies with a high positive predictive value for cancer, such as antineuronal nuclear antibody, type 1 (ANNA-1: anti-Hu); others still are seronegative. Recognition of an autoimmune basis for autonomic disorders is important, as their manifestations are disabling, may reflect an underlying neoplasm, and have the potential to improve with a combination of symptomatic and immune therapies.

  13. 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.

  14. Sensitivity Analysis of Vagus Nerve Stimulation Parameters on Acute Cardiac Autonomic Responses: Chronotropic, Inotropic and Dromotropic Effects

    Science.gov (United States)

    Ojeda, David; Le Rolle, Virginie; Romero-Ugalde, Hector M.; Gallet, Clément; Bonnet, Jean-Luc; Henry, Christine; Bel, Alain; Mabo, Philippe; Carrault, Guy; Hernández, Alfredo I.

    2016-01-01

    Although the therapeutic effects of Vagus Nerve Stimulation (VNS) have been recognized in pre-clinical and pilot clinical studies, the effect of different stimulation configurations on the cardiovascular response is still an open question, especially in the case of VNS delivered synchronously with cardiac activity. In this paper, we propose a formal mathematical methodology to analyze the acute cardiac response to different VNS configurations, jointly considering the chronotropic, dromotropic and inotropic cardiac effects. A latin hypercube sampling method was chosen to design a uniform experimental plan, composed of 75 different VNS configurations, with different values for the main parameters (current amplitude, number of delivered pulses, pulse width, interpulse period and the delay between the detected cardiac event and VNS onset). These VNS configurations were applied to 6 healthy, anesthetized sheep, while acquiring the associated cardiovascular response. Unobserved VNS configurations were estimated using a Gaussian process regression (GPR) model. In order to quantitatively analyze the effect of each parameter and their combinations on the cardiac response, the Sobol sensitivity method was applied to the obtained GPR model and inter-individual sensitivity markers were estimated using a bootstrap approach. Results highlight the dominant effect of pulse current, pulse width and number of pulses, which explain respectively 49.4%, 19.7% and 6.0% of the mean global cardiovascular variability provoked by VNS. More interestingly, results also quantify the effect of the interactions between VNS parameters. In particular, the interactions between current and pulse width provoke higher cardiac effects than the changes on the number of pulses alone (between 6 and 25% of the variability). Although the sensitivity of individual VNS parameters seems similar for chronotropic, dromotropic and inotropic responses, the interacting effects of VNS parameters provoke

  15. 神经干阻断治疗三叉神经痛初步分析%Preliminary Analysis of Trigeminal Neuralgia Treated by Nerve Block

    Institute of Scientific and Technical Information of China (English)

    韩贵轩

    2016-01-01

    目的:探讨神经干阻断治疗三叉神经痛临床疗效。方法选择三叉神经痛患者进行临床干预观察效果。结果治疗后半个月、1个月、3个月观察组评分明显低于对照组。结论神经干阻断治疗三叉神经痛明显优于一般疗法。%Objective To investigate the clinical efficacy of nerve block in the treatment of trigeminal neuralgia. Methods The clinical effect of the treatment of patients with trigeminal neuralgia was observed. Results The scores of the observation group were significantly lower than those in the control group after 1 months, months and 3 months after treatment. Conclusion The nerve block in the treatment of trigeminal neuralgia is better than the general treatment.

  16. 特发性室早气阴两虚证患者自主神经功能的变化%Changes of Autonomic Nerve Function in Premature Ventricular Contraction Beats Patients with Deficiency of both Qi and Yin

    Institute of Scientific and Technical Information of China (English)

    阮小芬; 王肖龙; 张一乐; 徐燕; 龚菊芬; 吴昉怡

    2013-01-01

    目的 探讨气阴两虚证室早患者自主神经功能变化的特点.方法 与30例健康对照组相比较,分析41例室早患者自主神经功能各项指标变化,及室早、中医证候与自主神经功能的相关性.结果 室早组患者的SDANN、rMSSD、PNN50显著降低,室早患者中医证候积分与rMSSD、PNN50显著负相关.结论 气阴两虚证室早患者存在迷走神经功能显著降低及交感神经功能亢进,室早临床症状产生与迷走神经功能低下相关.%Objective: To observe the characteristics of autonomic nerve function in premature ventricular contraction beats(PVC) patients. Methods: Compared with 30 healthy controls,the autonomic nervous function of 41 cases PVC patients and the relationship between ventricular premature, the clinical symptoms and autonomic nervous function were analysed. Results: SDANN, rMSSD, and PNN50 were significantly lower in patients with PVC. TCM syndrome and rMSSD, PNN50 was significantly negative correlation. Conclusions: The vagus nerve function are decreased and the sympathetic nerve functionin is hyperthyroidism in PVC patients of both deficiency qi and Yin. clinical symptoms have associated with the vagus nerve function.

  17. 心电图对功能性心血管疾病自主神经功能评价的意义%Significance of electrocardiogram in the evaluation of the autonomic nerve function in functional cardiovascular disease

    Institute of Scientific and Technical Information of China (English)

    刘丽萍; 王成

    2015-01-01

    Autonomic nervous system(ANS) activity plays an important role in the pathogenesis of cardiovascular disease,including organic cardiovascular disease(such as hypertension,coronary artery disease,etc) and functional cardiovascular disease (such as vasovagal syncope,postural orthostatic tachycardia syndrome,etc).Many methods was used to evaluate ANS function.Heart rate variability is a widely accepted method to assess cardiac autonomic nerve function.Autonomic nervous affected cardiac action potential and let electrocardiogram changes.Through the sympathetic and parasympathetic neurotransmitters which acting on the corresponding receptors.Electrocardiogram changes reflects autonomic nervous function.Present researches suggest that electrocardiogram has an important significance in the evaluation of autonomic nerve function in functional cardiovascular disease.%自主神经系统对心血管疾病的发生发展起重要调节作用,包括器质性心血管疾病(如高血压、冠状动脉粥样硬化性心脏病等)及功能性心血管疾病(如血管迷走性晕厥、体位性心动过速综合征等).评估自主神经功能的方法有很多,心率变异性分析是公认的评估心脏自主神经功能的方法.自主神经系统通过交感神经和副交感神经作用于相应受体,影响心肌动作电位导致心电图变化.因此,心电图能反映心脏自主神经功能变化,对功能性心血管疾病的自主神经功能评估具有重要意义.

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

    OpenAIRE

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

    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 exci...

  19. 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.

  20. Regulating autonomic nerve system:a new field of anti-inflammatory therapy for cardiovascular diseases%调节自主神经系统:心血管疾病抗炎治疗的新领域

    Institute of Scientific and Technical Information of China (English)

    马度芳; 姜萍; 杨金龙; 李晓

    2015-01-01

    The role of chronic inflammation and autonomic neuropathy in the crucial underlying process con -tributing to the initiation and the progression of various cardiovascular diseases is well established .It is well known that the immune system is innervated by the autonomic nervous system , and the inflammatory reaction and immune reaction are re-gulated by the autonomic nerve system .Vagus nerve depresses inflammatory reaction via cholinergic anti-inflammatory path-way (CAP), while sympathetic nervous system has bidirectional regulation of pro-inflammation and anti-inflammation, which are affected by several factors such as the concentration of neurotransmitters or types of receptors .In this paper , we reviewed different effects of CAP and sympathetic nervous system on cardiovascular inflammatory reaction .Activation of CAP and regaining normal sympathetic function will improve the chronic inflammation in the process of cardiovascular disea -ses.Low-toxic and selective α7nAchR agonist is expected to be applied in cardiovascular diseases to alleviate chronic in -flammation .

  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

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    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. Essential oil of Lippia alba and its main constituent citral block the excitability of rat sciatic nerves

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    D.G. Sousa

    2015-08-01

    Full Text Available Lippia alba is empirically used for infusions, teas, macerates, and hydroalcoholic extracts because of its antispasmodic, analgesic, sedative, and anxiolytic effects. Citral is a mixture of trans-geranial and cis-neral and is the main constituent of L. alba essential oil and possesses analgesic, anxiolytic, anticonvulsant, and sedative effects. The present study evaluated the effects of the essential oil of L. alba (EOLa and citral on compound action potentials (CAPs in Wistar rat sciatic nerves. Both drugs inhibited CAP in a concentration-dependent manner. The calculated half-maximal inhibitory concentrations (IC50 of peak-to-peak amplitude were 53.2 µg/mL and 35.00 µg/mL (or 230 µM for EOLa and citral, respectively. Peak-to-peak amplitude of the CAP was significantly reduced by 30 µg/mL EOLa and 10 µg/mL citral. EOLa and citral (at 60 and 30 µg/mL, values close to their respective IC50 for CAP blockade significantly increased chronaxy and rheobase. The conduction velocity of the first and second CAP components was statistically reduced to ∼86% of control with 10 µg/mL EOLa and ∼90% of control with 3 µg/mL citral. This study showed that EOLa inhibited nerve excitability and this effect can be explained by the presence of citral in its composition. Both EOLa and citral showed inhibitory actions at lower concentrations compared with other essential oils and constituents with local anesthetic activity. In conclusion, these data demonstrate that EOLa and citral are promising agents in the development of new drugs with local anesthetic activity.

  4. Essential oil of Lippia alba and its main constituent citral block the excitability of rat sciatic nerves.

    Science.gov (United States)

    Sousa, D G; Sousa, S D G; Silva, R E R; Silva-Alves, K S; Ferreira-da-Silva, F W; Kerntopf, M R; Menezes, I R A; Leal-Cardoso, J H; Barbosa, R

    2015-08-01

    Lippia alba is empirically used for infusions, teas, macerates, and hydroalcoholic extracts because of its antispasmodic, analgesic, sedative, and anxiolytic effects. Citral is a mixture of trans-geranial and cis-neral and is the main constituent of L. alba essential oil and possesses analgesic, anxiolytic, anticonvulsant, and sedative effects. The present study evaluated the effects of the essential oil of L. alba (EOLa) and citral on compound action potentials (CAPs) in Wistar rat sciatic nerves. Both drugs inhibited CAP in a concentration-dependent manner. The calculated half-maximal inhibitory concentrations (IC50) of peak-to-peak amplitude were 53.2 µg/mL and 35.00 µg/mL (or 230 µM) for EOLa and citral, respectively. Peak-to-peak amplitude of the CAP was significantly reduced by 30 µg/mL EOLa and 10 µg/mL citral. EOLa and citral (at 60 and 30 µg/mL, values close to their respective IC50 for CAP blockade) significantly increased chronaxy and rheobase. The conduction velocity of the first and second CAP components was statistically reduced to ∼86% of control with 10 µg/mL EOLa and ∼90% of control with 3 µg/mL citral. This study showed that EOLa inhibited nerve excitability and this effect can be explained by the presence of citral in its composition. Both EOLa and citral showed inhibitory actions at lower concentrations compared with other essential oils and constituents with local anesthetic activity. In conclusion, these data demonstrate that EOLa and citral are promising agents in the development of new drugs with local anesthetic activity.

  5. Topical airway anesthesia for awake fiberoptic intubation: Comparison between airway nerve blocks and nebulized lignocaine by ultrasonic nebulizer

    Directory of Open Access Journals (Sweden)

    Babita Gupta

    2014-01-01

    Full Text Available Overview: Awake fiberoptic bronchoscope (FOB guided intubation is the gold standard of airway management in patients with cervical spine injury. It is essential to sufficiently anesthetize the upper airway before the performance of awake FOB guided intubation in order to ensure patient comfort and cooperation. This randomized controlled study was performed to compare two methods of airway anesthesia, namely ultrasonic nebulization of local anesthetic and performance of airway blocks. Materials and Methods: A total of 50 adult patients with cervical spine injury were randomly allocated into two groups. Group L received airway anesthesia through ultrasonic nebulization of 10 ml of 4% lignocaine and Group NB received airway blocks (bilateral superior laryngeal and transtracheal recurrent laryngeal each with 2 ml of 2% lignocaine and viscous lignocaine gargles. FOB guided orotracheal intubation was then performed. Hemodynamic variables at baseline and during the procedure, patient recall, vocal cord visibility, ease of intubation, coughing/gagging episodes, and signs of lignocaine toxicity were noted. Results: The observations did not reveal any significant differences in demographics or hemodynamic parameters at any time during the study. However, the time taken for intubation was significantly lower in Group NB as compared with the Group L. Group L had an increased number of coughing/gagging episodes as compared with Group NB. Vocal cord visibility and ease of intubation were better in patients who received airway blocks and hence the amount of supplemental lignocaine used was less in this group. Overall patient comfort was better in Group NB with fewer incidences of unpleasant recalls as compared with Group L. Conclusion: Upper airway blocks provide better quality of anesthesia than lignocaine nebulization as assessed by patient recall of procedure, coughing/gagging episodes, ease of intubation, vocal cord visibility, and time taken to intubate.

  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. The study on the function of gastrointestinal autonomic nerve in reflux esophagitis patients%反流性食管炎患者胃肠道自主神经功能研究

    Institute of Scientific and Technical Information of China (English)

    赵威; 王瑞峰; 孙晓红; 方秀才; 王智凤; 朱丽明; 柯美云

    2011-01-01

    Objective To explore the features of autonomic nerve function in reflux esophagitis (RE) patients, and the role of abnormal function in the pathogenesis of RE. Methods Twenty RE patients (RE group) and 18 healthy controls (HS group) all underwent heart rate variability (HRV) with meal stimulation to test the function of autonomic nerve. At same time, the endoscopic Los Angeles (LA) Classification, RE symptom score, Gastroesophageal reflux disease-health related quality of life (GERD-HRQL), Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) were evaluated in the RE patients. Of those, 12 RE patients were re-examined the function of autonomic never after 2 to 4 months [mean (3.7±0.8) months] of proton pump inhibitors (PPI) treatment. Results In fasting state, the sympathetic activity was higher in RE group than in HS group, while the parasympathetic activity was lower in HS group (P=0.022 and 0.034). Postprandial, the trend of autonomic functional change was the same in RE group and HS group. Postprandial, the sympathetic activity was negatively correlated with symptom score in RE patients; however, the parasympathetic activity was positively correlated with RE symptom score. The influence of meal on the balance of sympathetic and parasympathetic was negatively correlated with RE symptom score (r=-0.48, P=0.022). The influence of meal on the parasympathetic nerve was positively correlated with RE symptom score and GERD-HRQL score. After PPI treatments, RE symptom score, GERD-HRQL score, SAS score and SDS score were all significantly decreased in RE patients. There was no significant difference in autonomic nerve function before and after PPI treatment. Conclusions There is abnormal autonomic nerve function in RE patients, characterized by higher sympathetic activity and lower parasympathetic activity in fasting state. The autonomic nerve function is correlated with RE symptom score. The abnormal autonomic nerve function may be one of the causes

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

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    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. Using a laser guidance system for CT-guided biopsy and treatment of nerve block; Verwendung eines Laserzielgeraetes fuer CT-gesteuerte Biopsien und Nervenblockaden

    Energy Technology Data Exchange (ETDEWEB)

    Zwaan, M. [Inst. fuer Radiologie, Medizinische Univ. Luebeck (Germany); Frahm, C. [Inst. fuer Radiologie, Medizinische Univ. Luebeck (Germany); Kloess, W. [Inst. fuer Radiologie, Medizinische Univ. Luebeck (Germany); Preuss, S. [Schmerzambulanz, Klinik fuer Anaesthesiologie, Medizinische Univ. Luebeck (Germany); Baumeier, W. [Schmerzambulanz, Klinik fuer Anaesthesiologie, Medizinische Univ. Luebeck (Germany); Grande-Nagel, I. [Inst. fuer Radiologie, Medizinische Univ. Luebeck (Germany); Gehl, H.B. [Inst. fuer Radiologie, Medizinische Univ. Luebeck (Germany); Weiss, H.D. [Inst. fuer Radiologie, Medizinische Univ. Luebeck (Germany)

    1996-07-01

    CT-guided intervention is a simple and pin-pointed modality for obtaining cytologic, biopsy, or microbiologic samples, and for treatment of the nerve blockade. In order to enhance the precision of punctures, and reduce complications, the authors developed and tested a novel laser guidance system (wavelength 365 nm at 4.5 mW). In 56 consecutive patients (representing 24 nerve blocks, 16 tumor biopsies, 16 microbiological punctures), a CT-guided intervention was performed. Despite a high accuracy (80 punctures), false punctures (6) could not be avoided in cases where anatomic conditions were misleading the needle, or due to patient movements. The system is not to be blamed for these unsuccessful attempts. As the system operates contactless guided by laser light, it is a good tool ensuring simple and sterile needle biopsy. (orig.) [Deutsch] Die computertomographisch gesteuerte Intervention ist ein einfaches und zielsicheres Verfahren fuer die Gewinnung zystologischer, bioptischer oder mikrobiologischer Proben und zur therapeutischen Nervenblockade. Zur Erhoehung der Punktionsgenauigkeit und zur Reduktion von Komplikationen haben wir fuer diese Indikationsgebiete ein neu entwickeltes Laserzielgeraet (Wellenlaenge 365 m bei 4,5 mW) erprobt. Es wurde bei 56 konsekutiven Patienten (24 Nervenblockaden, 16 Tumorbiopsien, 16 mikrobiologische Materialentnahmen) eine CT-gesteuerte Intervention duchgefuehrt. Trotz einer hohen Treffgenauigkeit (80 Punktionen) kann es aber weiterhin zu Fehlpunktionen (6) kommen, falls Koerperstrukturen zum Abweichen oder Abbiegen der Punktionsnadel fuehren oder der Patient sich bewegt. Dies ist dem System selbst nicht anzulasten. Da es mit Laserlicht beruehrungsfrei arbeitet, ist eine einfache und sterile Punktion sehr gut moeglich. (orig.)

  10. 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.

  11. 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

  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. 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。

  14. Do sensory calcitonin gene-related peptide nerve fibres in the rat pelvic plexus supply autonomic neurons projecting to the uterus and cervix?

    Science.gov (United States)

    Houdeau, E; Barranger, E; Rossano, B

    2002-10-25

    Sensory nerve fibres containing calcitonin gene-related peptide (CGRP) innervate neurons of the paracervical ganglion (PCG) in the female rat pelvic plexus. We have combined retrograde tracing with immunocytochemistry to investigate whether CGRP-immunoreactive (-IR) fibres supply neurons targeting the genital tract. Of the total neurons projecting to either the uterine horns or the cervix, 38 and 41% received CGRP-IR innervation, respectively. All these neurons displayed choline acetyltransferase-IR, thus are cholinergic. They were found throughout the PCG and other pelvic plexus ganglia, namely accessory ganglia (AG) and hypogastric plexus (HP). Pelvic nerve section showed that afferent fibres in these nerves provided most of the CGRP-IR fibres supplying uterine- or cervical-related neurons in the PCG/AG, none in HP. It is suggested that such sensory-motor network may provide a local pathway for reflex control of genital tract activity, acting through cholinergic nerve projections.

  15. Plasticity of autonomic nerves: differential effects of long-term guanethidine sympathectomy on the sensory innervation of the rat uterus during maturation.

    Science.gov (United States)

    Brauer, M M; Lincoln, J; Milner, P; Sarner, S; Blundell, D; Passaro, M; Corbacho, A; Burnstock, G

    1994-10-01

    The sensory nerves, containing substance P and calcitonin gene-related peptide, and noradrenaline-containing sympathetic nerves of the rat uterus were analyzed following long-term sympathectomy with guanethidine in prepubertal (four weeks), young adult (eight weeks) and fully adult animals (18 weeks). Immunohistochemical and histochemical methods were used in association with nerve density measurements and biochemical assays. The main findings were as follows: (1) long-term guanethidine treatment completely abolished the noradrenergic innervation of the uterine horn and parametrial tissue and markedly reduced the tissue levels of noradrenaline in both regions at the three ages analysed; (2) in the uterine horn guanethidine treatment had no effect on the tissue levels of either calcitonin gene-related peptide or substance P or on the density of calcitonin gene-related peptide-containing nerves, at any of the three ages studied; (3) in the parametrial tissue increased levels of calcitonin gene-related peptide were observed at 8 and 18 weeks of age, together with a significant increase in the density of calcitonin gene-related peptide-containing nerves. Substance P levels showed a transient increase in this tissue at eight weeks. In conclusion, long-term sympathectomy with guanethidine resulted in an increase in calcitonin gene-related peptide and substance P in sensory nerves in the parametrial tissue, but not in the uterine horn. The changes in the parametrial tissue only occurred after puberty. It is suggested that sensory nerves in the uterine horn may be less responsive to sympathetic denervation since loss of sympathetic nerves occurs as part of a normal physiological process during pregnancy in this region.

  16. Peripheral nerve lengthening as a regenerative strategy

    Institute of Scientific and Technical Information of China (English)

    Kenneth M.Vaz; Justin M.Brown; Sameer B.Shah

    2014-01-01

    Peripheral nerve injury impairs motor, sensory, and autonomic function, incurring substantial ifnancial costs and diminished quality of life. For large nerve gaps, proximal lesions, or chronic nerve injury, the prognosis for recovery is particularly poor, even with autografts, the current gold standard for treating small to moderate nerve gaps. In vivo elongation of intact proximal stumps towards the injured distal stumps of severed peripheral nerves may offer a promising new strategy to treat nerve injury. This review describes several nerve lengthening strategies, in-cluding a novel internal ifxator device that enables rapid and distal reconnection of proximal and distal nerve stumps.

  17. Anatomical basis and main points of pelvic autonomic nerve preserving in proctectomy%直肠切除术中保留盆腔内脏神经的解剖学基础及要点

    Institute of Scientific and Technical Information of China (English)

    马国龙; 王毅; 梁小波

    2014-01-01

    目的:了解盆腔内脏神经的走行及与盆腔筋膜的关系,寻找安全的操作平面,减少直肠癌手术中对内脏神经的损伤。方法通过解剖12例人骨盆标本,观察盆腔内脏神经的走向分布及与筋膜间隙的关系。结果腹下神经全程走行于骶前筋膜内,下腹下丛走行于盆壁层筋膜内,并于直肠2点及10点处(截石位)在多个平面交叉穿入 Denonvilliers 筋膜汇入泌尿生殖血管束, Denonvilliers筋膜内存在横行的神经交通支。结论直肠后方及侧方的手术操作平面在直肠固有筋膜与骶前筋膜之间靠近直肠固有筋膜一侧,在直肠前方的手术操作应注意保护直肠2点及10点位置的泌尿生殖神经血管束及Denonvillers筋膜内的神经交通支。%Objective To elucidate the course of pelvic autonomic nerves and its relationship with pelvic fascia in order to identify the safe plane to reduce the damage of pelvic autonomic nerves in total mesorectaI excision(TME). Methods The course and distribution of pelvic autonomic nerves were observed and their relationship with pelvic interfascial space was examined through the anatomy of 12 adult pelvic specimens. Results The entire course of hypogastric nerves ran within the anterior sacral fascia and the inferior hypogastric plexus ran within parietal fascia. Inferior hypogastric plexus crossed the fusion line of Denonvilliers fascia and parietal fascia in the 10 o′clock and 2 o′clock directions of the rectum, and joined urogenital vessel bundle finally. Laterigrade traffic nerves could be found in Denonvilliers fascia. Conclusion The safe plane should be chosen between rectal proper fascia and anterior sacral fascia near rectal proper fascia in posterior dissection and lateral dissection of rectum. More attention should be paid to protect the nervovascular bundle in the 10 o′clock and 2 o′clock directions of rectum and traffic nerve within Denonvilliers fascia in anterior

  18. Success rate of 10th semester dental students of Tehran University of Medical students in infra alveolar nerve block injection technique

    Directory of Open Access Journals (Sweden)

    Hoseinitodashki H.

    2009-03-01

    Full Text Available "nBackground and Aim: Inducing anesthesia is one of the important tasks in dentistry. Among various techniques for injection, the Inferior Alveolar Nerve Block (IANB technique is one of the most practical and prevalent methods. However, according to some proofs in reference books, the success rate for this technique is some how low. Therefore the success rate of IANB performed by 10th-semester undergraduare students from Faculty of Dentistry of Tehran University of Medical Sciences was assessed in this study. "nMaterials and Methods: In this cross-sectional study from patients referring to oral and maxillofacial surgery ward, 20 patients with predefined conditions were selected. For each of them, two IANB injections were done in two separated days; one by a student and the other by an attend (or resident of maxillofacial surgery ward. Success or failure of each injection was examined by Pin Prick test. In this study, the non-parametric Willcoxon test was used. "nResults: In this study, the success rate of IANB was 70% and 90%, respectively for students and attends (or resident. "nConclusion: Significant statistically difference was seen between the two groups, we hope that through further practical education, this differences rsduce in following similar studies.

  19. 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

  20. Effects of Expression Ways and Traits of Anger Emotion on Autonomic Nerve in the Emotion Recovery Stage%愤怒表达方式及特质对情绪恢复期自主神经的影响

    Institute of Scientific and Technical Information of China (English)

    詹向红; 乔明琦; 张惠云; 刘胜利; 杨雪; 徐玮玮

    2013-01-01

    Objective To explore the effects of expression ways and traits of anger emotion on autonomic nerve in the emotion recovery stage.Methods The 48 healthy undergraduate students were recruited as subjects,who were assigned to four groups,i.e.,anger-out of high trait group,anger-in of high trait group,anger-out of low trait group,anger-in of low trait group,12 in each group.The changes of autonomic nerve in emotion recovery stage [mainly including heart rate (HR),finger pulse volume (FPV),heart rate variability (HRV),and galvanic skin response (GSR)] were observed in an experimental paradigm processed dynamically by emotion induction (by watching movie clips) and emotion regulation (by phraseology clewing and regulating body reaction to anger).Results In the emotion recovery stage all increased data of vegetative reactions decreased in the four groups.The decrease extent of HR,FPV,and GSR was lower in the anger-in groups than that in the anger-out groups (P <0.05).The HRV showed a decreasing trend,but with no statistical significance (P >0.05).The decrease extent of HR was lower in the low-anger groups than in the high-anger group (P <0.05).Conclusions Both expression ways and traits of anger exerted influence on the autonomic nerve in the emotion recovery stage.The former influenced more broadly.The influence of anger-in on the autonomic nerve would be more sustainable.%目的 探讨愤怒表达方式和特质对情绪恢复期自主神经的影响.方法 以48名在校健康大学生作为被试,分为高特质发怒、高特质郁怒、低特质发怒、低特质郁怒4组,每组12名.采用情绪诱发(观看电影片段)和情绪调节(按语词提示调节对愤怒刺激的反应)动态加工的试验范式,研究情绪恢复期自主神经的变化,主要包括心率(heart rate,HR)、手指脉搏血容(finger pulse volume,FPV)、心率变异性(heart rate variability,HRV)及皮肤电反应(galvanic skin response,GSR).结果 在情绪恢复期,4组被试

  1. 腹腔镜保留盆腔自主神经的直肠癌根治术技术要领%Techniques of autonomic nerve preservation in laparoscopic radical resection for rectal cancer

    Institute of Scientific and Technical Information of China (English)

    卫洪波; 郑宗珩

    2015-01-01

    Pelvic autonomic nerve is a three-dimensional structure surrounding the rectum. There are several key points related to nerve injury during laparoscopic radical resection for rectal cancer. Hypogastric nerve has close relation with the upper and middle part of the rectum. Combined with S2-S4 pelvic splanchnic nerve, hypogastric nerve forms pelvic plexus. Incorrect operation in pelvic parietal peritoneum during dissection of upper rectum will lead to nerve injury. When performing dissection of inferior mesenteric artery, bilateral nerve tracts should be pushed to posterior abdominal wall and anterior fascia of the abdominal aorta should be well protected to avoid nerve injury. Pelvic plexus fibers located lateral to the rectum of pelvic floor, as well as neurovascular bundle closed to Denonvillier′s fascia, also have close relations with nerve injury. Dissection of either lateral or anterior wall of rectum should be performed behind the Denonvillier′s fascia and in front of the proper fascia of rectum. Sharp dissection should be performed closed to the mesorectum to protect branches of pelvic plexus.%盆腔自主神经丛是一个立体的结构,包裹于直肠周围。在腹腔镜直肠癌手术中,有多个容易造成神经损伤的关键点。腹下神经与直肠中上段关系密切,来自骶2至骶4的盆内脏神经与腹下神经共同组成盆腔神经丛;游离直肠上段时,如错误进入盆筋膜壁层之后,则可能会将神经层掀起,造成神经损伤或离断。游离肠系膜下动脉时,应将动脉双侧可见的神经束尽量推向后腹壁,注意避免切开腹主动脉前筋膜,以免损伤神经。盆底深部直肠侧方的盆腔神经丛纤维和靠近Denonvilliers筋膜的血管神经束这两个部位也是容易受损伤的关键点,在游离直肠侧壁及前壁时,可在Denonvilliers筋膜后方、直肠固有筋膜前方进行,紧贴直肠系膜锐性离断,保护由盆腔神经丛发出的支配其他器官的分支。

  2. Articaine and mepivacaine buccal infiltration in securing mandibular first molar pulp anesthesia following mepivacaine inferior alveolar nerve block: A randomized, double-blind crossover study

    Directory of Open Access Journals (Sweden)

    Giath Gazal

    2015-01-01

    Full Text Available Aims: A crossover double-blind, randomized study was designed to explore the efficacy of 2% mepivacaine with 1:100,000 adrenaline buccal infiltration and 4% articaine with 1:100,000 adrenaline buccal infiltration following 2% mepivacaine with 1:100,000 adrenaline inferior alveolar nerve block (IANB for testing pulp anesthesia of mandibular first molar teeth in adult volunteers. Materials and Methods: A total of 23 healthy adult volunteers received two regimens with at least 1-week apart; one with 4% articaine buccal infiltration and 2% mepivacaine IANB (articaine regimen and another with 2% mepivacaine buccal infiltration supplemented to 2% mepivacaine IANB (mepivacaine regimen. Pulp testing of first molar tooth was electronically measured twice at baseline, then at intervals of 2 min for the first 10 min, then every 5 min until 45 min postinjection. Anesthetic success was considered when two consecutive maximal stimulation on pulp testing readings without sensation were obtained within 10 min and continuously sustained for 45 min postinjection. Results: In total, the number of no sensations to maximum pulp testing for first molar teeth were significantly higher after articaine regimen than mepivacaine during 45 min postinjection (267 vs. 250 episodes, respectively, P 0.05. Interestingly, volunteers in the articaine regimen provided faster onset and longer duration (means 2.78 min, 42.22 min, respectively than mepivacaine regimen (means 4.26 min, 40.74 min, respectively for first molar pulp anesthesia (P < 0.001. Conclusions: Supplementary mepivacaine and articaine buccal infiltrations produced similar successful first molar pulp anesthesia following mepivacaine IANB injections in volunteers. Articaine buccal infiltration produced faster onset and longer duration than mepivacaine buccal infiltration following mepivacaine IANB injections.

  3. Dental Students’ Preference with regard to Tactile or Visual Determination of Injection Site for an Inferior Alveolar Nerve Block in Children: A Crossover Randomized Clinical Trial

    Directory of Open Access Journals (Sweden)

    Nahid Ramazani

    2016-08-01

    Full Text Available Objectives: Instruction of local anesthesia injection in an important part of dental education curricula. This study was performed to compare dental students’ preference with regard to tactile or visual determination of injection site for an inferior alveolar nerve block (IANB in children.Materials and Methods: This crossover randomized clinical trial was conducted on dental students of Zahedan Dental School who took the first practical course of pediatric dentistry in the first academic semester of 2013-14 (n=42. They were randomly divided into two groups. During the first phase, group I was instructed to find the needle insertion point for an IANB via tactile method and group II was instructed to do it visually. In the second phase, the groups received instructions for the alternate technique. Both instructions were done using live demonstrations by the same instructor and immediately after instruction the learners practiced an IANB using the taught method. A five-point Likert scale questionnaire was then filled out by the students. The preference score was determined by calculating the mean of item scores. Data were analyzed using Mann-Whitney U and Wilcoxon Singed Rank tests in SPSS 19 at P=0.05 level of significance.Results: Thirty-eight students completed the study. By using the visual method to perform an IANB, students gained a significantly higher mean preference score (P=0.020. There was a significant difference in the preference of male students (P=0.008.Conclusions: Instruction of IANB by visual identification of needle insertion point is more desirable by students. 

  4. 愤怒情志表达方式及特质对自主神经的影响%Effect of expression and trait of anger emotion on autonomic nerve

    Institute of Scientific and Technical Information of China (English)

    詹向红; 刘胜利; 江虹; 乔明琦; 张惠云; 潘芳; 杨雪; 徐玮玮

    2011-01-01

    Objective: To explore the effects of expression and trait of anger emotion on autonomic nerve. Methods:The subjects enrolled were screened from the health college students. The changes of autonomic nerve were researched in an experimental paradigm processed dynamically by emotion induction (by watching movie clips) and emotion regulation (by phraseology clewing and regulating body reaction to anger). Results: The increased extent of heart rate, finger pulse volume, heart rate variability, galvanic skin reflex in the anger-ont groups was higher than that in the anger-in groups(P=0.025, 0.028, 0.014,0.047). The skin temperature of the subjects increased when the anger expression of them in the high-trait anger group were suppressed (P=0.032). Conclusion: ①The extent of sympathetic nerve of the subjects activated by anger-out was more obvious than that by anger-in. ②There was the interaction between trait anger and anger expression.%目的:探讨愤怒情志表达方式和特质对自主神经的影响.方法:以健康在校大学生48人为被试,采用情绪诱发(观看电影片段)和情绪调节(按语词提示调节对愤怒刺激的反应)动态加工的实验范式,研究自主神经的变化.结果:发怒时心率(HR)、手脂脉搏血容(FPV)、心率变异性(HRV)、皮肤电(GSR)增幅大于郁怒(P=0.025,0.028,0.014,0.047);高特质怒在抑制情绪表达时皮肤温度升高(P=0.032).结论:①发怒时对交感神经的激活程度高于郁怒;②特质怒与愤怒表达方式间存在交互作用.

  5. 自主神经在电针“肾俞”穴利尿效应中的作用%The Role of Autonomic Nerve on Diuretic Response Induced by Acupuncturing “Shen-Shu” Point

    Institute of Scientific and Technical Information of China (English)

    马正行; 蔡乃真; 单敏初

    2001-01-01

    -05)。结论①针刺兔“肾俞”穴可引起肾交感神经系统活动加强和迷走神经传入纤维放电加强,但迷走传出活动无明显变化;②肾交感神经传出纤维放电增加,不但不能促进肾泌尿功能,而且对尿量和尿钠排出量的增加起抑制或推迟作用;③针刺“肾俞”穴后迷走神经传入纤维放电增加可能通过血浆AVP浓度降低和抑制肾交感传出纤维兴奋活动导致利尿和利钠效应。%Objective To observe the activities of autonomic nerve and to elucidate its role on diuretic response induced by acupuncturing “Shen-Shu” Point. Methods 38 anesthetized rabbits were divided into 5 groups: Group A, discharge of efferent fibers of renal nerve observed (DERN) (n=6); Group B, discharge of afferent fibers of renal nerve observed (DARN) (n=11); Group C, discharge of afferent fibers of cervical vagus nerve observed (n=6); Group D, amount of urine with denervation of bilateral cervical vagus nerve observed (n=6); Group E, heart rate variability observed (n=9). Results The duration of spontaneous discharge of efferent fiber plexus of renal nerve (Ti), the ratio of duration of discharge /cycle of discharge (Ti/Ti+Te) and the peak of accumulative curve of discharge were all gradually increased after acupuncturing “Shen-Shu” Point, and maintained at high levels for 60~120 minutes after withdrawing the needles. The frequency of discharge of efferent fibers of renal nerves was gradually increased and maintained at high level for 30~90 minutes after withdrawing the needles. The frequency of discharge of afferent fiber of vagus nerve was gradually increased after acupuncturing “Shen-Shu” Point and maintained at high level for 90~120 minutes after withdrawing the needles. All these reached the highest levels 90 minute after withdrawing the needles. The amount of urine after acupuncturing “Shen-Shu” Point in the rabbits with denervation of bilateral vagus was not

  6. 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.

  7. High division of sciatic nerve

    Directory of Open Access Journals (Sweden)

    Tripti Shrivastava

    2014-04-01

    Results: In all except two cadavers, the nerve divided at the apex of the popliteal fossa. In two cadavers the sciatic nerve divided bilaterally in the upper part of thigh. Conclusion: The high division presented in this study can make popliteal nerve blocks partially ineffective. The high division of sciatic nerve must always be borne in mind as they have important clinical implications. [Int J Res Med Sci 2014; 2(2.000: 686-688

  8. 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...... methods including nerve conduction studies and electromyography used in the study of patients suspected of having a neuropathy and the significance of the findings are discussed in detail and more novel and experimental methods are mentioned. Diagnostic considerations are based on a flow chart classifying...

  9. The vagus nerve blocking effects on cerebral ischemia in rat model%迷走神经阻断对脑缺血大鼠模型的影响

    Institute of Scientific and Technical Information of China (English)

    王忠; 孙建新; 连军; 吕晓敏; 安娟; 朱虎虎

    2013-01-01

    目的探讨阻断大鼠颈总迷走神经对脑缺血模型大鼠的脑缺血体征和生理指标的影响。方法取雄性SD大鼠40只,随机分为对照组、左侧迷走神经阻断组、右侧迷走神经阻断组和双侧迷走神经阻断组,每组10只。4组大鼠均采取结扎颈总动脉(CCA)的方法建立脑缺血大鼠模型;脑缺血模型建立后,除对照组大鼠不阻断迷走神经外,其余3组大鼠均阻断相应的迷走神经。手术后评价各组大鼠脑缺血体征,检测各组大鼠血压、呼吸和心率指标。结果4组大鼠均出现脑缺血体征,其中双侧迷走神经阻断组大鼠脑缺血体征最为显著,左侧迷走神经和右侧迷走神经阻断组次之,模型对照组最不明显,并且有3只大鼠无脑缺血症状。与对照组大鼠比较,其余3组大鼠呼吸频率减低,心率和血压明显增加,差异具有统计学意义(P <0.05)。结论阻断大鼠颈总迷走神经可加重脑缺血模型大鼠的脑缺血体征,同时可促使大鼠的呼吸变慢变深、心率加快及血压上升。%Objective To discuss vagus nerve blocking effects on the changes of cerebral ischemia symptoms and physiological indexes in rat model .Methods 40 SD male rats were randomly divided into 4 groups(10 each):control group ,left vagal blockade group ,the right vagus nerve block group and bilateral vagotomy group .Four groups were established the model of cerebral ischemia by taking ligation of common carotid artery (CCA) method;the rats in intomodel group were not blocked the vagus nerve ,while the other groups were blocked the vagus nerve .The rats cerebral ischemia ,rats were measured blood pressure , heart rate and respiratory rate of index evaluation after operation .Results 4 groups showed symptoms of cerebral ischemia ,in w hich the cerebral ischemia symptoms of bilateral vagotomy rats are the most signifi-cant ;then the left vagus nerve and the right vagus nerve block

  10. Clinical anatomy study of autonomic nerve anterior to the lumbar%腰椎前路手术相关自主神经的解剖及临床意义

    Institute of Scientific and Technical Information of China (English)

    陆声; 徐永清; 师继红; 丁自海; 李忠华; 钟世镇

    2008-01-01

    Objective The anatomical and histological characteristics of the autonomic nerve anterior to the lumbar are to study,in aiming to clarify anatomical basis for an ejaculation-preserving approach in the minimally invasive lumbar surgery.Methods The lumbar retroperitoneal region of 10 male cadavers was dissected and analyzed.The parietal peritoneum anterior to the abdominal aorta, iliac artery and lumbar spine was incised and dissection bilaterally.The main goal of these dissections was to understand the anatomic relations of autonomic nerves and analyzed a series of sections of paraffin-embedded preortic and para-aortic tissues,exposing the anatomic relations between nervous structure and the covering fasciae.Results The major part of the superior hypogastric plexus(SHP)was found slighted shifted to the left,with principal mass resting on the left common iliac artery.The main trunk of the SHP was situated in the triangle region before the distal abdominal aorta and its bifurcation plane.There were 7 cases (70%) situated at L5S1 intervertebral disc level and 3 cases(30%) situated at the sacral promontory level.The main trunk of the SHP situated on the left side of sacral promontory were found in 4 cases(40%).The other cases (60%) were situated on the left side of the midline of sacral promontory.These retroperitoneal structures appeared to be separated from the overlying fatty mass by a distinguishable loose connective tissue plane.Microscopic analysis of preaortic and para-aortic tissues conftrms the plane of separation.thus the nerve fiber plane exist as an independent plane.Conclusion According to the character of automatic nerve in front of lumbar, the peritoneum should be incised from right side in the transperitoneal approach.The nerve fiber fascia anterior to the aortic and sacral promontory can be mobilized as a whole to preserve the autonomic nerve.%目的 对腰椎前方的自主神经进行解剖和组织学观察,提出避免导致逆行射精的自主神

  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. Linking algorithm of discontinuity crack block based on autonomous edge growing%基于主动生长的断裂裂缝块的连接方法

    Institute of Scientific and Technical Information of China (English)

    朱平哲; 黎蔚

    2011-01-01

    In order to deal with the problem of false information and edge breakpoint about binary image of asphalt pavement crack image segmentation, a new method of discontinuity crack block linking was developed based on autonomous edge growing. This method removed false information according to the characteristics of circular noise and linearly cracks, and filled interstice by using method of region filling, thereby accomplished linking of discontinuity crack block based on autonomous edge growing. The experimental results show that the algorithm has excellent performance in edge linking of discontinuity crack block in different cases, and the noises can be removed at the same time, which is in favor of subsequent image processing such as image measurement and evaluating.%针对沥青路面裂缝图像分割成二值图像后,存在虚假信息和边缘断点的问题,提出一种基于主动生长的断裂裂缝块的连接方法.该方法依据噪声呈孤立圈状,裂缝呈线性的特征去除虚假噪声信息;并采用区域填充法将裂缝轮廓内部空隙填充,使裂缝呈现块状;然后采用主动生长法进行断裂裂缝块的连接.实验表明,该算法在去除噪声的情况下,较好实现了断裂裂缝块的连接,有利于后续的图像测量、评估等处理.

  13. Bilateral eventration of sciatic nerve

    Directory of Open Access Journals (Sweden)

    T Sharma

    2010-12-01

    Full Text Available During routine dissection of a 60 years male cadaver, it was observed that the two divisions of sciatic nerve were separate in the gluteal region on both the sides with the tibial nerve passing below the piriformis and the common peroneal nerve piercing the piriformis muscle. The abnormal passage of the sciatic nerve (SN, the common peroneal nerve (CPN, and the tibial nerve (TN, either through the piriformis or below the superior gemellus may facilitate compression of these nerves. Knowledge of such patterns is also important for surgeons dealing with piriformis syndrome which affects 5-6% of patients referred for the treatment of back and leg pain. A high division may also account for frequent failures reported with the popliteal block. Keywords: eventration, piriformis muscle, piriformis syndrome, sciatic nerve

  14. 自主神经功能检测对体位性心动过速综合征的诊断价值%Diagnostic Value of Autonomic Nerve Function Tests for Postural Orthastatic Tachycardia Syndrome

    Institute of Scientific and Technical Information of China (English)

    朱露璐; 张凤文; 张清友; 金红芳; 杜军保

    2011-01-01

    目的 探讨自主神经功能检测对体位性心动过速综合征(POTS)的诊断价值.方法 对POTS患儿26例和健康儿童20例分别测定其瓦式(Valsalva )比值、深呼吸心率差、30 s最长RR间期/15 s最短RR 间期(30/15)比值、卧立位血压差等自主神经功能及12 导联同步体表心电图(12 ECG)QT间期离散度(QTd)、P波离散度(Pd)水平的变化.采用SPSS 13.0软件进行统计学分析.结果 POTS患儿Valsalva比值、深呼吸心率差与健康对照组比较[Valsalva比值:(1.08±0.06) vs (1.22±0.03); 深呼吸心率差:(9.7±1.7) 次·min-1 vs (18.3±1.6)次·min-1] 均明显降低,差异均有统计学意义(t=5.86、11.34,Pa0.05).结论 POTS患儿自主神经明显受损,Valsalva比值、深呼吸心率差、QTd可作为诊断POTS的一种新方法.%Objective To explore the diagnostic value of autonomic nerve function tests for children with postural orthastatic tachycardia syndrome (POTS). Methods Cardiovascular autonomic nerve function tests, including response index of Valsalva maneuver, heart rate change with deep respiration, 30: 15 postural ratio, postural change of blood pressure, the variation of QT interval dispersion (QTd) and P - wave dispersion (Pd) of 12 - lead simultaneous body surface electrocardiogram were performed in POTS group including 26 cases of POTS and healthy control group including 20 cases of healthy children. The data were analyzed by SPSS 13.0 software. Results Index of Valsalva maneuver ratio and heart rate change with deep respiration of POTS children were significantly lower than those of healthy subjects [ Valsalva maneuver index: ( 1.08 ± 0.06) vs ( 1.22 ± 0.03 ); heart rate change with deep respiration: ( 9.7 ± 1.7 ) times per min vs ( 18.3 ± 1.6 ) times per min,Pa < 0.05 ]. In addition, compared with the healthy control group, maximal QT interval (QTmax), minimal QT interval (QTmin) and QTd prolonged (Pa < 0.01 ), maximal QT corrected for heart rate (QTcmax) and QT

  15. 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

  16. 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 ...

  17. Anatomical study of sciatic nerve and common peroneal nerve compression

    Institute of Scientific and Technical Information of China (English)

    Mingzhao Jia; Qing Xia; Jinmin Sun; Qiang Zhou; Weidong Wang

    2008-01-01

    suprapiriform foramen are where "the first threshold" sciatic nerve projects. The structures between the infrapiriform and suprapiriform gap were "the second threshold". This became the concept of "double threshold". The reduced area caused by pathological changes of "double threshold" may block and compress the sciatic nerve. Because the common peroneal nerve lies on the anterolateral side of the sciatic nerve, injury to the common peroneal nerve is more serious. CONCLUSION: Anatomical characteristics of the common peroneal nerve, as well as variation of the sciatic nerve, piriformis, and the reduced "double threshold", are the main causes of sciatic nerve injury, and are especially common in peroneal nerve injury.

  18. Effect of Nerve Block Combined with Oral Pregabalin on Postherpetic Neuralgia%神经阻滞联合普瑞巴林治疗带状疱疹后神经痛的研究

    Institute of Scientific and Technical Information of China (English)

    申颖; 罗芳; 王云珍

    2011-01-01

    目的 比较单纯口服普瑞巴林和联合神经阻滞两种方法治疗带状疱疹后神经痛(PHN)的效果.方法 60例病程超过6个月的PHN患者分成两组,每组各30例.A组口服普瑞巴林;B组在口服药物的基础上行神经阻滞(三叉神经、肋间神经、椎旁阻滞或腰丛阻滞).比较两组患者治疗前、治疗后3d、1周、2周、3周、4周、5周、6周、7周、8周疼痛视觉模拟评分(VAS)和睡眠评分(采用汉密尔顿抑郁量表的第4、5、6项).比较两组患者疼痛缓解>50%和>30%的人数,以及副作用的发生率.结果 两组患者治疗后1~8周VAS和睡眠评分均低于治疗前(P<0.05),B组患者在治疗后3 dVAS及睡眠评分明显低于A组(P<0.01);B组患者疼痛缓解>50%的人数和疼痛缓解>30%的人数高于A组(P<0.05).两组患者副作用无显著性差异.结论 神经阻滞联合口服普瑞巴林治疗带状疱疹后神经痛起效快、止痛作用强,无严重副作用发生.%Objective To evaluate the efficacy of pregabalin combined with nerve block on postherpetic neuralgia (PHN). Methods 60 patients were assigned into group A (n=30), who received pregabalin orally, and group B (n=30), who received nerve block (trigeminal nerve, intercostal nerve, lumbar nerve block) in addition. They were assessed with visual analogue scale (VAS) of pain, sleep score from Hamilton Rating Scale for Depression before and 3 d, 1 week, 2 weeks, 3 weeks, 4 weeks, 5 weeks, 6 weeks, 7 weeks, and 8 weeks after treatment. The incidence of pain decreased >50% and >30% were compared. Results The scores of VAS and sleep significantly reduced in both groups 1~8 weeks after treatment (P50% and >30% were more in group B than in group A (P<0.05). Conclusion Nerve block combined with oral pregabalin is more effective on PHN.

  19. Progresses of paravertebral nerve block in the treatment of thoracolumbar postherpetic neuralgia%椎旁神经阻滞在胸腰段带状疱疹后神经痛的应用进展

    Institute of Scientific and Technical Information of China (English)

    薛雁鸣; 薛朝霞; 郝燕飞

    2015-01-01

    带状疱疹(herpes zoster,HZ)的治疗方法有很多,但部分患者即使得到及时治疗也发展成为带状疱疹后神经痛(postherpetic neuralgia,PHN).尽早实施椎旁神经阻滞可以预防带状疱疹后神经痛发生.本文就椎旁神经阻滞在胸腰段带状疱疹后神经痛应用的最新进展进行了总结.%There are many method for treatment of herpes zoster(HZ).However, some patients still suffered from postherpetic neuralgia (PHN) even though they got timely treatments.Treatment with paravertebral nerve block as soon as possible can prevent occurrence of postherpetic neuralgia.In this paper, the latest application progresses of thoracolumbar paravertebral nerve block for the treatment of postherpetic neuralgia are summarized.

  20. Who Is at Risk for Heart Block?

    Science.gov (United States)

    ... degree heart block caused by an overly active vagus nerve. You have one vagus nerve on each side of your body. These nerves ... the way to your abdomen. Activity in the vagus nerve slows the heart rate. Rate This Content: NEXT >> ...

  1. Two Different Methods Replacement Affects Nerve Block for Postoperative Pain Following Total Knee%两种不同神经阻滞方法对全膝关节置换术后疼痛的影响

    Institute of Scientific and Technical Information of China (English)

    陈希刚; 田茂生; 段俊峰

    2015-01-01

    Objective:To compare the two methods of different nerve block for pain after total knee arthroplasty.Method:60 patients with TKA surgery of patients with knee arthritis were divided into observation group and control group,respectively adopt continuous posterior lumbar plexus combined sciatic nerve block and adopting continuous femoral nerve block,two methods analgesic effect were compared.Result:Two groups of 6 h,12 h when resting,1 d scores were increased,and the 3 d,5 d after VAS score were gradually decreased,but the change in observation group was obviously higher than that of control group (P<0.05).After 1 d,3 d,5 d two groups gradually reduce VAS score,but the decline in observation group was obviously greater than the control group (P<0.05). Number of additional use of painkillers observation group was obviously less than control group (P<0.05).Conclusion:Two methods of nerve block can be very good improve TKA postoperative pain,but a continuous posterior lumbar plexus combined sciatic nerve block analgesia effect is better,less number of additional use of painkillers.%目的:比较两种不同神经阻滞方法对全膝关节置换术后疼痛的影响。方法:将60例采用TKA手术治疗的膝关节炎患者分成观察组和对照组,分别采用连续后路腰丛联合坐骨神经阻滞和采用持续股神经阻滞,比较两种方法镇痛效果。结果:静息时两组6、12、1 d VAS评分均逐渐升高,而3、5 d后VAS评分均逐渐降低,但观察组变化幅度明显高于对照组,两组比较差异均有统计学意义(P<0.05)。活动后1、3、5 d两组VAS评分逐渐降低,但观察组降幅明显大于对照组(P<0.05)。观察组额外使用止痛药次数明显少于对照组,两组比较差异均有统计学意义(P<0.05)。结论:两种神经阻滞方法都能很好的改善TKA术后疼痛,但连续后路腰丛联合坐骨神经阻滞止痛效果更好,额外使用止痛药物次数更少。

  2. Acupuncture Effect and Central Autonomic Regulation

    Directory of Open Access Journals (Sweden)

    Qian-Qian Li

    2013-01-01

    Full Text Available Acupuncture is a therapeutic technique and part of traditional Chinese medicine (TCM. Acupuncture has clinical efficacy on various autonomic nerve-related disorders, such as cardiovascular diseases, epilepsy, anxiety and nervousness, circadian rhythm disorders, polycystic ovary syndrome (PCOS and subfertility. An increasing number of studies have demonstrated that acupuncture can control autonomic nerve system (ANS functions including blood pressure, pupil size, skin conductance, skin temperature, muscle sympathetic nerve activities, heart rate and/or pulse rate, and heart rate variability. Emerging evidence indicates that acupuncture treatment not only activates distinct brain regions in different kinds of diseases caused by imbalance between the sympathetic and parasympathetic activities, but also modulates adaptive neurotransmitter in related brain regions to alleviate autonomic response. This review focused on the central mechanism of acupuncture in modulating various autonomic responses, which might provide neurobiological foundations for acupuncture effects.

  3. Pharmacology of airway afferent nerve activity

    Directory of Open Access Journals (Sweden)

    Carr Michael J

    2001-05-01

    Full Text Available Abstract Afferent nerves in the airways serve to regulate breathing pattern, cough, and airway autonomic neural tone. Pharmacologic agents that influence afferent nerve activity can be subclassified into compounds that modulate activity by indirect means (e.g. bronchial smooth muscle spasmogens and those that act directly on the nerves. Directly acting agents affect afferent nerve activity by interacting with various ion channels and receptors within the membrane of the afferent terminals. Whether by direct or indirect means, most compounds that enter the airspace will modify afferent nerve activity, and through this action alter airway physiology.

  4. 神经阻滞联合穴位封闭治疗原发性头痛105例疗效观察%Efficacy of nerve blocking combined with acupoint blocking in the treatment of primary headache in 105 cases

    Institute of Scientific and Technical Information of China (English)

    滕海英; 孟兰芳; 毛媛媛; 甘国强; 张家良

    2016-01-01

    目的:分析神经阻滞联合穴位封闭治疗原发性头痛的疗效。方法:根据头痛症状选择头面部相应常用神经阻滞注射点,配合穴位封闭,同时配合心理治疗,随访3个月观察疗效。结果:治疗1次后完全缓解64例,部分缓解33例;重复注射20例,完全缓解1例,部分缓解3例;总有效率95.24%。结论:临床应用神经阻滞联合穴位封闭治疗原发性头痛效果明显,方法简单、安全,并发症及不良反应少,是治疗原发性头痛的理想方法。%Objective:To analyze the efficacy of nerve block combined with acupoint blocking in the treatment of primary headache.Methods:According to the symptoms of headache,we selected the corresponding nerve block injection point,combined with acupoint blocking,combined with psychological treatment.All patients were followed-up for 3 months and observed the curative effect.Results:After 1 times of treatment,64 cases were completely relieved and 33 cases were partially relieved.Repeated injection in 20 cases,complete remission in 1 cases,partial remission in 3 cases,the total effective rate was 95.24%.Conclusion:The effect of clinical application of nerve blocking combined with acupoint blocking in the treatment of primary headache is obvious,the method is simple and safe,with less complications and adverse reactions,which is an ideal method for the treatment of primary headache.

  5. 17beta-estradiol modulates baroreflex sensitivity and autonomic tone of female rats.

    Science.gov (United States)

    Saleh, T M; Connell, B J

    2000-05-12

    The following experiments examine the role of estrogen as a central modulator of autonomic tone and baroreflex sensitivity in the female rat. Female Sprague-Dawley rats were ovariectomized and then supplemented daily for 7 days with a fixed dose of estrogen (5 microg/kg; sc) to produce a stable level of estrogen similar to that present at proestrous (17 pg/ml). The rats were then anaesthetized with sodium thiobutabarbital (100 mg/kg) and instrumented to record blood pressure, heart rate and both vagal and renal efferent nerve activities. The sensitivity of the cardiac baroreflex was tested using intravenous injection of multiple doses of either phenylephrine hydrochloride or sodium nitroprusside. Estrogen-supplemented female rats exhibited a significantly enhanced BRS as compared to male rats from a previous study (0.78 vs. 0.5). Furthermore, bolus injection of estrogen (1x10(-2) mg/kg; iv) in estrogen-supplemented female rats produced a significant increase in vagal nerve activity and a significant decrease in renal nerve activity which together resulted in a further enhancement of the BRS (0.78 vs. 2.4). Injection of the selective estrogen receptor antagonist, ICI 182,780, into nucleus ambiguus and the intrathecal space of the spinal cord blocked the respective changes in parasympathetic and sympathetic nerve activities indicating that intravenously administered estrogen modulates baseline autonomic tone via the activation of central estrogen receptors.

  6. Nerve plane-sparing radical hysterectomy: a simplified technique of nerve-sparing radical hysterectomy for invasive cervical cancer

    Institute of Scientific and Technical Information of China (English)

    LI Bin; LI Wei; SUN Yang-chun; ZHANG Rong; ZHANG Gong-yi; YU Gao-zhi; WU Ling-ying

    2011-01-01

    Background In order to simplify the complicated procedure of nerve-sparing radical hysterectomy, a novel technique characterized by integral preservation of the autonomic nerve plane has been employed for invasive cervical cancer. The objective of this study was to introduce the nerve plane-sparing radical hysterectomy technique and compare its efficacy and safety with that of nerve-sparing radical hysterectomy.Methods From September 2006 to August 2010, 73 consecutive patients with International Federation of Gynecology and Obstetrics stage IB to IIA cervical cancer underwent radical hysterectomy with two different nerve-sparing approaches. Nerve-sparing radical hysterectomy was performed for the first 16 patients (nerve-sparing radical hysterectomy group). The detailed autonomic nerve structures were identified and separated by meticulous dissection during this procedure. After January 2008, the nerve plane-sparing radical hysterectomy procedure was developed and performed for the next 57 patients (nerve plane-sparing radical hysterectomy group). During this modified procedure, the nerve plane (meso-ureter and its extension) containing most of the autonomic nerve structures was integrally preserved. The patients' clinicopathologic characteristics, surgical parameters, and outcomes of postoperative bladder function were compared between the two groups.Conclusion Nerve plane-sparing radical hysterectomy Is a reproducible and simplified modification of nerve-sparing radical hysterectomy, and may be preferable to nerve-sparing radical hysterectomy for treatment of early-stage invasive cervical cancer.

  7. Clinical value of pelvic autonomic nerve preservation during laparoscopic surgery for low rectal cancer%腹腔镜下低位直肠癌手术中保留盆腔自主神经的临床价值

    Institute of Scientific and Technical Information of China (English)

    侯雷; 刘志满; 张学敏; 赵明明

    2013-01-01

    AIM:To observe the function of pelvic autonomic nerve preservation (PANP) during laparoscopic surgery for low rectal cancer.METHODS:Seventy-six elderly patients who underwent laparoscopic surgery for low rectal cancer were included in this study.These patients were divided into either an observation group (n =40) or a control group (n =36).The observation group underwent PANP,while the control group did not undergo PANP.After treatment,the short-term and long-term micturition function was observed.In addition,a three-year follow-up was performed,and the quality of life was scored at the last follow-up.RESULTS:The percentage of patients who had improved short-term and long-term micturition function was significantly higher in the observation group than in the control group (17.50% vs 47.22%,0% vs 5.56%,both P < 0.05).Psychological state (SAS,SDS) and self esteem (SES) scores were significantly better in the observation group than in the control group (36.64 + 4.27 vs 42.37 + 4.35,32.84 + 3.21 vs 39.43 + 3.92,24.45 +4.20 vs 18.54 + 3.20,all P < 0.01).CONCLUSION:PANP during laparoscopic surgery for low rectal cancer can improve micturition function and patient's quality of life.%目的:观察腹腔镜下低位直肠癌手术中保留盆腔自主神经(pelvic autonomic nerve,PANP)的作用,方法:对76例腹腔镜下中低位直肠癌手术进行回顾性临床研究,其中40例PANP(观察组),36例非PANP(对照组).观察两组近期、远期排尿情况,同时对患者进行了为期3年的临床随访,并在最后一次随访时进行生活质量评分调查.结果:观察组患者近期、远期排尿功能的恢复均好于对照组(17.50% vs 47.22%,0% vs5.56%,P<0.05).心理状态[焦虑自评量表(self-rating anxietyscale)、抑郁量表(self-ratingdepression scale)]、自尊评价(self esteem)等相关生活质量评分,观察组亦显著好于对照组(36.64±4.27 vs 42.37±4.35,32.84±3.21 vs 39.43±3.92,24.45±4.20 vs 18.54±3.20,

  8. 龙血竭胶囊配合神经阻滞治疗肩周炎临床观察%Therapeutic Effect of Resina Draconis Capsule Combined with Nerve Block for Scapulohumeral Periarthritis

    Institute of Scientific and Technical Information of China (English)

    郑志方; 张高耀

    2012-01-01

    [目的]探讨口服龙血竭胶囊配合肩胛上神经肩关节支阻滞治疗肩关节周围炎的效果.[方法]肩关节周围炎38例41肩,口服龙血竭胶囊4粒,每天3次,30 d为1个疗程.于肩胛上神经主干的外侧1.5 cm处,采用利多卡因和醋酸曲安奈德的混合液对肩胛上神经肩关节支进行阻滞,每肩治疗1~2个疗程.[结果](1)经6~ 24个月(平均11个月)的随访,患肩疼痛减轻、日常功能改善、运动范围增加,与治疗前比较差异均有统计学意义(P<0.01).治疗后患肩前屈、上举、外展、内旋与正常参考值间差异均无统计学意义(P>0.05),表明治疗后患肩的运动范围已基本恢复到正常肩水平.(2)安全性评价:治疗后全部病例均无明显并发症发生.[结论]龙血竭胶囊配合肩胛上神经关节支阻滞是治疗肩关节周围炎较为安全有效的方法.%Objective To observe the therapeutic effect of Resina Draconis Capsule (RDC) combined with nerve block for scapulohumeral periarthritis. Methods Thirty-eight scapulohumeral periarthritis patients (involving 41 shoulders) took 4 capsules of RDC orally per day, three times a day, and 30 days constituted one treatment course. Nerve block with the mixture of lidocaine and triameinolone acetonide was performed at lateral 1. 5cm of suprascapular nerve stem to block the shoulder joint branch. Each shoulder was given one or two treatment courses. Results The results of the follow-up covering 6-24 months ( averaged 11 months) showed that the pain of the affected shoulder was relieved, daily activities were improved, and movement range was increased, the difference being significant compared with those before treatment (P 0. 05). No complications occurred during the treatment. Conclusion RDC combined with nerve block on the shoulder joint branch of suprascapular nerve is effective and safe for treatment of scapulohumeral periarthritis.

  9. Block-based Community in China’s Social Housing Development:A Case Study on Old City Renovation of Kashgar,Xinjiang Uygur Autonomous Region

    Institute of Scientific and Technical Information of China (English)

    2011-01-01

    Through the analysis of the international definition and classification of slums,this paper explores the development of China’s social housing system and the renovation of the Old City of Kashgar.It argues that one of the issues in China’s social housing system is to solve the problems of the scarcity of spatial elements and the lack of developmental driving force in large mixed communities of the Han and minority nationalities.Then it examines the elements of renovation and approaches based on a survey of the local residents in different parts of Kashgar City.Comparing the international development of traditional residential quarters and block-based communities,the paper points out that the block-based community is preferred for its impartiality and sustainability,and applies this mode to the renovation of the Old City of Kashgar in the form of design guidelines.

  10. 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.

  11. ONB疗法对青少年CHE患者认知功能改善的临床研究%Clinical research of occipital nerve block in improving cognitive function of adolescents with neck source headache

    Institute of Scientific and Technical Information of China (English)

    韩广敬; 张建中

    2014-01-01

    目的:观察枕神经阻滞(ONB)治疗青少年颈源性头痛(CHE)的效果及安全性,并分析治疗前后患者认知功能的改善情况。方法选择近10年就诊的青少年颈源性头痛患者60例,其中A组30例患者采用枕神经阻滞并常规药物及理疗, B组30例患者采用常规药物治疗及理疗。并在本市一中学随机抽取正常儿童30例作为对照组C组。结果在治疗后, A、B两组在认知功能及精神状况上均比治疗前有明显改善,与C组比较,差异有统计学意义(P<005);A组满意度较B组好。结论适度进行枕神经阻滞对青少年颈源性头痛有着较好的临床价值,值得在临床上推广应用。%Objective To observe the effect and safety of occipital nerve block (ONB) in the treatment of adolescents neck source headache(CHE), and analyze the improvement of cognitive function of patients before and after treatment.Methods Choosing 60 cases of adolescents neck source headache patients in resent ten years to our hospital and dividing them in to two groups, 30 cases for each group, group A treated with nerve block the pillow and conventional drugs and physical therapy, group B treated with routine therapy and physical therapy. And in a city middle school randomly normal children in 30 cases as control group C.Results After treatment, cognitive function and mental status in group A and group B were obviously improved, but compared with group C, it still had obvious difference,P<005; satisfaction of group A was better than group B.Conclusion The nerve block moderate for pillow on youth journal source headache has good clinical value, it is worth clinical promotion.

  12. 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 block...

  13. Pourfour Du Petit syndrome after interscalene block.

    Science.gov (United States)

    Santhosh, Mysore Chandramouli Basappji; Pai, Rohini B; Rao, Raghavendra P

    2013-04-01

    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.

  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. 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

  16. 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.

  17. 第二产程阴部神经阻滞麻醉时机的研究%Research in the pudendal nerve block anesthesia timing during second stage of labor

    Institute of Scientific and Technical Information of China (English)

    罗瑞华; 余素乔

    2013-01-01

    Objective To discuss the influence of pudendal nerve block anesthesia on pain degree and labor course when presentation at different positions during the second stage of labor,in order to find the better anesthesia timing and method to reduce pain,shorten labor,increase maternal comfort to a maximum extent and provide the best service for the maternal.Methods 200 cases of primiparas with fullterm and single-birth were selected and numbered randomly,patients with odd numbers were set to the observation group,patients with even numbers were set to the control group,100 cases in each group.In the observation group,when the presentation reached S+1,1% lidocaine was used to perform pudendal nerve block anesthesia.In the control group,the pudendal nerve block anesthesia was performed before perineal incision.Results The pain intensity,time of the second labor stage,perineum damage degree between the two groups were statistically different.The observation group with Ⅱ-grade level,Ⅲ-grade level pain were 32 cases less than that of the control group.The perineum incision later crack number in the observation group was 24 cases less than that of the control group.The number of delivery within 1 hour in the second labor process in the observation group was 21 cases more than that in the control group.Conclusions Implementation of bilateral pudendal nerve block anesthesia in the second stage of labor when the presentation reaches S+1 can alleviate childbirth pain,shorten the second stage of labor,reduce the degree of perineal trauma.%目的 探讨第二产程中,先露在不同位置时施行阴部神经阻滞麻醉,对产妇疼痛程度及产程的影响,从而选择适当的麻醉时机,最大程度减轻疼痛,缩短产程,增加产妇的舒适感,为产妇提供最佳服务.方法 选取足月单胎可以阴道分娩初产妇200例,随机编号,奇数组为观察组,偶数组为对照组,每组各100例.观察组在第二产程,先露下降至坐骨棘下1 cm S+1

  18. To Explore the Nerve EMG in Patients With Autonomic Neuropathy and Early Diabetic Peripheral Neuropathy%浅析自主神经病变及早期糖尿病周围神经的神经肌电图情况

    Institute of Scientific and Technical Information of China (English)

    王鲲鹏

    2016-01-01

    Objective To study the nerve electromyography in patients with early diabetes mellitus and autonomic neuropathy.Methods 164 patients with diabetes research, on their median nerve, common peroneal nerve, tibial nerve motor nerve and the conduction velocity of median and peroneal, sural sensory nerve conduction velocity (SCV), median nerve F wave, H-reflex of tibial nerve and sympathetic skin response (SSR) for detection and analysis.Results The incidence of H reflex and SSR abnormality was higher in all patients, the more serious the patient's condition, the higher the abnormal probability.Conclusion The early stage of diabetes peripheral neuropathy can be judged by detecting the H-relfex of tibial nerve. The abnormal SSR is very important indicators, combined with nerve electromyography can have better judgment to the patient's illness.%目的:研究分析早期糖尿病和自主神经病变患者的神经肌电图情况。方法根据我院164例糖尿病患者进行研究,对正中神经、腓总神经、胫神经运动神经传导速度和正中、腓浅、腓肠感觉神经传导速度(SCV)、正中神经F波、胫神经H反射及交感神经皮肤反应(SSR)等进行检测和分析。结果全部患者的H反射和SSR异常发生率较高,患者病情越严重,其异常几率越高。结论糖尿病早期周围神经病变可以通过检测胫神经H反射来进行判断,SSR异常是重要指标,结合神经肌电图能够对患者的病情有较好的判断。

  19. Autonomic neuropathy

    DEFF Research Database (Denmark)

    Hilsted, J

    1980-01-01

    In order to elucidate the physiological significance of autonomic neuropathy in juvenile diabetics, cardiovascular, hormonal and metabolic functions have been investigated in three groups of juvenile diabetics: One group had no signs of neuropathy, one group had presumably slight autonomic...... neuropathy (reduced beat-to-beat variation in heart rate during hyperventilation) and one group had clinically severe autonomic neuropathy, defined by presence of orthostatic hypotension. In all three experimental situations we found sympathetic dysfunction causing cardiovascular and/or hormonal...... maladjustments in patients with autonomic neuropathy. Regarding metabolic functions we found normal responses to graded exercise and insulin-induced hypoglycemia in patients with autonomic neuropathy in spite of blunted catecholamine responses, suggesting increased sensitivity of glycogen stores and adipose...

  20. 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

    Directory of Open Access Journals (Sweden)

    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.

  1. 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

  2. Autonomic Regulation of Splanchnic Circulation

    Directory of Open Access Journals (Sweden)

    Kathleen A Fraser

    1991-01-01

    Full Text Available The role of the autonomic nervous system in circulatory regulation of the splanchnic organs (stomach, small intestine, colon, liver, pancreas and spleen is reviewed. In general, the sympathetic nervous system is primarily involved in vasoconstriction, while the parasympathetic contributes to vasodilation. Vasoconstriction in the splanchnic circulation appears to be mediated by alpha-2 receptors and vasodilation by activation of primary afferent nerves with subsequent release of vasodilatory peptides, or by stimulation of beta-adrenergic receptors. As well, an important function of the autonomic nervous system is to provide a mechanism by which splanchnic vascular reserve can be mobilized during stress to maintain overall cardiovascular homeostasis.

  3. Nerve growth factor blocks the glucose-induced down-regulation of caveolin-1 expression in Schwann cells via p75 neurotrophin receptor signaling.

    Science.gov (United States)

    Tan, Wenbin; Rouen, Shefali; Barkus, Kristin M; Dremina, Yelena S; Hui, Dongwei; Christianson, Julie A; Wright, Douglas E; Yoon, Sung Ok; Dobrowsky, Rick T

    2003-06-20

    Altered neurotrophism in diabetic peripheral neuropathy (DPN) is associated in part with substantial degenerative changes in Schwann cells (SCs) and an increased expression of the p75 neurotrophin receptor (p75NTR). Caveolin-1 (Cav-1) is highly expressed in adult SCs, and changes in its expression can regulate signaling through Erb B2, a co-receptor that mediates the effects of neuregulins in promoting SC growth and differentiation. We examined the hypothesis that hyperglycemia-induced changes in Cav-1 expression and p75NTR signaling may contribute to altered neurotrophism in DPN by modulating SC responses to neuregulins. In an animal model of type 1 diabetes, hyperglycemia induced a progressive decrease of Cav-1 in SCs of sciatic nerve that was reversed by insulin therapy. Treatment of primary neonatal SCs with 20-30 mm d-glucose, but not l-glucose, was sufficient to inhibit transcription from the Cav-1 promoter and decrease Cav-1 mRNA and protein expression. Hyperglycemia prolonged the kinetics of Erb B2 phosphorylation and significantly enhanced the mitogenic response of SCs to neuregulin1-beta1, and this effect was mimicked by the forced down-regulation of Cav-1. Intriguingly, nerve growth factor antagonized the enhanced mitogenic response of SCs to neuregulin1-beta1 and inhibited the glucose-induced down-regulation of Cav-1 transcription, mRNA, and protein expression through p75NTR-dependent activation of JNK. Our data suggest that Cav-1 down-regulation may contribute to altered neurotrophism in DPN by enhancing the response of SCs to neuregulins and that p75NTR-mediated JNK activation may provide a mechanism for the neurotrophic modulation of hyperglycemic stress.

  4. Effect of laparoscopic rectal-carcinoma surgery with pelvic autonomic nerve preservation on the urinary and sexual functions of male patients%腹腔镜下直肠癌手术保留盆腔自主神经对男性排尿及性功能的影响

    Institute of Scientific and Technical Information of China (English)

    郑逸川; 陈小勋; 黄克伟

    2014-01-01

    目的:研究腹腔镜下直肠癌手术保留盆腔自主神经对男性排尿及性功能的影响。方法:回顾性分析我院2010年1月至2012年12月接受腹腔镜下直肠癌根治术80例患者,其中观察组的40例患者接受腹腔镜下直肠癌根治术,并保留盆腔自主神经;对照组的40例患者只接受腹腔镜下直肠癌根治术,不保留自主神经。比较两组患者排尿功能及性功能恢复情况。结果:观察组术后排尿功能障碍、性功能障碍与对照组比较差异均有统计学意义(P<0.05),保留自主神经后排尿功能和性功能障碍的发生率更低。结论:腹腔镜下直肠癌手术保留盆腔自主神经有利于患者及时恢复,并有效减轻患者痛苦,提高患者的生存质量。%To study effects of laparoscopic rectal -carcinoma surgery with pelvic autonomic nerve preservation on the urinary and sexual functions of male patients.Methods:80 patients having received laparo-scopic rectal-carcinoma surgery in our hospital from January 2010 to December 2012 were selected and divided into two groups,with 40 patients in the observation group preserving pelvic autonomic nerve and the other 40 ones in the control group not.The urinary function and sexual function recovery of the two groups were compared.Results:Differences in the urinary function and sexual function recovery rate of the two groups were statistically significant (P<0.05 ),with lower incidence rate of urinary and sexual dysfunction in the pelvic autonomic nerve preservation group.Conclusion:Laparoscopic rectal-carcinoma surgery with pelvic autonomic nerve preservation is conducive to pa-tients’recovery in time,and can effectively alleviate the suffering of patients while improve the life quality of patients.

  5. A comparison of two anesthesia methods for the surgical removal of maxillary third molars: PSA nerve block technique vs. local infiltration technique

    OpenAIRE

    Al-Delayme, Ra´ed MA.

    2014-01-01

    Objectives: The purpose of this study was to compare the effect of PSA block injection with infiltration technique regarding local anesthesia for surgical extraction of upper third molar. Material and Methods: A prospective, intra individual, single-blind randomized controlled trial was designed to study the severity of pain during injection and after surgical extraction of the bilaterally and symmetrically similar upper third molar in a total of 53 patients, in addition to evaluating the nee...

  6. Lack of efficacy of an intradural somatic-to-autonomic nerve anastomosis (Xiao procedure) for bladder control in children with myelomeningocele and lipomyelomeningocele: results of a prospective, randomized, double-blind study.

    Science.gov (United States)

    Tuite, Gerald F; Polsky, Ethan G; Homsy, Yves; Reilly, Margaret A; Carey, Carolyn M; Parrish Winesett, S; Rodriguez, Luis F; Storrs, Bruce B; Gaskill, Sarah J; Tetreault, Lisa L; Martinez, Denise G; Amankwah, Ernest K

    2016-08-01

    OBJECTIVE Xiao et al. and other investigators have studied an intradural somatic-to-autonomic (e.g., L-5 to S3-4) nerve transfer as a method to create a reflex arc to allow bladder emptying in response to cutaneous stimulation (the Xiao procedure). In previous clinical studies of patients with spinal dysraphism who underwent the Xiao procedure, high success rates (70%-85%) were reported for the establishment of a "skin-CNS-bladder" reflex arc that allows spontaneous, controlled voiding in children with neurogenic bladder dysfunction. However, many of these studies did not use blinded observers, did not have control groups, and/or featured only limited follow-up durations. METHODS A randomized, prospective, double-blind trial was initiated in March 2009, enrolling children with myelomeningocele (MM), lipomyelomeningocele (LMM), and neurogenic bladder dysfunction who were scheduled for spinal cord detethering (DT) for the usual indications. At the time of DT, patients were randomized between 2 arms of the study: half of the patients underwent a standard spinal cord DT procedure alone (DT group) and half underwent DT as well as the Xiao procedure (DT+X group). Patients, families, and study investigators, all of whom were blinded to the surgical details, analyzed the patients' strength, sensory function, mobility, voiding, and urodynamic bladder function before surgery and at regular intervals during the 3-year follow-up. RESULTS Twenty patients were enrolled in the study: 10 underwent only DT and the other 10 underwent DT+X. The addition of the Xiao procedure to spinal cord DT resulted in longer operative times (p = 0.024) and a greater chance of wound infection (p = 0.03). Patients in both treatment arms could intermittently void or dribble small amounts of urine (Xiao procedure than in the patients who did not. No patient in either treatment arm was continent of urine before, during, or after the study. CONCLUSIONS Patients with MM and LMM who underwent the Xiao

  7. Acute GI bleeding by multiple jejunal gastrointestinal autonomic nerve tumour associated with neurofibromatosis type I Urgencia quirúrgica por sangrado intestinal debido a tumor intestinal de nervios autónomos asociados a neurofibromatosis tipo I

    Directory of Open Access Journals (Sweden)

    M. Keese

    2007-10-01

    Full Text Available We describe a surgical emergency due to GI-bleeding caused by gastrointestinal autonomic nerve tumours (GANT's in a patient with von Recklinghausen's disease. A 72 year old female patient with von Recklinghausen's disease was admitted with maelena. Endoscopy showed no active bleeding in the stomach and the colon. Therefore an angio-CT-scan was performed which revealed masses of the proximal jejunum as source of bleeding. Laparotomy was indicated and a 20 cm segment of jejunum which carried multiple extraluminal tumours was resected. The source of the bleeding was a 2 cm tumour which had eroded the mucosal surface. Immunohistologically, evidence of neuronal differentiation could be shown in the spindle-formed cells with positive staining for C-Kit (CD 117, CD 34, and a locally positive staining for synaptophysine and S100. This case report illustrates the association between neurofibromatosis and stromal tumours and should alert surgeons and gastroenterologist about gastrointestinal manifestations in patients with von Recklinghausen's disease.Se describe una urgencia quirúrgica por sangrado intestinal debido a tumor gastrointestinal de nervios autónomos (GANT asociado a enfermedad de von Recklinghausen. Una mujer de 72 años con neurofibromatosis fue ingresada con signos de melena. La endoscopia digestiva alta y baja fue negativa. Se indicó TAC con contraste que advirtió tumores yeyunales como causa del sangrado. Se realizó laparotomía y resección de un segmento de 20 cm de yeyuno que incluía varios tumores. La causa del sangrado activo fue lesión en mucosa intestinal por erosión tumoral. El análisis por inmunohistoquímica de la pieza mostró diferenciación neuronal, con células fusiformes con tinción positiva para el C-Kit (CD 117, CD 34. Esta nota clínica pone de manifiesto la asociación entre la neurofibromatosis y los tumores estromales y debe alertar a gastroenterólogos y cirujanos sobre las posibles manifestaciones

  8. 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

  9. Comparative anatomy of the autonomic nervous system.

    Science.gov (United States)

    Nilsson, Stefan

    2011-11-16

    This short review aims to point out the general anatomical features of the autonomic nervous systems of non-mammalian vertebrates. In addition it attempts to outline the similarities and also the increased complexity of the autonomic nervous patterns from fish to tetrapods. With the possible exception of the cyclostomes, perhaps the most striking feature of the vertebrate autonomic nervous system is the similarity between the vertebrate classes. An evolution of the complexity of the system can be seen, with the segmental ganglia of elasmobranchs incompletely connected longitudinally, while well developed paired sympathetic chains are present in teleosts and the tetrapods. In some groups the sympathetic chains may be reduced (dipnoans and caecilians), and have yet to be properly described in snakes. Cranial autonomic pathways are present in the oculomotor (III) and vagus (X) nerves of gnathostome fish and the tetrapods, and with the evolution of salivary and lachrymal glands in the tetrapods, also in the facial (VII) and glossopharyngeal (IX) nerves.

  10. 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

  11. Effects of perineurial block of sciatic nerve with different concentrations of alcohol on structure and function of the nerve and its innervated muscles in rats%不同浓度乙醇神经周围阻滞对大鼠坐骨神经及运动功能的影响

    Institute of Scientific and Technical Information of China (English)

    王蓓蓓; 王碧蕾; 曹震宇; 王岩

    2011-01-01

    Objective To observe the concentration effects of alcohol in perineurial block on the structure and function of sciatic nerve and it's innervated muscles in rats so as to provide the basis for clinical application of chemical neurolysis.Methods One hundred and fifty female Sprague-Dawley rats were used and randomly assigned into a blank group(BG,n =6),a control group(CG,n =36),a 50% alcohol group(50G,n =36),a 75% alcohol group(75G,n =36)and a 99.9% alcohol group(99.9G,n =36).The CG received physiological saline injection,the 50G,75G,99.9G received corresponding concentrations alcohol perineurial block,respectively.Changes of motor function was assessed,electrophysiological and histomorphological observations of sciatic nerve and its innervated muscles were conducted before and at 24 h,72 h,1 week,4 week,12 week after block.Results(① Hypokinesia and decrease of motor conduction velocity(MCV)were observed at 24 h after block,and peaked at 72 h after block; at 1 week after block,the motor function and MCV improved,the improvement persisted to the 12th week (P < 0.05); but at the 12th week,MCV was still slower than that before block(P < 0.01).②There were significant differences with regard to motot function and MCV of sciatic nerve among 99.9G and the other groups at e ery time point after block(P <0.05); ③ Reversible dengeneration of sciatic nerve and hind limb muscle,nonreversible necrosis of muscle occurred more seriously with the increase of alcohol concentration,and the cicatrization in 99.9G was more obvious than that in 50G and 75G at the 12th week; ④Structural lesion of sciatic nerve occurred at 24 h after block and peaked at the 72th h,myelinated axonal sprouts appeared at 1 week after block and persisted to the 12th weck.Conclusions ① The effects of 99.9 % alcohol perineural block on the structural lesion,motor function and MCV of sciatic nerve and its related muscle were more obvious than those of 50% and 75% alcohol; ② The

  12. 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

  13. 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

  14. Hereditary sensory and autonomic neuropathies.

    Science.gov (United States)

    Auer-Grumbach, Michaela

    2013-01-01

    Hereditary sensory and autonomic neuropathies (HSN/HSAN) are clinically and genetically heterogeneous disorders of the peripheral nervous system that predominantly affect the sensory and autonomic neurons. Hallmark features comprise not only prominent sensory signs and symptoms and ulcerative mutilations but also variable autonomic and motor disturbances. Autosomal dominant and autosomal recessive inheritance has been reported. Molecular genetics studies have identified disease-causing mutations in 11 genes. Some of the affected proteins have nerve-specific roles but underlying mechanisms have also been shown to involve sphingolipid metabolism, vesicular transport, structural integrity, and transcription regulation. Genetic and functional studies have substantially improved the understanding of the pathogenesis of the HSN/HSAN and will help to find preventive and causative therapies in the future.

  15. Peripheral autonomic neuropathy: diagnostic contribution of skin biopsy.

    Science.gov (United States)

    Donadio, Vincenzo; Incensi, Alex; Giannoccaro, Maria Pia; Cortelli, Pietro; Di Stasi, Vitantonio; Pizza, Fabio; Jaber, Masen Abdel; Baruzzi, Agostino; Liguori, Rocco

    2012-11-01

    Skin biopsy has gained widespread use for the diagnosis of somatic small-fiber neuropathy, but it also provides information on sympathetic fiber morphology. We aimed to ascertain the diagnostic accuracy of skin biopsy in disclosing sympathetic nerve abnormalities in patients with autonomic neuropathy. Peripheral nerve fiber autonomic involvement was confirmed by routine autonomic laboratory test abnormalities. Punch skin biopsies were taken from the thigh and lower leg of 28 patients with various types of autonomic neuropathy for quantitative evaluation of skin autonomic innervation. Results were compared with scores obtained from 32 age-matched healthy controls and 25 patients with somatic neuropathy. The autonomic cutoff score was calculated using the receiver operating characteristic curve analysis. Skin biopsy disclosed a significant autonomic innervation decrease in autonomic neuropathy patients versus controls and somatic neuropathy patients. Autonomic innervation density was abnormal in 96% of patients in the lower leg and in 79% of patients in the thigh. The abnormal findings disclosed by routine autonomic tests ranged from 48% to 82%. These data indicate the high sensitivity and specificity of skin biopsy in detecting sympathetic abnormalities; this method should be useful for the diagnosis of autonomic neuropathy, together with currently available routine autonomic testing.

  16. 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

  17. Pudendum Nerve Blocking Anesthesia Sclinical Application in Episiotomy Suture%阴部神经阻滞麻醉在会阴侧切缝合中的临床应用

    Institute of Scientific and Technical Information of China (English)

    郁春燕

    2014-01-01

    Objective To compare pudendum nerve blocking anesthesia combined local infiltration anesthesia's analgesic ef ects on episiotomy suture.Methods 62 cases of puerperas who need lateral episiotomy were randomly divided into observation group and control group(31 cases for each).The observation group used 2%lidocaine(20~40ml)to have pudendum nerve blocking anesthesia combined local infiltration anesthesia at the episiotomy place and perineorrhaphy.The control group only used 2%lidocaine at the episiotomy place to have the perineum local anesthesia and perineorrhaphy.Results The analgesia ef ect of total ef ective rate and ef iciency in the observation group were 96.77%and 77.42%,the ef ective rates were both higher than the control group's (54.84%and 32.26%).The inef iciency (3.22%)in observation was lower than the control group's (45.16%),the above dif erences were statistical y significant (P0.05).Conclusion The pudendum nerve blocking anesthesia combined local infiltration anesthesia's analgesic ef ects were fast,The suture time is short,less bleeding,safe,ef ective and simply operated.It has no adverse reaction and is worth to be popularized.%目的:比较阴部神经阻滞麻醉联合局部浸润麻醉在会阴侧切缝合中的镇痛效果。方法将需要行会阴侧切术的初产妇62例随机分成观察组和对照组各31例。观察组用2%利多卡因20ml~40ml在会阴侧切处行阴部神经阻滞麻醉联合局部浸润麻醉下行会阴缝合术;对照组只用2%的利多卡因在会阴侧切处行会阴局部麻醉下行会阴缝合术。结果观察组的镇痛效果的总有效率和显效率分别为96.77%和77.42%,均高于对照组的54.84%和32.26%,无效率3.22%低于对照组45.16%,以上差异均有统计学意义(P0.05)。结论阴部神经阻滞麻醉联合局部浸润麻醉在会阴侧切缝合中镇痛起效快,缝合时间短,出血少,操作简单,安全,无不良反应,值得在临床上推广。

  18. 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

  19. 超声引导和神经刺激仪引导腰大肌间隙阻滞效果的比较%The comparison of ultrasound-guided and nerve stimulator guided psoas compartment block effect

    Institute of Scientific and Technical Information of China (English)

    许莉; 袁嫕; 周雁; 林惠华; 王庚

    2015-01-01

    Objective To evaluate wheather ultrasound-guided psoas compartment block would increase the success rate and ease of performance with a greater benefit in patients. Method 40 ASA I-II Patients undergoing elective knee arthroscope operations were randomized to two groups:group N( undergoing nerve stimulator guided psoas com-partment block by palpation anatomy landmarks ) or group U ( ultrasound guided psoas compartment block) . Data collected included gender, age, height, weight, number of attempts, clinical effect, procedure time, patient satis-faction, and traumatic puncture. Statistical analysis of data included the Mann-Whitney U test and the Student t test. Result No statistical differences were found on procedure time, clinical effect or patient satisfaction between the two groups, except the number of attempts. Conclusion The use of ultrasound for psoas compartment block can sig-nificantly reduce the number of attempts in patients undergoing elective knee arthroscope operation.%目的评价超声引导法和神经刺激仪引导法腰大肌间隙阻滞的麻醉效果。方法选择40例在腰大肌间隙阻滞联合坐骨神经阻滞下行膝关节镜下前交叉韧带修复、异体肌腱移植术的患者,随机分为两组:N组(n=20)采用经典神经刺激仪引导法腰大肌间隙阻滞,U组(n=20)采用超声引导下腰大肌间隙阻滞。分别记录两组麻醉操作时间、穿刺次数、感觉和运动阻滞完善时间及患者满意度。结果两组间麻醉操作时间、感觉和运动阻滞完善时间及患者满意度差异均无显著性,但穿刺次数U组少于N组(P<0.001)。结论使用超声引导可明显减少穿刺次数,但不缩短麻醉操作时间和起效时间。

  20. Effect of different doses of ringer solution on the duration of nerve block induced by lidocaine in frog sciatic nerve in vitro%不同剂量任氏液灌注对利多卡因阻滞蛙离体坐骨神经时效的影响

    Institute of Scientific and Technical Information of China (English)

    甘宁; 王爱忠; 焦志华; 曾真; 江伟

    2012-01-01

    Objective To observe the effect of different doses of ringe solution on the duration of nerve block induced by lidocaine in frog sciatic nerve in vitro. Methods Twenty bullfrogs weighing from 250 to 300 g were enrolled in this study. The ex-vivo sciatic nerve of each side of each frog was randomly divided into group of rate 1 and group of rate 10. The maximum amplitude of the compound action potential (CAPMAX) and the minimal stimulus intensity for CAPMAX were measured. The middle of each nerve was bathed with 1.5% lidocaine in this stimulus intensity until CAPMAx was fully suppressed (tO). Then sciatic nerve of group of rate 1 and group of rate 10 were perfused with ringer solution at the rate of 1 mL/min and 10 mL/min, respectively. The time of initial recovery (t1) and full-recovery (t2) of CAP were recorded. The CAP amplitude was measured every 10 minutes from the beginning of the perfusion and the amplitude ratio of CAP to CAPmax was calculated until 120 minutes. Results There were no significant defferences in terms of CAPMAX and t0 between two groups (P>0. 05). Compared with group of rate 10, the t1 of group of rate 1 was prolonged, but there was no statistical difference between the two groups (P = 0.078). The t2 of group of rate 1 was significantly longer than group of rate 10 (P = 0. 008). The t2 of group of rate 10 was reduced by 15% as compared with group of rate 1. The repetitive analysis of variance showed the effect of perfusion speed of ringer solution on the recovery of CAP was significantly different between the two groups ( P = 0. 011). The percentage of restored CAP changed significantly with perfusion time (P<0.01). There was interaction between time and perfusion speed (P = 0.028). Conclusion The restoring time of sciatic nerve in vitro blocked by lidocaine can be reduced by increasing ringer solution in bullfrog, which suggests that the local blood flow of tissue has appreciable impact on the duration of nerve block, and the duration can be

  1. Hereditary sensory autonomic neuropathy and anaesthesia - a case report

    Directory of Open Access Journals (Sweden)

    Nandini Dave

    2007-01-01

    Full Text Available The hereditary sensory and autonomic neuropathies are a rare group of disorders characterized by progressive loss of function that predominantly affects the peripheral sensory nerves. Autonomic dysfunction is present to a variable degree and can have several implications for anaesthesia. We report the case of a patient with Hereditary sensory and autonomic neuropathy who was posted for a below knee amputation and discuss the anaesthesia management.

  2. Clinical Analysis of 5 Cervical Nerve Root Block in the Treatment of Intractable Tennis Elbow%颈5神经根阻滞联合封闭治疗顽固性网球肘临床疗效观察

    Institute of Scientific and Technical Information of China (English)

    孔亚明; 韩肇艺; 徐荣钢

    2015-01-01

    目的观察颈5神经根阻滞联合局部封闭治疗顽固性网球肘临床疗效。方法55例随机分为治疗组29例及对照组26例,治疗组封闭配合C5神经根阻滞治疗,对照组单纯局部封闭治疗。结果治疗组有效率96.5豫;对照组有效率85.0豫。结论颈5神经阻滞联合封闭治疗网球肘疗效较单纯局部封闭治疗疗效显著。%Objective To observe the clinical curative ef ect of local block combined with cervical 5 nerve block of Intractable tennis elbow.Methods 55 patients were randomly divided into treatment group and control group,the treatment group of 29 cases,and the control group of 26 cases.The treatment group with local block combined with cervical 5 nerve block,the control group with simple local blocking therapy.Results The treatment group ef iciency:96.5%;the control group ef iciency:85.0%.Conclusion The ef ect of local block combined with cervical 5 nerve block in the treatment of tennis elbow is bet er than simple local closed treatment.

  3. 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

  4. Autonomic Modification of Intestinal Smooth Muscle Contractility

    Science.gov (United States)

    Montgomery, Laura E. A.; Tansey, Etain A.; Johnson, Chris D.; Roe, Sean M.; Quinn, Joe G.

    2016-01-01

    Intestinal smooth muscle contracts rhythmically in the absence of nerve and hormonal stimulation because of the activity of pacemaker cells between and within the muscle layers. This means that the autonomic nervous system modifies rather than initiates intestinal contractions. The practical described here gives students an opportunity to observe…

  5. 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

  6. Baroreceptor control of heart rate in the awake toad: peripheral autonomic effectors and arterial baroreceptor areas.

    Science.gov (United States)

    Bianchi-da-Silva, L M; Menescal-de-Oliveira, L; Hoffmann, A

    2000-04-12

    Systemic injection of sodium nitroprusside (30 microg/kg, i.v.) in the awake Bufo paracnemis toad induced a fall in arterial blood pressure and tachycardia. This tachycardia, but not the hypotension, was significantly reduced in toads with bilateral electrolytic lesion of the caudal and commissural regions of the solitary tract nucleus and in animals with transection of the spinal cord, 2 mm below the obex. This indicates that the tachycardia is reflex, depends on the integrity of the solitary tract nucleus and is due to descending spinal autonomic activation. Pretreatment with propranolol (4 mg/kg, i.v.) significantly reduced the tachycardia but did not block it completely, showing the importance of beta-adrenoceptors in its genesis. The reflex increase in heart rate induced by nitroprusside was not statistically significant in animals with bilateral section of the laryngeal nerve, whose baroreceptor fibers originate from the pulmocutaneous artery or in animals in which the bilateral section of the laryngeal nerve was performed together with section of the glossopharyngeal nerves, which incorporate fibers originating from the carotid labyrinth. The reduction of the reflex tachycardia was significant in toads with aortic arch denervation alone or combined with section of the laryngeal nerves or in animals with complete denervation of the three baroreceptors areas. These results suggest that the region of the aortic arch, when submitted to unloading, is the most important baroreceptor zone for cardiac compensation in toads.

  7. Selective measurement of digital nerve conduction velocity.

    Science.gov (United States)

    Terai, Y; Senda, M; Hashizume, H; Nagashima, H; Inoue, H

    2001-01-01

    We developed a new method to measure the nerve conduction velocity of a single digital nerve. In 27 volunteers (27 hands), we separately stimulated each digital nerve on the radial and ulnar sides of the middle and ring fingers. A double-peaked potential was recorded above the median nerve at the wrist joint when either the radial-side nerve or the ulnar-side nerve of the middle finger was stimulated. The first peak of this potential had disappeared after the digital nerve was blocked under the stimulating electrodes, and the peak appeared again coinciding with the decrease of anesthesia. Shifting the stimulating electrodes on the digital nerve resulted in no significant difference in the peak conduction velocity. It is possible that each peak of the potential was attributable to conduction of an action potential along one of the two digital nerves. This new method allows the assessment of a single digital nerve, and may be clinically useful for assessing the rupture of a digital nerve and the sensory nerve action potentials in carpal tunnel syndrome.

  8. Bilateral high division of sciatic nerve

    Directory of Open Access Journals (Sweden)

    K. Shwetha

    2014-08-01

    Full Text Available Sciatic nerve is the thickest nerve in the body formed by the sacral plexus from L4 to S3 in the lesser pelvis. It emerges through the greater sciatic foramen below the piriformis and enter the gluteal region. Then the nerve passes on the back of the thigh and at the level of superior angle of popliteal fossa it terminates by dividing into tibial and common peroneal nerve. The knowledge of anatomical variations in the division of nerve is important for various surgical and anaesthetic procedures. During routine dissection in the department of anatomy, Mysore Medical College and Research Institute, Mysore, a rare bilateral high division of sciatic nerve was observed in a female cadaver aged about 40 years. In the present case there was bilateral high division of sciatic nerve. The nerve was seen dividing into two branches before it emerges through the greater sciatic foramen. The tibial nerve was entering the gluteal region below the piriformis muscle and common peroneal nerve was entering by piercing the piriformis. The knowledge of this variation is important as the nerve may get compressed with surrounding anatomical structures resulting in non discogenic sciatica. The awareness of variations is important for surgeons during various procedures like fracture, posterior dislocation of hip joint and hip joint replacement. The anatomical variations are important during deep intramuscular injections in gluteal region and also for anaesthetists during sciatic nerve block. [Int J Res Med Sci 2014; 2(4.000: 1785-1787

  9. 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

  10. Malignant peripheral nerve sheath tumour of the bladder associated with neurofibromatosis I.

    LENUS (Irish Health Repository)

    O'Brien, Julie

    2008-12-01

    Neurofibromatosis is a hamartomatous disorder of autonomic peripheral nerve sheaths associated with peripheral nerve sheath tumours. Most tumours are neurofibromas; however, the genitourinary system is rarely involved. We present a rare case of a nerve sheath tumour of the bladder in a young patient, which was discovered to be malignant.

  11. 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.

  12. Autonomous Search

    CERN Document Server

    Hamadi, Youssef; Saubion, Frédéric

    2012-01-01

    Decades of innovations in combinatorial problem solving have produced better and more complex algorithms. These new methods are better since they can solve larger problems and address new application domains. They are also more complex which means that they are hard to reproduce and often harder to fine-tune to the peculiarities of a given problem. This last point has created a paradox where efficient tools are out of reach of practitioners. Autonomous search (AS) represents a new research field defined to precisely address the above challenge. Its major strength and originality consist in the

  13. Raman microspectroscopy for visualization of peripheral nerves

    Science.gov (United States)

    Minamikawa, Takeo; Harada, Yoshinori; Koizumi, Noriaki; Takamatsu, Tetsuro

    2013-02-01

    The peripheral nervous system plays an important role in motility, sensory, and autonomic functions of the human body. Preservation of peripheral nerves in surgery is essential for improving quality of life of patients. To preserve peripheral nerves, detection of ne peripheral nerves that cannot be identi ed by human eye or under white light imaging is necessary. In this study, we sought to provide a proof-of-principle demonstration of a label-free detection technique of peripheral nerve tissues against adjacent tissues that employs spontaneous Raman microspectroscopy. A line-illumination confocal Raman microscope was used for the experiment. A laser operating at the wavelength of 532 nm was used as an excitation laser light. We obtained Raman spectra of peripheral nerve, brous connective tissue, skeletal muscle, blood vessel, and adipose tissue of Wistar rats, and extracted speci c spectral features of peripheral nerves and adjacent tissues. By applying multivariate image analysis, peripheral nerves were clearly detected against adjacent tissues without any preprocessing neither xation nor staining. These results suggest the potential of the Raman spectroscopic observation for noninvasive and label-free nerve detection, and we expect this method could be a key technique for nerve-sparing surgery.

  14. 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 plexus blockade. METHODS: According to the technique used, sixty-eight patients were allocated into two groups: interscalene group (IG, n = 34 and selective group (SG, n = 34, with neurostimulation approach used for both techniques. After appropriate motor response, IG received 30 mL of 0.33% levobupivacaine in 50% enantiomeric excess with adrenalin 1:200,000. After motor response of suprascapular and axillary nerves, SG received 15 mL of the same substance on each nerve. General anesthesia was then administered. Variables assessed were time to perform the blocks, analgesia, opioid consumption, motor block, cardiovascular stability, patient satisfaction and acceptability. RESULTS: Time for interscalene blockade was significantly shorter than for selective blockade. Analgesia was significantly higher in the immediate postoperative period in IG and in the late postoperative period in SG. Morphine consumption was significantly higher in the first hour in SG. Motor block was significantly lower in SG. There was no difference between groups regarding cardiocirculatory stability and patient satisfaction and acceptability. Failure occurred in IG (1 and SG (2. CONCLUSIONS: Both techniques are safe, effective, and with the same degree of satisfaction and acceptability. The selective blockade of both nerves showed satisfactory analgesia, with the advantage of providing motor block restricted to the shoulder.

  15. Ganglion block. When and how?; Ganglienblockade. Wann und wie?

    Energy Technology Data Exchange (ETDEWEB)

    Bale, R. [Medizinische Universitaet Innsbruck, Sektion fuer Mikroinvasive Therapie Universitaetsklinik fuer Radiologie, Innsbruck (Austria)

    2015-10-15

    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.) [German] Anatomische und physiologische Kenntnisse ueber die Funktion von Schmerzbahnen fuehrten zur Entwicklung chirurgischer und perkutaner destruktiver Verfahren, um einzelne Komponenten afferenter Schmerzbahnen anzusteuern bzw. auszuschalten. Neben anderen nervalen Strukturen gelten Hinterstrangganglien und insbesondere die Ganglien des autonomen Nervensystems als Ziele fuer radiologische Interventionen. Das vegetative Nervensystem ist fuer die Organfunktion durch Regulation des Gefaesstonus und fuer die Leitung

  16. 星状神经节阻滞治疗围绝经期自主神经系统功能不稳定症状的疗效%Curative Effect of Stellate Ganglion Block on Function Disorders of Autonomic Nervous System in Perimenopause Women

    Institute of Scientific and Technical Information of China (English)

    王玲玲; 马杰; 张海泉; 张宝琴; 赵树华; 房丽

    2011-01-01

    目的 探讨星状神经节阻滞治疗围绝经期自主神经系统功能不稳定症状的疗效.方法 对30例主要表现自主神经系统功能不稳定症状如失眠、眩晕、心悸,皮肤感觉异常等的围绝经期患者.采用前入路星状神经节阻滞(Stellate Canglion Block,SGB)每日1次,左右交替进行,每10次为1个疗程,均治疗2个疗程.观察血中E2,FSH的水平及自主神经系统功能不稳定症状改善情况.结果 运用星状神经阻滞法治疗后,围绝经期患者自主神经系统功能不稳定症状明显改善,血中E2水平显著升高,FSH下降(P<0.05).结论 星状神经节阻滞可以治疗围绝经期自主神经系统功能不稳定,其症状明显缓解或消失.%[ Objective] To observe the curative effect of stellate ganglion block on function disorders of autonomic nervous system in perimenopause women. [ Methods ] 30 perimenopause women with function disorders of autonomic nervous system were collected, which the symptoms included insomnia, vertigo, palpitation and paresthesia. The patients were given anterior approach stellate ganglion block (SGB) once a day, alternating left and right, 10 times was one course, and all patients were treated for two courses. The levels of E2 and FSH in blood, and improvement of disorders symptoms of autonomic nervous system were observed. [ Results] After SGB treatment, symptoms of function disorders of autonomic nervous system in perimenopause women improved significantly, level of blood E2 increased significantly, whereas FSH level decreased (P < 0.05). [ Conclusion ] SGB has good effect on the function disorders of autonomic nervous system in perimenopause women, the symptoms are significantly alleviated or disappeared.

  17. Effect and Safety of Nerve Block Therapy for Neck Pain:A Systematic Re-view%神经阻滞疗法治疗颈性疼痛患者的临床疗效及安全性评估

    Institute of Scientific and Technical Information of China (English)

    杨云涛

    2015-01-01

    目的:评价神经阻滞疗法在治疗颈性疼痛的临床疗效及安全性。方法将60例颈源性疼痛患者随机分为观察组与对照组,每组各30例。两组所有颞部疼痛或闷胀不适患者给予耳颞神经阻滞治疗,所有顶枕部疼痛伴有颈部僵硬不适患者给予颈椎旁神经阻滞,观察组在此基础上给予星状神经节阻滞治疗。结果经过4次治疗,观察组患者颈性疼痛总有效率为86.67豫明显高于对照组总有效率53.33豫,观察组治疗后VAS评分明显低于对照组,差异有统计学意义(P<0.05)。结论星状神经节阻滞治疗颈性头痛疗效显著,安全性好,有一定的短期临床优势。%Objective To evaluate the clinical effect and safety of nerve block therapy in the treatment neck pain. Methods 60 cases with Cervical pain were divided into observation group and control group, each with 30 cases. Give all stellate ganglion block treatment, including temporal pain or discomfort and auriculotemporal nerve block and occipital pain associated with neck stiffness discomfort and cervical nerve block extracted into the study of literature methodology, research quality. Results After four times of therapy, the total effective of the observation group,86.67%, was obviously higher than that of the control group, 53.33%. VAS scores of the observation were significantly lower than that of the control group with statistically significant differences (P<0.05). A large number of literature reports, occipital nerve block of no difference between the short-term and medium-term effects;Whether injection adding hormone short-term efficacy and long-term efficacy difference is not obvious, no statistical significance. Conclusion The curative effect of stellate ganglion block treatment for cervical headache is distinct, safety, so it has certain short-term clinical advantages.

  18. Inflammatory trigeminal nerve and tract lesions associated with inferior alveolar nerve anaesthesia.

    Science.gov (United States)

    Blair, N F; Parratt, J D E; Garsia, R; Brazier, D H; Cremer, P D

    2013-11-01

    Inferior alveolar nerve blocks are commonly performed for dental anaesthesia. The procedure is generally safe with a low rate of complications. We report a patient with a reproducible, delayed-onset sensory deficit associated with contrast-enhancing lesions in the trigeminal nerve, pons and medulla following inferior alveolar nerve local anaesthesia. We propose that this previously undescribed condition is a form of Type IV hypersensitivity reaction.

  19. Diabetic autonomic neuropathy.

    Science.gov (United States)

    Freeman, Roy

    2014-01-01

    Diabetes mellitus is the commonest cause of an autonomic neuropathy in the developed world. Diabetic autonomic neuropathy causes a constellation of symptoms and signs affecting cardiovascular, urogenital, gastrointestinal, pupillomotor, thermoregulatory, and sudomotor systems. Several discrete syndromes associated with diabetes cause autonomic dysfunction. The most prevalent of these are: generalized diabetic autonomic neuropathy, autonomic neuropathy associated with the prediabetic state, treatment-induced painful and autonomic neuropathy, and transient hypoglycemia-associated autonomic neuropathy. These autonomic manifestations of diabetes are responsible for the most troublesome and disabling features of diabetic peripheral neuropathy and result in a significant proportion of the mortality and morbidity associated with the disease.

  20. 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.

  1. 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 ...

  2. Vagus Nerve Stimulation

    Science.gov (United States)

    Vagus nerve stimulation Overview By Mayo Clinic Staff Vagus nerve stimulation is a procedure that involves implantation of a device that stimulates the vagus nerve with electrical impulses. There's one vagus nerve on ...

  3. Ulnar nerve dysfunction

    Science.gov (United States)

    Neuropathy - ulnar nerve; Ulnar nerve palsy; Mononeuropathy; Cubital tunnel syndrome ... neuropathy occurs when there is damage to the ulnar nerve. This ... syndrome may result. When damage destroys the nerve covering ( ...

  4. [Ultrasound for peripheral neural block].

    Science.gov (United States)

    Kefalianakis, F

    2005-03-01

    Ultrasound is well established in medicine. Unfortunately, ultrasound is still rarely used in the area of anesthesia. The purpose of the article is to illustrate the possibilities and limitations of ultrasound in regional anesthesia. The basic principles of ultrasound are the piezoelectric effect and the behaviour of acoustic waveforms in human tissue. Ultrasound imaging in medicine uses high frequency pulses of sound waves (2.5-10 MHz). The following images are built up from the reflected sounds. The ultrasound devices used in regional anesthesia (commonly by 10 MHz) deliver a two-dimensional view. The main step for a successful regional anaesthesia is to identify the exact position of the nerve. In addition, specific surface landmarks and the use of peripheral nerve stimulator help to detect the correct position of the needle. Nerves are demonstrated as an composition of hyperechogenic (white) and hypoechogenic (black) areas. The surrounding hyperechogenic parts are epi- and perineurium, the dark hypoechogenic part is the neural tissue. The composition of peripheral nerves are always similar, but the quantities of each part, of surrounding perineurium and nerval structures, differ. Further the imaging of nerves is significantly influenced by the angle of beam to the nerve and the surrounding anatomic structures. Only experience and correct interpretation make the ultrasound a valid method in clinical practice. Correct interpretation has to be learned by standardized education. Three examples of peripheral nerve blocks are described. The detection of nerves and the visualization of the correct spread of local anesthetics to the nerves are the main principles of effective ultrasound-guided regional anesthesia, whereas closest proximity of the needle to the target nerve is not necessary. The described examples of ultrasound guidance for nerval block illustrates the specific procedures with reduced probability of nerval irritation, high success and low rate of

  5. 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.

  6. Surgical anatomy of the retroperitoneal spaces, Part IV: retroperitoneal nerves.

    Science.gov (United States)

    Mirilas, Petros; Skandalakis, John E

    2010-03-01

    We present surgicoanatomical topographic relations of nerves and plexuses in the retroperitoneal space: 1) six named parietal nerves, branches of the lumbar plexus: iliohypogastric, ilioinguinal, genitofemoral, lateral femoral cutaneous, obturator, femoral. 2) The sacral plexus is formed by the lumbosacral trunk, ventral rami of S1-S3, and part of S4; the remainder of S4 joining the coccygeal plexus. From this plexus originate the superior gluteal nerve, which passes backward through the greater sciatic foramen above the piriformis muscle; the inferior gluteal nerve also courses through the greater sciatic foramen, but below the piriformis; 3) sympathetic trunks: right and left lumbar sympathetic trunks, which comprise four interconnected ganglia, and the pelvic chains; 4) greater, lesser, and least thoracic splanchnic nerves (sympathetic), which pass the diaphragm and join celiac ganglia; 5) four lumbar splanchnic nerves (sympathetic), which arise from lumbar sympathetic ganglia; 6) pelvic splanchnic nerves (nervi erigentes), providing parasympathetic innervation to the descending colon and pelvic splanchna; and 7) autonomic (prevertebral) plexuses, formed by the vagus nerves, splanchnic nerves, and ganglia (celiac, superior mesenteric, aorticorenal). They include sympathetic, parasympathetic, and sensory (mainly pain) fibers. The autonomic plexuses comprise named parts: aortic, superior mesenteric, inferior mesenteric, superior hypogastric, and inferior hypogastric (hypogastric nerves).

  7. The nature of the autonomic dysfunction in multiple system atrophy

    Science.gov (United States)

    Parikh, Samir M.; Diedrich, Andre; Biaggioni, Italo; Robertson, David

    2002-01-01

    The concept that multiple system atrophy (MSA, Shy-Drager syndrome) is a disorder of the autonomic nervous system is several decades old. While there has been renewed interest in the movement disorder associated with MSA, two recent consensus statements confirm the centrality of the autonomic disorder to the diagnosis. Here, we reexamine the autonomic pathophysiology in MSA. Whereas MSA is often thought of as "autonomic failure", new evidence indicates substantial persistence of functioning sympathetic and parasympathetic nerves even in clinically advanced disease. These findings help explain some of the previously poorly understood features of MSA. Recognition that MSA entails persistent, constitutive autonomic tone requires a significant revision of our concepts of its diagnosis and therapy. We will review recent evidence bearing on autonomic tone in MSA and discuss their therapeutic implications, particularly in terms of the possible development of a bionic baroreflex for better control of blood pressure.

  8. Nerve Regeneration Should Be Highly Valued in the Treatment of Diabetic Peripheral Neuropathy

    Institute of Scientific and Technical Information of China (English)

    LIANG Xiao-chun

    2008-01-01

    @@ Diabetic peripheral neuropathy (DPN) is the most common chronic complication of the long-term complications of diabetes, affecting up to 90% of patients during the progress of the disease. Many parts of the nerve system, including the sensory nerves, motor nerves and autonomic nerves, can be affected, leading to various clinical features. DPN leads not only to a great degree of mutilation and death but also to the occurrence and development of other long-term complications in diabetics.

  9. Rock blocks

    OpenAIRE

    Turner, W.

    2007-01-01

    Consider representation theory associated to symmetric groups, or to Hecke algebras in type A, or to q-Schur algebras, or to finite general linear groups in non-describing characteristic. Rock blocks are certain combinatorially defined blocks appearing in such a representation theory, first observed by R. Rouquier. Rock blocks are much more symmetric than general blocks, and every block is derived equivalent to a Rock block. Motivated by a theorem of J. Chuang and R. Kessar in the case of sym...

  10. 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.

  11. A novel internal fixator device for peripheral nerve regeneration.

    Science.gov (United States)

    Chuang, Ting-Hsien; Wilson, Robin E; Love, James M; Fisher, John P; Shah, Sameer B

    2013-06-01

    Recovery from peripheral nerve damage, especially for a transected nerve, is rarely complete, resulting in impaired motor function, sensory loss, and chronic pain with inappropriate autonomic responses that seriously impair quality of life. In consequence, strategies for enhancing peripheral nerve repair are of high clinical importance. Tension is a key determinant of neuronal growth and function. In vitro and in vivo experiments have shown that moderate levels of imposed tension (strain) can encourage axonal outgrowth; however, few strategies of peripheral nerve repair emphasize the mechanical environment of the injured nerve. Toward the development of more effective nerve regeneration strategies, we demonstrate the design, fabrication, and implementation of a novel, modular nerve-lengthening device, which allows the imposition of moderate tensile loads in parallel with existing scaffold-based tissue engineering strategies for nerve repair. This concept would enable nerve regeneration in two superposed regimes of nerve extension--traditional extension through axonal outgrowth into a scaffold and extension in intact regions of the proximal nerve, such as that occurring during growth or limb-lengthening. Self-sizing silicone nerve cuffs were fabricated to grip nerve stumps without slippage, and nerves were deformed by actuating a telescoping internal fixator. Poly(lactic co-glycolic) acid (PLGA) constructs mounted on the telescoping rods were apposed to the nerve stumps to guide axonal outgrowth. Neuronal cells were exposed to PLGA using direct contact and extract methods, and they exhibited no signs of cytotoxic effects in terms of cell morphology and viability. We confirmed the feasibility of implanting and actuating our device within a sciatic nerve gap and observed axonal outgrowth following device implantation. The successful fabrication and implementation of our device provides a novel method for examining mechanical influences on nerve regeneration.

  12. The effects of TME with preserving pelvic autonomic nerve on sexual and urinary function of male%保留盆腔自主神经对男性直肠癌TME术后性功能和排尿功能的影响

    Institute of Scientific and Technical Information of China (English)

    王亚国; 钱军

    2012-01-01

    目的:观察保留盆腔自主神经(pelvic autonomic nerve preservation,PANP)的全直肠系膜切除术(total mesorectal excision,TME)对男性直肠癌患者术后性功能及排尿功能的影响.方法:将行直肠癌根治术的108例男性患者,根据不同的手术方式分为TME+PANP组(56例)和TME组(52例),并对2组患者术后的性功能(包括勃起功能和射精功能)及排尿障碍发生率和局部复发率进行比较.结果:TME+PANP组与TME组患者术后勃起功能障碍发生率分别为32.1%和78.8%,射精功能障碍发生率分别为35.7%和78.8%,排尿障碍发生率分别为26.8%和82.7%,2组差异均有统计学意义(P0.05).结论:PANP+TME在不增加肿瘤局部复发率的同时,能有效降低男性患者术后排尿和性功能障碍的发生率.%Objective: To investigate the effects of total mesorectal excision (TME) with pelvic autonomic nerve preservation (PANP) on sexual and urinary function of male. Methods: One hundred and eight cases with radical resection for rectal carcinoma were divided into PANP and TME group (56 cases) plus TME group (52 cases) according to different operative techniques. Sexual dysfunction, urination disorder rates and local recurrence rates were compared. Results: Erectile dysfunction, ejaculation disorder and urination dysfunction rates of TME plus PANP group and TME group were 32. 1% and 78. 8% ,35. 7% and 78. 8% and 26. 8% and 82. 7% , respectively, which differences had statistical significance ( P 0. 05) . Conclusions:TME with PANP can effectively reduce the local recurrence and the sexual and urinary dysfunction rates.

  13. [Cardiovascular manifestations of chemical rhysolisis of the trigeminal nerve].

    Science.gov (United States)

    Igartua García, L; Sánchez Torres, G; González Mariscal, G; Etulain Maldonado, F; Méndez Venegas, J

    1979-01-01

    Twelve chemical rhyzolisis (surgical instilation of 10 c.c. of 15% NaCl solution) of trigeminal nerve were performed in 11 patients with trigeminal neuralgia resistent to medical treatment. Before and at least in the first 30 minutes after instilation the following parameters were monitorized: electrocardiogram, electroencephalogram, intrarradial arterial pressure and venous central pressure. In 10 cases after a 2.8 +/- 2.4 seg. latency period the following arrhythmias appeared (in paragraphs number of cases): sinus bradicardia, sinoauricular block, sinus arrest, atrial-ventricular block and atrial pacemaker migration. During sinus arrest (8 episodes in 4 cases; mean duration 17.6 secs.) slow, high voltage waves appeared in the electroencephalographic tracings. Ventricular scapes were not seen at the end of the sinus pauses. In 6 cases after this slow arrhythmic phase the following arrhythmias were observed: ventricular premature beats, atrial premature beats, sinus tachycardia, bidirectional ventricular tachycardia, and nodal tachycardia. All cases exhibited an elevation of mean arterial pressure after instilation of the nerve which was preceded by a short period of hypertension in 4 occasions. Average and standard deviations changes of systolic, diastolic and mean blood pressure (mm of Hg), pulse (beats/minute) and central venous pressure (cms of H2O) during the procedure were 46.7 +/- 29.3, 23.0 +/- 13.3, 34.1 +/- 16.4, 25.8 +/- 16.2 and 6.6 +/- 5.8, respectively (p less than or equal to 0.001) in all changes but the last ones, less than or equal to 0.05). Physiopathologic considerations of this autonomic crises are done.

  14. Autonomic nervous system and immune system interactions.

    Science.gov (United States)

    Kenney, M J; Ganta, C K

    2014-07-01

    The present review assesses the current state of literature defining integrative autonomic-immune physiological processing, focusing on studies that have employed electrophysiological, pharmacological, molecular biological, and central nervous system experimental approaches. Central autonomic neural networks are informed of peripheral immune status via numerous communicating pathways, including neural and non-neural. Cytokines and other immune factors affect the level of activity and responsivity of discharges in sympathetic and parasympathetic nerves innervating diverse targets. Multiple levels of the neuraxis contribute to cytokine-induced changes in efferent parasympathetic and sympathetic nerve outflows, leading to modulation of peripheral immune responses. The functionality of local sympathoimmune interactions depends on the microenvironment created by diverse signaling mechanisms involving integration between sympathetic nervous system neurotransmitters and neuromodulators; specific adrenergic receptors; and the presence or absence of immune cells, cytokines, and bacteria. Functional mechanisms contributing to the cholinergic anti-inflammatory pathway likely involve novel cholinergic-adrenergic interactions at peripheral sites, including autonomic ganglion and lymphoid targets. Immune cells express adrenergic and nicotinic receptors. Neurotransmitters released by sympathetic and parasympathetic nerve endings bind to their respective receptors located on the surface of immune cells and initiate immune-modulatory responses. Both sympathetic and parasympathetic arms of the autonomic nervous system are instrumental in orchestrating neuroimmune processes, although additional studies are required to understand dynamic and complex adrenergic-cholinergic interactions. Further understanding of regulatory mechanisms linking the sympathetic nervous, parasympathetic nervous, and immune systems is critical for understanding relationships between chronic disease

  15. Visualization of the course of the sciatic nerve in adult volunteers by ultrasonography.

    NARCIS (Netherlands)

    Bruhn, J.; Geffen, G.J. van; Gielen, M.J.M.; Scheffer, G.J.

    2008-01-01

    BACKGROUND: The sciatic nerve block by the posterior approaches represents one of the more difficult ultrasound-guided nerve blocks. Our clinical experiences with these blocks indicated a point slightly distal to the subgluteal fold as an advantageous position to allow good ultrasonic visibility. In

  16. SCIATIC NERVE AND ITS VARIATIONS: AN ANATOMICAL STUDY

    Directory of Open Access Journals (Sweden)

    Anbumani T.L

    2015-06-01

    Full Text Available Background and aims: The Sciatic nerve is the widest nerve of the body, consists of two components namely tibial and common peroneal components, derived from the lumbosacral plexus from the ventral rami of L4 to S3 spinal nerves. The Sciatic nerve usually enters the gluteal region under the piriformis muscle. The purpose of this study is to identify the variations in the course and branching pattern of the sciatic nerve and its relation to the piriformis muscle which may lead to various clinical manifestations like non-discogenic sciatica. Materials and methods: 50 gluteal regions and posterior compartment of thigh from 25 formalin fixed adult cadavers are used for this study, of which one is a female cadaver. Gluteal regions and the posterior aspect of thigh on both sides are dissected to expose the sciatic nerve. Variations in the sciatic nerve and their relationship to piriformis muscle are observed. Results: 41 gluteal regions and posterior compartments of thigh (82% showed normal anatomy of sciatic nerve and also piriformis muscle. 9 regions (18% showed variations in the sciatic nerve, of which 5 regions (10% showed variation of sciatic nerve in relation to piriformis muscle. Other details are explained further in the article. Conclusion: A proper knowledge about the variations of sciatic nerve, its relation to piriformis muscle is must for medical professionals during posterior hip surgeries, sciatic nerve decompression, total hip replacement, sciatic nerve injury during deep intramuscular gluteal injections, failed sciatic nerve block during anaesthetic procedures etc.

  17. A comparison between combined nerve block and spinal and epidural anesthesia for knee arthroscopy in elderly patients%联合神经阻滞与腰硬联合麻醉用于老年患者膝关节镜手术的比较

    Institute of Scientific and Technical Information of China (English)

    王新华

    2009-01-01

    [Objective] To compare the efficiency of combined lumbar plexus and sciatic nerve block and spinal and epidu-ral anesthesia for knee arthroscopy in elderly patients. [Methods] sixty old patients , 68 ~ 81years old, ASA Ⅰ~Ⅲ, scheduled for knee arthroscopic surgery were randomly divided into groups N and SEA. In group N patient s were under-gone lumbar plexus combined sciatic nerve block with the help of nerve stimulator. In group SEA, patient s were under-gone Spinal and epidural anesthesia. MAP, HR, onset time and duration of sensory and motor block and analgesia time were compared. [Results] The onset time of sensory and motor nerve block of group SEA was shorter than that of group N (P < 0.05), and the duration of group N was longer than that of group SEA (P < 0.05) . The patients' MAP, HR of group SEA were smoother than that of group N (P < 0.05) . [Conclusions] Combined nerve block for knee arthroscopy in elderly patients will produce a better anesthetic effect, a more smooth MAP and HR and a longer analgesia time.%[目的]老年患者膝关节镜手术中应用神经刺激仪定位下的腰丛联合坐骨神经阻滞与腰硬联合麻醉的麻醉效果的比较.[方法]60例拟行单侧膝关节镜手术的老年患者,年龄68~81岁,ASA Ⅰ~Ⅲ级,随机分为腰丛联合坐骨神经阻滞(N)和腰硬联合麻醉(SEA)两组.N组采用神经刺激仪定位下的腰丛和坐骨神经阻滞麻醉,SEA组行腰麻联合硬膜外麻醉.比较两组在不同时间段的NAP、HR、感觉、运动神经阻滞评分及镇痛时间.[结果]N组在手术过程中的MAP、HR较SEA组平稳;SEA组感觉、运动阻滞起效时间更短(P<0.05),N组感觉、运动阻滞维持时间更长(P<0.01).[结论]联合神经阻滞用于老年患者膝关节镜手术,麻醉效果良好,对血液动力学影响小,且镇痛维持时间长.

  18. 颈神经后支源性颈肩痛神经阻滞与手法治疗的效果比较%A comparative study on the effects of nerve block and manipulation therapy for cervical dorsal rami neck-shoulder pain

    Institute of Scientific and Technical Information of China (English)

    王希; 袁君君

    2004-01-01

    BACKGROUND: Still not completely understood due to lack of characteristic physical signs, cervical dorsal rami neck-shoulder pain(CDRNSP) is often confused with other diseases with similar symptoms but different causes. Misdiagnosis and wrong treatment are frequent.OBJECTIVE: To analyze the pathological characters of CDRNSP, and compare the therapeutic effects of nerve block and manipulation therapy.DESIGN: A retrospective controlled study was conducted on the basis of diagnosis.SETTING and PARTICIPANTS: Totally 130 CDRNSP patients, 45 males and 85 females, aged (40 ±4) years old, were selected from the Outpatient or Inpatient Departments, the Fifth Affilated Hospital of Sun Yat-sen University.INTERVENTIONS: Sixty-three patients in the nerve block group underwent nerve block at the cervical dorsal rami once a week. Sixty-seven patients in the manipulation group were treated with manipulation of rotation at fixed-points twice a week, 4 times making up a course of treatment.NAIN OUTCOME MEASURES: To observe and compare the improvement of the sign of neck-shoulder pain in these two groups.RESULTS: In the nerve block group, the treatment was markedly effective in 20 cases, effective in 26 cases, and ineffective in 17 cases, with a general effective rate of 73% (46/63) . In the manipulation group, the treatment was markedly effective in 40 cases, effective in 22 cases, and ineffective in 6 cases with a general effective rate of 90. 3% (61/67) . The difference in curative effect between these two groups was significant(X2 = 7.04, P < 0.01 ).CONCLUSION: Manipulation therapy for CDRNSP is more effective than nerve block therapy.%背景:颈神经后支源性颈肩痛(cervical dorsal rami neck-shoulder pain,CDRNSP)因缺乏特征性体征,目前认识不足.极容易同具有相似症状而不同病因的疾病相混淆,发生误诊误治.目的:分析CDRNSP的病理特点,对照比较神经阻滞和手法松解的治疗效果.设计:以诊断为依据,设立对照的回

  19. Autonomic Nervous System Disorders

    Science.gov (United States)

    Your autonomic nervous system is the part of your nervous system that controls involuntary actions, such as the beating of your heart ... breathing and swallowing Erectile dysfunction in men Autonomic nervous system disorders can occur alone or as the result ...

  20. 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.

  1. 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…

  2. [Trigeminal autonomic cephalgias].

    Science.gov (United States)

    Maximova, M Yu; Piradov, M A; Suanova, E T; Sineva, N A

    2015-01-01

    Review of literature on the trigeminal autonomic cephalgias are presented. Trigeminal autonomic cephalgias are primary headaches with phenotype consisting of trigeminal pain with autonomic sign including lacrimation, rhinorrhea and miosis. Discussed are issues of classification, pathogenesis, clinical picture, diagnosis, differential diagnosis and treatment of this headache. Special attention is paid to cluster headache, paroxysmal hemicrania, SUNCT syndrome, hemicrania continua.

  3. Ultrasound guided regional nerve blocks for children undergoing groin surgery%超声引导下区域神经阻滞在小儿腹股沟区术后镇痛的应用

    Institute of Scientific and Technical Information of China (English)

    薛杭

    2015-01-01

    Ultrasound guided regional nerve blockade in children is a kind of safe,visualized and efficient regional nerve blockade which can be supervised,probe-controlled synchronously and share a brand future compared with traditional land-mark based technique and the intravenous opiates.The aim of this review is to give an overview of the research and application development of ultrasound guided nerve blockade in children undergoing groin surgery.%超声引导下小儿腹股沟区域神经阻滞是在超声下引导实时可控探针方位、深度及给药剂量的局部神经阻滞方法,与传统体表定位神经阻滞及术后静脉阿片类镇痛相比,拥有安全、可视、高效性等特点,在小儿下腹部手术术后镇痛中拥有广泛前景.该文主要阐述了超声引导下小儿腹股沟区域神经阻滞的研究与应用进展.

  4. Ultrasound-guided truncal blocks: A new frontier in regional anaesthesia

    Directory of Open Access Journals (Sweden)

    Arunangshu Chakraborty

    2016-01-01

    Full Text Available The practice of regional anaesthesia is rapidly changing with the introduction of ultrasound into the working domain of the anaesthesiologist. New techniques are being pioneered. Among the recent techniques, notable are the truncal blocks, for example, the transversus abdominis plane block, rectus sheath block, hernia block and quadratus lumborum block in the abdomen and the pectoral nerves (Pecs block 1 and 2, serratus anterior plane block and intercostal nerve block. This narrative review covers the brief anatomical discourse along with technical description of the ultrasound-guided truncal blocks.

  5. Ultrasound-guided truncal blocks: A new frontier in regional anaesthesia

    Science.gov (United States)

    Chakraborty, Arunangshu; Khemka, Rakhi; Datta, Taniya

    2016-01-01

    The practice of regional anaesthesia is rapidly changing with the introduction of ultrasound into the working domain of the anaesthesiologist. New techniques are being pioneered. Among the recent techniques, notable are the truncal blocks, for example, the transversus abdominis plane block, rectus sheath block, hernia block and quadratus lumborum block in the abdomen and the pectoral nerves (Pecs) block 1 and 2, serratus anterior plane block and intercostal nerve block. This narrative review covers the brief anatomical discourse along with technical description of the ultrasound-guided truncal blocks. PMID:27761032

  6. Transcutaneous cervical vagal nerve stimulation modulates cardiac vagal tone and tumor necrosis factor-alpha

    DEFF Research Database (Denmark)

    Brock, C; Brock, B; Aziz, Q

    2016-01-01

    The vagus nerve is a central component of cholinergic anti-inflammatory pathways. We sought to evaluate the effect of bilateral transcutaneous cervical vagal nerve stimulation (t-VNS) on validated parameters of autonomic tone and cytokines in 20 healthy subjects. 24 hours after t...

  7. 腹腔镜与开腹直肠癌根治术保留盆腔自主神经对男性排尿及性功能影响的对比研究%The comparative study of urinary and sexual function after laparoscopic and open radical resection of rectal carcinoma withpelvic autonomic nerve preservation in males

    Institute of Scientific and Technical Information of China (English)

    郭炜; 王昭顺; 郭澎; 孙军席; 刘铁

    2011-01-01

    Objective:To evaluate the urinary and sexual functions after pelvic autonomic never preserving in laparoscopic radical resection for rectal cancer in male patients. Methods:Retrospective analysis was made on clinical data of 210 male patients with rectal cancer during 2007 to 2010. They were divided into two groups ( laparoscopic group, n = 96; open group, n = 114 ). Results: The urinary disorder rates, effective disorder rates and ejaculation disorder rates of laparoscopic group were 10.42%, 13.54% and 19.79% ,while values of open group were 18.42% ,25.43% and 29.82%. The difference between them was statistically significant( P <0.05 ). Conclusions: The laparoscopic radical resection with pelvic autonomic nerve preservation can effectively reduce the incidence of urinary dysfunction and sexual dysfunction after operation ,and improve patients'quality of life after operation.%目的:探讨腹腔镜直肠癌根治术保留盆腔自主神经对男性患者术后排尿及性功能的影响.方法:回顾分析2007~2010年为96例男性直肠癌患者施行腹腔镜手术的临床资料,总结其对患者术后排尿及性功能的影响,并与114例开腹手术对比.结果:腹腔镜组术后排尿功能障碍率10.42%,勃起功能障碍率13.54%,射精功能障碍率19.79%;开腹组分别为18.42%,25.43%,29.82%,两组差异均有统计学意义(P<0.05).结论:腹腔镜直肠癌根治术保留盆腔自主神经可有效降低男性患者术后排尿功能及性功能障碍的发生率,提高患者的生活质量.

  8. Activities of autonomic neurotransmitters in meibomian gland tissues are associated with menopausal dry eye

    Institute of Scientific and Technical Information of China (English)

    Lianxiang Li; Dongling Jin; Jinsheng Gao; Liguang Wang; Xianjun Liu; Jingzhang Wang; Zhongxin Xu

    2012-01-01

    The secretory activities of meibomian glands are regulated by the autonomic nervous system. The change in density and activity of autonomic nerves in meibomian glands during menopause play an important role in the pathogenesis of dry eye. In view of this, we established a dry eye rat model by removing the bilateral ovaries. We used neuropeptide Y and vasoactive intestinal polypeptide as markers of autonomic neurotransmitters. Our results showed that the concentration of estradiol in serum significantly decreased, the density of neuropeptide Y immunoreactivity in nerve fibers significantly increased, the density of vasoactive intestinal polypeptide immunoreactivity in nerve fibers significantly decreased, and the ratio of vasoactive intestinal polypeptide/neuropeptide Y positive staining significantly decreased. These results suggest that a decrease in ovary activity may lead to autonomic nervous system dysfunction, thereby affecting the secretory activity of the meibomian gland, which participates in sexual hormone imbalance-induced dry eye.

  9. 腹腔镜下保留盆腔自主神经平面根治性子宫切除术的初步临床研究%Preliminary clinical study of laparoscopic pelvic autonomic nerve-plane sparing radical hysterectomy

    Institute of Scientific and Technical Information of China (English)

    卢艳; 姚德生; 莫凌昭; 李菲; 潘忠勉

    2012-01-01

    目的 探讨保留盆腔自主神经平面的腹腔镜下根治性子宫切除术的技术要点、可行性及其对降低术后膀胱功能障碍的作用.方法 将2010年1月至2011年5月30例宫颈癌患者分为两组,一组(15例)根据盆腔自主神经的标志性结构行保留“神经平面”法,于腹腔镜下保留盆腔自主神经的根治性子宫切除术(LNSRH),另一组(15例)行腹腔镜下根治性子宫切除术(LRH)作为对照.结果 LNSRH组15例患者中2例因出血较多保留单侧神经,1例为ⅡA期选择性保留病灶对侧盆腔神经,其余成功保留了双侧神经.全组30例患者均顺利完成手术,LNSRH组的手术时间为(301.8±47.6) min,长于LRH组的(178.3±17.0) min(P <0.05).术中出血量、术后肠道恢复时间、切除盆腔淋巴结的数目、宫旁和阴道切除范围两组比较差异无统计学意义(P>0.05).术后LNSRH组的住院时间为(10.9±2.0)d,明显少于LRH组的(15.1±0.8)d(P<0.05).LNSRH组术后拔除尿管的平均时间为(10.8±3.2)d,明显短于LRH组的(17.4±3.2)d(P <0.05).随访3~19个月,全组无复发和转移病例.结论 LNSRH在技术上安全、可行,可明显减少术后膀胱功能障碍,既不降低根治性标准,又有利于患者术后恢复及生活质量提高.%Objective To study the feasibility of laparoscopic pelvic autonomic nerve-plane sparing radical hysterectomy (LN-SRH) technique and its effect on decreasing postoperative bladder dysfunction. Methods From February 2010 to May 2011, 30 consecutive patients with cervical cancer were divided into LNSRH group and laparoscopic radical hysterectomy (LRH) group. We performed 15 LNSRH with the fascia space dissection technique and according to the basic anatomic landmarks of pelvic autonomic nerves and the operating time, operating bleeding and the postoperative recovery of bladder function were assayed. The other 15 patients were in control group under LRH. Results In LNSRH group, 2 cases reserved

  10. Ganglioneuromas involving the hypoglossal nerve and the vagus nerve in a child: Surgical difficulties.

    Science.gov (United States)

    Bakshi, Jaimanti; Mohammed, Abdul Wadood; Lele, Saudamini; Nada, Ritambra

    2016-02-01

    Ganglioneuromas are benign tumors that arise from the Schwann cells of the autonomic nervous system. They are usually seen in the posterior mediastinum and the paraspinal retroperitoneum in relation to the sympathetic chain. In the head and neck, they are usually related to the cervical sympathetic ganglia or to the ganglion nodosum of the vagus nerve or the hypoglossal nerve. We describe what we believe is the first reported case of multiple ganglioneuromas of the parapharyngeal space in which two separate cranial nerves were involved. The patient was a 10-year-old girl who presented with a 2-year history of a painless and slowly progressive swelling on the left side of her neck and a 1-year history hoarseness. She had no history of relevant trauma or surgery. Intraoperatively, we found two tumors in the left parapharyngeal space-one that had arisen from the hypoglossal nerve and the other from the vagus nerve. Both ganglioneuromas were surgically removed, but the affected nerves had to be sacrificed. Postoperatively, the patient exhibited hypoglossal nerve and vocal fold palsy, but she was asymptomatic. In addition to the case description, we discuss the difficulties we faced during surgical excision.

  11. 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.

  12. 局部神经阻滞麻醉与腰硬联合麻醉下治疗腹股沟疝临床效果观察%Clinical Effect of Local Nerve Block Anesthesia and Epidural Anesthesia in the Treatment of Inguinal Hernia

    Institute of Scientific and Technical Information of China (English)

    荣学武

    2015-01-01

    目的:探究局部神经阻滞麻醉和腰硬联合麻醉对腹股沟疝的临床治疗效果。方法将我院收治的88例腹股沟疝患者作为此研究中的研究对象,按照麻醉方法的不同分为观察组以及对照组,并将局部神经阻滞麻醉与腰硬联合麻醉应用其中,比较两组患者的相关指标。结果观察组通过麻醉之后其手术用时、手术中出血量、伤口感染以及复发率低于对照组,采用统计学软件分析后可知两组间存在统计学意义(P<0.05)。结论腹股沟疝患者应采用局部神经阻滞麻醉其操作过程较为简单,同时具备一定的安全可靠性。%Objective To explore the efficacy of local nerve block anesthesia and epidural anesthesia in the treatment of inguinal hernia.Methods88 patients in our hospital inguinal hernia patients in this study as the object of study,according to different methods of anesthesia were divided into observation group and control group,and the local nerve block anesthesia and epidural anesthesia in which the two groups were compared the relevant indicators.Results The anesthesia after the adoption of its operation time,blood loss,wound infection and recurrence rate was significantly lower than the control group, after the analysis shows that the use of statistical software exists between the two groups was statisticaly significant(P<0.05).ConclusionInguinal hernia patients should use local nerve block anesthesia its operation is simple,but with a certain security and reliability.

  13. 局部神经阻滞麻醉下腹膜前无张力疝修补术治疗高龄腹股沟疝110例%Preperitoneal tension-free repair for elderly inguinal hernia under local nerve block anesthesia:a report of 110 cases

    Institute of Scientific and Technical Information of China (English)

    吴强; 李连红; 张晓丽

    2014-01-01

    目的:探讨局部神经阻滞麻醉下的腹膜前腹股沟无张力疝修补的应用。方法回顾性分析2012年1月至2013年12月,上海市第六人民医院收治的高龄腹股沟疝患者110例,行局部神阻滞麻醉下的腹膜前无张力疝修补。观察手术时间、住院时间、术后并发症。结果本组患者手术时间35~60 min,平均(45±5)min;住院时间2~3 d。术后出现尿潴留3例,阴囊浆液肿8例,慢性疼痛5例,无切口感染发生,随访4~12个月,无复发,无死亡患者。结论局部神经阻滞麻醉下的腹膜前无张力疝修补术是治疗高龄腹股沟疝患者较为理想的术式,临床治疗效果满意。%Objective To investigate the application of local nerve block anesthesia in preperitoneal tension-free inguinal hernia repair.Methods A total of 1 1 0 cases of elderly inguinal hernia which underwent preperitoneal tension-free hernia repair under local nerve block anesthesia in Shanghai No.6 People′s Hospital between January 201 2 and December 201 3,were analyzed retrospectively.The operating time,length of hospitalization stay and postoperative complications were observed.Results In this present series,the operating time was 35 to 60 minutes (mean of 45 ±5 minutes);the length of stay was 2 to 3 days.Urinary retention occurred in 3 cases,and scrotal seroma occurred in 8 cases.5 complained about chronic pain,no wound infection was observed.After a follow-up period of 4 to 1 2 months,there was no recurrence and death cases.Conclusion Preperitoneal tension-free hernia repair under local nerve block anesthesia have a satisfactory effect and have been shown to be an appropriate procedure for elder inguinal hernia patients.

  14. Bilateral variant of sciatic nerve exhibiting intra-pelvic division

    Directory of Open Access Journals (Sweden)

    Rejeena P Raj, Kunjumon PC, More Anju B

    2014-04-01

    Full Text Available Context (background: In case of high division of the sciatic nerve in the pelvis its, common peroneal component may pierce the Piriformis muscle. This anatomical variant can explain many clinical findings. Aims: Its objective is to report a case of high division of the sciatic nerve in order to contribute towards better anatomical understanding of the gluteal region. Methods and Material: Routine undergraduate dissection of a male cadaver revealed bilateral variation in sciatic nerve. Results: Sciatic nerve is dividing into tibial and common peroneal components in the pelvis. Common peroneal component is piercing through the piriformis muscle. Tibial component is emerging between piriformis and superior gemelli muscle. Conclusions: Sciatic nerve variation can lead to a Piriformis muscle syndrome, inadvertent injury during operations in the gluteal region, failure of sciatic nerve block and/or sciatic neuropathy. The differences in routes of these two nerve components can explain them.

  15. The lumber plexus and sacral plexus nerve block method of total hip arthroplasty for elder patients%老年患者全髋关节置换术的腰丛-骶丛神经阻滞麻醉方法

    Institute of Scientific and Technical Information of China (English)

    曹雪芹; 梅伟; 陈明兵; 刘九红

    2016-01-01

    Objective To explore an improved nerve block method for elder patients undergoing total hip arthroplasty. Methods Fourteen older patients scheduled for total hip arthroplasty from March to June of 2015 were given lumber plexus and sacral plexus nerve block. The block areas were tested with acupuncture. The hemodynamic changes before anesthesia and after skin incision were compared. The maximum change rate of hemodynamic changes during operation was observed. The perioperative adverse reactions and anesthesia satisfaction were also evaluated. Results The cutaneous pain of tensor fasciae latae innervated by superior gluteal nerve, gluteus maximus innervated by inferior gluteal nerve, quadriceps femoris innervated by femoral nerve and hamstrings innervated by sciatic nerve was insensible. There were no significant differences in the changes of systolic blood pressure, diastolic blood pressure, heart rate between after skin incision and pre-anesthesia (P>0.05). The variations of systolic blood pressure, diastolic blood pressure and heart rate were 13.9%± 6.2%, 15.8%± 7.8%, and 14.1%± 4.8%, respectively, which were less than 20%. The surgery was successfully completed in all patients under pure nerve block. There was no use of opiods. The patients didn't present local anesthetics poisoning, and circulating complications such as volatility, respiratory inhibition. The surgeons'satisfaction about anesthetic effect was all 10 points. Conclusion Lumber plexus sacral plexus nerve block is a safe and effective anesthetic technique for total hip arthroplasty. Because of the small sample size, further study is needed.%目的 探讨改良的老年患者人工髋关节置换术的神经阻滞麻醉方法.方法 选取2015年3~6月于我院行全髋关节置换手术的14例老年患者,予腰丛-骶丛神经阻滞麻醉,术前运用针刺法测试麻醉平面,记录术中血流动力学变化、不良反应,评估麻醉效果.结果 臀上神经支配的阔筋膜张肌区域

  16. Zitongdong Block

    Institute of Scientific and Technical Information of China (English)

    1996-01-01

    @@ The Zitongdong Block (Eastern Zitong Block) is located in the northwest of the Sichuan Basin. Tectonically, it is situated in the east part of Zitong Depression, southeast of mid-Longmenshan folded and faulted belt( as shown on Fig. 8 ), covering an area of 1 730 km2. The traffic is very convenient, the No. 108 national highway passes through the north of the block. Topographically, the area belongs to low hilly land at the elevation of 500-700 m.

  17. 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

  18. The anesthetic effects of Gow-Gates technique of inferior alveolar nerve block in impacted mandibular third molar extraction%Gow-Gates法下牙槽神经阻滞麻醉在下颌阻生第三磨牙拔除术中的麻醉效果研究

    Institute of Scientific and Technical Information of China (English)

    杨介平; 刘伟; 高庆红

    2013-01-01

    目的 通过临床随机对照试验的方法评价Gow-Gates法下牙槽神经阻滞麻醉在下颌阻生第三磨牙拔除术中的麻醉有效性和安全性.方法 使用左右半口设计,32例患者的左右下颌阻生第三磨牙分别随机采用Gow-Gates法和传统注射法进行下牙槽神经阻滞麻醉,并拔除下颌阻生第三磨牙,记录麻醉效果及不良事件.结果 所有患者均完成研究.Gow-Gates法的麻醉成功率为96.9%,传统注射法的麻醉成功率为90.6%,二者的麻醉成功率无统计学差异(P=0.317).在麻醉程度上,Gow-Gates法麻醉程度为A和B级的比率为96.9%,明显好于传统注射法的78.1%(P=0.034).Gow-Gates法的回抽出血率明显低于传统注射法(P=0.025),2种注射方法均未出现血肿.结论 Gow-Gates法下牙槽神经阻滞麻醉在下颌阻生第三磨牙拔除术中的麻醉效果好且较为安全,可以作为传统注射法的有效补充.%Objective To evaluate the anesthetic effects and safety of Gow-Gates technique of inferior alveolar nerve block in impacted mandibular third molar extraction.Methods A split-mouth study was designed.The bilateral impacted mandibular third molar of 32 participants were divided into Gow-Gates technique of inferior alveolar nerve block (Gow-Gates group) and conventional technique of inferior alveolar nerve block (conventional group) randomly with third molar extracted.The anesthetic effects and adverse events were recorded.Results All the participants completed the research.The anesthetic success rate was 96.9% in Gow-Gates group and 90.6% in conventional group with no statistical difference(P=0.317); but when comparing the anesthesia grade,Gow-Gates group had a 96.9% of grade A and B,and conventional group had a rate of 78.1%(P=0.034).And the Gow-Gates group had a much lower withdrawn bleeding than conventional group(P=0.025).Two groups had no hematoma.Conclusion Gow-Gates technique had a reliable anesthesia effects and safety in

  19. Avaliação da dor pós-operatória e alta hospitalar com bloqueio dos nervos ilioinguinal e ílio-hipogástrico durante herniorrafia inguinal realizada com raquianestesia: estudo prospectivo Assessment of postoperative pain and hospital discharge after inguinal and iliohypogastric nerve block for inguinal hernia repair under spinal anesthesia: a prospective study

    Directory of Open Access Journals (Sweden)

    Guilherme de Castro Santos

    2011-10-01

    Full Text Available OBJETIVO: Comparar a qualidade da analgesia (intensidade da dor e consumo de analgésicos e o tempo de alta hospitalar dos pacientes que receberam ou não bloqueio ilioinguinal (II e ílio- hipogástrico (IH pós-incisão associado à infiltração da ferida operatória com ropivacaína 0,75% em cirurgia de herniorrafia inguinal, sob raquianestesia. MÉTODOS: Foi realizado estudo prospectivo, aleatório, duplo-cego com 34 pacientes submetidos à herniorrafia inguinal. Eles foram divididos em dois grupos: controle (C e bloqueio II e IH (B. O grupo C (n = 17 recebeu raquianestesia com 15 mg de bupivacaína 0,5% hiperbárica e o grupo B (n = 17 recebeu raquianestesia com 15 mg de bupivacaína 0,5% hiperbárica em associação com bloqueio II e IH (10 mL de ropivacaína 0,75% e infiltração da ferida cirúrgica (10 mL de ropivacaína 0,75%. Foram registrados os dados antropométricos, intensidade da dor pela escala analógica visual (EAV e número de doses de analgésicos (dipirona, cetorolaco e nalbufina no pós-operatório imediato, assim como o tempo de alta hospitalar. RESULTADOS: A EAV em repouso três horas após o término do procedimento e o tempo de hospitalização foram significativamente menores no grupo B em comparação com o grupo C (p OBJECTIVE: This study was designed to evaluate analgesia (pain intensity and analgesic consumption and the time of discharge of patients who underwent ilioinguinal (II and iliohypogastric (IH nerve block associated with wound infiltration with 0.75% ropivacaine, or not, after inguinal hernia repair surgery under spinal anesthesia. METHODS: This was a prospective, randomized, double-blind study with 34 patients undergoing inguinal hernia repair. Patients were divided into two groups: control (C and II and IH nerve block (B. Group C (n = 17 received spinal anesthesia with 15 mg hyperbaric 0.5% bupivacaine and Group B (n = 17 received spinal anesthesia with 15 mg hyperbaric 0.5% bupivacaine associated

  20. 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.

  1. 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

  2. Improvement of sciatic nerve regeneration using laminin-binding human NGF-beta.

    Directory of Open Access Journals (Sweden)

    Wenjie Sun

    Full Text Available BACKGROUND: Sciatic nerve injuries often cause partial or total loss of motor, sensory and autonomic functions due to the axon discontinuity, degeneration, and eventual death which finally result in substantial functional loss and decreased quality of life. Nerve growth factor (NGF plays a critical role in peripheral nerve regeneration. However, the lack of efficient NGF delivery approach limits its clinical applications. We reported here by fusing with the N-terminal domain of agrin (NtA, NGF-beta could target to nerve cells and improve nerve regeneration. METHODS: Laminin-binding assay and sustained release assay of NGF-beta fused with NtA (LBD-NGF from laminin in vitro were carried out. The bioactivity of LBD-NGF on laminin in vitro was also measured. Using the rat sciatic nerve crush injury model, the nerve repair and functional restoration by utilizing LBD-NGF were tested. FINDINGS: LBD-NGF could specifically bind to laminin and maintain NGF activity both in vitro and in vivo. In the rat sciatic nerve crush injury model, we found that LBD-NGF could be retained and concentrated at the nerve injury sites to promote nerve repair and enhance functional restoration following nerve damages. CONCLUSION: Fused with NtA, NGF-beta could bind to laminin specifically. Since laminin is the major component of nerve extracellular matrix, laminin binding NGF could target to nerve cells and improve the repair of peripheral nerve injuries.

  3. Prolonged nerve blockade in a patient treated with lithium

    Directory of Open Access Journals (Sweden)

    Lehavi A

    2012-04-01

    Full Text Available Amit Lehavi, Boris Shenderey, Yeshayahu (Shai KatzDepartment of Anesthesiology, Rambam Health Care Campus, Haifa, IsraelAbstract: We report a case of a patient, chronically treated with oral lithium, who presented with an extremely prolonged (42-hour duration of sensory and motor paralysis following an uneventful infraclavicular block for hand surgery that was performed under ultrasound guidance using bupivacaine and lidocaine. Due to its direct effect on nerve conduction of action potential, we propose that lithium may have had a role in the unusually prolonged duration of a peripheral nerve block.Keywords: nerve blockade, lithium, duration, anesthesia

  4. Skin temperature measured by infrared thermography after ultrasound-guided blockade of the sciatic nerve

    NARCIS (Netherlands)

    Haren, F.G. van; Kadic, L.; Driessen, J.J.

    2013-01-01

    BACKGROUND: In the present study, we assessed the relationship between subgluteal sciatic nerve blocking and skin temperature by infrared thermography in the lower extremity. We hypothesized that blocking the sciatic nerve will lead to an increase in temperature, and that this will correlate with ex

  5. Endocrine tumors associated with the vagus nerve.

    Science.gov (United States)

    Varoquaux, Arthur; Kebebew, Electron; Sebag, Fréderic; Wolf, Katherine; Henry, Jean-François; Pacak, Karel; Taïeb, David

    2016-09-01

    The vagus nerve (cranial nerve X) is the main nerve of the parasympathetic division of the autonomic nervous system. Vagal paragangliomas (VPGLs) are a prime example of an endocrine tumor associated with the vagus nerve. This rare, neural crest tumor constitutes the second most common site of hereditary head and neck paragangliomas (HNPGLs), most often in relation to mutations in the succinate dehydrogenase complex subunit D (SDHD) gene. The treatment paradigm for VPGL has progressively shifted from surgery to abstention or therapeutic radiation with curative-like outcomes. Parathyroid tissue and parathyroid adenoma can also be found in close association with the vagus nerve in intra or paravagal situations. Vagal parathyroid adenoma can be identified with preoperative imaging or suspected intraoperatively by experienced surgeons. Vagal parathyroid adenomas located in the neck or superior mediastinum can be removed via initial cervicotomy, while those located in the aortopulmonary window require a thoracic approach. This review particularly emphasizes the embryology, molecular genetics, and modern imaging of these tumors.

  6. 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.

  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. 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

  9. 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。

  10. Semi-Autonomous Systems Laboratory

    Data.gov (United States)

    Federal Laboratory Consortium — Vision The Semi-Autonomous Systems Lab focuses on developing a comprehensive framework for semi-autonomous coordination of networked robotic systems. Semi-autonomous...

  11. Semi-Autonomous Systems Laboratory

    Data.gov (United States)

    Federal Laboratory Consortium — VisionThe Semi-Autonomous Systems Lab focuses on developing a comprehensive framework for semi-autonomous coordination of networked robotic systems. Semi-autonomous...

  12. Chengzikou Block

    Institute of Scientific and Technical Information of China (English)

    1996-01-01

    @@ Chengzikou Block is located in the north of Hekou district, Dongying City, Shandong Province, adjacent to Bohai Bay. It can be geographically divided into three units: onshore, transitional zone and offshore ultrashallow zone, totally covering an area of 470 km2. The southern onshore area is low and gentle in topography;the northern shallow sea is at water depths of 2-8 m below sea level, and the transitional zone occupies more than 60% of the whole block. The climate belongs to temperate zone with seasonal wind. Highways are welldeveloped here, and the traffic is very convenient. The Chengzikou Block is about 80 km away from Dongying City and 290 km from Jinan City in the south. The northern offshore area of the block is 160 km away from Longkou port in the east and only 38 km away in the west from Zhuangxi port.

  13. 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...

  14. 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 ...

  15. 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; ...

  16. 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.

  17. [Who is responsible for the postoperative nerve injury? Anesthesia? Orthopedics? Trauma?].

    Science.gov (United States)

    Kelsaka, Ebru; Güldoğuş, Fuat; Erdoğan, Murat; Zengin, Eyüp Cağatay

    2014-01-01

    In the pathogenesis of peripheral nerve injury, mechanical as well as vascular pressure, and chemical reasons play a role. In the applications of peripheral nerve block, there can be mechanical injury due to the type of needle and intrafascicular injections. In humerus fractures, nerve injury can be seen due to the surgical retractions and close proximity of the nerves with the bone. In addition, trauma may be the reason for posttraumatic nerve injury. In this presentation, we discussed the causes of postoperative nerve damage, which is seen after the operation of the distal humerus fracture.

  18. Longmenshan Block

    Institute of Scientific and Technical Information of China (English)

    1996-01-01

    @@ Longmenshan Block is located in Jiange County of Jiangyou City in the northwest of Sichuan Basin. covering an area of 2 628 km2. Geologically, it is situated in the Mid-Longmenshan fault and fold belt, neighbouring Zitong Depression in its southeast. There are mountains surrounding its northwest , the rest area being hilly land,with the elevation of 500-700 m. The BaoCheng railway and the No. 108 highway run through the block, the traffic is very convenient.

  19. 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

    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 the abdominal muscle-relaxing effect. RESULTS: The lateral part of the cutaneous sensory block area was a median of 266 cm2 (interquartile range, 191-310 cm2) and the medial part 76 cm 2(interquartile range, 54-127 cm2). In all the volunteers, lateral wall muscle thickness decreased significantly by 9.2 mm (6......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...

  20. Study on Variant Anatomy of Sciatic Nerve

    Science.gov (United States)

    V, Sangeetha

    2014-01-01

    Introduction: Sciatic Nerve (SN) is the nerve of the posterior compartment of thigh formed in the pelvis from the ventral rami of the L4 to S3 spinal nerves. It leaves the pelvis via the greater sciatic foramen below piriformis and divides into Common Peroneal Nerve (CPN) and Tibial Nerve (TN) at the level of the upper angle of the popliteal fossa. Higher division of the sciatic nerve is the most common variation where the TN and CPN may leave the pelvis through different routes. Such variation may lead to compression of the nerve and lead to Non-discogenic sciatica. Materials and Methods: Fifty lower limbs were used for the study from Department of Anatomy, J.J.M.M.C Davangere, Karnataka, India. Observation and Results: In our study on 25 cadavers (50 lower limbs), we have observed 4 (8 %) lower limbs high division of sciatic nerve was noted. High division of sciatic nerve in the back of thigh was noted in one specimen (2%), while high division within the pelvis was noted in 3 specimens (6%), while in 46 (92%) it occurred outside the pelvis. Conclusion: Knowledge regarding such variation and differences in the course of SN is important for the surgeons to plan for various surgical interventions pertaining to the gluteal region. The variant anatomy of SN may cause piriformis syndrome and failure of SN block. Hence present study is undertaken to know the level of division, exit, course, relationship to piriformis and variations in the branching pattern of SN. PMID:25302181

  1. Testing for autonomic neuropathy

    DEFF Research Database (Denmark)

    Hilsted, J

    1984-01-01

    Autonomic neuropathy is a common complication in long-term diabetes, about 30% of the patients showing measurable signs of autonomic dysfunction after 10 years duration of disease. The diagnosis is often difficult to establish because clinical symptoms generally occur late in the course...

  2. Soft tissue landmark for ultrasound identification of the sciatic nerve in the infragluteal region: the tendon of the long head of the biceps femoris muscle.

    NARCIS (Netherlands)

    Bruhn, J.; Moayeri, N.; Groen, G.J.; Veenendaal, A. van; Gielen, M.J.M.; Scheffer, G.J.; Geffen, G.J. van

    2009-01-01

    BACKGROUND AND OBJECTIVES: The sciatic nerve block represents one of the more difficult ultrasound-guided nerve blocks. Easy and reliable internal ultrasound landmarks would be helpful for localization of the sciatic nerve. Earlier, during ultrasound-guided posterior approaches to the infragluteal s

  3. The Physics of Nerves

    CERN Document Server

    Heimburg, Thomas

    2010-01-01

    The accepted model for nerve pulse propagation in biological membranes seems insufficient. It is restricted to dissipative electrical phenomena and considers nerve pulses exclusively as a microscopic phenomenon. A simple thermodynamic model that is based on the macroscopic properties of membranes allows explaining more features of nerve pulse propagation including the phenomenon of anesthesia that has so far remained unexplained.

  4. Clinical observation of intra-articular injections of sodium hyaluronate combined with periarticular pain spot nerve block for treatment of knee osteoarthritis-500 cases of report attached%玻璃酸钠关节腔内注射配合关节周围痛点神经阻滞治疗膝骨性关节炎临床观察500例

    Institute of Scientific and Technical Information of China (English)

    刘华; 洪春兰; 谢小香; 彭仁林

    2011-01-01

    目的:观察与探讨玻璃酸钠关节腔内注射配合关节周围痛点神经阻滞治疗膝骨性关节炎的临床疗效.方法:选取500例膝骨性关节炎患者,将其分为三组:股髌骨性关节炎组(156例)、股胫骨性关节炎组(167例)、全膝骨性关节炎组(177例).500例膝骨性关节炎患者每周关节腔内注射2.5 ml玻璃酸钠,配合利多卡因与泼尼松龙混合液痛点阻滞,连续治疗5周为1个疗程.结果:共治疗500例,随访24~36个月,临床疗效优149例,良247例,中82例,优良率为79.2%,有效率为95.6%.结论:玻璃酸钠腔内注射配合关节周围痛点神经阻滞治疗膝骨性关节炎疗效显著,安全可靠.%Objective: To observe and investigate the clinical effects of intra-articular injection of sodium hyaluronate combined with periarticular pain spot nerve block for the treatment of knee osteoarthritis.Methods: 500 patients with knee osteoarthritis were given intra-articular injection of 2.5 ml of sodium hyaluronate combined with the mixture of lidocaine and prednisolone for pain spot block per week.5 continuous weeks was a course of treatment.Results: 500 patients were treated and followed up for 24-36 months.The clinical effects of 149 patients were excellent, 247 patients were good and 82 patients were moderate, with the excellent and good rate of 79.2% and the effective rate of 95.6%.Conclusion: Intraarticular injection of sodium hyaluronate combined with periarticular pain spot nerve block for the treatment of knee osteoarthritis is significantly effective, safe and reliable.

  5. 腰丛-坐骨神经阻滞与腰麻在老年患者膝关节置换围术期的对比分析%Comparison of lumbar plexus-sciatic nerve block and spinal anesthesia on elderly patients with knee joint sur-gery during the perioperative period

    Institute of Scientific and Technical Information of China (English)

    黄文锋; 陈杰; 包晓航; 杜智勇; 黄河; 李洪; 杨天德

    2016-01-01

    Objective To compare and analyze the clinical application of lumbar plexus combined with sciatic nerve block and spinal anesthesia for elderly patients with knee joint surgery.Methods A total of 77 elderly patients with ASAⅠ ~Ⅲ undergoing single knee re-placement surgery were randomly divided into combined group which recieved lumbar plexus combined with sciatic nerve block and spinal an-esthesia group.The baseline values,blood pressure and heart rate at multiple time points,the block area and duration,the volume of intraoper-ative fluid,and other indexes of adverse reaction were observed.Results The MAP,SBP and DBP in the spinal anesthesia group after the op-eration have changed significantly at the time of T1,T2 and T3.The operating of anesthesia in the combined group was shorter than that of spi-nal anesthesia group.The rate of adverse reactions in combined group was significantly lower than that inspinal anesthesia group.Conclusion The spinal anesthesia can be satisfied for operation requirements,but it will cause the unstable circulation and varied adverse reactions.Lum-bar plexus combined with sciatic nerve block is safe and effective with less adverse reactions,less disturbance of hemodynamics,which is much better for the old or the patients with coagulation abnormalities combined heart and lung disease.%目的:对比分析腰丛联合坐骨神经阻滞与腰麻在老年患者膝关节手术中的应用,探讨两者在老年患者膝关节置换术围手术期的优缺点。方法77例老年单膝关节置换术患者,ASA Ⅰ~Ⅲ级,按麻醉方式不同分为腰丛神经阻滞联合坐骨神经阻滞组(联合组)和腰麻组,观察并纪录麻醉前基础值,以及麻醉后、切皮时、术中放置骨水泥后、手术结束时的血压、心率、阻滞区域及维持时间、术中输液量、围术期不良反应等指标。结果腰麻组患者在麻醉后 MAP、SBP、DBP 在 T1、T2、T3时间点波动明显,联合组麻醉

  6. 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

  7. Autonomous Lawnmower using FPGA implementation.

    Science.gov (United States)

    Ahmad, Nabihah; Lokman, Nabill bin; Helmy Abd Wahab, Mohd

    2016-11-01

    Nowadays, there are various types of robot have been invented for multiple purposes. The robots have the special characteristic that surpass the human ability and could operate in extreme environment which human cannot endure. In this paper, an autonomous robot is built to imitate the characteristic of a human cutting grass. A Field Programmable Gate Array (FPGA) is used to control the movements where all data and information would be processed. Very High Speed Integrated Circuit (VHSIC) Hardware Description Language (VHDL) is used to describe the hardware using Quartus II software. This robot has the ability of avoiding obstacle using ultrasonic sensor. This robot used two DC motors for its movement. It could include moving forward, backward, and turning left and right. The movement or the path of the automatic lawn mower is based on a path planning technique. Four Global Positioning System (GPS) plot are set to create a boundary. This to ensure that the lawn mower operates within the area given by user. Every action of the lawn mower is controlled by the FPGA DE' Board Cyclone II with the help of the sensor. Furthermore, Sketch Up software was used to design the structure of the lawn mower. The autonomous lawn mower was able to operate efficiently and smoothly return to coordinated paths after passing the obstacle. It uses 25% of total pins available on the board and 31% of total Digital Signal Processing (DSP) blocks.

  8. 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.

  9. 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...

  10. A case of hereditary sensory autonomic neuropathy type IV

    Directory of Open Access Journals (Sweden)

    G P Prashanth

    2012-01-01

    Full Text Available Hereditary sensory autonomic neuropathy type IV (HSAN -IV, also known as congenital insensitivity to pain with anhidrosis, is a very rare condition that presents in infancy with anhidrosis, absence of pain sensation and self -mutilation. Developmental delay and mental retardation are usually present. Ultrastructural study of the peripheral nerves demonstrates loss of the unmyelinated and small myelinated fibers. We here report a 8 year -old boy with HSAN IV with typical clinical features where the diagnosis was supported by nerve biopsy findings. However, our case was unusual since mental development was normal.

  11. 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

  12. Optic nerve oxygenation

    DEFF Research Database (Denmark)

    Stefánsson, Einar; Pedersen, Daniella Bach; Jensen, Peter Koch;

    2005-01-01

    -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...... 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...

  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. Immunomodulation by the autonomic nervous system: therapeutic approach for cancer, collagen diseases, and inflammatory bowel diseases.

    Science.gov (United States)

    Abo, Toru; Kawamura, Toshihiko

    2002-10-01

    The distribution of leukocytes is regulated by the autonomic nervous system in humans and animals. The number and function of granulocytes are stimulated by sympathetic nerves whereas those of lymphocytes are stimulated by parasympathetic nerves. This is because granulocytes bear adrenergic receptors, but lymphocytes bear cholinergic receptors on the surface. These regulations may be beneficial to protect the body of living beings. However, when the autonomic nervous system deviates too much to one direction, we fall victim to certain diseases. For example, severe physical or mental stress --> sympathetic nerve activation --> granulocytosis --> tissue damage, including collagen diseases, inflammatory bowel diseases, and cancer. If we introduce the concept of immunomodulation by the autonomic nervous system, a new approach for collagen diseases, inflammatory bowel diseases, and even cancer is raised. With this approach, we believe that these diseases are no longer incurable.

  15. Chadong Block

    Institute of Scientific and Technical Information of China (English)

    1996-01-01

    @@ The Chadong Block, located in the east of Qaidam Basin, Qinghai Province, covers an area of 12 452 km2. It is bounded by Kunlum Mountains in the south and the northwest is closely adjacent to Aimunike Mountain.Rivers are widely distributed, which always run in NWSE direction, including the Sulunguole, Qaidam and Haluwusu Rivers. The traffic condition is good, the Qinghai-Tibet highway stretching through the whole area and the Lan-Qing railway, 20-50 km away from the block, passing from north to west. A lot of Mongolia minority people have settled there, of which herdsmen always live nearby the Qaidam River drainage area.

  16. Autonomous surveillance for biosecurity.

    Science.gov (United States)

    Jurdak, Raja; Elfes, Alberto; Kusy, Branislav; Tews, Ashley; Hu, Wen; Hernandez, Emili; Kottege, Navinda; Sikka, Pavan

    2015-04-01

    The global movement of people and goods has increased the risk of biosecurity threats and their potential to incur large economic, social, and environmental costs. Conventional manual biosecurity surveillance methods are limited by their scalability in space and time. This article focuses on autonomous surveillance systems, comprising sensor networks, robots, and intelligent algorithms, and their applicability to biosecurity threats. We discuss the spatial and temporal attributes of autonomous surveillance technologies and map them to three broad categories of biosecurity threat: (i) vector-borne diseases; (ii) plant pests; and (iii) aquatic pests. Our discussion reveals a broad range of opportunities to serve biosecurity needs through autonomous surveillance.

  17. 20.7 Peripheral nerve disease

    Institute of Scientific and Technical Information of China (English)

    1993-01-01

    930394 A1—10 year follow—up study of 82cases of methamidophos induced delayedpolyneuropathy.Z1HENG Rongyuan (郑荣远),etal.Neurol Dept,Wenzhou Med Coll.325000.Chin J Industr Hyg & Occupat Dis 1992;10(6):344—347.A1—10 year follow—up study of 82 cases ofmethamidophos induced delayed polyneuropathywas reported.82 cases were classified into threetypes:motor (36.6%),sensory—motor (61%)and Guillain-Barre syndrome (2.4%).As awhole,the sensory disturbances disappearedwithin 2—3 months;the autonomic nerve func-tional disorder vanished within 3—6 months;

  18. An Electerophisioligic Study Of Autonomic Nervous System In Diabetic Patients

    Directory of Open Access Journals (Sweden)

    Noorolahi Moghaddam H

    2003-11-01

    Full Text Available Autonomic nervous system dysfunction in diabetics can occur apart from peripheral sensorimotor polyneuropathy and sometimes leads to complaints which may be diagnosed by electrodiagnostic methods. Moreover glycemic control of these patients may prevent such a complications."nMaterials and Methods: 30 diabetic patients were compared to the same number of age and sex-matched controls regarding to electrophysiologic findings of autonomic nervous system. Symptoms referable to autonomic disorder including nightly diarrhea, dizziness, urinary incontinence, constipation, nausea, and mouth dryness were recorded in all diabetic patients. Palmar and plantar SSR and expiration to inspiration ratio (E: I and Valsalva ratio were recorded in all diabetics and control individuals by electromyography device. In addition NCS was performed on two sensory and two motor nerves in diabetic patients."nResults: There was no relation between age of diabetics and abnormal D: I ratio, Valsalva ratio and degree of electrophysiologic autonomic impairment. Also no relation between peripheral sensorimotor polyneuropathy and electrophysiologic autonomic impairment was found. Plantar SSR was absent in 80% of diabetics with orthostatic hypotension (p~ 0.019. Palmar and plantar SSR were absent in many diabetics in comparison to control group (for palmar SSR p~ 0.00 and for plantar SSR p< 0.015. There was no relation between diabetes duration since diagnosis and electrophysiologic autonomic impairment."nConclusion: According to the above mentioned findings diabetic autonomic neuropathy develops apart from peripheral sensorimotor polyneuropathy and probably with different mechanisms. Remarkable absence of palmar SSR in diabetics with orthostatic hypotension can be due to its sympathetic origin. Absence of any relation between diabetes duration and electrophysiologic autonomic impairment can be due to late diagnosis of type 2 diabetes or no pathophysiologic relation between chronic

  19. Effect of Peripheral Nerve Block Anesthesia on Postoperative Stress Response in Patients with Hypertension after Undergoing Lower Limb Surgery%外周神经阻滞麻醉对高血压病患者下肢术后应激反应的影响

    Institute of Scientific and Technical Information of China (English)

    苏丹晨; 黄希照; 何健珊

    2015-01-01

    OBJECTIVE:To observe the effect of peripheral nerve block anesthesia versus traditional combined spinal epidural anesthesia on the stress response of patients with hypertension following undergoing lower limb operation. METHODS:A total of 135 hypertensive patients undergoing lower limb operation in Guangdong Provincial Maternity and Child Healthcare Hospital were randomized to peripheral nerve block anesthesia group ( observation group, n=68) and combined spinal-epidural anesthesia group ( control group, n=67 ) .The heart rate, blood pressure and serum levels of norepinephrine and adrenaline and plasma cortisol level were compared between the 2 groups.RESULTS: At 10 min of operation, the observation group was significantly better than the control group in blood pressure and heart rate, and the differences were statistically significant(P0.05);the observation group showed rapid onset and long duration of action of anesthetic effect yet few postoperative complications . CONCLUSIONS:The peripheral nerve block anesthesia can maintain the stability of the patient's hemodynamics meanwhile reducing the postoperative stress reaction and complications, hence it is worthy of clinical promotion.%目的:对比观察外周神经阻滞麻醉与传统腰-硬联合麻醉对高血压病患者下肢术后应激反应的影响。方法:选取广东省妇幼保健院行下肢手术的高血压病患者135例,以随机数字表法分为外周神经阻滞麻醉组(观察组,68例)和腰-硬联合麻醉(对照组,67例)。比较2组患者心率、血压及血清去甲肾上腺素、肾上腺素、血浆皮质醇水平,麻醉起效、神经阻滞时间,术后不良反应发生情况。结果:从术中10 min开始,观察组患者的血压、心率均明显优于对照组,差异均有统计学意义( P<0.05);术中及术后,2组患者血清去甲肾上腺素、肾上腺素、血浆皮质醇水平的差异无统计学意义( P>0.05);观

  20. 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

  1. 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

  2. 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

  3. 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

  4. Autonomic involvement in Parkinson's disease: pathology, pathophysiology, clinical features and possible peripheral biomarkers.

    Science.gov (United States)

    Cersosimo, Maria G; Benarroch, Eduardo E

    2012-02-15

    Autonomic nervous system involvement occurs at early stages in both Parkinson's disease (PD) and incidental Lewy body disease (ILBD), and affects the sympathetic, parasympathetic, and enteric nervous systems (ENS). It has been proposed that alpha-synuclein (α-SYN) pathology in PD has a distal to proximal progression along autonomic pathways. The ENS is affected before the dorsal motor nucleus of the vagus (DMV), and distal axons of cardiac sympathetic nerves degenerate before there is loss of paravertebral sympathetic ganglion neurons. Consistent with neuropathological findings, some autonomic manifestations such as constipation or impaired cardiac uptake of norepinephrine precursors, occur at early stages of the disease even before the onset of motor symptoms. Biopsy of peripheral tissues may constitute a promising approach to detect α-SYN neuropathology in autonomic nerves and a useful early biomarker of PD.

  5. Sympathetic nerves bridge the cross-transmission in hemifacial spasm.

    Science.gov (United States)

    Zheng, Xuesheng; Hong, Wenyao; Tang, Yinda; Wu, Zhenghai; Shang, Ming; Zhang, Wenchuan; Zhong, Jun; Li, Shiting

    2012-05-23

    The pathophysiologic basis of hemifacial spasm is abnormal cross-transmission between facial nerve fibers. The author hypothesized that the demyelinated facial nerve fibers were connected with the sympathetic nerve fibers on the offending artery wall, and thus the latter function as a bridge in the cross-transmission circuit. This hypothesis was tested using a rat model of hemifacial spasm. A facial muscle response was recorded while the offending artery wall was electrically stimulated. The nerve fibers on the offending artery wall were blocked with lidocaine, or the superior cervical ganglion, which innervates the offending artery, was resected, and meanwhile the abnormal muscle response was monitored and analyzed. A waveform was recorded from the facial muscle when the offending artery wall was stimulated, named as "Z-L response". The latency of Z-L response was different from that of abnormal muscle response. When the nerve fibers on the offending artery wall were blocked by lidocaine, the abnormal muscle response disappeared gradually and recovered in 2h. The abnormal muscle response disappeared permanently after the sympathetic ganglion was resected. Our findings indicate that cross-transmission between the facial nerve fibers is bridged by the nerve fibers on the offending artery wall, probably sympathetic nerve fibers.

  6. Pupil cycle time and early autonomic involvement in ocular leprosy.

    Science.gov (United States)

    Karaçorlu, M A; Sürel, Z; Cakiner, T; Hanyaloğlu, E; Saylan, T; Mat, C

    1991-01-01

    Ocular complications of leprosy patients often develop insidiously and with few if any symptoms. This study involves measurement of the pupil cycle time (PCT) to evaluate the autonomic nerve system of the iris to determine the presence of subclinical intraocular involvement. The study included 19 lepromatous (LL), 19 borderline lepromatous (BL), and five borderline tuberculoid (BT) leprosy patients and involved 25 healthy volunteers, 10 patients with pulmonary tuberculosis and eight with Duhring disease. The PCT was measured in these groups. In all leprosy groups included in the study the PCT was higher than in the control groups. Moreover, the PCT of the leprosy patients without any intraocular involvement was higher than in the controls. These results show that in the ophthalmic examination of leprosy patients without any symptoms the fact that autonomic nerve system of the eye is affected by the leprosy can often be determined by measuring the PCT.

  7. Inherited autonomic neuropathies.

    Science.gov (United States)

    Axelrod, Felicia B; Hilz, Max J

    2003-12-01

    Inherited autonomic neuropathies are a rare group of disorders associated with sensory dysfunction. As a group they are termed the "hereditary sensory and autonomic neuropathies" (HSAN). Classification of the various autonomic and sensory disorders is ongoing. In addition to the numerical classification of four distinct forms proposed by Dyck and Ohta (1975), additional entities have been described. The best known and most intensively studied of the HSANs are familial dysautonomia (Riley-Day syndrome or HSAN type III) and congenital insensitivity to pain with anhidrosis (HSAN type IV). Diagnosis of the HSANs depends primarily on clinical examinations and specific sensory and autonomic assessments. Pathologic examinations are helpful in confirming the diagnosis and in differentiating between the different disorders. In recent years identification of specific genetic mutations for some disorders has aided diagnosis. Replacement or definitive therapies are not available for any of the disorders so that treatment remains supportive and directed toward specific symptoms.

  8. 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.

  9. Long-axis ultrasound imaging of the nerves and advancement of perineural catheters under direct vision: a preliminary report of four cases

    DEFF Research Database (Denmark)

    Koscielniak-Nielsen, Z.J.; Rasmussen, H.; Hesselbjerg, L.

    2008-01-01

    nerve scans for controlling perineural catheter placement. METHODS: Four orthopedic patients scheduled for continuous peripheral nerve blocks (interscalene, femoral, midfemoral sciatic, and popliteal sciatic), had perineural catheters inserted under ultrasound guidance. After obtaining adequate short...

  10. Autonomous Star Tracker Algorithms

    DEFF Research Database (Denmark)

    Betto, Maurizio; Jørgensen, John Leif; Kilsgaard, Søren

    1998-01-01

    Proposal, in response to an ESA R.f.P., to design algorithms for autonomous star tracker operations.The proposal also included the development of a star tracker breadboard to test the algorithms performances.......Proposal, in response to an ESA R.f.P., to design algorithms for autonomous star tracker operations.The proposal also included the development of a star tracker breadboard to test the algorithms performances....

  11. Autonomic cardiac innervation

    OpenAIRE

    Hasan, Wohaib

    2013-01-01

    Autonomic cardiac neurons have a common origin in the neural crest but undergo distinct developmental differentiation as they mature toward their adult phenotype. Progenitor cells respond to repulsive cues during migration, followed by differentiation cues from paracrine sources that promote neurochemistry and differentiation. When autonomic axons start to innervate cardiac tissue, neurotrophic factors from vascular tissue are essential for maintenance of neurons before they reach their targe...

  12. Ulnar conduction block at the wrist.

    Science.gov (United States)

    Seror, P

    1999-10-01

    Two cases of ulnar nerve lesions at the wrist are reported. The lesions had an acute onset and exclusively impaired the ulnar motor deep branch. The coexistence of carpal tunnel syndrome in each case allowed an early diagnosis but was somewhat misleading. In both cases, the use of classic motor and sensory conduction studies did not provide clear abnormalities that would have precisely determined the site of the nerve lesion. In both cases, only palmar stimulation of the ulnar motor deep branch showed an important conduction block. This electrodiagnostic finding showed definitively the site of the ulnar nerve lesion at the wrist and excluded proximal ulnar nerve lesions or C8-T1 radiculopathy. In both cases recovery occurred without surgery.

  13. Pupil cycle time and early autonomic involvement in ocular leprosy.

    OpenAIRE

    Karaçorlu, M A; Sürel, Z; Cakiner, T; Hanyaloğlu, E; Saylan, T; MAT, C.

    1991-01-01

    Ocular complications of leprosy patients often develop insidiously and with few if any symptoms. This study involves measurement of the pupil cycle time (PCT) to evaluate the autonomic nerve system of the iris to determine the presence of subclinical intraocular involvement. The study included 19 lepromatous (LL), 19 borderline lepromatous (BL), and five borderline tuberculoid (BT) leprosy patients and involved 25 healthy volunteers, 10 patients with pulmonary tuberculosis and eight with Duhr...

  14. Variations of the sciatic nerve and its relation with the piriformis muscle in South Indian population

    Directory of Open Access Journals (Sweden)

    Sushma R. Kotian

    2015-09-01

    Conclusion: Although the variations of the sciatic nerve are common and are already reported, the present study indicates some additional findings not reported previously and further stresses on its applied significance. These variations are important for surgeons, as this is an area of frequent surgical manipulation, nerve injury during deep intramuscular injections, sciatic nerve block etc. They may lead to in-advertent injury during operations, piriformis syndrome, non-discogenic sciatica, muscle atrophy, failure of sciatic nerve block and many other complications. [J Exp Integr Med 2015; 5(3.000: 144-148

  15. [ELECTRIC STIMULATION OF VAGUS NERVE MODULATES A PROPAGATION OF OXYGEN EPILEPSY IN RABBITS].

    Science.gov (United States)

    Zhilyaev, S Yu; Moskvin, A N; Platonova, T F; Demchenko, I T

    2015-11-01

    The activation of autonomic afferents (achieved through the vagus nerve (VN) electrical stimulation) on CNS O2 toxicity and cardiovascular function was investigated. In conscious rabbits at 5 ATA 02, prodromal signs of CNS O2 toxicity and convulsion latency were determined with and without vagus nerve (VN) stimulation. EEG, ECG and respiration were also recorded. In rabbits at 5 ATA, sympathetic overdrive and specific patterns on the EEG (synchronization of slow-waves), ECG (tachycardia) and respiration (respiratory minute volume increase) preceded motor convulsions. Vagus nerve stimulation increased parasympathetic component of autonomic drive and significantly delayed prodromal signs of oxygen toxicity and convulsion latency. Autonomic afferent input to the brain is a novel target for preventing CNS toxicity in HBO2.

  16. Organ-specific activation of the gastric branch of the efferent vagus nerve by ghrelin in urethane-anesthetized rats.

    Science.gov (United States)

    Habara, Hiromi; Hayashi, Yujiro; Inomata, Norio; Niijima, Akira; Kangawa, Kenji

    2014-01-01

    Ghrelin plays multiple physiological roles such as growth hormone secretion and exerting orexigenic actions; however, its physiological roles in the electrical activity of autonomic nerves remain unclear. Here, we investigated the effects of human ghrelin on several autonomic nerve activities in urethane-anesthetized rats using an electrophysiological method. Intravenous injection of ghrelin at 3 μg/kg significantly and transiently potentiated the efferent activity of the gastric vagus nerve; however, it did not affect the efferent activity of the hepatic vagus nerve. The activated response to ghrelin in the gastric efferent vagus nerve was not affected by the gastric afferent vagotomy, suggesting that this effect was not induced via the gastric afferent vagus nerve. Ghrelin did not affect the efferent activity of the brown adipose tissue, adrenal gland sympathetic nerve, and the renal sympathetic nerve. In addition, rectal temperature and the plasma concentrations of norepinephrine, corticosterone, and renin were also not changed by ghrelin. These findings demonstrate that ghrelin stimulates the gastric efferent vagus nerve in an organ-specific manner without affecting the gastric afferent vagus nerve and that ghrelin does not acutely affect the efferent basal activity of the sympathetic nerve in rats.

  17. 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

  18. 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

  19. Mechanisms of disease in hereditary sensory and autonomic neuropathies.

    Science.gov (United States)

    Rotthier, Annelies; Baets, Jonathan; Timmerman, Vincent; Janssens, Katrien

    2012-01-24

    Hereditary sensory and autonomic neuropathies (HSANs) are a clinically and genetically heterogeneous group of disorders of the PNS. Progressive degeneration, predominantly of sensory and autonomic neurons, is the main pathological feature in patients with HSAN, and causes prominent sensory loss and ulcerative mutilations in combination with variable autonomic and motor disturbances. Advances in molecular genetics have enabled identification of disease-causing mutations in 12 genes, and studies on the functional effects of these mutations are underway. Although some of the affected proteins--such as nerve growth factor and its receptor--have obvious nerve-specific roles, others are ubiquitously expressed proteins that are involved in sphingolipid metabolism, vesicular transport, transcription regulation and structural integrity. An important challenge in the future will be to understand the common molecular pathways that result in HSANs. Unraveling the mechanisms that underlie sensory and autonomic neurodegeneration could assist in identifying targets for future therapeutic strategies in patients with HSAN. This Review highlights key advances in the understanding of HSANs, including insights into the molecular mechanisms of disease, derived from genetic studies of patients with these disorders.

  20. Intraarticular injection of sodium hyaluronate plus nerve and pain block with betamethasone in treatment of periarthritis of shoulder%玻璃酸钠关节腔内注射结合倍他米松神经及痛点阻滞治疗肩关节周围炎

    Institute of Scientific and Technical Information of China (English)

    罗芳; 申颖; 刘延青; 王恩真; 王保国

    2005-01-01

    BACKGROUND: Very satisfactory clinical effects have been achieved in treatment of osteoarthritis of knee with intraarticular injection of sodium hyaluronate (SH) allied with steroid hormones for nerve block. How will such allied treatment be used for periarthritis of shoulder?OBJECTIVE: To probe into the improvement of pain and joint function in periarthritis of shoulder treated with integration of intraarticular injection of SH with nerve and pain block with betamethasone.DESIGN: Self-control was designed before and after experiment.SETTING: Beijing Tiantan Hospital, Capital University of Medical Sciences PARTICIPANTS: Twenty patients with periarthritis of shoulder were included, aged from 40 to 65 years from Pain Clinic of Beijing Tiantan Hospital affiliated to Capital University of Medical Sciences from January to October 2004.METHODS: Integration of intraarticular injection of SH with nerve and pain block with betamethasone was applied to treat 20 cases of periarthritis of shoulder and the record was done before treatment and 1in which, "no any pain sensation" was 0 score, "unable to bear pain with imagination" was 10 scores. Pain score was recorded during quiet involved. 4 scores indicated being impossible completely, 3 scores indicate being possible with help, 2 scores indicate being possibled reluctantly and mostly feeling inconvenient, 1 score indicated being possible reluctantly without inconvenience and 0 score indicated being possible as healthy person.of daily life activity.RESULTS: According to practical management and analysis, 20 cases enment compared with that before treatment [(4.34±1.33),(8.27±1.37)scores,compared with that before treatment [(4.73±1.31), (8.49±1.35)scores,ment compared with that before treatment [ ( 1.10 ±0.74), (3.30 ±0.48 )scores, P < 0.01]. CONCLUSION: Integration of intraarticular injection of SH with nerve and pain block with betamethasone treats effectively periarthritis of shoulder, without remarkably harmful

  1. 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

  2. 超声引导局部神经阻滞麻醉下改良腹股沟疝双间隙无张力修补术的临床应用%Improving prolene hernia system tension-free repair for inguinal hernia under ultrasound-guided local nerve block anesthesia

    Institute of Scientific and Technical Information of China (English)

    蒋松松; 陈刚; 郑黎明; 张凯

    2015-01-01

    Objective To investigate the application of improving prolene hernia system(PHS) tensionfree repair for inguinal hernia under ultrasound-guided local nerve block anesthesia.Methods Retrospective analysis the clinical data of 40 patients with improving prolene hernia system(PHS) tension-free repair for inguinal hernia under ultrasound-guided local nerve block anesthesia from January 2013 to January 2014 in Gulou Hospital of Nanjing University.Results In group of ultrasound-guided local nerve block anesthesia , the average anesthesia time was (8.9 ± 1.5) min, the time to get out of bed was (5.6 ± 1.1) h, the length of stay was (2.9 ± 0.7) d,There were (12.4 4± 2.2) min, (10.2 ± 1.6) h and (3.7 ±± 0.7) d in general anesthesia group, and significant difference(P <0.05), the average operation time of two groups were (22.6 ± 2.0) min, (22.1 ± 2.4) min,the average duration of postoperative analgesia was (6.4 ± 1.6) h, (6.1 4± 1.5) h, and no significant difference (P > 0.05).Conclusions Improving prolene hernia system(PHS) tension-free repair for inguinal hernia under ultrasound-guided local nerve block anesthesia is simple , easy and safe to be performed with mild pain, faster recovery and less bleeding.It is worthy of popularization and application.%目的 探讨超声引导局部神经阻滞麻醉下改良腹股沟疝双间隙无张力修补术的临床应用.方法 回顾性分析2013年1月-2014年1月南京大学医学院附属鼓楼医院收治的40例超声引导局部神经阻滞麻醉下改良腹股沟疝双间隙无张力修补术患者的临床资料,并进行分析总结.结果 超声引导局部神经阻滞麻醉组患者平均麻醉时间为(8.9±1.5) min,平均早期下床活动时间为(5.6±1.1)h,平均住院时间为(2.9±0.7)d;全麻组患者分别为(12.4±2.2) min、(1o.2±1.6)h和(3.7±0.7)d,差异均有统计学意义(P<0.05).两组平均单纯手术时间分别为(22.6±2.0) min和(22.1±2.4) min,术后平均

  3. Autonomous Evolutionary Information Systems

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    Traditional information systems are passive, i.e., data orknowledge is created , retrieved, modified, updated, and deleted only in response to operations issued by users or application programs, and the systems only can execute queries or t ransactions explicitly submitted by users or application programs but have no ab ility to do something actively by themselves. Unlike a traditional information system serving just as a storehouse of data or knowledge and working passively a ccording to queries or transactions explicitly issued by users and application p rograms, an autonomous evolutionary information system serves as an autonomous a nd evolutionary partner of its users that discovers new knowledge from its datab ase or knowledge-base autonomously, cooperates with its users in solving proble m s actively by providing the users with advices, and has a certain mechanism to i mprove its own state of “knowing” and ability of “working”. This paper semi nall y defines what is an autonomous evolutionary information system, explain why aut onomous evolutionary information systems are needed, and presents some new issue s, fundamental considerations, and research directions in design and development of autonomous evolutionary information systems.

  4. Autonomic disturbances in narcolepsy.

    Science.gov (United States)

    Plazzi, Giuseppe; Moghadam, Keivan Kaveh; Maggi, Leonardo Serra; Donadio, Vincenzo; Vetrugno, Roberto; Liguori, Rocco; Zoccoli, Giovanna; Poli, Francesca; Pizza, Fabio; Pagotto, Uberto; Ferri, Raffaele

    2011-06-01

    Narcolepsy is a clinical condition characterized mainly by excessive sleepiness and cataplexy. Hypnagogic hallucinations and sleep paralysis complete the narcoleptic tetrad; disrupted night sleep, automatic behaviors and weight gain are also usual complaints. Different studies focus on autonomic changes or dysfunctions among narcoleptic patients, such as pupillary abnormalities, fainting spells, erectile dysfunction, night sweats, gastric problems, low body temperature, systemic hypotension, dry mouth, heart palpitations, headache and extremities dysthermia. Even if many studies lack sufficient standardization or their results have not been replicated, a non-secondary involvement of the autonomic nervous system in narcolepsy is strongly suggested, mainly by metabolic and cardiovascular findings. Furthermore, the recent discovery of a high risk for overweight and for metabolic syndrome in narcoleptic patients represents an important warning for clinicians in order to monitor and follow them up for their autonomic functions. We review here studies on autonomic functions and clinical disturbances in narcoleptic patients, trying to shed light on the possible contribute of alterations of the hypocretin system in autonomic pathophysiology.

  5. 腹腔镜下保留盆腔自主神经直肠癌根治术对冲洗液及血清中黏附分子、术后脏器功能的影响%Effect of pelvic autonomic nerve preservation in Iaparoscopic radical resection of rectal car-cinoma on adhesion molecules in washing fluid and serum as well as postoperative organ function

    Institute of Scientific and Technical Information of China (English)

    李超; 姚立彬; 孟松; 时林森; 王辉; 朱孝成

    2016-01-01

    目的::研究腹腔镜下保留盆腔自主神经直肠癌根治术对冲洗液及血清中黏附分子、术后脏器功能的影响。方法:选择2013年5月~2015年12月在本院接受全腹腔镜下直肠系膜切除术的86例直肠癌患者进行回顾性分析,37例患者在术中保留盆腔自主神经、纳入 A 组,49例患者在术中未保留盆腔自主神经、纳入B组。术后当天,测定血清肿瘤标志物、黏附分子的含量以及腹腔冲洗液中黏附分子的含量;术后1个月时,评估尿流动力学指标。结果:术后当天,A组患者血清中癌胚抗原(CEA)、糖类抗原199(CA199)、糖类抗原125(CA125)、糖类抗原724(CA724)、细胞间黏附分子-1(ICAM-1)、血管细胞黏附分子-1(VCAM-1)、CD44v6、骨桥蛋白(OPN)的含量以及腹腔冲洗液中 ICAM-1、VCAM-1、CD44v6、OPN的含量均显著低于B组,血清和腹腔冲洗液中 E-钙黏蛋白(E-cadherin)的含量显著高于B组;术后1个月时,A组患者最大尿流率(QMax)、最大膀胱逼尿肌收缩压(PdetMax)、排尿量均显著高于B组,残余尿量显著低于 B组。结论:腹腔镜下直肠癌根治术中保留盆腔自主神经能够减少黏附分子的释放、降低术后排尿功能障碍的发生风险,具有积极的临床应用价值。%[ABSTRACT]Objective:To study the effect of pelvic autonomic nerve preservation in laparoscopic radical resection of rec-tal carcinoma on adhesion molecules in washing fluid and serum as well as postoperative organ function.Methods:86 patients with rectal carcinoma who received laparoscopic total mesorectal excision in our hospital between May 2013 and December 2015 were retrospectively analyzed,37 patients were with intraoperative pelvic autonomic nerve preservation and included in group A,and 49 patients were without intraoperative pelvic autonomic nerve preservation and included in group B.The same day after operation,the levels of tumor markers and adhesion molecules in serum as

  6. Autonomic Modulation by Electrical Stimulation of the Parasympathetic Nervous System: An Emerging Intervention for Cardiovascular Diseases.

    Science.gov (United States)

    He, Bo; Lu, Zhibing; He, Wenbo; Huang, Bing; Jiang, Hong

    2016-06-01

    The cardiac autonomic nervous system has been known to play an important role in the development and progression of cardiovascular diseases. Autonomic modulation by electrical stimulation of the parasympathetic nervous system, which increases the parasympathetic activity and suppresses the sympathetic activity, is emerging as a therapeutic strategy for the treatment of cardiovascular diseases. Here, we review the recent literature on autonomic modulation by electrical stimulation of the parasympathetic nervous system, including vagus nerve stimulation, transcutaneous auricular vagal stimulation, spinal cord stimulation, and ganglionated plexi stimulation, in the treatment of heart failure, atrial fibrillation, and ventricular arrhythmias.

  7. Transcutaneous cervical vagal nerve stimulation modulates cardiac vagal tone and tumor necrosis factor-alpha.

    Science.gov (United States)

    Brock, C; Brock, B; Aziz, Q; Møller, H J; Pfeiffer Jensen, M; Drewes, A M; Farmer, A D

    2016-12-12

    The vagus nerve is a central component of cholinergic anti-inflammatory pathways. We sought to evaluate the effect of bilateral transcutaneous cervical vagal nerve stimulation (t-VNS) on validated parameters of autonomic tone and cytokines in 20 healthy subjects. 24 hours after t-VNS, there was an increase in cardiac vagal tone and a reduction in tumor necrosis factor-α in comparison to baseline. No change was seen in blood pressure, cardiac sympathetic index or other cytokines. These preliminary data suggest that t-VNS exerts an autonomic and a subtle antitumor necrosis factor-α effect, which warrants further evaluation in larger controlled studies.

  8. 腹腔镜自主神经保护的直肠癌根治术对女性性功能的影响%Effect of sexual function after pelvic autonomic nerve preservation of laparoscopic radical resection on for rectal in female patients

    Institute of Scientific and Technical Information of China (English)

    姚寒晖; 朱志强; 宁忠良; 梁伟; 张善家

    2012-01-01

    目的 探讨腹腔镜自主神经保护对女性直肠癌根治术患者的性功能保护价值.方法 回顾性分析100例女性中低位直肠癌患者分别行腹腔镜保盆腔自主神经手术(L-PANP,n=50)和开腹保盆腔自主神经手术(O-PANP,n=50)的临床资料,采用电话问卷调查的方式依据女性性功能指标量表(FSFI)中的内容量化患者在术后6、12个月的性功能情况,评估两种手术方式对女性患者性功能的影响.结果 100例均顺利完成手术,无中转开腹,且患者均康复出院,术后随访1年以上者95例:L-PANP组48例,O-PANP组47例.术后6个月性功能变化情况(性兴奋、性高潮、性交痛、性满意度指标),L-PANP组各型术式均优于O-PANP组同型术式,差异有统计学意义(P<0.05);术后12个月L-PANP的Ⅰ型及Ⅱ型术式优于O-PANP组同型术式患者(P<0.05),但两组行Ⅲ型术式差异无统计学意义.结论 在不增加局部复发率的前提下,L-PANP对女性患者性功能的保护优于O-PANP,提高患者术后生存质量.%To evaluate the protection of sexual function after laparoscopic radical resection with pelvic autonomic nerve preservation ( PANP ) for rectal cancer in female patients. Methods Prospectively 100 female patients with middle or low rectal cancer were divided into two groups( L-PANP,n = 50;O-PANP,n =50 ). The radicalism and safety of L-PANP surgery were analyzed and the effects on sexual function between the two groups assessed by erectile and ejaculation function study. Results Patients of L-PANP group had difference in those of 0-PANP group for six month PANP surgery( P <0. 05 ). Patients of subtypes I and II of L-PANP surgery had better sexual( sexual excitement, orgasm, pain disorder and sexual satisfaction ) than those of the same subtype of O-PANP surgery for twelve months, and there were no difference in patients of subtype M PANP surgery. Conclusion Compared with O-PANP surgery, L-PANP surgery without any increase in relapse

  9. 肥胖儿童心脏自主神经变化特征及有氧运动的干预作用%The characteristics of cardiac autonomic nerve changes and the intervention effect of aerobic exercises in obese children

    Institute of Scientific and Technical Information of China (English)

    王国祥; 刘殿玉

    2011-01-01

    : SDNN and LPNN50 in experimental group were significantly lower than those in control group ( P < 0. 01 ); in experimental group, SDNN and LPNN 50 after exercise were significantly higher than those before exercise ( P < 0. 05 ) . Conclusion: Compared with normal children, the children with simple obesity have heart rate variability, which mainly appears as the decrease of activity of pneumogastrie nerve; aerobic exercise can improve the autonomic nervous activity of children with simple obesity.

  10. Imaging the hypoglossal nerve

    Energy Technology Data Exchange (ETDEWEB)

    Alves, Pedro [Department of Radiology, Centro Hospitalar de Lisboa Central-Hospital de Sao Jose, Rua Jose Antonio Serrano, 1150-199 Lisboa Codex (Portugal)], E-mail: tojais.pedro@gmail.com

    2010-05-15

    The hypoglossal nerve is a pure motor nerve. It provides motor control to the intrinsic and extrinsic tongue muscles thus being essential for normal tongue movement and coordination. In order to design a useful imaging approach and a working differential diagnosis in cases of hypoglossal nerve damage one has to have a good knowledge of the normal anatomy of the nerve trunk and its main branches. A successful imaging evaluation to hypoglossal diseases always requires high resolution studies due to the small size of the structures being studied. MRI is the preferred modality to directly visualize the nerve, while CT is superior in displaying the bony anatomy of the neurovascular foramina of the skull base. Also, while CT is only able to detect nerve pathology by indirect signs, such as bony expansion of the hypoglossal canal, MRI is able to visualize directly the causative pathological process as in the case of small tumors, or infectious/inflammatory processes affecting the nerve. The easiest way to approach the study of the hypoglossal nerve is to divide it in its main segments: intra-axial, cisternal, skull base and extracranial segment, tailoring the imaging technique to each anatomical area while bearing in mind the main disease entities affecting each segment.

  11. Suprascapular nerve palsy.

    Science.gov (United States)

    Moskowitz, E; Rashkoff, E S

    1989-11-01

    Isolated traumatic suprascapular nerve palsy without associated fracture is a rare occurrence. Localized segmental muscle atrophy limited to the supraspinatus and infraspinatus muscles associated with weakness in initiating abduction and in external rotation of the shoulder should suggest the diagnosis. Electromyography will confirm the diagnosis by excluding nerve root and brachial plexus involvement with denervation potentials limited to the supraspinatus and infraspinatus muscles.

  12. Simple Autonomous Chaotic Circuits

    Science.gov (United States)

    Piper, Jessica; Sprott, J.

    2010-03-01

    Over the last several decades, numerous electronic circuits exhibiting chaos have been proposed. Non-autonomous circuits with as few as two components have been developed. However, the operation of such circuits relies on the non-ideal behavior of the devices used, and therefore the circuit equations can be quite complex. In this paper, we present two simple autonomous chaotic circuits using only opamps and linear passive components. The circuits each use one opamp as a comparator, to provide a signum nonlinearity. The chaotic behavior is robust, and independent of nonlinearities in the passive components. Moreover, the circuit equations are among the algebraically simplest chaotic systems yet constructed.

  13. 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.

  14. Overview of the Autonomic Nervous System

    Science.gov (United States)

    ... be reversible or progressive. Anatomy of the autonomic nervous system The autonomic nervous system is the part of ... organs they connect with. Function of the autonomic nervous system The autonomic nervous system controls internal body processes ...

  15. [The "3-in-1" block: myth or reality?].

    Science.gov (United States)

    Cauhèpe, C; Oliver, M; Colombani, R; Railhac, N

    1989-01-01

    The technique described by Winnie in 1973 is supposed to provide a regional block of the femoral, femoral cutaneous, and obturator nerves by a single injection within the femoral nerve sheath. This study aimed to assess the diffusion spaces for the local anaesthetic solution used in this technique. The anatomical study included the dissection of 2 adult and 1 foetal cadavers. It was associated with a radiographic study in adult volunteers. About 20 to 60 ml of an isotonic radiographic contrast (iopamidol 150) were injected into the femoral nerve sheath located with the help of a nerve stimulator. Standard pelvic radiographs and computerised tomographic scans were carried out at the time of injection, and 30 min later. Two different unpredictable distributions were found; which were independent of the injected volume. One type consisted in an internal diffusion towards the psoas major muscle, the liquid thus reaching the three nerves. The other type was an external diffusion, in front of the iliacus muscle, the liquid never reaching the internal side of the psoas major muscle, and therefore the obturator nerve. The "3 in 1" block would therefore seem to be useful for those surgical acts requiring only a block of the femoral and femoral cutaneous nerves, i.e. those involving the anterior aspect of the thigh and knee, the femoral shaft, and the patella. On the other hand, its usefulness for surgery of the hip (dislocation, fractured neck of femur) is rather uncertain.

  16. [sup 123]I-MIBG myocardial scintigraphy in diabetic patients. Association with autonomic neuropathy

    Energy Technology Data Exchange (ETDEWEB)

    Nagamachi, Shigeki; Hoshi, Hiroaki; Ohnishi, Takashi; Jinnouchi, Seishi; Futami, Shigemi; Watanabe, Katsushi; Nakatsuru, Kuninobu; Toshimori, Toshitaka; Matsukura, Shigeru (Miyazaki Medical Coll., Kiyotake (Japan))

    1994-09-01

    [sup 123]I-metaiodobenzylguanidine (MIBG) myocardial scintigraphy was performed in 20 diabetic patients (NIDDM) and 8 control subjects to investigate the association between clinical autonomic nerve dysfunction and myocardial accumulation of MIBG. We used coefficient variance of R-R interval (CV[sub R-R]) as a index of the autonomic neuropathy and categorized diabetes into two groups (CV[sub R-R][>=]2.0: non-autonomic neuropathy. CV[sub R-R]<2.0: autonomic neuropathy). In planar imaging studies, heart to mediastinum MIBG uptake ratio (H/M) was calculated on both early and delayed images. The washout ratio of [sup 123]I-MIBG in the heart (%WR) was also obtained using myocardial tracer activity on the both images. Mean value of these indices in diabetic group did not reveal any significant difference with the value in the control group. On the SPECT images, low uptake was observed in the posterior-inferior wall with normal uptake of [sup 201]Tl in diabetic patients with non-autonomic neuropathy. These areas extended in patients with autonomic neuropathy. The mean value of count ratio of posterior-interior to anterior wall (posterior-inferior/anterior ratio: PI/A) in the diabetic autonomic neuropathy group was significantly higher than in the control group on the both early and delayed images. And the mean value of regional %WR in the posterior-inferior wall calculated by the both MIBG SPECT images was significantly higher in the non-autonomic neuropathy group than in the control group. In the diabetic patients, retention mechanism of [sup 123]I-MIBG was considered to be involved at an early stage without autonomic nerve dysfunction clinically. As autonomic neuropathy progressed severely, uptake mechanism was also supposed to be involved. Therefore, [sup 123]I-MIBG myocardial scintigraphy was useful for early detection of cardiac sympathetic nervous dysfunction in diabetic patients. (author).

  17. Autonomous unmanned air vehicles (UAV) techniques

    Science.gov (United States)

    Hsu, Ming-Kai; Lee, Ting N.

    2007-04-01

    The UAVs (Unmanned Air Vehicles) have great potentials in different civilian applications, such as oil pipeline surveillance, precision farming, forest fire fighting (yearly), search and rescue, boarder patrol, etc. The related industries of UAVs can create billions of dollars for each year. However, the road block of adopting UAVs is that it is against FAA (Federal Aviation Administration) and ATC (Air Traffic Control) regulations. In this paper, we have reviewed the latest technologies and researches on UAV navigation and obstacle avoidance. We have purposed a system design of Jittering Mosaic Image Processing (JMIP) with stereo vision and optical flow to fulfill the functionalities of autonomous UAVs.

  18. Bloqueio do plexo braquial pela via posterior com uso de neuroestimulador e ropivacaína a 0,5% Bloqueo del plexo braquial por la vía posterior con el uso de neuroestimulador y ropivacaína a 0,5% Posterior brachial plexus block with nerve stimulator and 0.5% ropivacaine

    Directory of Open Access Journals (Sweden)

    Lúcia Beato

    2005-08-01

    ícula y húmero proximal. El objetivo de este estudio fue mostrar los resultados observados en pacientes sometidos a bloqueo del plexo braquial por la vía posterior con el uso del neuroestimulador y ropivacaína a 0,5%. MÉTODO: Veintidós pacientes con edad entre 17 y 76 años, estado físico ASA I y II, sometidos a cirugías ortopédicas envolviendo el hombro, clavícula y húmero proximal fueron anestesiados con bloqueo de plexo braquial por la vía posterior utilizando neuroestimulador desde 1 mA. Lograda la contracción deseada, la corriente fue disminuida para 0,5 MA y, permaneciendo la respuesta contráctil, fueron inyectados 40 mL de ropivacaína a 0,5%. Fueron evaluados los siguientes parámetros: latencia, analgesia, duración de la cirugía, duración de la analgesia y del bloqueo motor, complicaciones y efectos colaterales. RESULTADOS: El bloqueo fue efectivo en 20 de los 22 pacientes; la latencia media fue de 15,52 min; la duración media de la cirugía fue de 1,61 hora. La media de duración de la analgesia fue de 15,85 horas y del bloqueo motor 11,16 horas. No fueron observados señales y síntomas clínicos de toxicidad del anestésico local y ningún paciente presentó efectos adversos del bloqueo. CONCLUSIONES: En las condiciones de este estudio el bloqueo del plexo braquial por la vía posterior con el uso del neuroestimulador y ropivacaína a 0,5% demostró que es una técnica efectiva, confortable para el paciente y de fácil realización.BACKGROUND AND OBJECTIVES: There are several approaches to the brachial plexus depending on the experience of the anesthesiologist and the site of the surgery. Posterior brachial plexus block may be an alternative for shoulder, clavicle and proximal humerus surgery. This study aims at presenting the results of patients submitted to posterior brachial plexus block with 0.5% ropivacaine and the aid of nerve stimulator. METHODS: Participated in this study 22 patients aged 17 to 76 years, physical status ASA I and II

  19. Autonomous Hexapod Spider Robot

    DEFF Research Database (Denmark)

    Pandey, Nisha; Pandey, Bishwajeet; Hussain, Dil muhammed Akbar

    2017-01-01

    of a hexapod robot. It is controlled through Arduino-unoR3 based SSC servo control module. Servos of torque 2.5kg-cm are used in robot to show different working movements including back and forth movement and sitting posture. Another trending technology i.e. Bluetooth is used to control autonomous feature...

  20. Experimental Autonomous Vehicle Systems

    DEFF Research Database (Denmark)

    Ravn, Ole; Andersen, Nils Axel

    1998-01-01

    The paper describes the requirements for and a prototype configuration of a software architecture for control of an experimental autonomous vehicle. The test bed nature of the system is emphasised in the choice of architecture making re-configurability, data logging and extendability simple...

  1. Autonomous component carrier selection

    DEFF Research Database (Denmark)

    Garcia, Luis Guilherme Uzeda; Pedersen, Klaus; Mogensen, Preben

    2009-01-01

    in local areas, basing our study case on LTE-Advanced. We present extensive network simulation results to demonstrate that a simple and robust interference management scheme, called autonomous component carrier selection allows each cell to select the most attractive frequency configuration; improving...

  2. Autonomous Forest Fire Detection

    NARCIS (Netherlands)

    Breejen, E. den; Breuers, M.; Cremer, F.; Kemp, R.A.W.; Roos, M.; Schutte, K.; Vries, J.S. de

    1998-01-01

    Forest fire detection is a very important issue in the pre-suppression process. Timely detection allows the suppression units to reach the fire in its initial stages and this will reduce the suppression costs considerably. The autonomous forest fire detection principle is based on temporal contrast

  3. Nerve Damage (Diabetic Neuropathies)

    Science.gov (United States)

    ... normally. A woman may have difficulty with arousal, lubrication, or orgasm. Sweat Glands Autonomic neuropathy can affect ... performed in people with diabetes. Comprehensive foot care programs can reduce amputation rates by 45 to 85 ...

  4. 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.

  5. 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.

  6. Pituitary adenylatecyclase-activating polypeptide-immunoreactive nerve fibers in the rat epiglottis and pharynx.

    Science.gov (United States)

    Kano, Mitsuhiro; Shimizu, Yoshinaka; Suzuki, Yujiro; Furukawa, Yusuke; Ishida, Hiroko; Oikawa, Miho; Kanetaka, Hiroyasu; Ichikawa, Hiroyuki; Suzuki, Toshihiko

    2011-12-20

    The distribution of pituitary adenylatecyclase-activating polypeptide-immunoreactive (PACAP-IR) nerve fibers was studied in the rat epiglottis and pharynx. PACAP-IR nerve fibers were located beneath the mucous epithelium, and occasionally penetrated the epithelium. These nerve fibers were abundant on the laryngeal side of the epiglottis and in the dorsal and lateral border region between naso-oral and laryngeal parts of the pharynx. PACAP-IR nerve fibers were also detected in taste buds within the epiglottis and pharynx. In addition, many PACAP-IR nerve fibers were found around acinar cells and blood vessels. The double immunofluorescence method demonstrated that distribution of PACAP-IR nerve fibers was similar to that in CGRP-IR nerve fibers in the epithelium and taste bud. However, distributions of PACAP-IR and CGRP-IR nerve fibers innervating mucous glands and blood vessels were different. The retrograde tracing method also demonstrated that PACAP and CGRP were co-expressed by vagal and glossopharyngeal sensory neurons innervating the pharynx. These findings suggest that PACAP-IR nerve fibers in the epithelium and taste bud of the epiglottis and pharynx which originate from the vagal and glossopharyngeal sensory ganglia include nociceptors and chemoreceptors. The origin of PACAP-IR nerve fibers which innervate mucous glands and blood vessels may be the autonomic ganglion.

  7. 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。

  8. 静脉注射帕瑞昔布联合股神经阻滞用于老年病人膝关节置换术后镇痛及膝关节功能康复的效果%Efficacy of intravenous parecoxib combined with femoral nerve block for postoperative analgesia and knee functional rehabilitation in elderly patients following total knee replacement

    Institute of Scientific and Technical Information of China (English)

    周红梅; 祝胜美

    2011-01-01

    目的 评价静脉注射帕瑞昔布联合股神经阻滞用于老年病人膝关节置换术后镇痛及膝关节功能康复的效果.方法 拟在全身麻醉下行单侧膝关节置换术老年病人40例,ASA分级Ⅱ级,年龄65~74岁,体重45~90 kg,采用随机数字表法,将其随机分为2组:单纯股神经阻滞组(FNB组,n=20)和股神经阻滞联合间断静脉注射帕瑞昔布组(FNB-Pa组,n=20).FNB组术毕时通过股神经阻滞导管注入0.25%罗哌卡因25 ml镇痛,每8h给药1次,至术后72 h;FNB-Pa组在术毕前30 min、术后12、24、48 h分别静脉注射帕瑞昔布40 mg;股神经阻滞用药同FNB组,至术后72 h.于术后2、12、24、36、48及72 h时记录静态时VAS评分,并于术后36、48及72 h时记录动态时VAS评分.于术前、术后24、48及72 h对患膝关节功能进行评分(HSS评分);并记录有关不良反应的发生情况.结果 FNB-Pa组术后静态、动态时VAS评分均比FNB组明显降低(P<0.05).与术前比较,术后两组病人HSS评分均明显提高(P<0.05或0.01);FNB- Pa组术后48、72 h HSS评分明显高于FNB组(P<0.05).两组均未见有关不良反应发生.结论 股神经阻滞联合间断静脉注射帕瑞昔布,可安全、有效地缓解老年病人膝关节置换术后静态和动态时疼痛,有助于术后关节功能的康复.%Objective To investigate the efficacy of intravenous parecoxib combined with femoral nerve block on postoperative analgesia and knee functional rehabilitation in elderly patients following total knee replacement.Methods Forty elderly patients with osteoarthritis schedu[ed for total knee arthroplasty under general anesthesia,aged 65-74 years,weighing 45-90 kg,ASA [Ⅱ,were randomly divided into two groups( n = 20 each).FNB group received femoral nerve blockade for postoperative analgesia ( local injection of 0.25 % ropivacaine 25 ml at the end of surgery,repeated every 8 h up to 72 h after surgery).FNB-Pa group received the femoral nerve

  9. 右美托咪定辅助腰丛联合坐骨神经阻滞在膝关节镜手术中的应用研究%Clinical study of dexmedetomidine as a supplementary to combined lumbar plexus-sciatic nerve block for arthroscopic knee surgery

    Institute of Scientific and Technical Information of China (English)

    田兵; 崔永康; 张选强; 史晓燕; 解铁科; 王静

    2013-01-01

    Objective To evaluate the effect of dexmedetomidine as a supplementary to combined lumbar plexus-sciatic nerve block for arthroscopic knee surgery.Methods Fifty patients who were scheduled for arthroscopic knee surgery and ASA class Ⅰ or Ⅱ grade,were divided into control group and dexmedetomidine group by random digits table method with 25 cases each.The patients of dexmedetomidine group were given loading dose dexmedetomidine 0.8 μ g/kg(injection time 10 min) by intravenous infusion,then were given maintenance dose 0.4 μμ g/(kg· h) to the end of operation.The patients of control group were given 0.9% sodium chloride,methods with the dexmedetomidine group.After 10 min,combined lumbar plexus-sciatic nerve block was performed by a nerve stimulator in both groups.Fentanyl 50 μμ g was infused intravenously to the patient whose effect of block was inadequately.The mean arterial pressure (MAP),heart rate (HR),pulse oxygen saturation (SpO2),respiratory frequency at preanesthesia (T0),beginning of dexmedetomidine infusion (T1),beginning of surgery (T2),10 minutes of surgery (T3) and the end of surgery (T4) were recorded,and intraoperative untoward reaction,using of fentanyl and doctor's satisfaction rate were recorded.Results There were no statistical differences in MAP and HR at T0 between the 2 groups (P> 0.05).MAP and HR at T2-4 were significantly higher than those at T0 in control group,furthermore MAP and HR at T2-4 in control group were significantly higher than those in dexmedetomidine group [MAP:(137 ± 18) mm Hg(1 mm Hg =0.133 kPa) vs.(107 ± 14) mm Hg,(132 ± 11) mm Hgvs.(107 ± 11) mm Hg,(131±13) mm Hg vs.(95 ± 12) mm Hg;HR:(99 ± 17) times/rmin vs.(88 ± 14) times/min,(99 ± 14) times/min vs.(81 ± 15) times/min,(97 ± 14) times/rmin vs.(76 ± 11) times/min],there were statistical differences (P < 0.05).There were no statistical differences in respiratory frequency and SpO2 between the 2 groups (P >0.05),but 2 cases in dexmedetomidine group

  10. 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....

  11. 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 ...

  12. 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 ...

  13. 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. ...

  14. 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 ...

  15. 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.

  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. 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)

  18. 术前股神经阻滞对全麻下全膝关节置换术老年患者的超前镇痛效果分析%Analysis of effect of preoperative femoral nerve block for preemptive anal-gesia in elderly patients undergoing total knee arthroplasty under general anesthesia

    Institute of Scientific and Technical Information of China (English)

    王海兰

    2016-01-01

    目的:探讨全麻下全膝关节置换术前股神经阻滞对老年患者超前镇痛的效果。方法:86例接受全麻下全膝关节置换术治疗的老年患者随机分为观察组(n =43)与对照组(n =43),观察组给予术前股神经阻滞+全身麻醉,对照组给予单纯全身麻醉,对比两组患者术后疼痛视觉模拟评分(visual Analogue Scale,VAS)、镇痛药物使用情况及不良反应。结果:术后24 h 观察组 VAS 评分显著低于对照组(P <0.01);观察组术后首次使用镇痛药物时间显著长于对照组(P <0.01),术后48 h内镇痛药物使用次数显著少于对照组(P <0.01),术后48 h 镇痛药物使用率显著低于对照组(P <0.05);观察组不良反应发生率为显著低于对照组的48.8%(P <0.01)。结论:术前股神经阻滞用于全麻下老年全膝关节置换术的超前镇痛,能够更加有效的缓解患者围手术期疼痛程度,减少镇痛药物使用量,降低不良反应发生率,值得推广。%Objective:To discuss the Analysis of effect of preoperative femoral nerve block for preemptive analgesia in elderly patients undergoing total knee arthroplasty under general anesthesia.Methods:86 elderly patients undergoing total knee arthroplasty un-der general anesthesia were randomly divided into observation group (n =43 )and control group(n =43 ),the observation group re-ceived preoperative femoral nerve block and general anesthesia,general anesthesia was used in the control group,postoperative pain vis-ual analogue scale(visual analogue scale,VAS),usage of analgesic drug and adverse reactions were compared in the two groups.Re-sults:24 h after operation,visual Analogue Scale(VAS)score in the observation group was significantly lower than that in the control group(P <0.01 ).After operation,the time of the usage of analgesic drugs in the observation group for the first time was longer than that in the

  19. 肋间神经阻滞联合盐酸羟考酮超前镇痛在胸腔镜肺叶切除术中的观察应用%Observation Application of Preemptive Analgesia with Intercostal Nerve Blocking Combined with Oxyc-odone Hydrochloride in Thoracoscopic Surgery of Pulmonary Lobectomy

    Institute of Scientific and Technical Information of China (English)

    郝晓燕; 王群超; 赵华国

    2016-01-01

    目的:研究肋间神经阻滞联合盐酸羟考酮超前镇痛在胸腔镜肺叶切除术的应用效果。方法2014年11月-2015年11月择期进行胸腔镜肺叶切除术患者60例,随机分为两组,实验组和对照组。实验组在麻醉后切皮前于超声引导下行肋间神经阻滞和手术结束前给予盐酸羟考酮0.1 mg/kg静脉推注;对照组于手术结束前给予芬太尼1μg/kg静脉推注。分别记录麻醉诱导前(T0)、手术结束时(T1)、拔管时(T2)、拔管后30 min(T3)、拔管后2 h(T4)、拔管后4 h( T5)的血压、心率、脉氧饱和度及两组患者的呼吸恢复时间,睁眼时间及气管导管的拔出时间,以及两组患者恶心呕吐等不良反应的发生率。评价患者于T3、T4、T5时视觉模拟评分( VAS)。结果对照组呼吸恢复时间、睁眼时间和气管导管拔出时间明显较实验组长,差异有显著性。两组患者在T0、T1时SBP、DBP、HR无统计学意义,T2到T5对照组SBP、DBP、HR明显升高,和实验组有显著差异;T3到T5时实验组患者的VAS评分明显低于对照组,差异有显著性。结论肋间神经阻滞联合盐酸羟考酮超前镇痛可以有效的防止胸腔镜肺叶切除术引起的术后疼痛,减少不良反应的发生。%Objective To study the application effect of preemptive analgesia with intercostal nerve blocking com-bined with oxycodone hydrochloride in thoracoscopic surgery of pulmonary lobectomy.Methods Our hospital selected 60 cases of patients to undergo thoracoscopic surgery of pulmonary lobectomy from November 2014 to November 2015 and randomly divided them into two groups:experimental group and control group.The experimental group was treated with intercostal nerve blocking under ultrasonic guidance after anesthesia and before skin incision and intravenous injec-tion of 0.1 mg/kg oxycodone hydrochloride before ending of the surgery.The control group was treated with

  20. 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

  1. Efficacy of ultrasound-guided lower extremity nerve block combined with general anesthesia with laryngeal mask airway in patients undergoing total knee arthroplasty%超声引导下肢神经阻滞联合喉罩下全麻用于全膝关节置换术的效果

    Institute of Scientific and Technical Information of China (English)

    赵霖霖; 王爱忠; 江伟

    2011-01-01

    目的 评价超声引导下肢神经阻滞联合喉罩下全麻用于全膝关节置换术的效果.方法 择期行全膝关节置换术的病人加例,性别不限,年龄52~80岁,体重67~94 kg,ASA分级Ⅰ~Ⅲ级,采用随机数字表法,将其随机分为2组(n=20).Ⅰ组在气管插管下行静吸复合全麻;Ⅱ组先在超声引导下行下肢神经阻滞,然后在喉罩下行静吸复合全麻.术中和麻醉恢复室(PACU)停留期间维持HR 50~100次/min,维持MAP波动幅度不超过基础值的20%.必要时给予血管活性药物(阿托品、艾司洛尔、麻黄碱、乌拉地尔或拉贝洛尔).术后采用曲马多和氯诺昔康行PCIA(背景输注速率2 ml/h,PCA量1 ml,锁定时间15 min),维持VAS评分≤2分.记录术中和PACU停留期间血管活性药物的使用情况;记录PACU停留时间;记录术后24 h内PCA药物用量和恶心呕吐的发生情况.结果 与Ⅰ组比较,Ⅱ组术中各血管活性药物的使用率降低,PACU停留期间艾司洛尔、乌拉地尔和拉贝洛尔的使用率降低,PACU停留时间缩短,PCA药物用量减少,术后恶心呕吐发生率降低(P<0.01).结论 超声引导下肢神经阻滞联合喉罩下全麻用于全膝关节置换术麻醉效果较好,并发症少,术后镇痛药物用量少,优于气管插管下全麻.%Objective To evaluate the efficacy of uhrasound-guided lower extremity nerve block combined with general anesthesia with laryngeal mask airway in patients undergoing total knee arthroplasty.Methods Forty ASA Ⅰ-Ⅲ patients of both sexes,aged 52-80 yr,weighing 67-94 kg,undergoing total knee arthroplasty under general anesthesia,were randomly divided into 2 groups(n=20 each).Group Ⅰ received combined intravenous-inhalational anesthesia with endotracheal tube.Group Ⅱ received lower extremity nerve block guided by ultrasound and then combined intravenous-inhalational anesthesia with laryngeal mask airway.HR was maintained at 50-100bpm,MAP was maintained at the preoperative

  2. Conjoined lumbosacral nerve roots

    Directory of Open Access Journals (Sweden)

    Atila Yılmaz

    2012-03-01

    Full Text Available Lumbosacral nerve root anomalies are a rare group ofcongenital anatomical anomalies. Various types of anomaliesof the lumbosacral nerve roots have been documentedin the available international literature. Ttheseanomalies may consist of a bifid, conjoined structure, ofa transverse course or of a characteristic anastomizedappearance. Firstly described as an incidental findingduring autopsies or surgical procedures performed forlumbar disk herniations and often asymptomatic, lumbosacralnerve root anomalies have been more frequentlydescribed in the last years due to the advances made inradiological diagnosis.

  3. Electrophysiology of autonomic neuromuscular transmission involving ATP.

    Science.gov (United States)

    Sneddon, P

    2000-07-01

    Electrophysiological investigations of autonomic neuromuscular transmission have provided great insights into the role of ATP as a neurotransmitter. Burnstock and Holman made the first recordings of excitatory junction potentials (e.j.p.s) produced by sympathetic nerves innervating the smooth muscle of the guinea-pig vas deferens. This led to the identification of ATP as the mediator of e.j.p.s in this tissue, where ATP acts as a cotransmitter with noradrenaline. The e.j.p.s are mediated solely by ATP acting on P2X(1) receptors leading to action potentials and a rapid phasic contraction, whilst noradrenaline mediates a slower, tonic contraction which is not dependent on membrane depolarisation. Subsequent electrophysiological studies of the autonomic innervation of smooth muscles of the urogenital, gastrointestinal and cardiovascular systems have revealed a similar pattern of response, where ATP mediates a fast electrical and mechanical response, whilst another transmitter such as noradrenaline, acetylcholine, nitric oxide or a peptide mediates a slower response. The modulation of junction potentials by a variety of pre-junctional receptors and the mechanism of inactivation of ATP as a neurotransmitter will also be described.

  4. Intercostal nerve blockade for evaluation of local anaesthetic agents.

    Science.gov (United States)

    Bridenbaugh, P O

    1975-02-01

    Bilateral intercostal nerve block provides the opportunity to subject as many as 16 separate peripheral nerves in a single subject to known or unknown local anaesthetic agents in a variety of concentrations, volumes, and additives. It permits the observation of local (e.g., neuritis), clinical (e.g., onset and duration), and systemic (e.g., toxicity and blood concentration) effects of these variables. In double-blind studies, bilateral intercostal nerve block allows the use of each side of the trunk for comparison of two experimental drugs, a new drug against a standard, or two new drugs. Subtle differences in clinical properties as well as simultaneous blood concentrations may be detected in these studies. The advantages of this technique in evaluating local anaesthetic agents are primarily the use of a single subject as his own control while studying may separate peripheral nerves. This aids appreciably in limiting the variable of age, temperature, and perfusion, as well as techniques of administration and evaluation. The constancy of the anatomy of the intercostal nerve provides a highly reliable and reproducible block technique.

  5. 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.

  6. 神经阻滞与轻比重麻醉在高龄患者单侧下肢创伤手术麻醉中的安全性与有效性比较%Comparison of Safety and Effectiveness of Nerve Block Anesthesia and Light-weight Anesthesia in Elderly Patients Undergoing Unilateral Lower Limb Trauma Operation

    Institute of Scientific and Technical Information of China (English)

    梁萌; 唐娟

    2016-01-01

    Objective To compare the safety and effectiveness of the nerve block anesthesia and light anesthesia in elderly patients undergoing unilateral lower limb trauma .Methods Total of 80 patients( age>80 years old) for lower limb trauma surgery in Affiliated Hospital of Guilin Medical College from May 2011 to Apr.2014 were included in the study,and were divided into a study group(41 cases) and a control group(39 cases) according to the random number table method.The study group received lumbar plexus sciatic nerve block:10 mL of 1% lidocaine then 20 mL of 0.4%-0.5% ropivacaine,withdraw every 5 mL to ensure no blood until finishing the whole amount;the control group underwent hypobaric spinal anesthesia:mixed injec-tion of 1% ropivacaine 1 mL+sterile water 1 mL,then keep the side position for 10 min to adjust the anes-thesia plane.The systolic blood pressure( SBP) ,diastolic blood pressure( DBP) ,heart rate,pulse oxygen sat-uration ( SpO2 ) changes and the onset time of anesthesia,complete block time and dosage of drugs of the two groups were recorded before injection,15 min,30 min,60 min after injection and at the end of surgery,and Bromage score was adopted to compare the anesthetic effect of the two groups.Results SBP,DBP,heart rate of the two groups at 15 min,30 min,60 min after injection showed a downward trend,and recovered to the level before injection at the end of the surgery,the differences were statistically significant(P<0.05);SpO2 at 15 min,30 min,60 min after injection was in an upward trend,and recovered to the level before injection at the end of the surgery,the differences were statistically significant(P<0.05);the dosage of anesthetics, the onset time of anesthesia, complete block time of the study group were higher than the control group [(125.4 ±30.1) mg vs (10.6 ±2.5) mg,(14.3 ±3.1) min vs (6.9 ±2.5) min;(20 ±7) min vs (12 ±5) min,P<0.01]; the intraoperative hypotension incidence of the study group was lower than the control group[4

  7. Mobile Autonomous Humanoid Assistant

    Science.gov (United States)

    Diftler, M. A.; Ambrose, R. O.; Tyree, K. S.; Goza, S. M.; Huber, E. L.

    2004-01-01

    A mobile autonomous humanoid robot is assisting human co-workers at the Johnson Space Center with tool handling tasks. This robot combines the upper body of the National Aeronautics and Space Administration (NASA)/Defense Advanced Research Projects Agency (DARPA) Robonaut system with a Segway(TradeMark) Robotic Mobility Platform yielding a dexterous, maneuverable humanoid perfect for aiding human co