WorldWideScience

Sample records for autonomic nerve block

  1. Gastrointestinal autonomic nerve tumor of the stomach

    OpenAIRE

    Meshikhes, Abdul-Wahed N.; Al-Garni, Ayed A.; Sami A Al-Momen; Al-Nahawi, Mamdouh; Abu Subaih, Jawad

    2014-01-01

    Patient: Female, 32 Final Diagnosis: Gastrintestinal Autonomic Nerve Tumor (GANT) Symptoms: anemia • anorexia • fatigue • fever • hearburn • nausea • weight loss Medication: — Clinical Procedure: — Specialty: Gastroenterology and Hepatology Objective: Rare disease Background: Gastrointestinal autonomic nerve tumors (GANT) are extremely rare tumors that are related to gastrointestinal autonomic nervous plexuses. They are distinguished from stromal tumors by their unique ultrastructural feature...

  2. Techniques of facial nerve block.

    OpenAIRE

    Schimek, F; Fahle, M

    1995-01-01

    The efficacy of different techniques of facial nerve block for cataract surgery was investigated. Forty four patients underwent either modified O'Brien, Atkinson, van Lint, or lid blocks. Intentional muscle activity of the orbicularis oculi muscle was recorded and the area under the EMG curve calculated for quantitative comparison of muscle activity between the groups before and after injection of lignocaine with the vasoconstrictor naphazoline nitrate. In addition, the force of lid closure w...

  3. Continuous peripheral nerve blocks in children.

    Science.gov (United States)

    Dadure, C; Capdevila, X

    2005-06-01

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

  4. Nerve injury caused by mandibular block analgesia

    DEFF Research Database (Denmark)

    Hillerup, S; Jensen, Rigmor H

    2006-01-01

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

  5. 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...

  6. Ultrasound Guided Obturator Versus Sciatic Nerve Block in Addition to Continuous Femoral Nerve Block for Analgesia After Total Knee Arthroplasty

    OpenAIRE

    Keita Sato; Seijyu Sai; Naoto Shirai; Takehiko Adachi

    2011-01-01

    Both obturator and sciatic nerve block in combination with femoral nerve block (FNB) have been suggested to be useful in relieving pain after total knee arthroplasty (TKA), compared with FNB alone. We compared their efficacy in this retrospective study. For six consecutive months, patients undergoing unilateral TKA under general anesthesia with continuous FNB plus obturator nerve block (n = 8) or continuous FNB plus sciatic nerve block (n = 8) were investigated. Knee pain was assessed using v...

  7. The Role of Continuous Peripheral Nerve Blocks

    OpenAIRE

    José Aguirre; Alicia Del Moral; Irina Cobo; Alain Borgeat; Stephan Blumenthal

    2012-01-01

    A continuous peripheral nerve block (cPNB) is provided in the hospital and ambulatory setting. The most common use of CPNBs is in the peri- and postoperative period but different indications have been described like the treatment of chronic pain such as cancer-induced pain, complex regional pain syndrome or phantom limb pain. The documented benefits strongly depend on the analgesia quality and include decreasing baseline/dynamic pain, reducing additional analgesic requirements, decrease of po...

  8. Anatomical basis for sciatic nerve block at the knee level

    OpenAIRE

    Fabiano Timbó Barbosa; Tatiana Rosa Bezerra Wanderley Barbosa; Rafael Martins da Cunha; Amanda Karine Barros Rodrigues; Fernando Wagner da Silva Ramos; Célio Fernando de Sousa-Rodrigues

    2015-01-01

    BACKGROUND AND OBJECTIVES: Recently, administration of sciatic nerve block has been revised due to the potential benefit for postoperative analgesia and patient satisfaction after the advent of ultrasound. The aim of this study was to describe the anatomical relations of the sciatic nerve in the popliteal fossa to determine the optimal distance the needle must be positioned in order to realize the sciatic nerve block anterior to its bifurcation into the tibial and common fibular nerve. METHOD...

  9. Ultrasonic doppler flowmeter-guided occipital nerve block

    OpenAIRE

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

    2010-01-01

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

  10. 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

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

    Directory of Open Access Journals (Sweden)

    Anupama Wadhwa

    2011-01-01

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

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

    Science.gov (United States)

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

    2011-01-01

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

  13. The successful use of peripheral nerve blocks for femoral amputation

    DEFF Research Database (Denmark)

    Bech, B.; Melchiors, J.; Borglum, J.; Jensen, K.; Bech, B; Melchiors, J; Børglum, J; Jensen, K; Jensen, Kenneth

    2009-01-01

    We present a case report of four patients with severe cardiac insufficiency where peripheral nerve blocks guided by either nerve stimulation or ultrasonography were the sole anaesthetic for above-knee amputation. The patients were breathing spontaneously and remained haemodynamically stable during...... surgery. Thus, use of peripheral nerve blocks for femoral amputation in high-risk patients seems to be the technique of choice that can lower perioperative risk....

  14. Post operative pain relief through intermittent mandibular nerve block

    OpenAIRE

    Sawhney, Chhavi; Agrawal, Pramendra; Soni, Kapil Dev

    2011-01-01

    Mandibular nerve block is often performed for diagnostic, therapeutic and anesthetic purposes for surgery involving mandibular region. Advantages of a nerve block include excellent pain relief and avoidance of the side effects associated with the use of opiods or Non-steroidal anti-inflammatory drug (NSAIDs). A patient with maxillo facial trauma was scheduled for open reduction and internal fixation of right parasymphyseal mandibular fracture. The mandibular nerve was approached using the lat...

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

    OpenAIRE

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

    2011-01-01

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

  16. Gastrointestinal autonomic nerve tumors (plexosarcomas). Is a radiological diagnosis possible?

    International Nuclear Information System (INIS)

    The gastrointestinal autonomic nerve (GAN) tumor, or plexosarcoma, is a very uncommon stromal tumor of the gastrointestinal tract and retroperitoneum. Distinction of GAN tumors from other stromal tumors is not possible based on imaging studies, and needs specific ultrastructural and inmunohistochemical techniques. There are some morphologic characteristics that the radiologist should know, so as to include these rare tumors in the differential diagnosis of an abdominal mass. We report two new cases: small bowel (jejunum-ileum) and stomach GAN tumors. (orig.)

  17. 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.

  18. 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

  19. Evidence of peripheral nerve blocks for cancer-related pain

    DEFF Research Database (Denmark)

    Klepstad, P; Kurita, G P; Mercadante, S; Sjøgren, P

    2015-01-01

    evidence of analgesic efficacy for peripheral nerve blocks in adult patients with cancer. A search strategy was elaborated with words related to cancer, pain, peripheral nerve and block. The search was performed in PubMed, EMBASE, and Cochrane for the period until February 2014. The number of abstracts...... good pain relief and no side effects. The use of peripheral blocks is based upon anecdotal evidence. However, this review only demonstrates the lack of studies, which does not equal a lack of effectiveness....

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

    DEFF Research Database (Denmark)

    Nielsen, Zbigniew Jerzy Koscielniak

    2008-01-01

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

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

    OpenAIRE

    Ayman I Tharwat

    2011-01-01

    Background We compared the efficacy of combined posterior lumbar plexus–sciatic nerve block with that of combined femoral–obturator–sciatic nerve block as anesthesia for anterior cruciate ligament reconstruction surgery, because both block combinations have been recommended for lower limb arthroscopic and reconstructive surgery. Methods Forty-eight patients undergoing elective unilateral anterior cruciate ligament reconstruction under local anesthesia were randomized to undergo either combine...

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

    OpenAIRE

    Tharwat, Ayman I

    2011-01-01

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

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

    Science.gov (United States)

    Dadure, C; Capdevila, X

    2007-02-01

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

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

    Science.gov (United States)

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

    2015-01-01

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

  5. Ventricular Pneumocephalus with Meningitis after Lumbar Nerve Root Block

    OpenAIRE

    Shin Ahn; Young Sang Ko; Kyung Soo Lim

    2013-01-01

    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-o...

  6. A randomized prospective comparative study of nerve stimulator and ultrasonogram in popliteal sciatic nerve block for ankle and foot surgeries

    OpenAIRE

    2015-01-01

    Background: Regional blocks in the field of anaesthesia were done traditionally with paraesthesia technique. To overcome the demerits with paraesthesia technique, nerve locator was applied for nerve blocks. Later, the application of ultrasonogram for regional blocks got the real time imaging of the nerves and drug administration. This resulted in publications of numerous studies with variable results. Therefore we planned to compare ultrasonogram and nerve locator in popliteal sciatic nerve b...

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

    DEFF Research Database (Denmark)

    Jaeger, Pia; Zaric, Dusanka; Fomsgaard, Jonna Storm; Hilsted, Karen Lisa; Bjerregaard, Jens; Gyrn, Jens; Mathiesen, Ole; Larsen, Tommy; Dahl, J�rgen Berg

    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....

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

    Science.gov (United States)

    Sawka, Andrew; Tang, Raymond; Vaghadia, Himat

    2015-04-15

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

  9. Development of Phantom Limb Pain after Femoral Nerve Block

    OpenAIRE

    Sadiah Siddiqui; Anthony N. Sifonios; Vanny Le; Martinez, Marc E.; Eloy, Jean D.; Andrew G. Kaufman

    2014-01-01

    Historically, phantom limb pain (PLP) develops in 50–80% of amputees and may arise within days following an amputation for reasons presently not well understood. Our case involves a 29-year-old male with previous surgical amputation who develops PLP after the performance of a femoral nerve block. Although there have been documented cases of reactivation of PLP in amputees after neuraxial technique, there have been no reported events associated with femoral nerve blockade. We base our discussi...

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

    Directory of Open Access Journals (Sweden)

    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.

  11. Nerve stimulator-guided thoracic paravertebral block for gynecomastia surgery

    OpenAIRE

    Ashok Jadon

    2012-01-01

    Thoracic paravertebral block (TPVB) is gaining popularity for female breast surgeries due to various advantages like less nausea and vomiting and better post-operative pain relief, which helps in early ambulation and discharge from the hospital. Use of nerve stimulator during this block has further enhanced its success and safety profile. Male breast surgery is usually done either under general anaesthesia or local infiltrative anaesthesia combining with intravenous sedation. We postulated th...

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

    OpenAIRE

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

    2010-01-01

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

  13. Development of phantom limb pain after femoral nerve block.

    Science.gov (United States)

    Siddiqui, Sadiah; Sifonios, Anthony N; Le, Vanny; Martinez, Marc E; Eloy, Jean D; Kaufman, Andrew G

    2014-01-01

    Historically, phantom limb pain (PLP) develops in 50-80% of amputees and may arise within days following an amputation for reasons presently not well understood. Our case involves a 29-year-old male with previous surgical amputation who develops PLP after the performance of a femoral nerve block. Although there have been documented cases of reactivation of PLP in amputees after neuraxial technique, there have been no reported events associated with femoral nerve blockade. We base our discussion on the theory that symptoms of phantom limb pain are of neuropathic origin and attempt to elaborate the link between regional anesthesia and PLP. Further investigation and understanding of PLP itself will hopefully uncover a relationship between peripheral nerve blocks targeting an affected limb and the subsequent development of this phenomenon, allowing physicians to take appropriate steps in prevention and treatment. PMID:24872817

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

    Directory of Open Access Journals (Sweden)

    Stefan Landgraeber

    2012-03-01

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

  15. Post operative pain relief through intermittent mandibular nerve block.

    Science.gov (United States)

    Sawhney, Chhavi; Agrawal, Pramendra; Soni, Kapil Dev

    2011-01-01

    Mandibular nerve block is often performed for diagnostic, therapeutic and anesthetic purposes for surgery involving mandibular region. Advantages of a nerve block include excellent pain relief and avoidance of the side effects associated with the use of opiods or Non-steroidal anti-inflammatory drug (NSAIDs). A patient with maxillo facial trauma was scheduled for open reduction and internal fixation of right parasymphyseal mandibular fracture. The mandibular nerve was approached using the lateral extraoral approach with an 18-gauge i.v. cannula under general anesthesia. He received 4 ml boluses of 0.25% plain bupivacaine for intraoperative analgesia and 12 hourly for 48 h post operatively. VAS scores remained less than 4 through out observation period. The only side effect was numbness of ipsilateral lower jaw line, which subsided after local anesthetic administration was discontinued. Patient was discharged after four days. PMID:22442616

  16. Simulation of spinal nerve blocks for training anesthesiology residents

    Science.gov (United States)

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

    1998-06-01

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

  17. Evidence of peripheral nerve blocks for cancer-related pain

    DEFF Research Database (Denmark)

    Klepstad, P; Kurita, G P; Mercadante, S; Sjøgren, P

    2015-01-01

    The European Association for Palliative Care has initiated a comprehensive program to achieve an over-all review of the evidence of multiple cancer pain management strategies in order to extend the current guideline for treatment of cancer pain. The present systematic review analyzed the existing...... good pain relief and no side effects. The use of peripheral blocks is based upon anecdotal evidence. However, this review only demonstrates the lack of studies, which does not equal a lack of effectiveness....... evidence of analgesic efficacy for peripheral nerve blocks in adult patients with cancer. A search strategy was elaborated with words related to cancer, pain, peripheral nerve and block. The search was performed in PubMed, EMBASE, and Cochrane for the period until February 2014. The number of abstracts...

  18. INGUINAL NERVE BLOCK FOR PATIENTS UNDERGOING INGUINAL HERNIOPLASTY

    Directory of Open Access Journals (Sweden)

    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.

  19. Comparative analysis between direct Conventional Mandibular nerve block and Vazirani-Akinosi closed mouth Mandibular nerve block technique

    Science.gov (United States)

    Mishra, Sobhan; Tripathy, Ramanupam; Sabhlok, Samrat; Panda, Pankaj Kumar; Patnaik, Satyabrata

    2012-11-01

    Introduction: Over the years different techniques have been developed for achieving mandibular nerve anaesthesia. The main aim of our study was to carry out comparison and clinical efficacy of mandibular nerve anaesthesia by Direct Conventional technique with that of Vazirani-Akinosi mandibular nerve block technique.Materials and Methods: 50 adult patients requiring surgical extraction of premolars, mandibular first, second and third molars were selected randomly to receive Direct Conventional technique and Vazirani- Akinosi technique for nerve block alternatively.Results: No statistically significant differences were observed regarding complete lip anaesthesia at 5 minutes and 10 minutes, nerves anaesthetized with single injection, effectiveness of anaesthesia, supplementary injections and complications in both the techniques. However, onset of lip anaesthesia was found to be faster in Vazirani-Akinosi technique, patients experienced less pain during the Vazirani-Akinosi technique as compared to the Direct Conventional technique. Post injection complication complications were less in the VaziraniAkinosi Technique.Conclusions: Except for faster onset of lip anaesthesia, less pain during injection and fewer post injection complications in Vazirani-Akinosi technique all other parameters were of same efficacy as Direct Conventional technique. This has strong clinical applications as in cases with limited mouth opening, apprehensive patients Vazirani-Akinosi technique is the indicated technique of choice.

  20. Combination of spinal anesthesia and peripheral nerve block: Case report

    OpenAIRE

    Vildan Temel; Sedat Kaya; Gönül Ölmez Kavak; Haktan Karaman; Adnan Tüfek; Feyzi Çelik

    2010-01-01

    Regional anaesthesia has advantages such as, control of postoperative pain, early mobilization, and does not affect respiratory function. In recent years, regional anaesthesia had improved by the application of the peripheral nerve stimulator and ultrasound guided blocks, new local anaesthetic drugs with the use of additional adjunctive agents. Especially in emergency conditions, combination of regional anaesthesia may avoid the complications of general anesthesia in patients with chronic dis...

  1. Combination of spinal anesthesia and peripheral nerve block: Case report

    OpenAIRE

    Çelik, Feyzi; Tüfek, Adnan; Temel, Vildan; Karaman, Haktan; Kaya, Sedat; Kavak, Gönül Ölmez

    2010-01-01

    Regional anaesthesia has advantages such as, control of postoperative pain, early mobilization, and does not af­fect respiratory function. In recent years, regional anaes­thesia had improved by the application of the peripheral nerve stimulator and ultrasound guided blocks, new local anaesthetic drugs with the use of additional adjunctive agents. Especially in emergency conditions, combination of regional anaesthesia may avoid the complications of general anesthesia in patient...

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

    International Nuclear Information System (INIS)

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

  3. 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

    non-existing extremity. This sensation was verbally described by the patient and thus used as an alternative to visual identification of motor response. After surgery the patient was pain free. The technique thus presents an alternative method for anesthesia and perioperative pain management in a high-risk......We present a case of a sciatic nerve block performed with the nerve stimulation technique. This technique is normally not used in amputees because detection of a motor response to an electrical stimulation is impossible. In our patient the stimulation provoked a phantom sensation of movement in the...

  4. Nerve stimulator-guided thoracic paravertebral block for gynecomastia surgery

    Directory of Open Access Journals (Sweden)

    Ashok Jadon

    2012-01-01

    Full Text Available Thoracic paravertebral block (TPVB is gaining popularity for female breast surgeries due to various advantages like less nausea and vomiting and better post-operative pain relief, which helps in early ambulation and discharge from the hospital. Use of nerve stimulator during this block has further enhanced its success and safety profile. Male breast surgery is usually done either under general anaesthesia or local infiltrative anaesthesia combining with intravenous sedation. We postulated that the advantages of TPVB could be helpful for early mobilization and discharge of minor breast surgery in male patients. However, to our knowledge, there is no such report suggestive of TPVB for exclusive male breast surgery. We used nerve stimulator-guided TPVB for gynecomastia surgery in two patients where general anaesthesia was not feasible. Both patients had successful block and showed good post-operative recovery and were discharged on the same day. They had long post-operative pain relief without any block-related complication. A case report of two such cases of gynecomastia surgery (male breast surgery done under TPVB is presented.

  5. Anti-inflammatory effect of peripheral nerve blocks after knee surgery: clinical and biologic evaluation. : Postoperative peripheral nerve blocks reduce clinical inflammation after total knee arthroplasty

    OpenAIRE

    Martin, Frédéric; Martinez, Valéria; Mazoit, Jean Xavier; Bouhassira, Didier; Cherif, Kamel; Gentili, Marc Edouard; Piriou, Philippe; Chauvin, Marcel; Fletcher, Dominique

    2008-01-01

    BACKGROUND: Nerve blocks provide analgesia after surgery. The authors tested whether nerve blocks have antiinflammatory effects. METHODS: Patients had combined sciatic (single-shot) and continuous femoral block (48 h) (block group) or morphine patient-controlled analgesia after total knee arthroplasty. Pain at rest and upon movement was monitored at 1 (D1), 4 (D4), and 7 days (D7) and 1 (M1) and 3 months (M3) after surgery. Knee inflammation was evaluated (skin temperature, knee circumference...

  6. CT-guided obturator nerve block via the posterior approach

    Energy Technology Data Exchange (ETDEWEB)

    House, C.V.; Ali, K.E.; Bradshaw, C.; Connell, D.A. [Royal National Orthopaedic Hospital NHS Trust, Department of Radiology, Stanmore, Middlesex (United Kingdom)

    2006-04-15

    To describe the technique of obturator nerve block under CT guidance via the posterior approach, and to evaluate the efficacy of the procedure in the short-term and mid-term relief of chronic hip pain. Consecutive patients referred for obturator nerve block were prospectively enrolled in this study. Under CT-guidance, via a posterior approach through the pelvis, local anaesthetic and steroid were infiltrated around the obturator nerve using a 22G spinal needle. Fifty-one patients (19 male, 32 female), mean age 54 years, with hip pain refractory to conventional therapy underwent the procedure. Visual Analogue Scale pain scores were recorded before the procedure and at 30 minutes, 24 hours, 1 week and 3 months thereafter. Pain scores within 30 minutes showed a decrease from a mean {+-} SD score of 8.41{+-}1.22 pre-procedure to 2.86{+-}2.1, p<0.001. At 24 hours, the mean pain score was 2.06{+-}1.76, a decrease of 76% from pre-procedural score, p<0.001. Sustained pain relief at 1 week and 3 months was attained in 92% (mean pain score 2.41{+-}2.2, p<0.001) and 82% (mean pain score 3.80{+-}2.94, p<0.001) of cases respectively. Follow-up data was complete for all 51 patients. No serious side-effects were reported. (orig.)

  7. RoBlock: a prototype autonomous manufacturing cell

    Science.gov (United States)

    Baekdal, Lars K.; Balslev, Ivar; Eriksen, Rene D.; Jensen, Soren P.; Jorgensen, Bo N.; Kirstein, Brian; Kristensen, Bent B.; Olsen, Martin M.; Perram, John W.; Petersen, Henrik G.; Petersen, Morten L.; Ruhoff, Peter T.; Skjolstrup, Carl E.; Sorensen, Anders S.; Wagenaar, Jeroen M.

    2000-10-01

    RoBlock is the first phase of an internally financed project at the Institute aimed at building a system in which two industrial robots suspended from a gantry, as shown below, cooperate to perform a task specified by an external user, in this case, assembling an unstructured collection of colored wooden blocks into a specified 3D pattern. The blocks are identified and localized using computer vision and grasped with a suction cup mechanism. Future phases of the project will involve other processes such as grasping and lifting, as well as other types of robot such as autonomous vehicles or variable geometry trusses. Innovative features of the control software system include: The use of an advanced trajectory planning system which ensures collision avoidance based on a generalization of the method of artificial potential fields, the use of a generic model-based controller which learns the values of parameters, including static and kinetic friction, of a detailed mechanical model of itself by comparing actual with planned movements, the use of fast, flexible, and robust pattern recognition and 3D-interpretation strategies, integration of trajectory planning and control with the sensor systems in a distributed Java application running on a network of PC's attached to the individual physical components. In designing this first stage, the aim was to build in the minimum complexity necessary to make the system non-trivially autonomous and to minimize the technological risks. The aims of this project, which is planned to be operational during 2000, are as follows: To provide a platform for carrying out experimental research in multi-agent systems and autonomous manufacturing systems, to test the interdisciplinary cooperation architecture of the Maersk Institute, in which researchers in the fields of applied mathematics (modeling the physical world), software engineering (modeling the system) and sensor/actuator technology (relating the virtual and real worlds) could

  8. Computerized tomography-guided neurolytic splanchnic nerve block

    International Nuclear Information System (INIS)

    Computerized tomography-guided neurolytic splanchnic nerve block is a technique for relieving abdominal cancer pain; the goal is the alcoholic neurolytic interruption of the sensitive structures in retroperitoneal space. Computerized tomography yields accurate anatomical detailing and the course for needle placement and alcohol spread. January, 1993, to July, 1996, twenty-one bilateral splanchnic nerve blocks were performed through the posterior access. Forty-eight hours after alcoholism. 14 patients (66%) had complete pain regression; 52% of the patients needed no analgesics for 6 to 54 days and only 9 patients (42%) needed another low opioid therapy. Complications included hypotension and diarrhea in all cases. One had a cardiac arrest and diet 8 days after the procedure. There were no other complications. The whole procedure usually lasted 60 min (range: 45 to 90 min). Splanchnic nerve neurolysis is a useful treatment in the patients with severe chronic abdominal pain. It is used as a second line treatment when large lesions change celia anatomy and complicate the percutaneous block of the celiac plexus. Endosulfan, Malathion and Methyl parathion, on the metabolic rate of the estuarine clam, Villorita cyprinoides var. cochinensis, have been investigated. The animals exposed to the lower sublethal concentrations of Endosulfan, Malthion and Methyl parathion consumed oxygen at the rate of 1.60, 1.98 and 2.09 ml. 02 g-1 h-1 respectively, while at the higher concentrations of the pesticides, consumption of oxygen by the animal dropped to nearly half the control value. When compared to Malathion and Methyl parathion. Endosulfan induced animals recorded a greater reduction in her percentage deviation (from control) of oxygen consumption, possibly due to hypoxia induced by the pollutants

  9. Combination of spinal anesthesia and peripheral nerve block: Case report

    Directory of Open Access Journals (Sweden)

    Vildan Temel

    2010-12-01

    Full Text Available Regional anaesthesia has advantages such as, control of postoperative pain, early mobilization, and does not affect respiratory function. In recent years, regional anaesthesia had improved by the application of the peripheral nerve stimulator and ultrasound guided blocks, new local anaesthetic drugs with the use of additional adjunctive agents. Especially in emergency conditions, combination of regional anaesthesia may avoid the complications of general anesthesia in patients with chronic disease who suffer from upper and lower extremity injuries. In this paper, we present two cases who underwent combined regional anaesthesia techniques for the lower and upper extremity surgery.

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

    DEFF Research Database (Denmark)

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

    2014-01-01

    BACKGROUND: The standard approach for the suprascapular nerve block is deep in the supraspinous fossa. However, with this approach, the suprascapular nerve is difficult to visualize by ultrasound. The aim of this study was to describe a new method to visualize and selectively block the...... suprascapular nerve in a more superficial and proximal location. METHODS: Twelve healthy volunteers were included. We located the brachial plexus in transverse section with ultrasound, and by longitudinal slide, we identified the departure of the suprascapular nerve from the superior trunk. The suprascapular...... nerve was followed under ultrasound visualization into the subclavian triangle under the inferior belly of the omohyoid muscle. We performed in-plane ultrasound-guided selective suprascapular nerve block by injecting 1 ml of lidocaine, 20 mg/ml close to the nerve. Nerve identification was aided by nerve...

  11. Sciatic nerve blocks for diagnosis of piriformis syndrome

    International Nuclear Information System (INIS)

    We used sciatic nerve block (SNB) to make the differential diagnosis of piriformis syndrome in 188 consecutive patients with sciatica in whom it was impossible to make the diagnosis based on the lumbar MRI findings. We rated the effectiveness of SNB as excellent (60%), good (25%) and poor (15%). After performing SNBs, lumbar radicular blocks, and surgeries based on the initial diagnosis, the final diagnoses were piriformis syndrome (56%), piriformis syndrome complicated with lumbar degenerative disease (4%), lumbar degenerative disease (23%), others or unknown (16%). The prevalence of piriformis syndrome in the excellent effectiveness group was 81%. SNB was effective in all patients with piriformis syndrome and in 66% of the lumbar degeneration patients. The diagnostic value of SNB is of limited value for differentiating piriformis syndrome from lumbar degenerative disease. (author)

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

    OpenAIRE

    Messeha, Medhat M.

    2016-01-01

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

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

    OpenAIRE

    Wang Cong-Yi; Tominaga Makoto; Johnson Richard D; Chen Meng; Ling Jennifer X; Xing Hong; Gu Jianguo

    2008-01-01

    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 retrograd...

  14. Diabetic autonomic neuropathy. The distribution of structural changes in sympathetic nerves of the BB rat.

    OpenAIRE

    Yagihashi, S.; Sima, A A

    1985-01-01

    Ultrastructural and morphometric studies were performed longitudinally to characterize the topographic distribution of autonomic neuropathy in the BB-rat. Four levels of predominantly sympathetic nerves were examined. Typical axonal dystrophic changes were consistently increased in diabetic rats and were found to be most severe in the prevertebral celiac ganglion, the mesenteric nerve, the superior cervical ganglion, and the paravertebral ganglion, in that order. Dystrophic changes were also ...

  15. Augmented reality guidance system for peripheral nerve blocks

    Science.gov (United States)

    Wedlake, Chris; Moore, John; Rachinsky, Maxim; Bainbridge, Daniel; Wiles, Andrew D.; Peters, Terry M.

    2010-02-01

    Peripheral nerve block treatments are ubiquitous in hospitals and pain clinics worldwide. State of the art techniques use ultrasound (US) guidance and/or electrical stimulation to verify needle tip location. However, problems such as needle-US beam alignment, poor echogenicity of block needles and US beam thickness can make it difficult for the anesthetist to know the exact needle tip location. Inaccurate therapy delivery raises obvious safety and efficacy issues. We have developed and evaluated a needle guidance system that makes use of a magnetic tracking system (MTS) to provide an augmented reality (AR) guidance platform to accurately localize the needle tip as well as its projected trajectory. Five anesthetists and five novices performed simulated nerve block deliveries in a polyvinyl alcohol phantom to compare needle guidance under US alone to US placed in our AR environment. Our phantom study demonstrated a decrease in targeting attempts, decrease in contacting of critical structures, and an increase in accuracy of 0.68 mm compared to 1.34mm RMS in US guidance alone. Currently, the MTS uses 18 and 21 gauge hypodermic needles with a 5 degree of freedom sensor located at the needle tip. These needles can only be sterilized using an ethylene oxide process. In the interest of providing clinicians with a simple and efficient guidance system, we also evaluated attaching the sensor at the needle hub as a simple clip-on device. To do this, we simultaneously performed a needle bending study to assess the reliability of a hub-based sensor.

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

    Directory of Open Access Journals (Sweden)

    GUO Xiang-fei

    2013-10-01

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

  17. A cadaveric study comparing the three approaches for ulnar nerve block at wrist

    OpenAIRE

    Rohit Varshney; Nidhi Sharma; Shraddha Malik; Sunny Malik

    2014-01-01

    Background: Ulnar nerve blockade as a component of wrist block is a promising technique for adequate anesthesia and analgesia for different surgeries of the hand. Due to anatomical variations in the location of ulnar nerve under the flexor carpi ulnaris (FCU) a technique with good results and minimal complications are required. Aim: The aim of the following study is to compare the three techniques (volar, transtendinous volar [TTV] and ulnar) for ulnar nerve block at the wrist in human cadave...

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

    Directory of Open Access Journals (Sweden)

    Herman Sehmbi

    2015-01-01

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

  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. Femoral nerve block versus fentanyl: Analgesia for positioning patients with fractured femur

    OpenAIRE

    Iamaroon, Arissara; Raksakietisak, Manee; Halilamien, Pathom; Hongsawad, Jitaporn; Boonsararuxsapong, Kwankamol

    2010-01-01

    Purpose Fracture of femur is a painful bone injury, worsened by any movement. This prospective study was performed to compare the analgesic effects of femoral nerve block (FNB) with intravenous (IV) fentanyl prior to positioning patients with fractured femur for spinal block. Patients and methods Sixty-four ASA I–III patients aged 18–80 years undergoing surgery for femur fracture were randomized into two groups. Fifteen minutes before spinal block, the FNB group received nerve stimulator-assi...

  1. 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

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

    Science.gov (United States)

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

    2015-01-01

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

  3. Artifacts produced during electrical stimulation of the vestibular nerve in cats. [autonomic nervous system components of motion sickness

    Science.gov (United States)

    Tang, P. C.

    1973-01-01

    Evidence is presented to indicate that evoked potentials in the recurrent laryngeal, the cervical sympathetic, and the phrenic nerve, commonly reported as being elicited by vestibular nerve stimulation, may be due to stimulation of structures other than the vestibular nerve. Experiments carried out in decerebrated cats indicated that stimulation of the petrous bone and not that of the vestibular nerve is responsible for the genesis of evoked potentials in the recurrent laryngeal and the cervical sympathetic nerves. The phrenic response to electrical stimulation applied through bipolar straight electrodes appears to be the result of stimulation of the facial nerve in the facial canal by current spread along the petrous bone, since stimulation of the suspended facial nerve evoked potentials only in the phrenic nerve and not in the recurrent laryngeal nerve. These findings indicate that autonomic components of motion sickness represent the secondary reactions and not the primary responses to vestibular stimulation.

  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. Real-Time Assessment of Autonomic Nerve Activity During Adaptive Servo-Ventilation Support or Waon Therapy.

    Science.gov (United States)

    Imamura, Teruhiko; Kinugawa, Koichiro; Nitta, Daisuke; Komuro, Issei

    2016-07-27

    Adaptive servo-ventilation support and Waon therapy are recently developed non-pharmacological and noninvasive therapies for patients with heart failure refractory to guideline-directed medical therapy. These therapies decrease both preload and afterload, increase cardiac output, and appear to ameliorate autonomic nerve activity. However, the time course of autonomic nerve activity during these therapies remains unclear. We performed heart rate variability analysis using the MemCalc power spectral density method (MemCalc system; Suwa Trust Co, Tokyo) to assess autonomic nerve activity during adaptive servo-ventilation support and Waon therapy in two different cases and determined the time course of autonomic nerve activity during these therapies. During both therapies, we found a drastic increase in parasympathetic nerve activity and continuous suppression of sympathetic nerve activity. Heart rate variability analysis using the MemCalc method may be promising for the assessment of the efficacy of various treatments, including adaptive servo-ventilation support and Waon therapy, from the viewpoint of autonomic nerve activity. PMID:27385607

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

    Science.gov (United States)

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

    2013-10-01

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

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

    DEFF Research Database (Denmark)

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

    2014-01-01

    With the advancement of ultrasound-guidance for peripheral nerve blocks, still pictures from representative ultrasonograms are increasingly used for clinical procedure documentation of the procedure and for educational purposes in textbook materials. However, little is actually known about the...

  9. Conduction Block of Peripheral Nerve Using High Frequency Alternating Currents Delivered through an Intrafascicular Electrode

    OpenAIRE

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

    2010-01-01

    Many diseases are characterized by undesired or pathological neural activity. The local delivery of high frequency currents has been shown to be an effective method for blocking neural conduction in peripheral nerves and may provide a therapy for these conditions. To date, all studies of high frequency conduction block have utilized extraneural (cuff) electrodes to achieve conduction block. In this study we show that high frequency conduction block is feasible using intrafascicular electrodes.

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

    Directory of Open Access Journals (Sweden)

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

    Directory of Open Access Journals (Sweden)

    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.

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

    DEFF Research Database (Denmark)

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

    1996-01-01

    whether a prolonged nerve block administered before a superficial burn injury could reduce local inflammation and late hyperalgesia after recovery from the block. METHODS: The effects of a preemptive saphenous nerve block on primary and secondary hyperalgesia, skin erythema, and blister formation, were......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 examined...... compared to the opposite unblocked leg for 12 h after bilateral thermal injuries (15 x 25 mm, 49 degrees C for 5 min) in 20 healthy volunteers. Recovery from the block was identified by return of sensation to cold. RESULTS: Six subjects were excluded because of insufficient initial block (2 subjects) or...

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

    DEFF Research Database (Denmark)

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

    1997-01-01

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

  14. High Frequency Stimulation Selectively Blocks Different Types of Fibers in Frog Sciatic Nerve

    OpenAIRE

    Joseph, Laveeta; Butera, Robert J

    2011-01-01

    Conduction block using high frequency alternating current (HFAC) stimulation has been shown to reversibly block conduction through various nerves. However, unlike simulations and experiments on myelinated fibers, prior experimental work in our lab on the sea-slug, Aplysia, found a nonmonotonic relationship between frequency and blocking thresholds in the unmyelinated fibers. To resolve this discrepancy, we investigated the effect of HFAC waveforms on the compound action potential of the sciat...

  15. Distribution and putative function of autonomic nerve fibres in the bill skin of the platypus (Ornithorhynchus anatinus).

    OpenAIRE

    Manger, P. R.; Keast, J R; Pettigrew, J D; Troutt, L

    1998-01-01

    The electroreceptors located in the bill skin of the platypus are modified secretory glands. The electroreceptive nerve terminals form bare endings in close proximity to the duct of these glands. In this study, we describe the autonomic innervation of the glands and a separate specialized autonomic innervation of the epidermal portion of the glandular duct. A range of immunohistochemical labels showed that the gland cells of the electroreceptors have a non-noradrenergic (putative parasympathe...

  16. A Comparison of Epidural Anesthesia and Lumbar Plexus-Sciatic Nerve Blocks for Knee Surgery

    OpenAIRE

    Eyup Horasanli; Mehmet Gamli; Yasar Pala; Mustafa Erol; Fazilet Sahin; Bayazit Dikmen

    2010-01-01

    OBJECTIVES: The efficacy of combined lumbar plexus-sciatic nerve blocks was compared to epidural anesthesia in patients undergoing total knee surgery. PATIENTS AND METHODS: The study included 80 American Society of Anesthesiologists (ASA) Physical Status I-III patients (age range 18 to 65) undergoing knee surgery. The patients were randomly divided into one of two groups. Epidural anesthesia was performed in the epidural anesthesia (EA) group (n=40), and the lumbar plexus and sciatic nerves w...

  17. A Fully Implanted Drug Delivery System for Peripheral Nerve Blocks in Behaving Animals

    OpenAIRE

    Pohlmeyer, Eric A; Jordon, Luke R.; Kim, Peter; Miller, Lee E.

    2009-01-01

    Inhibiting peripheral nerve function can be useful for many studies of the nervous system or motor control. Accomplishing this in a temporary fashion in animal models by using peripheral nerve blocks permits studies of the immediate effects of the loss, and/or any resulting short-term changes and adaptations in behavior or motor control, while avoiding the complications commonly associated with permanent lesions, such as sores or self-mutilation. We have developed a method of quickly and repe...

  18. Comparison of tumescent versus ultrasound guided femoral and obturator nerve blocks for treatment of varicose veins by endovenous laser ablation

    Directory of Open Access Journals (Sweden)

    Karim Youssef Kamal Hakim

    2014-07-01

    Conclusion: Ultrasound guided femoral and obturator nerve blocks combined with tumescent anesthesia are effective methods of anesthesia during endovenous laser ablation than using tumescent anesthesia alone.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    Harsha Shanthanna

    2014-01-01

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

  1. Evaluation of Effect of Pudendal Nerve Block on Post Hemmorrhoidectomy Pain

    Directory of Open Access Journals (Sweden)

    M.H. Sarmast Shoshtari

    2008-10-01

    Full Text Available Introduction & Objective: Hemorrhoid is one of the most common anorectal disease which presents with pain, bleeding and mass protrusion from anus. One of the most important reasons to avoid operation in these patients fears of the pain. Pain control specially during the first 24 hour postoperation period results in decreasing urinary retension and constipation as well as increasing patients pleasant. In this study we assisted the effect of pudendal nerve block to reduce pain in posthemorrhoidectomy period and compared with those patients without pudendal nerve block.Materials & Methods: We randomized 120 patients with average age of 37.7 year who referred to the hospitals of Ahwaz university for hemorrhoidectomy into 2 groups (N1: 60 N2:60. In the first group pudendal nerve block was done but in the second group we didn't. Then pain scores by analogue scale method were calculated in each group at 2, 6, 12& 24 hours after operations. The scores were matched with Chi- Square test. Also we calculated and compared the dosages of injected narcotics.Results: The average pain scores at 2, 6, 12, 24 hours after operation in the first group (with nerve block. Were 2.53, 2.4, 1.91, 2.7, 2.38, and in the second group (without nerve block were 3.43, 3.23, 2.98, 2.81, 3.11. The average of narcotic dosage in the first group was 0.69 and in the second group was 1.3. P-value in two groups in those times were 0.001, 0.002, 0.001, 0.66. P-value for comparison of two groups was 0.01. P-value for comparison of narcotic consumption was 0.003Conclusions: In this study, we showed that pudendal nerve block in post hemorrhoidectomy period, reduced pain significantly and decreased narcotic consumption as well.

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

    Directory of Open Access Journals (Sweden)

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

    DEFF Research Database (Denmark)

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

    2016-01-01

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

  4. 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. PMID:19765668

  5. Femoral nerve block versus fentanyl: Analgesia for positioning patients with fractured femur

    OpenAIRE

    Lamaroon, A

    2010-01-01

    Arissara Iamaroon, Manee Raksakietisak, Pathom Halilamien, Jitaporn Hongsawad, Kwankamol BoonsararuxsapongDepartment of Anesthesiology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, ThailandPurpose: Fracture of femur is a painful bone injury, worsened by any movement. This prospective study was performed to compare the analgesic effects of femoral nerve block (FNB) with intravenous (IV) fentanyl prior to positioning patients with fractured femur for spinal block.Patients...

  6. 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

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

    Directory of Open Access Journals (Sweden)

    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

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

    Directory of Open Access Journals (Sweden)

    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.

  9. Focal conduction block in compression neuropathy of the proximal sciatic nerve.

    OpenAIRE

    Inaba, A; Komori, T; Yamada, K; Hirose, K.; Yokota, T.

    1995-01-01

    Direct percutaneous stimulation of the proximal sciatic nerve with a high voltage electrical stimulator was given to a patient with acute sciatic compression neuropathy. Results clearly showed a focal conduction block at the sciatic notch, which could not be precisely localised and quantified by conventional electrodiagnostic methods.

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

    Directory of Open Access Journals (Sweden)

    Mahin Seyedhejazi

    2013-01-01

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

  11. 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...... describe a new method to perform an ultrasound-guided specific axillary nerve block.......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 and...

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

    Directory of Open Access Journals (Sweden)

    Abualhassan A Abdellatif

    2012-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Alok Kumar

    2014-01-01

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

  14. Sonoanatomical Change of Phrenic Nerve According to Posture During Ultrasound-Guided Stellate Ganglion Block

    Science.gov (United States)

    Joeng, Eui Soo; Jeong, Young Cheol; Park, Bum Jun; Kang, Seok; Yang, Seung Nam

    2016-01-01

    Objective To evaluate the risk of phrenic nerve injury during ultrasound-guided stellate ganglion block (US-SGB) according to sonoanatomy of the phrenic nerve, and determine a safer posture for needle insertion by assessing its relationship with surrounding structure according to positional change. Methods Twenty-nine healthy volunteers were recruited and underwent ultrasound in two postures, i.e., supine position with the neck extension and head rotation, and lateral decubitus position. The transducer was placed at the anterior tubercle of the C6 level to identify phrenic nerve. The cross-sectional area (CSA), depth from skin, distance between phrenic nerve and anterior tubercle of C6 transverse process, and the angle formed by anterior tubercle, posterior tubercle and phrenic nerve were measured. Results The phrenic nerve was clearly identified in the intermuscular fascia layer between the anterior scalene and sternocleidomastoid muscles. The distance between the phrenic nerve and anterior tubercle was 10.33±3.20 mm with the supine position and 9.20±3.31 mm with the lateral decubitus position, respectively. The mean CSA and skin depth of phrenic nerve were not statistically different between the two positions. The angle with the supine position was 48.37°±27.43°, and 58.89°±30.02° with the lateral decubitus position. The difference of angle between the two positions was statistically significant. Conclusion Ultrasound is a useful tool for assessing the phrenic nerve and its anatomical relation with other cervical structures. In addition, lateral decubitus position seems to be safer by providing wider angle for needle insertion than the supine position in US-SGB. PMID:27152274

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

    OpenAIRE

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

    2016-01-01

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

  16. 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

    -guided blocks of the ilioinguinal and iliohypogastric nerves with lidocaine.Methods:A randomized, double-blind, placebo-controlled, crossover trial in 12 patients with severe persistent inguinal postherniorrhaphy pain, including a control group of 12 healthy controls, was performed. Assessments included pain......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...

  17. 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

    strength. METHODS: We included 50 TKA patients with severe movement-related pain; defined as having visual analog scale pain score of greater than 60 mm during active flexion of the knee. The ACB group received an ACB with ropivacaine 0.2% 30 mL and a femoral nerve block (FNB) with 30 mL saline. The FNB......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...... ambulate and changes in pain scores (Clinicaltrials.gov identifier NCT01922596). RESULTS: After block, the quadriceps maximum voluntary isometric contraction increased to 193% (95% confidence interval [CI], 143-288) of the baseline value in the ACB group and decreased to 16% (95% CI, 3-33) in the FNB group...

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

    International Nuclear Information System (INIS)

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2013-02-15

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

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

    Science.gov (United States)

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

    2016-01-01

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

  1. Morphological changes in the sciatic nerve, skeletal muscle, heart and brain of rabbits receiving continuous sciatic nerve block with 0.2% ropivacaine

    OpenAIRE

    Zhou, Yangning; He, Miao; Zou, Tianxiao; Yu, Bin

    2015-01-01

    Objective: To investigate the morphological changes in various tissues of rabbits receiving sciatic nerve block with 0.2% ropivacaine for 48 h. Methods: Twenty healthy were randomly assigned to normal saline group (N group) and ropivacaine group (R group). The right sciatic nerve was exposed, and a nerve-blocking trocar cannula embedded. Animals received an injection of 0.5% ropivacaine hydrochloride at a dose of 0.75 ml/kg. Rabbit was then connected to an infusion pump containing 50 ml of no...

  2. 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.

  3. Infraorbital nerve block within the Pterygopalatine fossa of the horse: anatomical landmarks defined by computed tomography

    International Nuclear Information System (INIS)

    In order to provide anaesthesia of the equine maxillary cheek teeth, a local nerve block of the infraorbital nerve in the pterygopalatine fossa had been proposed, which is referred to as the 'Palatine Bone Insertion' (PBI). As several complications with this method were reported, our study was designed to recommend a modified injection technique which avoids the risk of puncturing of relevant anatomical structures. Five cadaver heads and two living horses were examined by contrast medium injections and subsequent computed tomography (CT). Spinal needles were inserted using two different insertion techniques: The above mentioned (PBI), and a modification called 'Extraperiorbital Fat Body Insertion' (EFBI). Both techniques (PBI and EFBI) provide a consistent distribution of contrast medium around the infraorbital nerve. However, only the EFBI technique is appropriate to minimize the risk of complications. This study is an example for the permanent challenge of anatomists to supply a basis for clinical and surgical procedures

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

    Science.gov (United States)

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

    2004-06-10

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

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

    Directory of Open Access Journals (Sweden)

    T.V.S Gopal

    2014-06-01

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

  6. Bilateral sciatic nerve block after orthopedic surgery in a pediatric patient

    OpenAIRE

    Levent Şahin; Mehrican Şahin; Rauf Gül

    2011-01-01

    Early postoperative pain is one of the most important problems in pediatric orthopedic surgery. Introduction of the use of ultrasound (US) has led to very important developments in pediatric regional anesthesia. We aimed to present with the literature data about that we applied the bilateral US-guided sciatic nerve block to the patient who was operated under bilateral knee disarticulation because of congenital tibia agenesis and talipes equinovarus. In conclusion we entertain that US-guided p...

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

    Directory of Open Access Journals (Sweden)

    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.

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

    OpenAIRE

    Lucía Vizcaíno-Martínez; Manuel Ángel Gómez-Ríos; Beatriz López-Calviño

    2014-01-01

    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, main...

  9. Effect of saphenous nerve block for postoperative pain on knee surgery: a meta-analysis

    OpenAIRE

    Jin, Shu-Qing; Ding, Xi-Bing; Tong, Yao; Ren, Hao; Chen, Zhi-Xia; Wang, Xin; Li, Quan

    2015-01-01

    Early post-operative mobilization is important both to reduce immobility-related complications and to get the best functional result following surgery on knee. We hypothesized that saphenous nerve block would reduce pain in this patient category compared with placebo injection. In this study, two reviewers independently searched the databases of PubMed, EMBASE, and Cochrane Library (last performed on 12 October, 2014) to retrieve eligible randomized controlled clinical trials. The primary out...

  10. Pain Management for Total Knee Arthroplasty: Single-Injection Femoral Nerve Block versus Local Infiltration Analgesia

    OpenAIRE

    Moghtadaei, Mehdi; Farahini, Hossein; Faiz, Seyed Hamid-Reza; Mokarami, Farzam; Safari, Saeid

    2014-01-01

    Background: Pain is one of the major concerns of patients underwent Total Knee Arthroplasty (TKA); appropriate pain management is a key factor in patient's early physical fitness to move, physiotherapy, and most importantly, patient satisfaction. Objectives: In this study the analgesic effect of single injection femoral nerve block (SFNB) was compared with local infiltration analgesia (LIA). Patients and Methods: Forty patients who underwent TKA under spinal anesthesia were randomized to rece...

  11. Cross recurrence quantification analysis of precision grip following peripheral median nerve block

    OpenAIRE

    Li, Ke; Li, Zong-Ming

    2013-01-01

    Background Precision grip by the thumb and index finger is vulnerable to sensorimotor deficits. Traditional biomechanical parameters offer limited insight into the dynamical coordination between digits during precision grip. In this study, the thumb and index finger were viewed as “coupled systems”, and a cross recurrence quantification analysis (CRQA) was used to examine the changes of interdigit dynamics and synchronization caused by peripheral median nerve block. Methods Seven subjects per...

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

    OpenAIRE

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

    2010-01-01

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

  13. Perinatal taurine exposure programs patterns of autonomic nerve activity responses to tooth pulp stimulation in adult male rats

    Science.gov (United States)

    Khimsuksri, Sawita; Wyss, J. Michael; Thaeomor, Atcharaporn; Paphangkorakit, Jarin; Jirakulsomchok, Dusit; Roysommuti, Sanya

    2016-01-01

    Perinatal taurine excess or deficit influences adult health and disease, especially relative to the autonomic nervous system. This study tests the hypothesis that perinatal taurine exposure influences adult autonomic nervous system control of arterial pressure in response to acute electrical tooth pulp stimulation. Female Sprague-Dawley rats were fed normal rat chow with 3% β-alanine (taurine depletion, TD), 3% taurine (taurine supplementation, TS) or water alone (control, C) from conception to weaning. Their male offspring were fed normal rat chow and tap water throughout the experiment. At 8–10 weeks of age, blood chemistry, arterial pressure, heart rate and renal sympathetic nerve activity were measured in anesthetized rats. Age, body weight, mean arterial pressure, heart rate, plasma electrolytes, blood urea nitrogen, plasma creatinine and plasma cortisol were not significantly different among the three groups. Before tooth pulp stimulation, low (0.3–0.5 Hz) and high frequency (0.5–4.0 Hz) power spectral densities of arterial pressure were not significantly different among groups, while the power spectral densities of renal sympathetic nerve activity were significantly decreased in TD compared to control rats. Tooth pulp stimulation did not change arterial pressure, heart rate, renal sympathetic nerve and arterial pressure power spectral densities in the 0.3–4.0 Hz spectrum or renal sympathetic nerve firing rate in any group. In contrast, perinatal taurine imbalance disturbed very low frequency power spectral densities of both arterial pressure and renal sympathetic nerve activity (below 0.1 Hz), both before and after the tooth pulp stimulation. The power densities of TS were most sensitive to ganglionic blockade and central adrenergic inhibition, while those of TD were sensitive to both central and peripheral adrenergic inhibition. The present data indicate that perinatal taurine imbalance can lead to aberrant autonomic nervous system responses in

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

    Science.gov (United States)

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

    2016-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Young Eun Moon

    2016-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Moisés Ortega Ramírez

    2013-01-01

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

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

    Science.gov (United States)

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

    2016-03-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2011-12-23

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

  19. 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.

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

    International Nuclear Information System (INIS)

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

  1. Nerve Blocks

    Science.gov (United States)

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

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

    Directory of Open Access Journals (Sweden)

    Hossein Alimohammadi

    2013-12-01

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

  3. Bilateral infraorbital nerve blocks decrease postoperative pain but do not reduce time to discharge following outpatient nasal surgery

    OpenAIRE

    Mariano, Edward R.; Watson, Deborah; Loland, Vanessa J.; Chu, Larry F; Cheng, Gloria S.; Mehta, Sachin H.; Maldonado, Rosalita C.; Ilfeld, Brian M.

    2009-01-01

    Purpose While infraorbital nerve blocks have demonstrated analgesic benefits for pediatric nasal and facial plastic surgery, no studies to date have explored the effect of this regional anesthetic technique on adult postoperative recovery. We designed this study to test the hypothesis that infraorbital nerve blocks combined with a standardized general anesthetic decrease the duration of recovery following outpatient nasal surgery. Methods At a tertiary care university hospital, healthy adult ...

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

    OpenAIRE

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

    2013-01-01

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

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

    OpenAIRE

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

    2012-01-01

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

  6. Comparative Evaluation of Factors Minimizing the Amount of Needle Deflection During Inferior Alveolar Nerve Block – An In Vitro Study

    OpenAIRE

    Mathew, Asok; Ansari, Aysha Rashed Ali Al; Radaideh, Ahmed Ali; Varughese, Nisha T

    2013-01-01

    Failure of local anaesthesia is a common problem faced in the clinical practice. Inferior alveolar nerve block is showing high percentage of failure among the local anaesthesia techniques. The study is conducted to understand the factors minimising the amount of needle deflection during the inferior alveolar nerve block. Successful local anaesthesia has been critical to the daily practice of dentistry. It is required to ensure maximum patient comfort while clinical procedures are being perfor...

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

    OpenAIRE

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

    2013-01-01

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

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

    OpenAIRE

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

    2013-01-01

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

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

    OpenAIRE

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

    2015-01-01

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

  10. A Descriptive Study of 100 Patients Undergoing Palliative Nerve Blocks for Chronic Intractable Headache and Neck Ache

    OpenAIRE

    Rothbart, Peter; Fiedler, Katherine; Gale, George D; Nussbaum, David; Hendlerb, Nelson

    2000-01-01

    OBJECTIVE: To ascertain whether repeated (palliative) nerve blocks over a long period of time provide benefit to patients with chronic intractable headache and neck ache.SUBJECTS AND METHODS: One hundred patients who were receiving repeated nerve blocks as part of their pain management regimen completed a structured interview questionnaire. The patients had all been investigated and received a diagnosis of cervicogenic headache. Changes in pain rating, depression rating, anxiety rating, activ...

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

    OpenAIRE

    Tofuku Katsuhiro; Koga Hiroaki; Komiya Setsuro

    2012-01-01

    Abstract Introduction Although uncommon, selective cervical nerve root blocks can have serious complications. The most serious complications that have been reported include cerebral infarction, spinal cord infarction, transient quadriplegia and death. Case presentation A 40-year-old Japanese woman with a history of severe right-sided cervical radicular pain was scheduled to undergo a right-sided C6 selective cervical nerve root block using a transforaminal approach under fluoroscopic guidance...

  12. 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; Kristensen, P L; Skjønnemand, M; Nørgaard, P

    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.......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....

  13. Analysis of autonomic nerve preservation and pouch reconstruction influencing fragmentation of defecation after sphincter-preserving surgery for rectal cancer.

    Science.gov (United States)

    Katsumata, K; Sumi, T; Enomoto, M; Mori, Y; Aoki, T

    2010-01-01

    Our questionnaire survey on defecation disorders after rectal cancer surgery revealed that 66.7% of postoperative patients were most annoyed with fragmentation of defecation. Therefore, we performed a change-over-time analysis on the relationship of fragmentation and factors including location of rectal cancer, surgical technique, anastomosis method, pouch reconstruction, extent of lymph node dissection, and degree of pelvic and colonic nerve preservation surrounding the superior mesenteric artery. The fragmentation decreased over time at the postoperative time points of 6 months, 2 and 5 years. A statistical analysis of factors influencing fragmentation revealed that location of cancer, reconstruction technique, anastomosis method and degree of pelvic nerve preservation were significant factors for the entire patient population and that colonic nerve preservation was a significant factor 5 years after surgery. Analysis of patients with lower rectal cancer only showed that in addition to surgical technique and anastomosis method, pouch reconstruction was effective and autonomic nerve preservation was effective 5 years after surgery. As a result, when the anastomotic site was closer to the anus, the frequency of fragmentation increased; we concluded that pouch reconstruction was an effective surgical technique and colonic nerve preservation was effective in the longer term. PMID:21051900

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

    Directory of Open Access Journals (Sweden)

    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.

  15. The onset and rate of myelination in six peripheral and autonomic nerves of the rat.

    OpenAIRE

    K. Schäfer; Friede, R L

    1988-01-01

    A light and electron microscopic study was carried out of the numbers of myelinated fibres in 6 nerves of the rat for 7 age groups from birth to 73 weeks. The hypoglossal nerve and the mandibular branch of the facial nerve had short and early myelination periods, essentially complete by the second week. The glossopharyngeal nerve and the sympathetic rami communicantes myelinated late and over a protracted period. Myelination of the rami communicantes continued up to 20 weeks, followed by a ma...

  16. Rat whisker movement after facial nerve lesion: Evidence for autonomic contraction of skeletal muscle.

    NARCIS (Netherlands)

    Heaton, J.T.; Sheu, S.H.; Hohman, M.H.; Knox, C.J.; Weinberg, J.S.; Kleiss, I.J.; Hadlock, T.A.

    2014-01-01

    Vibrissal whisking is often employed to track facial nerve regeneration in rats; however, we have observed similar degrees of whisking recovery after facial nerve transection with or without repair. We hypothesized that the source of non-facial nerve-mediated whisker movement after chronic denervati

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

    International Nuclear Information System (INIS)

    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.)

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

    Directory of Open Access Journals (Sweden)

    Sanjeev Bhoi

    2012-01-01

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

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

    Science.gov (United States)

    Patzkowski, Michael S

    2016-03-01

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

  20. Development and validation of an equine nerve block simulator to supplement practical skills training in undergraduate veterinary students.

    Science.gov (United States)

    Gunning, P; Smith, A; Fox, V; Bolt, D M; Lowe, J; Sinclair, C; Witte, T H; Weller, R

    2013-04-27

    Lameness is the most common presenting complaint in equine practice. Performing diagnostic nerve blocks is an integral part of any lameness work-up, and is therefore an essential skill for equine practitioners. However, the opportunities for veterinary students to practice this skill are limited. The aim of this study was to design and validate an equine nerve block simulator. It was hypothesised that the simulator would improve students' ability and enhance their confidence in performing nerve blocks. A simulator was built using an equine forelimb skeleton and building foam. Wire wool targets were placed under the foam in the positions corresponding to the anatomical location of the most palmar digital, abaxial and low four-point nerve blocks and attached to an electrical circuit. The circuit became complete when the operator placed a needle in the correct position and immediate audible feedback with a buzzer was provided. To validate the simulator, it was compared with two established teaching methods: cadaver training and theoretical training with a hand-out. Cadaver-trained students achieved the best results (73 per cent correct blocks), compared with simulator-trained students (71 per cent correct blocks), and a hand-out trained group (58 per cent correct blocks). Feedback obtained with a questionnaire showed that students enjoyed simulator training more, and that they felt more confident in performing diagnostic nerve blocks than the other two groups. The equine nerve block simulator provides a safe, cost-effective method to supplement the teaching of diagnostic analgesia to undergraduate veterinary students. PMID:23486507

  1. 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

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

    DEFF Research Database (Denmark)

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

    2011-01-01

    impact passive and guided active mobilization by the performing physiotherapist for three consecutive weeks. This case and a short topical review on the use of SSN block in painful shoulder conditions highlight the possibility of a USG continuous nerve block of the SSN as sufficient pain management...

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

    Directory of Open Access Journals (Sweden)

    RachaelBrown

    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.

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

    Science.gov (United States)

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

    2015-08-31

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

  5. 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; Kristensen, P L; Skjønnemand, M; Nørgaard, P

    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....

  6. 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

  7. Preoperatıve Ultrasound-Guıded Suprascapular Nerve Block for Postthoracotomy Shoulder Paın ☆

    OpenAIRE

    Özyuvaci, Emine; Akyol, Onat; Şitilci, Tolga; Dübüs¸, Türkan; Topac¸ogˇlu, Hakan; Leblebici, Hülya; Ac¸ikgöz, Alican

    2013-01-01

    Background Acute postthoracotomy pain is a well-known potential problem, with pulmonary complications, ineffective respiratory rehabilitation, and delayed mobilization in the initial postoperative period, and it is followed by chronic pain. The type of thoracotomy, intercostal nerve damage, muscle retraction, costal fractures, pleural irritation, and incision scar are the most responsible mechanisms. Objective Our aim was to assess whether preoperative ultrasound suprascapular nerve block wit...

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

    Directory of Open Access Journals (Sweden)

    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.

  9. Pain during Transrectal Ultrasound-Guided Prostate Biopsy and the Role of Periprostatic Nerve Block: What Radiologists Should Know

    Energy Technology Data Exchange (ETDEWEB)

    Nazir, Babar [Dept. of Oncologic Imaging, National Cancer Centre, Singapore (Singapore)

    2014-10-15

    Early prostate cancers are best detected with transrectal ultrasound (TRUS)-guided core biopsy of the prostate. Due to increased longevity and improved prostate cancer screening, more men are now subjected to TRUS-guided biopsy. To improve the detection rate of early prostate cancer, the current trend is to increase the number of cores obtained. The significant pain associated with the biopsy procedure is usually neglected in clinical practice. Although it is currently underutilized, the periprostatic nerve block is an effective technique to mitigate pain associated with prostate biopsy. This article reviews contemporary issues pertaining to pain during prostate biopsy and discusses the practical aspects of periprostatic nerve block.

  10. Pain during Transrectal Ultrasound-Guided Prostate Biopsy and the Role of Periprostatic Nerve Block: What Radiologists Should Know

    International Nuclear Information System (INIS)

    Early prostate cancers are best detected with transrectal ultrasound (TRUS)-guided core biopsy of the prostate. Due to increased longevity and improved prostate cancer screening, more men are now subjected to TRUS-guided biopsy. To improve the detection rate of early prostate cancer, the current trend is to increase the number of cores obtained. The significant pain associated with the biopsy procedure is usually neglected in clinical practice. Although it is currently underutilized, the periprostatic nerve block is an effective technique to mitigate pain associated with prostate biopsy. This article reviews contemporary issues pertaining to pain during prostate biopsy and discusses the practical aspects of periprostatic nerve block.

  11. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

  13. 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.

  14. Continuous Femoral Nerve Block versus Intravenous Patient Controlled Analgesia for Knee Mobility and Long-Term Pain in Patients Receiving Total Knee Replacement: A Randomized Controlled Trial

    OpenAIRE

    Lihua Peng; Li Ren; Peipei Qin; Jing Chen; Ping Feng; Haidan Lin; Min Su

    2014-01-01

    Objectives. To evaluate the comparative analgesia effectiveness and safety of postoperative continuous femoral nerve block (CFNB) with patient controlled intravenous analgesia (PCIA) and their impact on knee function and chronic postoperative pain. Methods. Participants were randomly allocated to receive postoperative continuous femoral nerve block (group CFNB) or intravenous patient controlled analgesia (group PCIA). Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scor...

  15. 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.

  16. 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.)

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

    Science.gov (United States)

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

    2016-01-01

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

  18. 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.

  19. Magnetic resonance imaging study of lumbosacral spinal cord nerves before artificial somatic-central nervous system-autonomic reflex pathway establish ment

    International Nuclear Information System (INIS)

    Objective: To investigate the value of MRI as imaging technique for lumbosacral spinal nerves before artificial somatic-central nervous system-autonomic reflex pathway establish ment. Methods: Conventional MRI and T2W CISS 3D were performed in 10 patients with neurogenic bladder planned for the operation of artificial somatic-central nervous system-autonomic reflex pathway. The Three-dimensional data were then constructed into composite images using a standard multiple planar reformation (MPR). Results: Five patients showed tethered spinal cord syndrome, whose spinal cord nerves were circuitous distributed and had abnormity number when penetrated the dura. Of these 5 patients, one patient was accompanied by spinal cord vas malformation. Four patients had vertebral fracture and spinal injury, and the other one patients demonstrated tumor in vertebral canal on MRI examinations. The spinal cord nerves in these 5 patients floated down river and had normal number of spinal cord nerves. Conclusion: Conventional MRI and T2W CISS 3D MRI were essential for the pre-operative planning of artificial somatic-central nervous system-autonomic reflex pathway, especially in patients with tethered spinal cord syndrome. Spinal cord nerves distribute and anterior and posterior roots array can be clearly showed by MPR. (authors)

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

    International Nuclear Information System (INIS)

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

  1. 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.)

  2. 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

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

    Directory of Open Access Journals (Sweden)

    Luo D

    2013-07-01

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

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

    Science.gov (United States)

    Grewal, Gurpreeti; Grewal, Anju

    2015-01-01

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

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

    Directory of Open Access Journals (Sweden)

    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.

  6. Respiratory Cycle-Dependent Atrial Trachycardia; its Unique Characteristics and Relation with Autonomic Nerve System

    Directory of Open Access Journals (Sweden)

    Teppei Yamamoto, MD

    2012-12-01

    Full Text Available Respiration influences the sinus heart rate, however, little is still known about the tachyarrhythmias related to respiration. Atrial tachycardia (AT rarely emerges during inspiration and it also ceases during expiration. This type of AT is thus called respiratory cycle-dependent atrial tachycardia (RCAT, and it demonstrates a centrifugal activation pattern. Based on these peculiar P wave morphologies, the foci converged either around the right superior pulmonary vein (RSPV or inside the superior vena cava where the anterior right ganglionated plexi (ARGP is considered to be located. The mechanism of such AT is therefore thought to be related to the activity of the autonomic system.

  7. 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.

  8. Medial and Lateral Pectoral Nerve Block with Liposomal Bupivacaine for the Management of Postsurgical Pain after Submuscular Breast Augmentation

    OpenAIRE

    David Leiman, MD; Mark Barlow, MD; Kimberly Carpin, MD; Edward M. Piña, MD; Daniel Casso, MD

    2014-01-01

    Summary: This report describes an ultrasound-guided medial and lateral pectoralis nerve block using liposome bupivacaine, performed before the surgical incision, in a patient undergoing submuscular breast augmentation. The anatomic basis and technique are described. This procedure may be offered to patients undergoing submuscular insertion of a breast implant or tissue expander. Advancements in ultrasound guidance allow for more precise anatomic placement of local anesthetic agents. The injec...

  9. Variability of bladder dysfunction in post radical hysterectomy effect of pelvic autonomic nerve preservation with/without postoperative radiation therapy

    International Nuclear Information System (INIS)

    The objective of this study was to demonstrate an improved method for radical hysterectomy procedures to prevent post-operative variable bladder dysfunction. This study presents the results of a Urodynamic Study performed in subjects who underwent radical hysterectomy to clarify the efficacy of the new surgical method. Participants in this study consisted of 40 Stage 1B cervical cancer patients. These 40 participants were divided into two categories. The control group, consisting of 21 patients, underwent surgery by the established procedure. The experimental group was treated by our improved surgical method for retaining pelvic autonomic nerve function after radical hysterectomy. The groups were further divided into those who received radiation therapy and those who did not require radiation therapy. Two UDS (Urodynamic Study) methods were chosen to estimate bladder function; cystometry and uroflowmetry. The cystometry measurement parameters indicate bladder pliancy at the point of maximum desire to void. The uroflowmetry measurement parameters indicate the time required from post-surgical dysfunctional urinary flow pattern to the recovery of a normal pattern. Initial cystometry and uroflowmetry measurements were established pre-operatively. Further measurements were taken 1, 3, 6, 12, and 24 months post-operation. Four groups were divided as indicated in the methods section above. The non-radiated group who underwent our improved surgical method showed significantly better quality of improvement in cystometry measurements compared to those treated by the established method on measurements obtained 24 months post-operatively. Even the group requiring post-op radiation showed significantly better results at the 1 and 24 month points. At the 24 month point, the group receiving radiation therapy showed the lowest level of pliancy improvement, indicating a tendency for a longer recovery time than this study allowed. Irrespective of radiation therapy, the groups

  10. 保留自主神经的胃癌D2淋巴结清扫技术%Surgical techniques of autonomic nerve preservation in lymph nodes dissection for gastric cancer

    Institute of Scientific and Technical Information of China (English)

    胡祥

    2012-01-01

    Resection of the automonic nervous system in the process of lymph nodes dissection is a major factor leading to postoperative gastrointestinal dysfunction.The era of blind expansion of the wide excision has been questioned,and safety first,radical dissection of the metastatic lymph nodes,low invasive rate and organ function-saving surgery have been highly emphasized.Preserving the gastric autonomic nerve effectively reduces postoperative diarrhea,shortens the time for weight recovery,and prevents insulin secretion disorders and postoperative cholelithiasis.In the process of laparoscopic or open autonomic nerve preservation in lymph node dissection for gastric cancer,full understanding of the anatomy of the autonomic nervous system,recognizing the landmark of the nerves,proper designing the surgical space,dissecting according to the extracellular space in the membrane of the nerve fibers and nerve plexus are factors which ensures the quality and effects of the surgery.

  11. 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. Clin. Anat. 29:333-341, 2016. © 2015 Wiley Periodicals, Inc. PMID:26506515

  12. A randomized prospective comparative study of nerve stimulator and ultrasonogram in popliteal sciatic nerve block for ankle and foot surgeries

    Directory of Open Access Journals (Sweden)

    Ramamoorthi Panneerselvam

    2015-06-01

    Conclusion: The duration of block technique and number of needle reinsertions are better with ultrasound. Though the onset of motor and sensory blockade were better with ultrasound success rate is not significantly different. [Int J Res Med Sci 2015; 3(3.000: 606-611

  13. 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...

  14. 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

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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

  18. Peripheral nerve blocks versus general anesthesia for total knee replacement in elderly patients on the postoperative quality of recovery

    Directory of Open Access Journals (Sweden)

    Liu JL

    2014-02-01

    Full Text Available JunLe Liu,1,* WeiXiu Yuan,1,* XiaoLin Wang,1,* Colin F Royse,2,3 MaoWei Gong,1 Ying Zhao,1 Hong Zhang1 1Anesthesia 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; 2Anesthesia and Pain Management Unit, Department of Surgery, University of Melbourne, Melbourne, Victoria, Australia; 3Department of Anesthesia and Pain Management, The Royal Melbourne Hospital, Melbourne, Victoria, Australia *These authors contributed equally to this work Background: Both peripheral nerve blocks with sedation or general anesthesia can be used for total knee replacement surgery. Objectives: We compared these anesthetic techniques on the postoperative quality of recovery early in elderly patients. Materials and methods: In our study, 213 patients who were ≥65 years old and undergoing total knee replacement were randomized to peripheral nerve blocks (PNBs – lumbar plexus and sciatic – with propofol sedation, or general anesthesia with combined propofol and remifentanil. Blocks were performed using nerve stimulation and 0.35% ropivacaine. All patients received postoperative multimodal analgesia. Postoperative recovery was assessed at 15 minutes, 40 minutes, 1 day, 3 days, and 7 days after surgery, with the Postoperative Quality of Recovery Scale, in physiological, nociceptive, emotive, modified activities of daily living, modified cognitive, and overall patient perspective domains. Results: Intraoperative blood pressure and heart rate were more stable with PNBs (P<0.001. The recovery was better with PNBs in physiological (P<0.001, emotive (depression and anxiety (P<0.001, nociceptive (pain and nausea (P<0.001, modified cognitive (P<0.001, and all domains recovery (P<0.001, but not in activities of daily living (P=0.181. Intraoperative drugs and the postoperative sulfentanil requirement of the PNBs group were lower (all P<0.001. Differences were

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

    Directory of Open Access Journals (Sweden)

    Tofuku Katsuhiro

    2012-06-01

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

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

    International Nuclear Information System (INIS)

    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

  1. 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.

  2. Medial and Lateral Pectoral Nerve Block with Liposomal Bupivacaine for the Management of Postsurgical Pain after Submuscular Breast Augmentation

    Directory of Open Access Journals (Sweden)

    David Leiman, MD

    2014-12-01

    Full Text Available Summary: This report describes an ultrasound-guided medial and lateral pectoralis nerve block using liposome bupivacaine, performed before the surgical incision, in a patient undergoing submuscular breast augmentation. The anatomic basis and technique are described. This procedure may be offered to patients undergoing submuscular insertion of a breast implant or tissue expander. Advancements in ultrasound guidance allow for more precise anatomic placement of local anesthetic agents. The injection technique used for this procedure resulted in complete relaxation of the pectoralis major, facilitating the surgical dissection and markedly diminishing postsurgical pain and muscle spasms.

  3. Comparison of peri- and intraarticular analgesia with femoral nerve block after total knee arthroplasty: a randomized clinical trial

    DEFF Research Database (Denmark)

    Toftdahl, Karen; Nikolajsen, Lone; Haraldsted, Viggo;

    2007-01-01

    BACKGROUND: Postoperative pain after total knee arthroplasty (TKA) can be difficult to manage and may delay recovery. Recent studies have suggested that periarticular infiltration with local anesthetics may improve outcome. METHODS: 80 patients undergoing TKA under spinal anesthesia were randomized...... to receive continuous femoral nerve block (group F) or peri- and intraarticular infiltration and injection (group I). Group I received a solution of 300 mg ropivacaine, 30 mg ketorolac, and 0.5 mg epinephrine by infiltration of the knee at the end of surgery, and 2 postoperative injections of these...

  4. [Joint and sensory branch block of the obturator and femoral nerves in a case of femoral head osteonecrosis and arthritis].

    Science.gov (United States)

    Cortiñas-Sáenz, M; Salmerón-Velez, G; Holgado-Macho, I A

    2014-01-01

    The sensory innervation of the hip joint is complex. The joint and sensory branch block of the obturator and femoral nerves is effective for treating the pain caused due to different hip diseases. This could be an option to be considered in certain circumstances such as, being a surgical-anaesthetic high risk, or if there is significant overweight, It could also be useful on other occasions if the traumatoligist considers that it is better to delay hip replacement for a limited period. PMID:24656423

  5. An Analysis of Location of Needle Entry Point and Palpated PSIS in S1 Nerve Root Block

    OpenAIRE

    Kim, Shin Hyung; Yoon, Kyung Bong; Yoon, Duck Mi; Choi, Seong Ah; Kim, Eun Mi

    2010-01-01

    Background The first sacral nerve root block (S1NRB) is a common procedure in pain clinic for patients complaining of low back pain with radiating pain. It can be performed in the office based setting without C-arm. The previously suggested method of locating the needle entry point begins with identifying the posterior superior iliac spine (PSIS). Then a line is drawn between two points, one of which is 1.5 cm medial to the PSIS, and the other of which is 1.5 cm lateral and cephalad to the ip...

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

    Directory of Open Access Journals (Sweden)

    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.

  7. 内脏神经-体神经端侧吻合后神经纤维再生研究%The nerve regeneration after end-to-side nerve anastomosis of distal stump of autonomic nerve to somatic nerve in rats

    Institute of Scientific and Technical Information of China (English)

    高宛生; 李兵

    2010-01-01

    Objective To observe the nerve regeneration after end-to-side anastomosis of distal stump of autonomic nerve to somatic nerve in rats. Methods Twenty-four Sprague-Dawley rats were divided into two groups: experimental group (n = 12) and control group (n = 12). In experimental group, rats had the left lumbar 6 ventral root (L6VR) transected in dura and the distal stump was sutured to the lateral face of left lumbar 4 ventral root (L4VR). In control group, rats had not been done any surgery. After 6 months, in experimental group, the nerves were intercepted 10 mm in length, from the proximal and distal end-to-side nerve anastomosis, regarded as donor nerve (L4VR) and recipient nerve (L%VR), and 10 mm from the pelvic parasympathetic nerve (PPN) and pudendal nerve (PN) from L6VR was intercepted, respectively. In control group, the corresponding nerves were harvested. The cross-sectional nerve slices were stained with toluidine blue through the use of histochemical technique, and the number of myelinated nerve fibers was counted. By comparing L6VR with L4VR the nerve passing rate was calculated, and the number of the nerve fibers of L6VR, PPN and PN between experimental group and control group was compared. Results The new myelinated nerve fibers were observed in the cross-sectional slices of the experimental rats. The number of the nerve fibers located in the L4VR, L6VR, PPN and PN was 1602. 2 ± 75.7,1037.9 ± 123.6, 817. 0 ±52. 2 and 510. 4 ± 29. 1, respectively. The nerve passing rate of the distal and the proximal ends from the anastomosis was 64. 8%, the ratio of the number of nerve fibers in L6VR, PPN and PN was 70.2%, 68.9% and 62.2%, respectively, between the experimental group and control group. Conclusion The somatic nerve can grow into and replace the autonomic nerve after the reflex pathway established by end-to-side anastomosis of autonomic nerve and somatic nerve in rats.%目的 观察大鼠内脏神经-体神经端侧吻合

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

    DEFF Research Database (Denmark)

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

    2015-01-01

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

  9. Motor nerve inexcitability in Guillain-Barré syndrome. The spectrum of distal conduction block and axonal degeneration.

    Science.gov (United States)

    Triggs, W J; Cros, D; Gominak, S C; Zuniga, G; Beric, A; Shahani, B T; Ropper, A H; Roongta, S M

    1992-10-01

    We studied 34 patients with the Guillain-Barré syndrome (GBS) to clarify the clinical significance of inexcitable motor nerves and of low amplitude compound muscle action potentials (CMAPs). The patients were subdivided into two groups. Group 1 included eight patients who had electrically inexcitable motor nerves within 2 wks of the first symptom. (Two patients without extensive conduction studies had only one inexcitable motor nerve.) The outcome in this group at 1 yr varied from complete recovery (five patients) to severe motor sequelae (three patients). Group 2 included 26 patients who had two electrophysiological assessments, and in whom the serial changes in CMAP amplitudes were analysed and correlated to outcome. Fourteen of these 26 sets of serial studies were performed within 1 mth. Twelve of 26 patients in Group 2 showed decrease in the amplitude of CMAPs between serial studies; only six of these had a good outcome at 1 yr. Nine of 26 patients showed increase in CMAP amplitude between serial studies, of these eight had a good clinical outcome. Low-amplitude CMAPs or inexcitable motor nerves in the initial stages of GBS are due to distal pathology of the motor axons, either distal conduction block or axonal degeneration. The nature of these changes cannot be predicted by the results of the initial electrophysiological evaluation, including the presence or absence of active denervation. However, improvement of CMAP amplitude on sequential studies suggests a good outcome at 1 yr. We believe that, in the absence of a biological marker for GBS, individualization of an 'axonal variant' of the syndrome is not warranted at the present time. PMID:1422789

  10. Diphtheritic neuropathy, an analysis based on muscle and nerve biopsy and repeated neurophysiological and autonomic function tests.

    OpenAIRE

    Solders, G; Nennesmo, I; Persson, A.

    1989-01-01

    A patient with diphtheritic neuropathy was investigated with repeated tests of parasympathetic and sympathetic vasomotor and sudomotor functions for one year after the onset of symptoms. Somatic nerve function was tested with nerve conduction studies and an index based on ten variables was used to follow the course of the neuropathy. Sural nerve and anterior tibial muscle biopsies were performed. A severe but shortlasting impairment of the parasympathetic vagal reflex arc was found. The recov...

  11. Comparison of Adductor Canal Block and Femoral Nerve Block for Postoperative Pain in Total Knee Arthroplasty: A Systematic Review and Meta-analysis.

    Science.gov (United States)

    Dong, Cui-Cui; Dong, Shu-Ling; He, Fu-Cheng

    2016-03-01

    A total knee arthroplasty (TKA) has always been associated with moderate-to-severe pain. A systematic review of randomized controlled trials (RCTs) and non-RCTs was performed to evaluate the efficacy and safety of pain control of adductor canal block (ACB) and femoral nerve block (FNB) after TKA.Relevant literatures about the ACB and FNB after TKA for reducing pain were searched from Medline (1996-January, 2015), Embase (1980-January, 2015), PubMed (1980-January, 2015), Web of Science (1980-January, 2015), and The Cochrane Central Register of Controlled Trials. High-quality RCTs and non-RCTs were picked to evaluate the visual analogue scale (VAS) and other outcome. This systematic review and meta-analysis were performed according to the PRISMA statement criteria. The software RevMan 5.30 was used for the meta-analysis.Eight literatures fitted into the inclusion criteria. There were no significant differences in VAS score with rest or mobilization at 4, 24, and 48 h between ACB group and FNB group. There were also no significant differences in the strength of quadriceps and adductor, the length of hospital stay, and complications of vomiting and nausea.Present meta-analysis indicated that ACB shows no superiority than FNB group. Both of them can reduce the pain score after TKA. As referred to which method to adopt, it is determined by the preference of the surgeons and anesthesiologists. PMID:27015172

  12. Local Anesthetic Adjuvants Providing the Longest Duration of Analgesia for Single- Injection Peripheral Nerve Blocks in Orthopedic Surgery: A Literature Review.

    Science.gov (United States)

    Patacsil, Jason A; McAuliffe, Maura S; Feyh, Leah S; Sigmon, Lorie L

    2016-04-01

    Inadequate pain relief after surgery may delay surgical recovery, decrease patient satisfaction, increase length of stay, raise the risk of hospital readmissions, and increase overall healthcare costs. One way to decrease postoperative pain for patients undergoing orthopedic surgery is through the use of peripheral nerve blocks. Anesthesia providers can add many adjuvants to local anesthetics to improve quality and prolong duration of analgesia. The purpose of this literature review is to evaluate local anesthetic adjuvants to peripheral nerve blocks. A review of published studies using PubMed, MEDLINE, and Cochrane search engines was performed using predefined data fields. Based on this literature review, recommendations for practice are provided. PMID:27311150

  13. Testing for autonomic neuropathy

    DEFF Research Database (Denmark)

    Hilsted, J

    1984-01-01

    disease, and may be nonspecific. A number of recently developed quantifiable and reproducible autonomic nerve function tests are reviewed, with emphasis on the physiological basis of the tests and on practical applicability. Finally, diagnostic criteria, based on autonomic nerve function tests, are...

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

    Directory of Open Access Journals (Sweden)

    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.

  15. Upper extremity nerve block: how can benefit, duration, and safety be improved? An update

    Science.gov (United States)

    Brattwall, Metha; Jildenstål, Pether; Warrén Stomberg, Margareta; Jakobsson, Jan G.

    2016-01-01

    Upper extremity blocks are useful as both sole anaesthesia and/or a supplement to general anaesthesia and they further provide effective postoperative analgesia, reducing the need for opioid analgesics. There is without doubt a renewed interest among anaesthesiologists in the interscalene, supraclavicular, infraclavicular, and axillary plexus blocks with the increasing use of ultrasound guidance. The ultrasound-guided technique visualising the needle tip and solution injected reduces the risk of side effects, accidental intravascular injection, and possibly also trauma to surrounding tissues. The ultrasound technique has also reduced the volume needed in order to gain effective block. Still, single-shot plexus block, although it produces effective anaesthesia, has a limited duration of postoperative analgesia and a number of adjuncts have been tested in order to prolong analgesia duration. The addition of steroids, midazolam, clonidine, dexmedetomidine, and buprenorphine has been studied, all being off-label when administered by perineural injection, and the potential neurotoxicity needs further study. The use of perineural catheters is an effective option to improve and prolong the postoperative analgesic effect. Upper extremity plexus blocks have an obvious place as a sole anaesthetic technique or as a powerful complement to general anaesthesia, reducing the need for analgesics and hypnotics intraoperatively, and provide effective early postoperative pain relief. Continuous perineural infusion is an effective option to prolong the effects and improve postoperative quality.

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

    Science.gov (United States)

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

    2016-08-01

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

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

    Directory of Open Access Journals (Sweden)

    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

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

    Science.gov (United States)

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

    2006-03-01

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

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

    Directory of Open Access Journals (Sweden)

    Antonio Medeiros Venancio

    2016-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Jigisha

    2016-02-01

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

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

    Directory of Open Access Journals (Sweden)

    Kévin Buffenoir

    2013-01-01

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

  2. 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

    2014-10-01

    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.

  3. 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

  4. 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; Sosnovtseva, O. V.

    2011-01-01

    . Uptake of potassium leads to Schwann cell swelling and myelin restructuring that impacts the electrical properties of the myelin. In order to further understand the dynamic interaction that takes place between the myelin and the axon, we have modelled submyelin potassium accumulation and related changes...... in myelin resistance during prolonged high-frequency stimulation. We predict that potassium-mediated decrease in myelin resistance leads to a functional excitation block with various patterns of altered spike trains. The patterns are found to depend on stimulation frequency and amplitude and to range...

  5. Male sexual and urinary functions after autonomic-nerve-preserving operations for rectal cancer and individualization of the operation based on thin-section MRI findings

    International Nuclear Information System (INIS)

    A prospective study on male sexual and urinary functions after mesorectal excision (ME) or ME plus extended lateral pelvic lymph node dissection (LD) for rectal cancer showed that the patients undergoing ME alone had excellent sexual and urinary functions. The functional results of the patients with ME plus LD were worse than those of the patients with ME alone. Degrees of sexual and urinary dysfunctions depend on the degrees of both autonomic nerve preservation (ANP) and LD. Thus, ideally, ANP and LD should be individualized according to tumor extent. Another prospective study assessing accuracy of thin-section MRI (TSMRI) with a phased-array coil in rectal cancer staging demonstrated that TSMRI is very accurate in detection of mesorectal fascia invasion and lateral pelvic lymph node metastasis, and TSMRI is moderately accurate in prediction of transmural invasion depth and mesorectal lymph node metastasis. In conclusion, individualization of ANP and LD seems possible if it depends on TSMRI findings. (author)

  6. 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

  7. 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

  8. 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

  9. Trial of finger contamination reduction of the operator in nerve block treatment. Comparison of over- and under-table systems

    International Nuclear Information System (INIS)

    Fluoroscopy-guided intervention of the lumbar spine, such as nerve block, plays an important role in the management of disc hernia patients. However, irradiation of operators' fingers remains a problem even with careful collimation and operation, especially when performed by non-radiologists. We compared the irradiation doses of under-table and over-table fluoroscopy systems, and we discuss the most advantageous method of reducing irradiation. The effectiveness and conditions of use of lead protection gloves were also evaluated. Skin dose was monitored using polymethyl methacrylate (PMMA) and an electronic dose meter. The skin doses of over- and under-table fluoroscopy were compared using C-arm fluoroscopy. Finger irradiation dose with 0.03 mmPb protection gloves was also measured. The under-table method reduced skin dose by 95% compared with the over-table method. Thicker PMMA resulted in a higher rate of irradiation reduction. Protection gloves reduced radiation dose by half, although this reduction was cancelled when automatic brightness control (ABC) was utilized. Under-tube fluoroscopy was superior to over-tube fluoroscopy in reducing irradiation to the fingers. (author)

  10. Development of an autonomous detector for sensing of nerve agents based on functionalized silicon nanowire field-effect transistors.

    Science.gov (United States)

    Clavaguera, Simon; Raoul, Nicolas; Carella, Alexandre; Delalande, Michael; Celle, Caroline; Simonato, Jean-Pierre

    2011-10-15

    The ability to detect minute traces of chemical warfare agents is mandatory both for military forces and homeland security. Various detectors based on different technologies are available but still suffer from serious drawbacks such as false positives. There is still a need for the development of innovative reliable sensors, in particular for organophosphorus nerve agents like Sarin. We report herein on the fabrication of a portable, battery-operated, microprocessor-based prototype sensor system relying on silicon nanowire field-effect transistors for the detection of nerve agents. A fast, supersensitive and highly selective detection of organophosphorus molecules is reported. The results show also high selectivity in complex mixtures and on contaminated materials. PMID:21962681

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

    Science.gov (United States)

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

    2014-01-01

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

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

    International Nuclear Information System (INIS)

    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.)

  13. 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.)

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

    OpenAIRE

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

    2013-01-01

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

  15. An Evaluation of the Effectiveness of Hyaluronidase in the Selective Nerve Root Block of Radiculopathy: A Double Blind, Controlled Clinical Trial

    OpenAIRE

    Ko, Sang-Bong; Alexander R Vaccaro; Chang, Ho-Jin; Shin, Dong-Young

    2015-01-01

    Study Design Prospective, double-blind, randomized controlled trial. Purpose To determine the ability of hyaluronidase to provide longer lasting pain relief and functional improvement in patients with lumbar radiculopathy. Overview of Literature Selective nerve root block (SNRB) is a good treatment option in lumbar radiculopathy. We studied the effectiveness of hyaluronidase when added to the traditional SNRB regimen. Methods A sample size of 126 patients per group was necessary. A sample of ...

  16. Ganglion block. When and how?

    International Nuclear Information System (INIS)

    Increasing understanding of the anatomy and physiology of neural structures has led to the development of surgical and percutaneous neurodestructive methods in order to target and destroy various components of afferent nociceptive pathways. The dorsal root ganglia and in particular the ganglia of the autonomous nervous system are targets for radiological interventions. The autonomous nervous system is responsible for the regulation of organ functions, sweating, visceral and blood vessel-associated pain. Ganglia of the sympathetic chain and non-myelinized autonomous nerves can be irreversibly destroyed by chemical and thermal ablation. Computed tomography (CT)-guided sympathetic nerve blocks are well established interventional radiological procedures which lead to vasodilatation, reduction of sweating and reduction of pain associated with the autonomous nervous system. Sympathetic blocks are applied for the treatment of various vascular diseases including critical limb ischemia. Other indications for thoracic and lumbar sympathectomy include complex regional pain syndrome (CRPS), chronic tumor associated pain and hyperhidrosis. Neurolysis of the celiac plexus is an effective palliative pain treatment particularly in patients suffering from pancreatic cancer. Percutaneous dorsal root ganglion rhizotomy can be performed in selected patients with radicular pain that is resistant to conventional pharmacological and interventional treatment. (orig.)

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

    International Nuclear Information System (INIS)

    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

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

    Science.gov (United States)

    Mujeeb, Sabeen; Akhtar, Jamshed; Ahmed, Soofia

    2013-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Rajesh S Mane

    2011-01-01

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

  1. 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

    OpenAIRE

    Keese, M; Riester, T; K. Schwenke; Dinter, D.; Back, W; Palma, P.

    2007-01-01

    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 m...

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

    Directory of Open Access Journals (Sweden)

    Prakash Khairnar

    2016-01-01

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

  3. 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.

  4. 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.

  5. Neuromuscular nicotinic receptors mediate bladder contractions following bladder reinnervation with somatic to autonomic nerve transfer after decentralization by spinal root transection

    OpenAIRE

    Gomez-Amaya, Sandra M.; Barbe, Mary F.; Lamarre, Neil S.; Brown, Justin M.; Braverman, Alan S.; RUGGIERI, MICHAEL R.

    2014-01-01

    This study investigates whether the reinnervated neuronal pathway mediates contraction via the same neurotransmitter and receptor mechanisms as the original pathway. Following bladder decentralization by transection of sacral roots, peripheral nerve transfer was performed with bilateral genitofemoral to pelvic nerve transfer (GFNT) and unilateral (left) femoral nerve to bilateral pelvic nerve transfer (FNT). Reinnervation was assessed 7.5 months post operatively by monitoring bladder pressure...

  6. 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.

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

    Science.gov (United States)

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

    2016-03-01

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

  8. Upper extremity nerve block: how can benefit, duration, and safety be improved? An update [version 1; referees: 3 approved

    OpenAIRE

    Metha Brattwall; Pether Jildenstål; Margareta Warrén Stomberg; Jakobsson, Jan G.

    2016-01-01

    Upper extremity blocks are useful as both sole anaesthesia and/or a supplement to general anaesthesia and they further provide effective postoperative analgesia, reducing the need for opioid analgesics. There is without doubt a renewed interest among anaesthesiologists in the interscalene, supraclavicular, infraclavicular, and axillary plexus blocks with the increasing use of ultrasound guidance. The ultrasound-guided technique visualising the needle tip and solution injected reduces the risk...

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

    Institute of Scientific and Technical Information of China (English)

    唐毅; 耿智隆; 马辉兰; 时圣武

    2011-01-01

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

  10. A cell type-specific allele of the POU gene Oct-6 reveals Schwann cell autonomous function in nerve development and regeneration

    NARCIS (Netherlands)

    M. Ghazvini (Mehrnaz); W.J. Mandemakers (Wim); M.M. Jaegle (Martine); M. Piirsoo (Marko); M. Koutsourakis (Manousos); X. Smit (Xander); D.N. Meijer (Dies); M.J.F. Driegen (Siska); F.G. Grosveld (Frank)

    2002-01-01

    textabstractWhile an important role for the POU domain transcription factor Oct-6 in the developing peripheral nerve has been well established, studies into its exact role in nerve development and regeneration have been hampered by the high mortality rate of newborn Oct-6 mutant an

  11. A cell type-specific allele of the POU gene Oct-6 reveals Schwann cell autonomous function in nerve development and regeneration.

    NARCIS (Netherlands)

    M. Ghazvini (Mehrnaz); W.J. Mandemakers (Wim); M.M. Jaegle (Martine); M. Piirsoo (Marko); M. Koutsourakis (Manousos); X. Smit (Xander); F.G. Grosveld (Frank); D.N. Meijer (Dies); M.J.F. Driegen (Siska)

    2002-01-01

    textabstractWhile an important role for the POU domain transcription factor Oct-6 in the developing peripheral nerve has been well established, studies into its exact role in nerve development and regeneration have been hampered by the high mortality rate of newborn Oct-6 mutant animals. In this stu

  12. 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.

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

    OpenAIRE

    Kévin Buffenoir; Philippe Decq; Chantal Pérot

    2013-01-01

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

  14. Femoral nerve block Intervention in Neck of Femur fracture (FINOF): study protocol for a randomized controlled trial

    OpenAIRE

    Sahota, Opinder; Rowlands, Martin; Bradley, Jim; van der Walt, Gerrie; Bedforth, Nigel; Armstrong, Sarah; Moppett, Iain

    2014-01-01

    Background Hip fractures are very painful leading to lengthy hospital stays. Conventional methods of treating pain are limited. Non-steroidal anti-inflammatories are relatively contraindicated and opioids have significant side effects.Regional anaesthesia holds promise but results from these techniques are inconsistent. Trials to date have been inconclusive with regard to which blocks to use and for how long. Interpatient variability remains a problem. Methods/Design This is a single centre s...

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

    Science.gov (United States)

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

    2015-01-01

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

  16. 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

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

    Institute of Scientific and Technical Information of China (English)

    阳垚鑫(综述); 李羽(审校)

    2016-01-01

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

  18. 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。

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

    Directory of Open Access Journals (Sweden)

    Amit Jena

    2013-01-01

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

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

    Science.gov (United States)

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

    2009-02-01

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

  1. 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

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

    Institute of Scientific and Technical Information of China (English)

    陈茜; 赵守国

    2015-01-01

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

  3. 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.

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

    OpenAIRE

    Osborne, Peregrine B.

    2015-01-01

    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, recov...

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

    OpenAIRE

    Forrest, Shelley L.; Sophie C Payne; Keast, Janet R; Osborne, Peregrine B.

    2015-01-01

    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 signaling. 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, recove...

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

    Institute of Scientific and Technical Information of China (English)

    孙光孝; 朱亚文; 陶高见

    2011-01-01

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

  7. Dorsal Penile Nerve Block With Ropivacaine-Reduced Postoperative Catheter-Related Bladder Discomfort in Male Patients After Emergence of General Anesthesia: A Prospective, Randomized, Controlled Study.

    Science.gov (United States)

    Li, Jing-Yi; Yi, Ming-Liang; Liao, Ren

    2016-04-01

    Catheter-related bladder discomfort (CRBD) is a distressing symptom complex after surgery, especially in male patients who have had urinary catheterization under general anesthesia. In this prospective, randomized, controlled trial, we compared dorsal penile nerve block (DPNB) with 0.33% ropivacaine with intravenous tramadol 1.5 mg kg in prevention of CRBD, as well as the incidences of postoperative side effects.Fifty-eight male patients aged 18 to 50 years, undergoing elective liver surgery and limb surgery with urinary catheterization, were enrolled and divided randomly into 2 groups. In the DPNB group, patients were given dorsal penile nerve block with 15 mL of 0.33% ropivacaine, and in the tramadol intravenous administration (TRAM) group, patients were given 1.5 mg kg tramadol after the completion of surgery before extubation. The primary outcome was the incidence of CRBD, and the secondary outcomes included the severity of CRBD, postoperative side effects, postoperative pain, and the acceptance of urinary catheterization. Patients were evaluated upon arrival to postanesthetic care unit (PACU), at 0.5, 1, 2, 4, and 6 hours after patients' arrival in the PACU for outcomes.The incidence of CRBD was significantly lower in the DPNB group than in the TRAM group, either upon arrival to PACU (10.3% vs 37.9%, P = 0.015), or at 0.5 hours (3.4% vs 34.5%, P = 0.003), 1 hours (3.4% vs 37.9%, P = 0.001), 2 hours (6.9% vs 34.5%, P = 0.010), and 4 hours (6.9% vs 27.6%, P = 0.039) after patients' arrival in PACU. Compared with the TRAM group, the severity of postoperative CRBD upon arrival to PACU (P = 0.011) and at 0.5 hours (P = 0.005), 1 hours (P = 0.002), 2 hours (P = 0.005), 4 hours (P = 0.017), and 6 hours (P = 0.047) after patients' arrival in PACU were all significantly reduced in the DPNB group. The incidences of postoperative nausea, vomiting, dizziness, and sedation were decreased

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

    Institute of Scientific and Technical Information of China (English)

    许菁; 贾功伟; 谭波涛; 虞乐华

    2012-01-01

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

  10. Pinched Nerve

    Science.gov (United States)

    ... Enhancing Diversity Find People About NINDS NINDS Pinched Nerve Information Page Table of Contents (click to jump ... being done? Clinical Trials Organizations What is Pinched Nerve? The term "pinched nerve" is a colloquial term ...

  11. 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 ...

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

    Institute of Scientific and Technical Information of China (English)

    窦桂珍

    2014-01-01

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

  13. 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.

  14. Agent, autonomous

    OpenAIRE

    Luciani, Annie

    2007-01-01

    The expression autonomous agents, widely used in virtual reality, computer graphics, artificial intelligence and artificial life, corresponds to the simulation of autonomous creatures, virtual (i.e. totally computed by a program), or embodied in a physical envelope, as done in autonomous robots.

  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. Seborrheic dermatitis treatment with stellate ganglion block: a case report.

    Science.gov (United States)

    Kim, Gun Woo; Mun, Ki Ho; Song, Jeong Yun; Kim, Byung Gun; Jung, Jong Kwon; Lee, Choon Soo; Cha, Young Deog; Song, Jang Ho

    2016-04-01

    Seborrheic dermatitis is a chronic recurrent inflammatory disorder presumed to be caused by increased sebaceous gland secretion, metabolic changes in the cutaneous microflora, and changes in the host immune function. Stellate ganglion block (SGB) is known to increase the blood flow rate without altering the blood pressure, heart rate, or cardiac output, to stabilize hypertonic conditions of the sympathetic nerves, and to affect the endocrine and immune systems. It is used in the differential diagnosis and treatment of autonomic nervous system disorders of the head, neck, and upper limbs. The authors report the first case of successful treatment of a patient with seborrheic dermatitis through repeated SGB trials. PMID:27064785

  17. 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,

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

    Directory of Open Access Journals (Sweden)

    Thimmaiah. P. B.

    2013-08-01

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

  19. Autonomic dysreflexia in a tetraplegic patient due to a blocked urethral catheter: spinal cord injury patients with lesions above T-6 require prompt treatment of an obstructed urinary catheter to prevent life-threatening complications of autonomic dysreflexia

    OpenAIRE

    Vaidyanathan, Subramanian; Soni, Bakul; Oo, Tun; Hughes, Peter; Singh, Gurpreet; Pulya, Kamesh

    2012-01-01

    Background The Manchester Triage System is commonly used as the triage system in emergency departments of the UK. As per the Manchester Triage System, patients presenting with retention of urine to the accident and emergency department are categorized to yellow, which denotes that the ideal maximum time to first contact with a treating clinician will be 60 min. Cervical spinal cord injury patients, in whom urinary catheter is blocked, may develop suddenly headache, sweating, high blood pressu...

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

    Institute of Scientific and Technical Information of China (English)

    李冰; 励建安; 朱杰; 刘守国

    2011-01-01

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

  1. 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.

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

    Institute of Scientific and Technical Information of China (English)

    郭向飞; 郭玉娜; 倪家骧; 卿恩明

    2012-01-01

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

  3. Nerve conduction

    Science.gov (United States)

    ... the central nervous system (CNS) and peripheral nervous system (PNS). The CNS contains the brain and the spinal cord and the PNS consists of thousands of nerves that connect the spinal cord to muscles and sensory receptors. A peripheral nerve is composed of nerve ...

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

    Directory of Open Access Journals (Sweden)

    Affonso H. Zugliani

    2007-10-01

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

  5. 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.

  6. 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

  7. 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.

  8. Terminal nerve: cranial nerve zero

    Directory of Open Access Journals (Sweden)

    Jorge Eduardo Duque Parra

    2006-12-01

    Full Text Available It has been stated, in different types of texts, that there are only twelve pairs of cranial nerves. Such texts exclude the existence of another cranial pair, the terminal nerve or even cranial zero. This paper considers the mentioned nerve like a cranial pair, specifying both its connections and its functional role in the migration of liberating neurons of the gonadotropic hormone (Gn RH. In this paper is also stated the hypothesis of the phylogenetic existence of a cerebral sector and a common nerve that integrates the terminal nerve with the olfactory nerves and the vomeronasals nerves which seem to carry out the odors detection function as well as in the food search, pheromone detection and nasal vascular regulation.

  9. Effects of forearm bier block with bretylium on the hemodynamic and metabolic responses to handgrip

    Science.gov (United States)

    Lee, F.; Shoemaker, J. K.; McQuillan, P. M.; Kunselman, A. R.; Smith, M. B.; Yang, Q. X.; Smith, H.; Gray, K.; Sinoway, L. I.

    2000-01-01

    We tested the hypothesis that a reduction in sympathetic tone to exercising forearm muscle would increase blood flow, reduce muscle acidosis, and attenuate reflex responses. Subjects performed a progressive, four-stage rhythmic handgrip protocol before and after forearm bier block with bretylium as forearm blood flow (Doppler) and metabolic (venous effluent metabolite concentration and (31)P-NMR indexes) and autonomic reflex responses (heart rate, blood pressure, and sympathetic nerve traffic) were measured. Bretylium inhibits the release of norepinephrine at the neurovascular junction. Bier block increased blood flow as well as oxygen consumption in the exercising forearm (P bier block (6.41 +/- 0.08 vs. 6.20 +/- 0.06; P bier block. The results support the conclusion that sympathetic stimulation to muscle during exercise not only limits muscle blood flow but also appears to limit anaerobiosis and H(+) release, presumably through a preferential recruitment of oxidative fibers.

  10. Functions of adrenergic and cholinergic nerves in canine effectors of seminal emission.

    Science.gov (United States)

    Arver, S; Sjöstrand, N O

    1982-05-01

    Spontaneous activity responses to acetylcholine (ACh), adrenaline (A), noradrenaline (NA) and barium chloride as well as the effects of various autonomic drugs on effects of field stimulation of nerves and muscle cells of isolated pieces or strips of cauda epididymidis, vas deferens, ampulla ductus deferentis and prostate of dog were studied. The main results and conclusions are: the muscles show little spontaneous activity but rhythmicity can easily be produced by e.g. stimulating agonists. The muscles are contracted by alpha-adrenoceptor stimulants. ACh has usually no or a very weak contractile effect in high concentrations. Muscles of young dogs are more sensitive to ACh. The excitatory innervation of the muscles is adrenergic and completely blocked by adrenergic neuron blockers as well as alpha-adrenoceptor blocking drugs. Stimulation of adrenergic nerves leads to maximum response already at low frequencies (4-6 Hz). This response is very similar to that provoked by a supramaximal dose of NA. Scopolamine enhances neurogenic contractile effects while physostigmine suppresses them. Hence cholinergic nerves may act by muscarinic prejunctional inhibition of the excitatory adrenergic neurotransmission rather than act directly upon the smooth muscle cells. Since secretory cells receive cholinergic innervation prejunctional inhibition of the adrenergic myomotor nerves may be of functional significance in at least the long copulatory events of the dog. PMID:6127870

  11. 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

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

    Institute of Scientific and Technical Information of China (English)

    张浩; 魏关子; 张兰兰; 陈卫平

    2012-01-01

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

  13. Terminal nerve: cranial nerve zero

    OpenAIRE

    Jorge Eduardo Duque Parra; Carlos Alberto Duque Parra

    2006-01-01

    It has been stated, in different types of texts, that there are only twelve pairs of cranial nerves. Such texts exclude the existence of another cranial pair, the terminal nerve or even cranial zero. This paper considers the mentioned nerve like a cranial pair, specifying both its connections and its functional role in the migration of liberating neurons of the gonadotropic hormone (Gn RH). In this paper is also stated the hypothesis of the phylogenetic existence of a cerebral sector and a co...

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

    Institute of Scientific and Technical Information of China (English)

    唐毅; 徐鹏; 耿智隆; 马辉兰; 李兴福

    2011-01-01

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

  15. 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

  16. 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 (< 20% total bladder capacity) in response to scratching in dermatomes T-9 through S-2 using a standardized protocol, but the voiding was not reproducible and the volume voided was not clinically useful in

  17. Microvascular Cranial Nerve Palsy

    Science.gov (United States)

    ... Español Eye Health / Eye Health A-Z Microvascular Cranial Nerve Palsy Sections What Is Microvascular Cranial Nerve Palsy? ... Microvascular Cranial Nerve Palsy Treatment What Is Microvascular Cranial Nerve Palsy? Aug. 02, 2012 Microvascular cranial nerve palsy ( ...

  18. Sensory nerve function and auto-mutilation after reconstruction of various gap lengths with nerve guides and autologous nerve grafts.

    Science.gov (United States)

    den Dunnen, W F; Meek, M F

    2001-05-01

    The aim of this study was to evaluate sensory nerve recovery and auto-mutilation after reconstruction of various lengths of nerve gaps in the sciatic nerve of the rat, using different techniques. Group 4, in which the longest nerve gap (15 mm) was reconstructed with a thin-walled p(DL-lactide-gamma-caprolactone) nerve guide filled with modified denatured muscle tissue, showed the best results in the electro-stimulation tests and signs of severe auto-mutilation were not observed. Even in the control group, in which a 10 mm nerve gap was left open, in two of the five rats improvement of the sensory nerve function was observed, which was caused by re-innervation of the sciatic nerve and not by expansion of the neighboring saphenous nerve. It is hypothesized that a better quality of nerve reconstruction/guidance channel/support results in faster regeneration and hence re-innervation, thereby, preventing auto-mutilation. A thin red glabrous skin, anhydrosis (dryness of the skin), short nails and edema were interpreted as signs of autonomic dysfunction. PMID:11352096

  19. Jugular venous overflow of noradrenaline from the brain: a neurochemical indicator of cerebrovascular sympathetic nerve activity in humans

    DEFF Research Database (Denmark)

    Mitchell, D.A.; Lambert, G.; Secher, Niels H.; Raven, P.B.; J., van Lieshout; Esler, M.D.

    )) overflow rates were measured. These measurements were also made following ganglion blockade (trimethaphan, n = 6), central sympathetic inhibition (clonidine, n = 4) and neuronal noradrenaline uptake blockade (desipramine, n = 13) and in a group of patients (n = 9) with pure autonomic failure (PAF). The...... = 0.3). Neuronal noradrenaline uptake block with desipramine lowered the transcranial plasma extraction of tritiated noradrenaline (P = 0.001). The PAF patients had 77% lower brain noradrenaline spillover than healthy recruits (P = 0.06), indicating that in them sympathetic nerve degeneration extended...

  20. Autonomic nervous regulation of ovarian function by noxious somatic afferent stimulation

    OpenAIRE

    Uchida, Sae; Kagitani, Fusako

    2014-01-01

    It is well known that ovarian function is regulated by hypothalamic–pituitary–ovarian hormones. However, although several histological studies have described the autonomic innervation of the ovary, the involvement of these autonomic nerves in ovarian function is unclear. Recently, it has been shown that both the superior ovarian nerve (SON) and the ovarian nerve plexus (ONP) induce vasoconstrictor activity by activation of alpha 1-adrenoceptors, whereas the SON, but not the ONP, inhibits ovar...

  1. 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…

  2. Autonomic control of the eye

    Science.gov (United States)

    McDougal, David H.; Gamlin, Paul D.

    2016-01-01

    The autonomic nervous system influences numerous ocular functions. It does this by way of parasympathetic innervation from postganglionic fibers that originate from neurons in the ciliary and pterygopalatine ganglia, and by way of sympathetic innervation from postganglionic fibers that originate from neurons in the superior cervical ganglion. Ciliary ganglion neurons project to the ciliary body and the sphincter pupillae muscle of the iris to control ocular accommodation and pupil constriction, respectively. Superior cervical ganglion neurons project to the dilator pupillae muscle of the iris to control pupil dilation. Ocular blood flow is controlled both via direct autonomic influences on the vasculature of the optic nerve, choroid, ciliary body, and iris, as well as via indirect influences on retinal blood flow. In mammals, this vasculature is innervated by vasodilatory fibers from the pterygopalatine ganglion, and by vasoconstrictive fibers from the superior cervical ganglion. Intraocular pressure is regulated primarily through the balance of aqueous humor formation and outflow. Autonomic regulation of ciliary body blood vessels and the ciliary epithelium is an important determinant of aqueous humor formation; autonomic regulation of the trabecular meshwork and episcleral blood vessels is an important determinant of aqueous humor outflow. These tissues are all innervated by fibers from the pterygopalatine and superior cervical ganglia. In addition to these classical autonomic pathways, trigeminal sensory fibers exert local, intrinsic influences on many of these regions of the eye, as well as on some neurons within the ciliary and pterygopalatine ganglia. PMID:25589275

  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. 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

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

    Institute of Scientific and Technical Information of China (English)

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

    2010-01-01

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

  6. 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.

  7. Readiness for surgery after axillary block

    DEFF Research Database (Denmark)

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

    1997-01-01

    We have assessed prospectively the time to readiness for surgery following axillary block (sum of block performance and latency times) in 80 patients. The brachial plexus was identified using a nerve stimulator, and anaesthetized with 45 mL of mepivacaine 1% with adrenaline 5 micrograms mL-1. In...... group 1 (single injection) the whole volume of mepivacaine was injected after locating only one of the plexus nerves. In group 2 (multiple injections) at least three plexus nerves were located, and the volume of mepivacaine was divided between them. Sensory block was assessed by a blinded observer every...... required less time for block performance (mean 5.5 min) than multiple injections (mean 9.5 min), P <0.0001. However, latency of the block was longer and the requirement for supplemental nerve blocks was greater, after single injections (33 min and 57%) than after multiple injections (15.5 min and 7...

  8. 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.

  9. 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.

  10. 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 ...

  11. 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

  12. 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

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

    Institute of Scientific and Technical Information of China (English)

    黄天丰; 张扬; 方向志; 王存金; 高巨

    2016-01-01

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

  14. Pure Autonomic Failure

    Science.gov (United States)

    ... Drugs GARD Information Navigator FAQs About Rare Diseases Pure autonomic failure Title Other Names: Bradbury Eggleston syndrome; ... Categories: Nervous System Diseases ; RDCRN Summary Summary Listen Pure autonomic failure is characterized by generalized autonomic failure ...

  15. 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.

  16. What Are Nerve Blocks for Headache?

    Science.gov (United States)

    ... Pain at the Montefiore Headache Center, Department of Neurology, Albert Einstein College of Medicine, Bronx, NY. Matthew S. Robbins, MD, FAHS, is the director of the neurology service at the Einstein Division of Montefiore Medical ...

  17. What Are Nerve Blocks for Headache?

    Science.gov (United States)

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

  18. 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.

  19. 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

  20. Effects of forearm bier block with bretylium on the hemodynamic and metabolic responses to handgrip

    Science.gov (United States)

    Lee, F.; Shoemaker, J. K.; McQuillan, P. M.; Kunselman, A. R.; Smith, M. B.; Yang, Q. X.; Smith, H.; Gray, K.; Sinoway, L. I.

    2000-01-01

    We tested the hypothesis that a reduction in sympathetic tone to exercising forearm muscle would increase blood flow, reduce muscle acidosis, and attenuate reflex responses. Subjects performed a progressive, four-stage rhythmic handgrip protocol before and after forearm bier block with bretylium as forearm blood flow (Doppler) and metabolic (venous effluent metabolite concentration and (31)P-NMR indexes) and autonomic reflex responses (heart rate, blood pressure, and sympathetic nerve traffic) were measured. Bretylium inhibits the release of norepinephrine at the neurovascular junction. Bier block increased blood flow as well as oxygen consumption in the exercising forearm (P blood flow but also appears to limit anaerobiosis and H(+) release, presumably through a preferential recruitment of oxidative fibers.

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

    Institute of Scientific and Technical Information of China (English)

    张启栋; 刘朝晖; 程立明; 曹三利; 徐广春; 路玉峰; 郭万首

    2013-01-01

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

  2. Autonomic Activation in Insomnia: The Case for Acupuncture

    OpenAIRE

    Huang, Wei; Kutner, Nancy; Bliwise, Donald L.

    2011-01-01

    Current conceptualizations of the biological basis for insomnia typically invoke central nervous system and/or autonomic nervous system arousal. Acupuncture may represent a unique avenue of treatment for poor sleep by virtue of its direct effects on peripheral nerves and muscles, which, in turn, modulate autonomic tone and central activation. In this review, we summarize both basic and clinical research indicating that acupuncture exerts profound influences via a wide variety of potential neu...

  3. The level of the sciatic nerve division and its relations to the piriform muscle

    OpenAIRE

    Ugrenović Slađana Z.; Jovanović Ivan D.; Krstić Vladislav; Stojanović Vesna R.; Vasović Ljiljana P.; Antić Svetlana; Pavlović Snežana S.

    2005-01-01

    Background. The sciatic nerve, as the terminal branch of the sacral plexus, leaves the pelvis through the greater sciatic foramen beneath the piriform muscle. Afterwards, it separates into the tibial and the common peroneal nerve, most frequently at the level of the upper angle of the popliteal fossa. Higher level of the sciatic nerve division is a relatively frequent phenomenom and it may be the cause of an incomplete block of the sciatic nerve during the popliteal block anesthesia. There is...

  4. 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.

  5. Nerve excitability testing and its clinical application to neuromuscular diseases.

    Science.gov (United States)

    Nodera, Hiroyuki; Kaji, Ryuji

    2006-09-01

    Non-invasive nerve excitability testing measures the membrane polarization, ion channel function and paranodal/internodal condition of peripheral nerves. This technique has been recently used for various neuromuscular disorders, such as pure motor conduction block in multifocal motor neuropathy, conduction block in carpal tunnel syndrome and Na(+) channel function disorders in diabetic neuropathy, to shed light on their pathophysiology. Here, we review the basics of ion channel functions and membrane properties that influence nerve excitability, the basic principles of nerve excitability testing and the reported findings in various disorders. PMID:16631406

  6. 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.

  7. Ischemic and reperfusion injury of rat peripheral nerve

    International Nuclear Information System (INIS)

    A rat model of severe nerve ischemia was used to study the effects of ischemia and reperfusion on nerve conduction, blood flow, and the integrity of the blood-nerve barrier. Conduction failure was consistently found in the sciatic-tibial nerve during 1- and 3-hr ischemic periods. Recovery of the compound muscle action potential was prompt and complete upon reperfusion following 1 hr of ischemia. However, after 3 hr of ischemia, recovery in the proximal portion of the sciatic nerve was 14C]sucrose following 1 hr of ischemia but was significantly impaired after 3 hr of ischemia. The permeability-surface area product was consistently greater following 1 hr of reperfusion than during the immediate reperfusion period. These data indicate that severe ischemia of peripheral nerve results in reperfusion injury, conduction block, and blood-nerve barrier disruption. Microvascular events, which may occur during reperfusion, may be important in amplifying the nerve fiber damage that began during ischemia

  8. Cervical Radiculopathy (Pinched Nerve)

    Science.gov (United States)

    ... the seven small vertebrae that form the neck. Spinal nerve root. AAOS does not endorse any treatments, procedures, ... whether your symptoms are caused by pressure on spinal nerve roots and nerve damage or by another condition ...

  9. Nerve conduction velocity

    Science.gov (United States)

    Nerve conduction velocity (NCV) is a test to see how fast electrical signals move through a nerve. ... surface electrodes are placed on the skin over nerves at different spots. Each patch gives off a ...

  10. Optic Nerve Imaging

    Science.gov (United States)

    ... News About Us Donate In This Section Optic Nerve Imaging email Send this article to a friend ... measurements of nerve fiber damage (or loss). The Nerve Fiber Analyzer (GDx) uses laser light to measure ...

  11. Femoral nerve damage (image)

    Science.gov (United States)

    The femoral nerve is located in the leg and supplies the muscles that assist help straighten the leg. It supplies sensation ... leg. One risk of damage to the femoral nerve is pelvic fracture. Symptoms of femoral nerve damage ...

  12. Ulnar nerve damage (image)

    Science.gov (United States)

    The ulnar nerve originates from the brachial plexus and travels down arm. The nerve is commonly injured at the elbow because of elbow fracture or dislocation. The ulnar nerve is near the surface of the body where ...

  13. Peripheral nerve injuries in the athlete.

    Science.gov (United States)

    Feinberg, J H; Nadler, S F; Krivickas, L S

    1997-12-01

    Peripheral nerves are susceptible to injury in the athlete because of the excessive physiological demands that are made on both the neurological structures and the soft tissues that protect them. The common mechanisms of injury are compression, traction, ischaemia and laceration. Seddon's original classification system for nerve injuries based on neurophysiological changes is the most widely used. Grade 1 nerve injury is a neuropraxic condition, grade 2 is axonal degeneration and grade 3 is nerve transection. Peripheral nerve injuries are more common in the upper extremities than the lower extremities, tend to be sport specific, and often have a biomechanical component. While the more acute and catastrophic neurological injuries are usually obvious, many remain subclinical and are not recognised before neurological damage is permanent. Early detection allows initiation of a proper rehabilitation programme and modification of biomechanics before the nerve injury becomes irreversible. Recognition of nerve injuries requires an understanding of peripheral neuroanatomy, knowledge of common sites of nerve injury and an awareness of the types of peripheral nerve injuries that are common and unique to each sport. The electrodiagnostic exam, usually referred to as the 'EMG', consists of nerve conduction studies and the needle electrode examination. It is used to determine the site and degree of neurological injury and to predict outcome. It should be performed by a neurologist or physiatrist (physician specialising in physical medicine and rehabilitation), trained and skilled in this procedure. Timing is essential if the study is to provide maximal information. Findings such as decreased recruitment after injury and conduction block at the site of injury may be apparent immediately after injury but other findings such as abnormal spontaneous activity may take several weeks to develop. The electrodiagnostic test assists with both diagnosis of the injury and in predicting

  14. 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 ...

  15. Autoimmune Autonomic Ganglionopathy

    Science.gov (United States)

    ... Accessed 9/2/2015. Autoimmune Autonomic Ganglionopathy Summary. Dysautonomia International . http://www.dysautonomiainternational.org/page.php?ID= ... page Basic Information In Depth Information Basic Information Dysautonomia International offers an information page on Autoimmune autonomic ...

  16. Human primordial germ cells migrate along nerve fibers and Schwann cells from the dorsal hind gut mesentery to the gonadal ridge

    DEFF Research Database (Denmark)

    Møllgård, Kjeld; Jespersen, Åse; Lutterodt, Melissa Catherine;

    2010-01-01

    The aim of this study was to investigate the spatiotemporal development of autonomic nerve fibers and primordial germ cells (PGCs) along their migratory route from the dorsal mesentery to the gonadal ridges in human embryos using immunohistochemical markers and electron microscopy. Autonomic nerve...... PGCs arrive at the gonadal ridge between 29 and 33 days pc. In conclusion, our data suggest that PGCs in human embryos preferentially migrate along autonomic nerve fibers from the dorsal mesentery to the developing gonad where they are delivered via a fine nerve plexus....

  17. The cranial nerve skywalk: A 3D tutorial of cranial nerves in a virtual platform.

    Science.gov (United States)

    Richardson-Hatcher, April; Hazzard, Matthew; Ramirez-Yanez, German

    2014-01-01

    Visualization of the complex courses of the cranial nerves by students in the health-related professions is challenging through either diagrams in books or plastic models in the gross laboratory. Furthermore, dissection of the cranial nerves in the gross laboratory is an extremely meticulous task. Teaching and learning the cranial nerve pathways is difficult using two-dimensional (2D) illustrations alone. Three-dimensional (3D) models aid the teacher in describing intricate and complex anatomical structures and help students visualize them. The study of the cranial nerves can be supplemented with 3D, which permits the students to fully visualize their distribution within the craniofacial complex. This article describes the construction and usage of a virtual anatomy platform in Second Life™, which contains 3D models of the cranial nerves III, V, VII, and IX. The Cranial Nerve Skywalk features select cranial nerves and the associated autonomic pathways in an immersive online environment. This teaching supplement was introduced to groups of pre-healthcare professional students in gross anatomy courses at both institutions and student feedback is included. PMID:24678025

  18. 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.

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

    Science.gov (United States)

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

    2016-09-01

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

  20. 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.

  1. The pathological basis of conduction block in human neuropathies.

    OpenAIRE

    Feasby, T E; Brown, W F; Gilbert, J J; Hahn, A F

    1985-01-01

    Conduction block was detected in patients with neuropathy by measuring a decrease in the size of the compound muscle action potential of more than 20% on proximal versus distal stimulation of the peroneal, median or ulnar nerve in the absence of excess temporal dispersion of the potential. The teased fibre analyses of nerve biopsies from four patients with "definite" and six patients with "probable" conduction block and from seven patients with neuropathy but without conduction block were com...

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

    Institute of Scientific and Technical Information of China (English)

    袁志民; 魏建仝; 温景荣; 杨森; 全东和

    2015-01-01

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

  3. 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.

  4. A Comparison of the Analgesic Efficacy of Femoral Nerve Block vs Intra-articular Injection for Anterior Cruciate Ligament Reconstruction-a Meta-analysis of Randomized Controlled Trials%股神经阻滞和关节内浸润控制前交叉韧带重建术后疼痛疗效比较的Meta分析

    Institute of Scientific and Technical Information of China (English)

    孙羽; 白希壮

    2012-01-01

    Objective To compare the efficacy of femoral nerve block and intraarticukr injection on relieving pain after anterior cruciate ligament reconstruction. Methods We searched electronic databases to identify randomized control trials,assessed methodological qualities and identified parameters for comparison. Mela-analysis was performed using Review Manager. Weighted mean difference was calculated for numerical data with 93% confidence interval. Heterogeneity was analyzed. Results 5 studies including 437 patients were identified. Meta-analysis of VAS with sensitivity analysis favored nerve block,WMD -5.50 (-9.897,-1.14). However,the effect may not be clinically significant. Conclusion Femoral nerve block might provide better pain relief, but the effect might not be clinically significant.%目的 比较股神经阻滞(FNB)和关节内浸润(IA)治疗前交叉韧带重建术后疼痛的疗效.方法 计算机检索MEDLINE(1966至2011.6)、EMBASE(1980至2011.6)、Cochrane图书馆以及ClinicalTrials.gov网站,检索相关随机对照研究,利用Detsky分级对纳入文献作方法学评估,对可合并结果行Meta分析,无法合并结果作描述分析.试构建倒漏斗图分析发表偏倚.结果 共纳入5项随机对照试验,计437例患者.术后疼痛视觉模拟量表(VAS)评分Meta分析显示FNB镇痛优于IA,WMD-5.50(-9.897,-1.14).未能构建有意义的倒漏斗图.结论 现有证据表明FNB镇痛优于IA,但优势程度难以体现出实际临床意义.本分析仅纳入5项研究,病例较少,尚需多中心、大样本随机对照研究验证.

  5. Cutaneous Sensory Block Area, Muscle-Relaxing Effect, and Block Duration of the Transversus Abdominis Plane Block

    DEFF Research Database (Denmark)

    Støving, Kion; Rothe, Christian; Rosenstock, Charlotte V;

    2015-01-01

    BACKGROUND AND OBJECTIVES: The transversus abdominis plane (TAP) block is a widely used nerve block. However, basic block characteristics are poorly described. The purpose of this study was to assess the cutaneous sensory block area, muscle-relaxing effect, and block duration. METHODS: Sixteen...... healthy volunteers were randomized to receive an ultrasound-guided unilateral TAP block with 20 mL 7.5 mg/mL ropivacaine and placebo on the contralateral side. Measurements were performed at baseline and 90 minutes after performing the block. Cutaneous sensory block area was mapped and separated into a...... medial and lateral part by a vertical line through the anterior superior iliac spine. We measured muscle thickness of the 3 lateral abdominal muscle layers with ultrasound in the relaxed state and during maximal voluntary muscle contraction. The volunteers reported the duration of the sensory block and...

  6. [Peroneal nerve injury: anesthesia is not always to blame].

    Science.gov (United States)

    Curt Nuño, F; López Álvarez, S; Juncal Díaz, J; Domínguez Chaos, A; Llorca González, F; Pensado Castiñeiras, A

    2015-02-01

    We introduce a case report of a woman that was operated of foot surgery under locoregional anesthesia with an echo-guided peripheral sciatic-popliteal nerve block. As post operatory complication a peroneal nerve injury was noticed. We revised differential diagnosis of peripheral nerve block and therapeutic strategy we should take. In our case the finding was a high degree axonotmesis secondary to extrinsic compressure due to pneumatic tourniquet placed in the ankle used during surgery. There was no relationship with the anesthetic technique. PMID:25048997

  7. Heart Block

    Science.gov (United States)

    ... the signal causes the heart to contract and pump blood. Heart block occurs if the electrical signal is ... degree heart block limits the heart's ability to pump blood to the rest of the body. This type ...

  8. The Shamrock lumbar plexus block

    DEFF Research Database (Denmark)

    Sauter, Axel R; Ullensvang, Kyrre; Niemi, Geir;

    2015-01-01

    BACKGROUND: The Shamrock technique is a new method for ultrasound-guided lumbar plexus blockade. Data on the optimal local anaesthetic dose are not available. OBJECTIVE: The objective of this study is to estimate the effective dose of ropivacaine 0.5% for a Shamrock lumbar plexus block. DESIGN: A...... prospective dose-finding study using Dixon's up-and-down sequential method. SETTING: University Hospital Orthopaedic Anaesthesia Unit. INTERVENTION: Shamrock lumbar plexus block performance and block assessment were scheduled preoperatively. Ropivacaine 0.5% was titrated with the Dixon and Massey up......-and-down method using a stepwise change of 5 ml in each consecutive patient. Combined blocks of the femoral, the lateral femoral cutaneous and the obturator nerve were prerequisite for a successful lumbar plexus block. PATIENTS: Thirty patients scheduled for lower limb orthopaedic surgery completed the study...

  9. 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…

  10. Diabetes and nerve damage

    Science.gov (United States)

    Nerve damage that occurs in people with diabetes is called diabetic neuropathy. This condition is a complicaiton ... In people with diabetes, the body's nerves can be damaged by ... sugar level . This condition is more likely when the blood sugar ...

  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 ... viruses. Sometimes the cause is not known. Degenerative nerve diseases include Alzheimer's disease Amyotrophic lateral sclerosis Friedreich's ...

  12. Radial nerve dysfunction (image)

    Science.gov (United States)

    The radial nerve travels down the arm and supplies movement to the triceps muscle at the back of the upper arm. ... the wrist and hand. The usual causes of nerve dysfunction are direct trauma, prolonged pressure on the ...

  13. 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.

  14. Sensory nerves and pancreatitis

    OpenAIRE

    Li, Qingfu; PENG, JIE

    2014-01-01

    Sensory nerves are a kind of nerve that conduct afferent impulses from the periphery receptors to the central nervous system (CNS) and are able to release neuromediators from the activated peripheral endings. Sensory nerves are particularly important for microcirculatory response, and stimulation of pancreatic sensory nerves releases a variety of neuropeptides such as substance P (SP), calcitonin gene-related peptide (CGRP), etc., leading to neurogenic inflammation characterized as the local ...

  15. The Furcal Nerve Revisited

    OpenAIRE

    Harshavardhana, Nanjundappa S.; Harshad V. Dabke

    2014-01-01

    Atypical sciatica and discrepancy between clinical presentation and imaging findings is a dilemma for treating surgeon in management of lumbar disc herniation. It also constitutes ground for failed back surgery and potential litigations thereof. Furcal nerve (Furcal = forked) is an independent nerve with its own ventral and dorsal branches (rootlets) and forms a link nerve that connects lumbar and sacral plexus. Its fibers branch out to be part of femoral and obturator nerves in-addition to t...

  16. 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

  17. 心理疗法在神经阻滞治疗在老年带状疱疹后遗神经痛中的疗效分析%Explore the efficacy of nerve blocking and psychotherapy in the combined treatment of senile post herpetic neuralgia

    Institute of Scientific and Technical Information of China (English)

    陈星玲; 宋世兰; 杨建平; 魏武洪; 陈晓玉; 周甜甜; 雷山川

    2013-01-01

    Objective :To explore the efficacy of nerve blocking and psychotherapy in the combined treatment of senile post herpetic neuralgia .Method Sixty senile patients with post -herpetic neuralgia were randomly divided into 2 groups(n = 30):nerve blocking combined with psychotherapy as a trial group and nerve blocking as a control group .Assess the pain degree 1 hours before and 35 days after the first treatment by Visual analog scale ,observe the efficacy and adverse reaction of two groups of patients ,and investigate the patient satisfaction for the treatment .Results :In the trial group 17 cases were cured ;10 cases were effective and the total effective rate was 90% .In the control group 12 cases were cured ;9 cases were effective and the total effective rate was 70% .The difference of total effective rate between two groups was statistically significant (P <0 .05) .Satisfaction with treatment of the trial group was 97% and the control group was 76% . The two groups on satisfaction with treatment difference was statistically significant (P < 0 .05 ) .Conclusions The treatment of senile post herpetic neuralgia is effective by Nerve blocking combined with psychotherapy .And the treatment should be widely applied ,since there are fewer complications and the high degree of patient satisfaction with the treatment .%目的:探讨神经阻滞联合心理治疗应用于老年带状疱疹后遗神经痛的疗效。方法:选择老年带状疱疹后遗神经痛60例,采用随机对照试验,随机分为两组(n=30):采用神经阻滞联合心理治疗作为试验组;采用神经阻滞作为对照组。采用视觉模拟评分法评估首次治疗前1h、首次治疗后35d时患者疼痛程度,观察两组患者的疗效及不良反应,调查患者对治疗的满意度评价。结果试验组基本治愈17例,显效10例,总有效率为90%,对照组基本治愈12例,显效9例,总有效率为70%,两组总有效率比较

  18. Unusual Communications between the Cutaneous Branches of Ulnar Nerve in the Palm

    OpenAIRE

    Sirasanagandla, Srinivasa Rao; Padavinangady, Abhinitha; Nayak, Satheesha B.; Jetti, Raghu

    2015-01-01

    Variations of dorsal and volar digital cutaneous branches of ulnar nerve are of tremendous clinical importance for successful regional nerve blocks, skin flaps, carpal tunnel release and placement of electrodes for electrophysiological studies. With the aforementioned clinical implications it is worth to report the variations of cutaneous branches of ulnar nerve. In the current case, we have encountered a rare variation (Kaplan`s anastomosis) of ulnar nerve, in the right upper limb. We have n...

  19. 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

  20. 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.

  1. Intraparotid facial nerve schwannoma.

    OpenAIRE

    Shah H; Kantharia C; Shenoy A

    1997-01-01

    Intraparotid facial nerve schwannoma are uncommon. Preoperative diagnosis of parotid tumour as schwannoma is difficult when facial nerve function is normal. A rare case of solitary schwannoma involving the upper branch of the facial nerve is described and the literature on the subject is reviewed.

  2. Laryngeal nerve damage

    Science.gov (United States)

    Laryngeal nerve damage is injury to one or both of the nerves that are attached to the voice box. ... Injury to the laryngeal nerves is uncommon. When it does occur, it can be from: A complication of neck or chest surgery (especially thyroid, lung, ...

  3. Optic Nerve Pit

    Science.gov (United States)

    ... Conditions Frequently Asked Questions Español Condiciones Chinese Conditions Optic Nerve Pit What is optic nerve pit? An optic nerve pit is a ... may be seen in both eyes. How is optic pit diagnosed? If the pit is not affecting ...

  4. Trigeminal autonomic cephalgias

    OpenAIRE

    Benoliel, Rafael

    2012-01-01

    1. Trigeminal autonomic cephalgias (TACs) are headaches/facial pains classified together based on:a suspected common pathophysiology involving the trigeminovascular system, the trigeminoparasympathetic reflex and centres controlling circadian rhythms;a similar clinical presentation of trigeminal pain, and autonomic activation.

  5. Optic nerve oxygenation

    DEFF Research Database (Denmark)

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

    2005-01-01

    The oxygen tension of the optic nerve is regulated by the intraocular pressure and systemic blood pressure, the resistance in the blood vessels and oxygen consumption of the tissue. The oxygen tension is autoregulated and moderate changes in intraocular pressure or blood pressure do not affect the...... optic nerve oxygen tension. If the intraocular pressure is increased above 40 mmHg or the ocular perfusion pressure decreased below 50 mmHg the autoregulation is overwhelmed and the optic nerve becomes hypoxic. A disturbance in oxidative metabolism in the cytochromes of the optic nerve can be seen 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...

  6. [Ganglia of peripheral nerves].

    Science.gov (United States)

    Tatagiba, M; Penkert, G; Samii, M

    1993-01-01

    The authors present two different types of ganglion affecting the peripheral nerves: extraneural and intraneural ganglion. Compression of peripheral nerves by articular ganglions is well known. The surgical management involves the complete removal of the lesion with preservation of most nerve fascicles. Intraneural ganglion is an uncommon lesion which affects the nerve diffusely. The nerve fascicles are usually intimately involved between the cysts, making complete removal of all cysts impossible. There is no agreement about the best surgical management to be applied in these cases. Two possibilities are available: opening of the epineural sheath lengthwise and pressing out the lesion; or resection of the affected part of the nerve and performing a nerve reconstruction. While in case of extraneural ganglion the postoperative clinical evolution is very favourable, only long follow up studies will reveal in case of intraneural ganglion the best surgical approach. PMID:8128785

  7. Assessment of nerve morphology in nerve activation during electrical stimulation

    Science.gov (United States)

    Gomez-Tames, Jose; Yu, Wenwei

    2013-10-01

    The distance between nerve and stimulation electrode is fundamental for nerve activation in Transcutaneous Electrical Stimulation (TES). However, it is not clear the need to have an approximate representation of the morphology of peripheral nerves in simulation models and its influence in the nerve activation. In this work, depth and curvature of a nerve are investigated around the middle thigh. As preliminary result, the curvature of the nerve helps to reduce the simulation amplitude necessary for nerve activation from far field stimulation.

  8. 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...

  9. Imaging the trigeminal nerve

    International Nuclear Information System (INIS)

    Of all cranial nerves, the trigeminal nerve is the largest and the most widely distributed in the supra-hyoid neck. It provides sensory input from the face and motor innervation to the muscles of mastication. In order to adequately image the full course of the trigeminal nerve and its main branches a detailed knowledge of neuroanatomy and imaging technique is required. Although the main trunk of the trigeminal nerve is consistently seen on conventional brain studies, high-resolution tailored imaging is mandatory to depict smaller nerve branches and subtle pathologic processes. Increasing developments in imaging technique made possible isotropic sub-milimetric images and curved reconstructions of cranial nerves and their branches and led to an increasing recognition of symptomatic trigeminal neuropathies. Whereas MRI has a higher diagnostic yield in patients with trigeminal neuropathy, CT is still required to demonstrate the bony anatomy of the skull base and is the modality of choice in the context of traumatic injury to the nerve. Imaging of the trigeminal nerve is particularly cumbersome as its long course from the brainstem nuclei to the peripheral branches and its rich anastomotic network impede, in most cases, a topographic approach. Therefore, except in cases of classic trigeminal neuralgia, in which imaging studies can be tailored to the root entry zone, the full course of the trigeminal nerve has to be imaged. This article provides an update in the most recent advances on MR imaging technique and a segmental imaging approach to the most common pathologic processes affecting the trigeminal nerve.

  10. 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.

  11. 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;

  12. Testbed for an autonomous system

    Science.gov (United States)

    Dikshit, Piyush; Guimaraes, Katia; Ramamurthy, Maya; Agrawala, Ashok K.; Larsen, Ronald L.

    1989-01-01

    In previous works we have defined a general architectural model for autonomous systems, which can easily be mapped to describe the functions of any automated system (SDAG-86-01), and we illustrated that model by applying it to the thermal management system of a space station (SDAG-87-01). In this note, we will further develop that application and design the detail of the implementation of such a model. First we present the environment of our application by describing the thermal management problem and an abstraction, which was called TESTBED, that includes a specific function for each module in the architecture, and the nature of the interfaces between each pair of blocks.

  13. Autonomous linear lossless systems

    OpenAIRE

    Rao, Shodhan; Rapisarda, Paolo

    2008-01-01

    We define a lossless autonomous system as one having a quadratic differential form associated with it called an energy function, which is positive and which is conserved. We define an oscillatory system as one which has all its trajectories bounded on the entire time axis. In this paper, we show that an autonomous system is lossless if and only if it is oscillatory. Next we discuss a few properties of energy functions of autonomous lossless systems and a suitable way of splitting a given ener...

  14. 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. PMID:25744760

  15. 经“Holy plane”间隙保留盆腔自主神经侧方淋巴结清扫术的临床观察%Preserving pelvic autonomic nerve and lateral lymph node dissection in lower rectal cancer through the ‘ Holy Plane'

    Institute of Scientific and Technical Information of China (English)

    贾勇; 侯俊明; 魏辉; 田博; 贾奇

    2011-01-01

    Objective To explore the clinical and pathological characteristics of renal mucinous tubular and spindle cell carcinoma. Methods Clinical data of 4 patients including 3 female and 1 male aged from 35 to 56 were analyzed retrospectively. Among the 4 cases, two tumors were in the left side and two in right. Three tumors located in the upper part of kidneys, one in the lower part. The size of tumors ranged from 3.5 to 6.5 cm. There was no obvious symptom or physical sign in all cases and the tumors were detected during healthy examination. In B type untrasonography, two patients showed cystsolid tumor and two showed thick-wall cyst of kidney. In CT scan, three patients showed cystsolid tumor and one showed thick-wall cyst of kidney. In MRI scan, two patients showed cystsolid tumor. All the imaging examinations indicated the lump was benign. Results There were clear boundaries between the tumors and normal kidney tissue and the lesions were easy to be separated during operation. The rumors displayed globular appearance and were cyst-solid which capsule walls were uniformly think, pale and smooth. The freezing pathological slices suggested two low-grade cancers and one suspicious clear cell carcinoma. The final pathological diagnosis was renal mucinous tubular and spindle cell carcinomas. Conclusion Renal mucinous tubular and spindle cell carcinoma is a kind of low malignant tendency cancer with benign features.Objective To study the value of pelvic autonomic nerve preservation and lateral lymph node dissection through the ' Holy Plane' in male lower rectal carcinoma patients for preserving anus. Methods The distance from tumor's edge to anus, 3-year survival rate, local recurrence rate, urinary function and sexual function were prospectively analyzed in pelvic autonomic nerve preservation through ' Holy Plane' ( HPANP) + lateral lymph node dissection(LLND) group and traditional operation group. Results The distance from tumor's edge to anus in HPANP + LLND group was

  16. Sciatic nerve injection injury.

    Science.gov (United States)

    Jung Kim, Hyun; Hyun Park, Sang

    2014-06-11

    Nerve injury is a common complication following intramuscular injection and the sciatic nerve is the most frequently affected nerve, especially in children, the elderly and underweight patients. The neurological presentation may range from minor transient pain to severe sensory disturbance and motor loss with poor recovery. Management of nerve injection injury includes drug treatment of pain, physiotherapy, use of assistive devices and surgical exploration. Early recognition of nerve injection injury and appropriate management are crucial in order to reduce neurological deficit and to maximize recovery. Sciatic nerve injection injury is a preventable event. Total avoidance of intramuscular injection is recommended if other administration routes can be used. If the injection has to be administered into the gluteal muscle, the ventrogluteal region (gluteal triangle) has a more favourable safety profile than the dorsogluteal region (the upper outer quadrant of the buttock). PMID:24920643

  17. The furcal nerve revisited

    Directory of Open Access Journals (Sweden)

    Nanjundappa S. Harshavardhana

    2014-10-01

    Full Text Available Atypical sciatica and discrepancy between clinical presentation and imaging findings is a dilemma for treating surgeon in management of lumbar disc herniation. It also constitutes ground for failed back surgery and potential litigations thereof. Furcal nerve (Furcal = forked is an independent nerve with its own ventral and dorsal branches (rootlets and forms a link nerve that connects lumbar and sacral plexus. Its fibers branch out to be part of femoral and obturator nerves in-addition to the lumbosacral trunk. It is most commonly found at L4 level and is the most common cause of atypical presentation of radiculopathy/sciatica. Very little is published about the furcal nerve and many are unaware of its existence. This article summarizes all the existing evidence about furcal nerve in English literature in an attempt to create awareness and offer insight about this unique entity to fellow colleagues/ professionals involved in spine care.

  18. The Furcal Nerve Revisited

    Science.gov (United States)

    Dabke, Harshad V.

    2014-01-01

    Atypical sciatica and discrepancy between clinical presentation and imaging findings is a dilemma for treating surgeon in management of lumbar disc herniation. It also constitutes ground for failed back surgery and potential litigations thereof. Furcal nerve (Furcal = forked) is an independent nerve with its own ventral and dorsal branches (rootlets) and forms a link nerve that connects lumbar and sacral plexus. Its fibers branch out to be part of femoral and obturator nerves in-addition to the lumbosacral trunk. It is most commonly found at L4 level and is the most common cause of atypical presentation of radiculopathy/sciatica. Very little is published about the furcal nerve and many are unaware of its existence. This article summarizes all the existing evidence about furcal nerve in English literature in an attempt to create awareness and offer insight about this unique entity to fellow colleagues/professionals involved in spine care. PMID:25317309

  19. 高位颈神经阻滞联合臭氧注射治疗颈源性头痛的疗效分析%Clinical study of upper cervical nerve block combined with injection of ozone for the treatment of cervicogenic headache

    Institute of Scientific and Technical Information of China (English)

    何明伟; 于密生; 郭玉娜; 王琦; 李玄英; 刘京杰; 岳建宁; 马骏; 倪家骧

    2013-01-01

    目的 探讨高位颈神经阻滞联合臭氧注射治疗颈源性头痛的效果.方法 60例颈源性头痛患者完全随机分为A组(31例)和B组(29例).A组接受颈2、3神经阻滞联合臭氧注射治疗,B组仅接受颈2、3神经阻滞治疗.分别于治疗后1周和3、6个月进行疗效评价.结果 治疗后1周、3个月和6个月的视觉模拟评分法(VAS)评分A组分别为(1.3±0.4)、(1.8±1.2)和(2.3+1.4)分,B组分别为(1.5±1.1)、(3.4±1.3)和(4.3±2.2)分,A组治疗后3、6个月VAS评分均明显低于B组,差异均有统计学意义(均P<0.05).治疗后1周及3、6个月A组优良率分别为100.0%(31例)、87.1%(27例)、80.6%(25例),B组分别为100.0%(29例)、72.4%(21例)、62.1%(18例),A组治疗后3、6个月优良率均高于B组,差异均有统计学意义(均P<0.05).各组无明显并发症发生.结论 高位颈神经阻滞联合臭氧注射治疗颈源性头痛疗效优于单纯高位颈椎旁神经阻滞治疗,但其远期疗效有待于进一步探讨.%Objective To study the effect of the upper cervical nerve block combined with injection of ozone for the treatment of cervicogenic headache.Methods Sixty patients suffering from cervicogenic headache were randomly divided into group A(n =31)and group B(n =29).Group A received C2,3 nerve block combined with injection of ozone;group B received upper cervical nerve block.The efficacy and improvement of pain were compared.Results For group A,at 1 week,1 month and 3 months after opeartaion,the visual analogue scale(VAS) scores were (1.3 ± 0.4),(1.8 ± 1.2) and (3.1 ± 1.4) scores ; the excellent and good rate was 100.0% (31/31),87.1% (27/31),80.6% (25/31) respectively.For group B,the VAS scores were (1.5 ± 1.1),(3.4 ± 1.3) and (4.3 ± 2.2) scores ; the excellent and good rate was 100.0% (29/29),72.4% (21/29),62.1% (18/29),respectively.Compared with group B,3 months and 6 months after treatment,the VAS in group A were significantly reduced

  20. Spinal accessory nerve neurilemmoma

    International Nuclear Information System (INIS)

    A neurilemmoma of the spinal accessory nerve extending from the lower brain stem to the high cervical region, without typical jugular foramen syndome is presented. Preoperative diagnosis is difficult but should be considered in the differential diagnosis of a high cervical intradural extramedullary lesion in patients with lower cranial nerve(s) dysfunction. The value of intrathecal and intravenous contrast enhancement computed tomography (CT) myelogram is emphasized. 13 refs.; 3 figs

  1. Facial Nerve Neuroma Management

    OpenAIRE

    Weber, Peter C; Osguthorpe, J. David

    1998-01-01

    Three facial nerve neuromas were identified in the academic year 1994-1995. Each case illustrates different management dilemmas. One patient with a grade III facial nerve palsy had a small geniculate ganglion neuroma with the dilemma of decompression versus resection clear nerve section margins. The second patient underwent facial neuroma resection with cable graft reconstruction, but the permanent sections were positive. The last patient had a massive neuroma in which grafting versus other f...

  2. 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

  3. AUTONOMOUS DRIVEN CAR

    OpenAIRE

    Meeshika Arora

    2013-01-01

    In order to achieve autonomous operation of a vehiclein urban situations with unpredictable traffic, several real timesystems must interoperate, including environment perceptionplanning and control. In addition a robust vehicle platform withappropriate sensors, computational hardware, networking andsoftware infrastructure is essential.

  4. Highly Autonomous Systems Workshop

    Science.gov (United States)

    Doyle, R.; Rasmussen, R.; Man, G.; Patel, K.

    1998-01-01

    It is our aim by launching a series of workshops on the topic of highly autonomous systems to reach out to the larger community interested in technology development for remotely deployed systems, particularly those for exploration.

  5. 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

  6. Acute Autonomic, Sensory and Motor Neuropathy Associated with Meningoencephalitis

    OpenAIRE

    Satoko Kinoshita; Kazuma Sugie; Hiroshi Kataoka; Miho Sugie; Makito Hirano; Satoshi Ueno

    2009-01-01

    We report the first case of acute autonomic, motor and sensory neuropathy (AASMN) associated with meningoencephalitis. A 62-year-old man presented with fever, neck stiffness, and coma. Respiratory failure developed. Magnetic resonance images showed an abnormality in the medial temporal lobe. Cerebrospinal fluid analysis revealed pleocytosis with a high protein level. Intensive care gradually improved the consciousness level, but paralysis of the four extremities persisted. Nerve conduction st...

  7. Engineering Autonomous Driving Software

    OpenAIRE

    Berger, Christian; Rumpe, Bernhard

    2014-01-01

    A larger number of people with heterogeneous knowledge and skills running a project together needs an adaptable, target, and skill-specific engineering process. This especially holds for a project to develop a highly innovative, autonomously driving vehicle to participate in the 2007 DARPA Urban Challenge. In this contribution, we present essential elements of a software and systems engineering process to develop a so-called artificial intelligence capable of driving autonomously in complex u...

  8. 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....

  9. Role of Autonomic Reflex Arcs in Cardiovascular Responses to Air Pollution Exposure

    OpenAIRE

    Perez, Christina M.; Hazari, Mehdi S.; Farraj, Aimen K.

    2015-01-01

    The body responds to environmental stressors by triggering autonomic reflexes in the pulmonary receptors, baroreceptors, and chemoreceptors to maintain homeostasis. Numerous studies have shown that exposure to various gases and airborne particles can alter the functional outcome of these reflexes, particularly with respect to the cardiovascular system. Modulation of autonomic neural input to the heart and vasculature following direct activation of sensory nerves in the respiratory system, eli...

  10. 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

  11. Autonomic nuclear installation that is distinguished by long reloading period, ecological purity, higher reliability, possibility of the large-block conveyance to an operation place and following transportation after ending of exploitation, and that is destined for electric and heat delivery of distant hard-access regions

    International Nuclear Information System (INIS)

    Autonomic nuclear energy installation is presented, that can be delivered to operation place in large-block modules and completely removed after the exploitation completion. Such installation may be the alternative of energy sources, based on the organic fuel. The construction of this installation provides its complete production, pleat and ordering on machine building plants with the following delivery to the operation place. The proposed installation is oriented to the use of water cooled reactor, worked on natural circulation of the coolant. It has three inter correlated thermal hydraulic circuits. All consumers of thermal energy with summary power up to 10-30 MW are accommodated in the last circuit. A special attention devoted to safety of the nuclear energy installation and to ecological problems, related to its possible influence on environment. It is foreseen creation of five protection barriers against dissemination of radionuclides into the environment. The proposed conception creates suppositions for creation of nuclear energy installations, that work in the condition of self-regulation without reload of their active zone during 15-20 years and are compete able relative energy sources, using organic fuel

  12. Ulnar nerve palsy due to axillary crutch.

    OpenAIRE

    Veerendrakumar M; Taly A; Nagaraja D.

    2001-01-01

    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...

  13. 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

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

    Institute of Scientific and Technical Information of China (English)

    姜德志; 屈波; 杜传亮

    2014-01-01

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

  15. Interventional multispectral photoacoustic imaging with a clinical ultrasound probe for discriminating nerves and tendons: an ex vivo pilot study

    Science.gov (United States)

    Mari, Jean Martial; Xia, Wenfeng; West, Simeon J.; Desjardins, Adrien E.

    2015-11-01

    Accurate and efficient identification of nerves is an essential component of peripheral nerve blocks. While ultrasound (US) imaging is increasingly used as a guidance modality, it often provides insufficient contrast for identifying nerves from surrounding tissues such as tendons. Electrical nerve stimulators can be used in conjunction with US imaging for discriminating nerves from surrounding tissues, but they are insufficient to reliably prevent neural punctures, so that alternative methods are highly desirable. In this study, an interventional multispectral photoacoustic (PA) imaging system was used to directly compare the signal amplitudes and spectra acquired from nerves and tendons ex vivo, for the first time. The results indicate that the system can provide significantly higher image contrast for discriminating nerves and tendons than that provided by US imaging. As such, photoacoustic imaging could be valuable as an adjunct to US for guiding peripheral nerve blocks.

  16. Intraoperative vagal nerve monitoring.

    Science.gov (United States)

    Leonetti, J P; Jellish, W S; Warf, P; Hudson, E

    1996-08-01

    A variety of benign and malignant neoplasms occur in the superior cervical neck, parapharyngeal space or the infratemporal fossa. The surgical resection of these lesions may result in postoperative iatrogenic injury to the vagus nerve with associated dysfunctional swallowing and airway protection. Anatomic and functional preservation of this critical cranial nerve will contribute to a favorable surgical outcome. Fourteen patients with tumors of the cervical neck or adjacent skull base underwent intraoperative vagal nerve monitoring in an attempt to preserve neural integrity following tumor removal. Of the 11 patients with anatomically preserved vagal nerves in this group, seven patients had normal vocal cord mobility following surgery and all 11 patients demonstrated normal vocal cord movement by six months. In an earlier series of 23 patients with tumors in the same region who underwent tumor resection without vagal nerve monitoring, 18 patients had anatomically preserved vagal nerves. Within this group, five patients had normal vocal cord movement at one month and 13 patients demonstrated normal vocal cord movement at six months. This paper will outline a technique for intraoperative vagal nerve monitoring utilizing transcricothyroid membrane placement of bipolar hook-wire electrodes in the vocalis muscle. Our results with the surgical treatment of cervical neck and lateral skull base tumors for patients with unmonitored and monitored vagal nerves will be outlined. PMID:8828272

  17. Acute Autonomic, Sensory and Motor Neuropathy Associated with Meningoencephalitis

    Directory of Open Access Journals (Sweden)

    Satoko Kinoshita

    2009-01-01

    Full Text Available We report the first case of acute autonomic, motor and sensory neuropathy (AASMN associated with meningoencephalitis. A 62-year-old man presented with fever, neck stiffness, and coma. Respiratory failure developed. Magnetic resonance images showed an abnormality in the medial temporal lobe. Cerebrospinal fluid analysis revealed pleocytosis with a high protein level. Intensive care gradually improved the consciousness level, but paralysis of the four extremities persisted. Nerve conduction studies revealed demyelinating sensory and motor polyneuropathy. Severe orthostatic hypotension, urinary retention, and constipation were also present. Clinical autonomic tests suggested both sympathetic and parasympathetic dysfunction. After intravenous immunoglobulin therapy, motor and sensory symptoms resolved rapidly; dysautonomia resolved gradually over the next 2 months. The response to immunological therapy and the presence of antecedent infection suggest that AASMN is a postinfectious, immune-mediated, autonomic, sensory and motor nervous system dysfunction.

  18. Preoperative transcutaneous electrical nerve stimulation for localizing superficial nerve paths.

    Science.gov (United States)

    Natori, Yuhei; Yoshizawa, Hidekazu; Mizuno, Hiroshi; Hayashi, Ayato

    2015-12-01

    During surgery, peripheral nerves are often seen to follow unpredictable paths because of previous surgeries and/or compression caused by a tumor. Iatrogenic nerve injury is a serious complication that must be avoided, and preoperative evaluation of nerve paths is important for preventing it. In this study, transcutaneous electrical nerve stimulation (TENS) was used for an in-depth analysis of peripheral nerve paths. This study included 27 patients who underwent the TENS procedure to evaluate the peripheral nerve path (17 males and 10 females; mean age: 59.9 years, range: 18-83 years) of each patient preoperatively. An electrode pen coupled to an electrical nerve stimulator was used for superficial nerve mapping. The TENS procedure was performed on patients' major peripheral nerves that passed close to the surgical field of tumor resection or trauma surgery, and intraoperative damage to those nerves was apprehensive. The paths of the target nerve were detected in most patients preoperatively. The nerve paths of 26 patients were precisely under the markings drawn preoperatively. The nerve path of one patient substantially differed from the preoperative markings with numbness at the surgical region. During surgery, the nerve paths could be accurately mapped preoperatively using the TENS procedure as confirmed by direct visualization of the nerve. This stimulation device is easy to use and offers highly accurate mapping of nerves for surgical planning without major complications. The authors conclude that TENS is a useful tool for noninvasive nerve localization and makes tumor resection a safe and smooth procedure. PMID:26420473

  19. 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.

  20. 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

  1. Classical radical hysterectomy and nerve-sparing radical hysterectomy in the treatment of cervical cancer

    OpenAIRE

    Marcin Makowski; Marek Nowak; Marian Szpakowski; Jacek Władziński; Anna Serwach-Nowińska; Łukasz Janas; Jacek R. Wilczyński

    2014-01-01

    Aim of the study: To compare Piver III radical hysterectomy (RH) with nerve-sparing radical hysterectomy (NSRH) for cervical cancer patients in terms of postoperative physiology of pelvic autonomic nerves and perioperative complications. Material and methods : Seventy-three consecutive patients with invasive cervical cancer underwent RH (53 cases) or NSRH (20 cases) from 2001 to 2012 at the Department of Gynecology and Gynecologic Oncology of Polish Mother’s Memorial Hospital – Research...

  2. 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. PMID:26914959

  3. Ghost Block

    OpenAIRE

    Webb, Neil

    2011-01-01

    Filmed on the English south coast 'Ghost Block' depicts the uncanny and eerie atmosphere at the site of a WW2 coastal defence line. The concrete cubes were used as an anti-invasion blockade against potential landing forces. This protection line now slowly decaying and becoming enmeshed into the environment still acts as a defence to repel unwanted visitors. The area is a natural reserve to nesting birds that often lay eggs directly onto the beach surface. The blocks act as a final barrier ...

  4. 奥卡西平联合神经阻滞治疗原发性三叉神经痛的随机对照试验%RANDOMIZED CONTROLLED TRIAL OF OXCARBAZEPINE COMBINED WITH NERVE BLOCK IN TREATMENT OF PRIMARY TRIGEMINAL NEURALGIA

    Institute of Scientific and Technical Information of China (English)

    苏芳; 盖成林; 袁源; 张倩

    2013-01-01

    目的:评估奥卡西平联合神经阻滞是否可以提高治疗原发性三叉神经痛的临床效果.方法:选择原发性三叉神经痛患者60例,随机分为3组:奥卡西平治疗组(O组)、神经阻滞组(B组)和奥卡西平联合神经阻滞组(OB组).采用视觉模拟评分(visual analogue scale,VAS)评估3组患者治疗前及治疗后第1、2、4周的疼痛分值以及睡眠、生活质量、MPQ总评分、患者自我评价等指标,同时观察患者的不良反应.结果:O组患者口服奥卡西平起效缓慢,但能有效缓解疼痛,治疗后第4周与治疗前VAS疼痛评分比较差异有显著性(P<0.01);B组治疗后第1、2、4周疼痛缓解效果与O组比较,差异有显著性(P<0.05);B组治疗后第4周与治疗前VAS疼痛评分比较有显著性差异(P<0.01); OB组奥卡西平联合神经阻滞组患者,治疗后第4周与治疗前VAS疼痛评分比较差异有显著性(P<0.01);且OB组较其他两组治疗后各时间点疼痛评分统计学差异显著(P<0.05).患者评价显示OB组较其他两组总体效果更让人满意(P<0.05).3组均有不良反应发生,其中O组不良反应发生例数最多;OB组不良反应发生例数最少,差异有显著性(P<0.05).结论:奥卡西平联合神经阻滞治疗原发性三叉神经痛有效且安全;其疗效优于单独服药和单独神经阻滞治疗.%Objective:To study the efficacy of Oxcarbazepine combined with nerve block in the treatment of primary trigeminal neuralgia.Methods:Sixty primary trigeminal neuralgia patients were randomly divided into three groups:group O (Oxcarbazepine),group B (nerve block) and group OB (Oxcarbazepine combined with nerve block).We evaluated the degree of the patients' pain of pre-therapy and post-therapy after the first week,the second week and the fourth week by visual analogue scale (VAS).Results:The pain of group O relieve slowly,while have an effective relief after therapy; and there was a significant difference between the

  5. WAYPOINT FLIGHT PARAMETER COMPARISON OF AN AUTONOMOUS UAV

    Directory of Open Access Journals (Sweden)

    Nils Gageik

    2013-05-01

    Full Text Available The present paper compares the effect of different waypoint parameters on the flight performance of a special autonomous indoor UAV (unmanned aerial vehicle fusing ultrasonic, inertial, pressure and optical sensors for 3D positioning and controlling. The investigated parameters are the acceptance threshold for reaching a waypoint as well as the maximal waypoint step size or block size. The effect of these parameters on the flight time and accuracy of the flight path is investigated. Therefore the paper addresses how the acceptance threshold and step size influence the speed and accuracy of the autonomous flight and thus influence the performance of the presented autonomous quadrocopter under real indoor navigation circumstances. Furthermore the paper demonstrates a drawback of the standard potential field method for navigation of such autonomous quadrocopters and points to an improvement.

  6. Architecture of autonomous systems

    Science.gov (United States)

    Dikshit, Piyush; Guimaraes, Katia; Ramamurthy, Maya; Agrawala, Ashok; Larsen, Ronald L.

    1989-01-01

    Automation of Space Station functions and activities, particularly those involving robotic capabilities with interactive or supervisory human control, is a complex, multi-disciplinary systems design problem. A wide variety of applications using autonomous control can be found in the literature, but none of them seem to address the problem in general. All of them are designed with a specific application in mind. In this report, an abstract model is described which unifies the key concepts underlying the design of automated systems such as those studied by the aerospace contractors. The model has been kept as general as possible. The attempt is to capture all the key components of autonomous systems. With a little effort, it should be possible to map the functions of any specific autonomous system application to the model presented here.

  7. Exercise and autonomic function.

    Science.gov (United States)

    Goldsmith, R L; Bloomfield, D M; Rosenwinkel, E T

    2000-03-01

    The complex interplay between the dichotomous subdivisions of the autonomic nervous system establishes and maintains a delicately tuned homeostasis in spite of an ever-changing environment. Aerobic exercise training can increase activity of the parasympathetic nervous system and decrease sympathetic activity. Conversely, it is well-documented that cardiac disease is often characterized by attenuated parasympathetic activity and heightened sympathetic tone. A correlation between autonomic disequilibrium and disease has led to the hypothesis that exercise training, as a therapy that restores the autonomic nervous system towards normal function, may be associated with, and possibly responsible for, outcome improvements in various populations. This is merely one of the many benefits that is conferred by chronic exercise training and reviewed in this issue. PMID:10758814

  8. Epidural block

    Science.gov (United States)

    ... Drugs & Supplements Videos & Tools Español You Are Here: Home ... It numbs or causes a loss of feeling in the lower half your body. This lessens the pain of contractions during childbirth. An epidural block may also be used to ...

  9. Optic nerve oxygenation

    DEFF Research Database (Denmark)

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

    2005-01-01

    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...... through a mechanism of vasodilatation and lowering of the intraocular pressure. Carbonic anhydrase inhibition reduces the removal of CO2 from the tissue and the CO2 accumulation induces vasodilatation resulting in increased blood flow and improved oxygen supply. This effect is inhibited by the cyclo...

  10. Radial Nerve Tendon Transfers.

    Science.gov (United States)

    Cheah, Andre Eu-Jin; Etcheson, Jennifer; Yao, Jeffrey

    2016-08-01

    Radial nerve palsy typically occurs as a result of trauma or iatrogenic injury and leads to the loss of wrist extension, finger extension, thumb extension, and a reduction in grip strength. In the absence of nerve recovery, reconstruction of motor function involves tendon transfer surgery. The most common donor tendons include the pronator teres, wrist flexors, and finger flexors. The type of tendon transfer is classified based on the donor for the extensor digitorum communis. Good outcomes have been reported for most methods of radial nerve tendon transfers as is typical for positional tendon transfers not requiring significant power. PMID:27387076

  11. High Ulnar Nerve Injuries: Nerve Transfers to Restore Function.

    Science.gov (United States)

    Patterson, Jennifer Megan M

    2016-05-01

    Peripheral nerve injuries are challenging problems. Nerve transfers are one of many options available to surgeons caring for these patients, although they do not replace tendon transfers, nerve graft, or primary repair in all patients. Distal nerve transfers for the treatment of high ulnar nerve injuries allow for a shorter reinnervation period and improved ulnar intrinsic recovery, which are critical to function of the hand. PMID:27094893

  12. Dysfunctional penile cholinergic nerves in diabetic impotent men

    International Nuclear Information System (INIS)

    Impotence in the diabetic man may be secondary to a neuropathic condition of the autonomic penile nerves. The relationship between autonomic neuropathy and impotence in diabetes was studied in human corporeal tissue obtained during implantation of a penile prosthesis in 19 impotent diabetic and 15 nondiabetic patients. The functional status of penile cholinergic nerves was assessed by determining their ability to accumulate tritiated choline (34), and synthesize (34) and release (19) tritiated-acetylcholine after incubation of corporeal tissue with tritiated-choline (34). Tritiated-choline accumulation, and tritiated-acetylcholine synthesis and release were significantly reduced in the corporeal tissue from diabetic patients compared to that from nondiabetic patients (p less than 0.05). The impairment in acetylcholine synthesis worsened with the duration of diabetes (p less than 0.025). No differences in the parameters measured were found between insulin-dependent (11) and noninsulin-dependent (8) diabetic patients. The ability of the cholinergic nerves to synthesize acetylcholine could not be predicted clinically with sensory vibration perception threshold testing. It is concluded that there is a functional penile neuropathic condition of the cholinergic nerves in the corpus cavernosum of diabetic impotent patients that may be responsible for the erectile dysfunction

  13. Dysfunctional penile cholinergic nerves in diabetic impotent men

    Energy Technology Data Exchange (ETDEWEB)

    Blanco, R.; Saenz de Tejada, I.; Goldstein, I.; Krane, R.J.; Wotiz, H.H.; Cohen, R.A. (Boston Univ. School of Medicine, MA (USA))

    1990-08-01

    Impotence in the diabetic man may be secondary to a neuropathic condition of the autonomic penile nerves. The relationship between autonomic neuropathy and impotence in diabetes was studied in human corporeal tissue obtained during implantation of a penile prosthesis in 19 impotent diabetic and 15 nondiabetic patients. The functional status of penile cholinergic nerves was assessed by determining their ability to accumulate tritiated choline (34), and synthesize (34) and release (19) tritiated-acetylcholine after incubation of corporeal tissue with tritiated-choline (34). Tritiated-choline accumulation, and tritiated-acetylcholine synthesis and release were significantly reduced in the corporeal tissue from diabetic patients compared to that from nondiabetic patients (p less than 0.05). The impairment in acetylcholine synthesis worsened with the duration of diabetes (p less than 0.025). No differences in the parameters measured were found between insulin-dependent (11) and noninsulin-dependent (8) diabetic patients. The ability of the cholinergic nerves to synthesize acetylcholine could not be predicted clinically with sensory vibration perception threshold testing. It is concluded that there is a functional penile neuropathic condition of the cholinergic nerves in the corpus cavernosum of diabetic impotent patients that may be responsible for the erectile dysfunction.

  14. Overview of the Autonomic Nervous System

    Science.gov (United States)

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

  15. 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. ...

  16. Can neural blocks prevent phantom limb pain?

    Science.gov (United States)

    Borghi, Battista; D'Addabbo, Marco; Borghi, Raffaele

    2014-07-01

    Phantom limb syndrome (PLS) is a syndrome including stump pain, phantom limb pain and not-painful phantom sensations, which involves a large part of amputee patients and often has devastating effects on their quality of life. The efficacy of standard therapies is very poor. Nerve blocks have been investigated for the treatment and prevention of PLS. Epidural and peripheral blocks limited to the first three postamputation days can only reduce acute pain but cannot prevent the later development of PLS. Recent studies have shown that ambulatory prolonged peripheral nerve block (up to 30 days postamputation) may represent a new possible option to treat phantom pain and prevent the development of PLS and chronic pain. PMID:25300383

  17. Raquianestesia com morfina versus raquianestesia sem morfina associada a bloqueio do nervo pudendo: avaliação da analgesia e complicações em hemorroidectomias Spinal anesthesia with morphine versus spinal anesthesia without morphine associated to pudendal nerve block: evaluation of the analgesia and complications in hemorrhoidectomy

    Directory of Open Access Journals (Sweden)

    Carlos Henrique Marques dos Santos

    2009-03-01

    , some authors have reported that the pudendal nerve block using ropivacaine provides good postoperative analgesia. Thus, we consider of interest to compare two anesthetic methods checking postoperative analgesia and adverse effects. OBJECTIVE: To compare two anesthetic techniques (spinal anesthesia with morphine versus spinal anesthesia without morphine associated with pudendal nerve block for hemorrhoidectomy in relation to postoperative analgesia and adverse effects. MATERIALS AND METHODS: We studied 40 patients from Hospital Regional de Mato Grosso do Sul among March to October of 2008. All patients were randomized by lot immediately before surgery, distributed in two groups: Group 1: 20 patients undergoing spinal anesthesia with morphine 0.15µg associated with hyperbaric bupivacaine 10mg; - Group 2: 20 patients undergoing spinal anesthesia with heavy bupivacaine 10mg associated with bilateral pudendal nerve block with ropivacaine 10mg/ml diluted in 10ml of distilled water. RESULTS: Most patients were female (N = 21. The average age was 52 years, ranging from 21 to 72 years. The group 1 presented a higher prevalence of adverse effects (62.5%. Among the adverse effects of group 1 was higher prevalence of itch, urinary retention and migraine. Most patients who reported pain in the postoperative range from group 1 was male and prevailing in the first 12 hours, with the average level of pain of 1.55. In group 2 the pain was observed in equal proportion in both sexes and in the first six hours, with the average level of pain of 1.75. CONCLUSION: The hemorrhoidectomy accomplished with spinal anesthesia without morphine and blockade of the pudendal nerve using ropivacaine provided better analgesic effect in the period of 12 hours after the surgery and it didn't present complications in this casuistry, being shown superior to the spinal anesthesia with morphine.

  18. Optic nerve oxygen tension

    DEFF Research Database (Denmark)

    la Cour, M; Kiilgaard, Jens Folke; Eysteinsson, T;

    2000-01-01

    To investigate the influence of acute changes in intraocular pressure on the oxygen tension in the vicinity of the optic nerve head under control conditions and after intravenous administration of 500 mg of the carbonic anhydrase inhibitor dorzolamide.......To investigate the influence of acute changes in intraocular pressure on the oxygen tension in the vicinity of the optic nerve head under control conditions and after intravenous administration of 500 mg of the carbonic anhydrase inhibitor dorzolamide....

  19. Cardiovascular, hormonal and metabolic responses to graded exercise in juvenile diabetics with and without autonomic neuropathy

    DEFF Research Database (Denmark)

    Hilsted, J; Galbo, H; Christensen, N J

    1980-01-01

    Thirteen juvenile diabetics were studied in order to determine if decreased beat-to-beat variation during deep respiration, indicating abnormal autonomic nerve function, imply that cardiovascular, hormonal and metabolic responses are impaired. Patients with decreased beat-to-beat variation had to...

  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. The...

  1. ADAM: ADaptive Autonomous Machine

    NARCIS (Netherlands)

    Oosten, van Daan C.; Nijenhuis, Lucas F.J.; Bakkers, André W.P.; Vervoort, Wiek A.

    1996-01-01

    This paper describes a part of the development of an adaptive autonomous machine that is able to move in an unknown world extract knowledge out of the perceived data, has the possibility to reason, and finally has the capability to exchange experiences and knowledge with other agents. The agent is n

  2. Autonomous Security Patrol System

    OpenAIRE

    Erramouspe, Jake

    2010-01-01

    This project provides an efficient and cost-effective solution to building security and active monitoring. The security is monitored and controlled by autonomous patrol robots. Any indication of a security breach will result in an immediate alarm and activation of the robot group to subdue and tranquilize the intruder.

  3. Vestibular influences on autonomic cardiovascular control in humans

    Science.gov (United States)

    Biaggioni, I.; Costa, F.; Kaufmann, H.; Robertson, D. (Principal Investigator)

    1998-01-01

    There is substantial evidence that anatomical connections exist between vestibular and autonomic nuclei. Animal studies have shown functional interactions between the vestibular and autonomic systems. The nature of these interactions, however, is complex and has not been fully defined. Vestibular stimulation has been consistently found to reduce blood pressure in animals. Given the potential interaction between vestibular and autonomic pathways this finding could be explained by a reduction in sympathetic activity. However, rather than sympathetic inhibition, vestibular stimulation has consistently been shown to increase sympathetic outflow in cardiac and splanchnic vascular beds in most experimental models. Several clinical observations suggest that a link between vestibular and autonomic systems may also exist in humans. However, direct evidence for vestibular/autonomic interactions in humans is sparse. Motion sickness has been found to induce forearm vasodilation and reduce baroreflex gain, and head down neck flexion induces transient forearm and calf vasoconstriction. On the other hand, studies using optokinetic stimulation have found either very small, variable, or inconsistent changes in heart rate and blood pressure, despite substantial symptoms of motion sickness. Furthermore, caloric stimulation severe enough to produce nystagmus, dizziness, and nausea had no effect on sympathetic nerve activity measured directly with microneurography. No effect was observed on heart rate, blood pressure, or plasma norepinephrine. Several factors may explain the apparent discordance of these results, but more research is needed before we can define the potential importance of vestibular input to cardiovascular regulation and orthostatic tolerance in humans.

  4. Nerve Conduction Studies and Electromyography

    OpenAIRE

    Keyes, Robert D.

    1990-01-01

    Nerve conduction studies and electromyography can aid in the diagnosis of peripheral nervous system disease. The author reviews various techniques used during electromyography and nerve conduction studies. He reviews briefly peripheral nerve and muscle neuroanatomy and neurophysiology. The author defines terms used in nerve conduction studies and electromyography and relates terminology to the underlying pathophysiology and histopathology. He also reviews briefly typical nerve conduction and ...

  5. Software Architecture for Autonomous Spacecraft

    Science.gov (United States)

    Shih, Jimmy S.

    1997-01-01

    The thesis objective is to design an autonomous spacecraft architecture to perform both deliberative and reactive behaviors. The Autonomous Small Planet In-Situ Reaction to Events (ASPIRE) project uses the architecture to integrate several autonomous technologies for a comet orbiter mission.

  6. Unusual Communications between the Cutaneous Branches of Ulnar Nerve in the Palm

    Science.gov (United States)

    Sirasanagandla, Srinivasa Rao; Nayak, Satheesha B.; Jetti, Raghu

    2015-01-01

    Variations of dorsal and volar digital cutaneous branches of ulnar nerve are of tremendous clinical importance for successful regional nerve blocks, skin flaps, carpal tunnel release and placement of electrodes for electrophysiological studies. With the aforementioned clinical implications it is worth to report the variations of cutaneous branches of ulnar nerve. In the current case, we have encountered a rare variation (Kaplan`s anastomosis) of ulnar nerve, in the right upper limb. We have noticed that the dorsal cutaneous branch of ulnar nerve divided into three branches, the lateral two branches supplied the skin of the medial one and half fingers of the dorsum of hand. The medial branch established communications with the superficial branches of ulnar nerve and distributed to the skin of the one and half fingers of the volar aspect of hand. The possible outcome of this communications is discussed. Course and distribution of ulnar nerve on the contralateral side was found to be normal. PMID:25954612

  7. 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.

  8. 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

  9. Transcompartmental reversal of single fibre hyperexcitability in juxtaparanodal Kv1.1-deficient vagus nerve axons by activation of nodal KCNQ channels.

    Science.gov (United States)

    Glasscock, Edward; Qian, Jing; Kole, Matthew J; Noebels, Jeffrey L

    2012-08-15

    Kv1.1 channels cluster at juxtaparanodes of myelinated axons in the vagus nerve, the primary conduit for parasympathetic innervation of the heart. Kcna1-null mice lacking these channels exhibit neurocardiac dysfunction manifested by atropine-sensitive atrioventricular conduction blocks and bradycardia that may culminate in sudden death. To evaluate whether loss of Kv1.1 channels alters electrogenic properties within the nerve, we compared the intrinsic excitability of single myelinated A- and Aδ-axons from excised cervical vagus nerves of young adult Kcna1-null mice and age-matched, wild-type littermate controls. Although action potential shapes and relative refractory periods varied little between genotypes, Kv1.1-deficient large myelinated A-axons showed a fivefold increase in susceptibility to 4-aminopyridine (4-AP)-induced spontaneous ectopic firing. Since the repolarizing currents of juxtaparanodal Kv1 channels and nodal KCNQ potassium channels both act to dampen repetitive activity, we examined whether augmenting nodal KCNQ activation could compensate for Kv1.1 loss and reverse the spontaneous hyperexcitability in Kv1.1-deficient A-axons. Application of the selective KCNQ opener flupirtine raised A-axon firing threshold while profoundly suppressing 4-AP-induced spontaneous firing, demonstrating a functional synergy between the two compartments. We conclude that juxtaparanodal Kv1.1-deficiency causes intrinsic hyperexcitability in large myelinated axons in vagus nerve which could contribute to autonomic dysfunction in Kcna1-null mice, and that KCNQ openers reveal a transcompartmental synergy between Kv1 and KCNQ channels in regulating axonal excitability. PMID:22641786

  10. [Biophysics of nerve excitation].

    Science.gov (United States)

    Kol'e, O R; Maksimov, G V

    2010-01-01

    The studies testifying to the presence of the interrelation between the physiological functions of the organism and physical and chemical processes in nerves are discussed. Changes in some physical and chemical parameters observed both upon elicited rhythmic exaltation of nerves and during the spontaneous rhythmic activity of neurons are analyzed. Upon rhythmic exaltation, a complex of physical and chemical processes is triggered, and reversible structural and metabolic rearrangements at the subcellular and molecular levels occur that do not take place during the generation of a single action potential. Thus, only in conditions of rhythmic exaltation of a nerve, it is possible to reveal those processes that provide exaltation of nerves in the organism. The future possibilities of the investigations combining the biophysical and physiological approaches are substantiated. Characteristic changes in physicochemical parameters are observed in nerves during the generation of a series of action potentials of different frequency and duration ("frequency dependence") under normal physiological conditions, as well as in extreme situations and in nerve pathology. The structural and metabolic rearrangements are directly related to the mode of rhythmic exaltation and proceed both in the course of rhythmic exaltation and after its termination. Participation and the basic components of the nervous fulcrum (an axon, Shwan cell, myelin, subcellular organelles) in the realization of rhythmic exaltation is shown. In the coordination of all processes involved in rhythmic exaltation, the main role is played by the systems of redistribution and transport of intercellular and endocellular calcium. The idea is put forward that myelin of nerve fibers is not only an isolator, but also an "intercellular depot" of calcium and participates in the redistribution of different ions. Thus, the rhythmic excitation is of great importance in the realization of some physiological functions, the

  11. 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。

  12. Evidence Basis for Ultrasound-Guided Block Characteristics Onset, Quality, and Duration.

    Science.gov (United States)

    Liu, Spencer S

    2016-01-01

    This systematic review summarizes existing evidence for superior onset, quality, and duration of block for ultrasound guidance versus other techniques for nerve localization. MEDLINE was systematically searched from 1966 to June 2013 for randomized controlled trials (RCTs) comparing ultrasound guidance to another technique for peripheral nerve blocks. Twenty-three RCTs were identified for upper-extremity peripheral nerve blocks and 17 for lower extremity. Jadad scores for quality of RCT ranged from 1 to 5 with a median of 3. For upper-extremity blocks, 11 (48%) of 23 RCTs reported faster onset of block, 9 (39%) of 23 reported better quality of block, and 1 (14%) of 7 reported longer duration of block with ultrasound. One RCT reported that ultrasound was inferior for onset of combined median and ulnar block. For lower-extremity blocks, 8 (80%) of 10 RCTs reported faster onset, 9 (56%) of 16 reported better quality, and 2 (33%) of 6 RCTs reported longer duration of blocks. One RCT reported that ultrasound was inferior for quality and duration for ankle block. There is level 1b evidence to make a grade A recommendation that ultrasound guidance provides a modest improvement in block onset and quality of peripheral nerve blocks, especially for lower extremity. Ultrasound is rarely inferior to other techniques. PMID:26244287

  13. Perioperative Nerve Blockade: Clues from the Bench

    Directory of Open Access Journals (Sweden)

    M. R. Suter

    2011-01-01

    Full Text Available Peripheral and neuraxial nerve blockades are widely used in the perioperative period. Their values to diminish acute postoperative pain are established but other important outcomes such as chronic postoperative pain, or newly, cancer recurrence, or infections could also be influenced. The long-term effects of perioperative nerve blockade are still controversial. We will review current knowledge of the effects of blocking peripheral electrical activity in different animal models of pain. We will first go over the mechanisms of pain development and evaluate which types of fibers are activated after an injury. In the light of experimental results, we will propose some hypotheses explaining the mitigated results obtained in clinical studies on chronic postoperative pain. Finally, we will discuss three major disadvantages of the current blockade: the absence of blockade of myelinated fibers, the inappropriate duration of blockade, and the existence of activity-independent mechanisms.

  14. Regional anesthesia in transurethral resection of prostate (TURP) surgery: A comparative study between saddle block and subarachnoid block

    OpenAIRE

    Susmita Bhattacharyya; Subrata Bisai; Hirak Biswas; Mandeep Kumar Tiwary; Suchismita Mallik; Swarna Mukul Saha

    2015-01-01

    Background: Spinal anesthesia is the technique of choice in transurethral resection of prostate (TURP). The major complication of spinal technique is risk of hypotension. Saddle block paralyzed pelvic muscles and sacral nerve roots and hemodynamic derangement is less. Aims and objectives: To compare the hemodynamic changes and adequate surgical condition between saddle block and subarachnoid block for TURP. Material and methods: Ninety patients of aged between 50 to 70 years of ASA-PS I, II s...

  15. 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-workers in a range of environments. This system uses stereo vision to locate human team mates and tools and a navigation system that uses laser range and vision data to follow humans while avoiding obstacles. Tactile sensors provide information to grasping algorithms for efficient tool exchanges. The autonomous architecture utilizes these pre-programmed skills to form human assistant behaviors. The initial behavior demonstrates a robust capability to assist a human by acquiring a tool from a remotely located individual and then following the human in a cluttered environment with the tool for future use.

  16. Small gap anastomosis to repair peripheral nerve rupture using a nerve regeneration chamber constructed by scissoring and sleeve jointing autologous epineurium

    Institute of Scientific and Technical Information of China (English)

    Peiji Wang; Zhongliang Zhou; Qirong Dong

    2011-01-01

    A number of studies have shown how to eliminate the misorientated docking of the peripheral nerve bundle in the traditional epineurium or perineudum anastomosis, thus avoiding neuroma formation and axonal outgrowth from the coaptation sites, and seriously hindering neural function recovery. Based on the "peripheral nerve selective regeneration theory", this experiment was designed to investigate the feasibility and benefits of a new small gap anastomosis repairing peripheral nerve rupture, by scissoring and sleeve jointing an autologous epineurium. In the proximal stump of the nerve, a 1 mm-long epineurium was annularly separated and removed, while a 3 mm-long epineurium was longitudinally incised in the distal stump after the epineurium was dissociated from proximal to distal. The epineuria of the two stumps and the longitudinal incision were sutured, leaving a 2 mm gap between the two nerve stumps. Results show that the experimental rats quickly recovered autonomic activities, and there were minimal adhesions at the outer surface of the epineurial tube to the surrounding tissue. The morphologic changes to the sciatic nerve showed that connective tissue hyperplasia of the small gaps was significantly reduced, and nerve fibers were arranged orderly. No such changes were observed in the neurorrhaphy in situ group. Thus, the experiment confirmed that the new small gap anastomosis to repair peripheral nerve rupture by scissoring and sleeve jointing autologous epineurium is feasible, and that it is superior to epineurium neurorrhaphy in situ.

  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. A comparison of ultrasound-guided supraclavicular and infraclavicular blocks for upper extremity surgery

    DEFF Research Database (Denmark)

    Koscielniak-Nielsen, Z J; Frederiksen, B S; Rasmussen, H;

    2009-01-01

    -guided supraclavicular or infraclavicular blocks. We hypothesized that the supraclavicular approach, being more superficial and easier to visualize using a 10 MHz transducer, will produce a faster and a more extensive sensory block. METHODS: One hundred and twenty patients were randomized to two equal groups......BACKGROUND: Ultrasound (US)-guided supraclavicular or infraclavicular blocks are commonly used for upper extremity surgery. The aims of this randomized study were to compare the block performance and onset times, effectiveness, incidence of adverse events and patient's acceptance of US......) of the seven terminal nerves was assessed every 10 min. Patients were declared ready for surgery when they had an effective surgical block--anaesthesia or analgesia of the five nerves below the elbow. Thirty minutes after the block, the unblocked nerves were supplemented. The block performance and...

  19. Blocked strainers

    International Nuclear Information System (INIS)

    Thermal insulation was the cause of the blockages that shut down five BWRs in Sweden. The main culprit was mineral wool installed when the plants started up. Physical degradation of the wool over the lifetime of the plant meant it could easily be washed out of place during a loss of coolant accident and could quickly block strainers in the emergency core cooling systems. The five BWRs are almost all back on line, equipped with larger strainers and faster backwashing capability. But the incident prompted more detailed investigation into how materials in the containment would behave during an accident. One material that caused particular concern is Caposil, a material often used to insulate the reactor vessel. Composed of natural calcium, aluminium silicates and cellulose fibres, in the event of a LOCA Caposil becomes particularly hazardous. Under high pressure, or when brought into contact with high pressure water and steam, Caposil fragments into 1 cm clumps, free fibres, and ''fines''. It is these fines which cause major problems and can block a strainer extremely quickly. The successful testing of a high performance water filter which can handle Caposil is described. (4 figures) (Author)

  20. Autonomous single camera exploration

    OpenAIRE

    Vidal-Calleja, Teresa A.; Sanfeliu, Alberto; Andrade-Cetto, J.

    2006-01-01

    In this paper we present an active exploration strategy for a mobile robot navigating in 3D. The aim is to control a moving robot that autonomously builds a visual feature map while at the same time optimises its localisation in this map. The technique chooses the most appropriate commands maximising the information gain between prior states and measurements, while performing 6DOF bearing only SLAM at video rate. Maximising the mutual information helps the vehicle avoid ill-conditioned measur...

  1. Autonomous Underwater Vehicle control

    OpenAIRE

    Vidal Morató, Jordi; Gomáriz Castro, Spartacus; Manuel Lázaro, Antonio

    2005-01-01

    In this paper the system control design stages for an autonomous underwater vehicle are presented. The vehicle must be able to sail on sea surface, following a path without losing its route and once a position is reached, a dive following a perpendicular path to the surface is carried out. A two level system control are proposed. The primary level will control the navigation of the vehicle where a linear controllers are proposed. Whereas in secondary level guidance system, collision system, s...

  2. The autonomous acoustic buoy

    OpenAIRE

    Pellicer, Francisco; Reitsma, Robert; Agüera, Joaquín; Marinas, Alexandra

    2013-01-01

    The Acoustic Buoy is a project between the Laboratory of Applied Bioacoustics (LAB) and the Universitat Politècnica de Catalunya (UPC). In areas that the human activities produce high noise levels, such as oil exploration or construction, there is a need to monitor the environment for the presence of cetaceans. Another need is for fishing, to prevent endangered species from being killed. This can be done with an Autonomous Acoustic Buoy (AAB). Mooring or anchoring at to the seaflo...

  3. Mobile Intelligent Autonomous Systems

    OpenAIRE

    Jitendra R. Raol; Ajith Gopal

    2010-01-01

    Mobile intelligent autonomous systems (MIAS) is a fast emerging research area. Although it can be regarded as a general R&D area, it is mainly directed towards robotics. Several important subtopics within MIAS research are:(i) perception and reasoning, (ii) mobility and navigation,(iii) haptics and teleoperation, (iv) image fusion/computervision, (v) modelling of manipulators, (vi) hardware/software architectures for planning and behaviour learning leadingto robotic architecture, (vii) ve...

  4. Role of dexamethasone in brachial plexus block

    International Nuclear Information System (INIS)

    To evaluate the effect of dexamethasone added to (lignocaine) on the onset and duration of axillary brachial plexus block. Study Design: Randomized controlled trial. Place and Duration of Study: Combined Military Hospital Rawalpindi, from September 2009 to March 2010. Patients and Methods: A total of 100 patients, who were scheduled for elective hand and forearm surgery under axillary brachial plexus block, were randomly allocated to group A in which patients received 40 ml 1.5% lidocaine with 2 ml of isotonic saline (0.9%) and group B in which patients received 40 ml 1.5% lidocaine with 2 ml of dexamethasone (8 mg). Nerve stimulator with insulated needle for multiple stimulations technique was used to locate the brachial plexus nerves. After the injection onset of action and duration of sensory blockade of brachial plexus were recorded at 5 minutes and 15 minutes interval. Results: Group A showed the onset of action of 21.64 ± 2.30 min and in group B it was 15.42 ± 1.44 min (p< 0.001). Duration of nerve block was 115.08 ± 10.92 min in group A and 265.42 ± 16.56 min in group B (p < 0.001). Conclusion: The addition of dexamethasone to 1.5% lignocaine solution in axillary brachial plexus block prolongs the duration of sensory blockade significantly. (author)

  5. Prolonged hemidiaphragmatic paresis following continuous interscalene brachial plexus block: A case report.

    Science.gov (United States)

    Shinn, Helen Ki; Kim, Byung-Gun; Jung, Jong Kwon; Kwon, Hee Uk; Yang, Chunwoo; Won, Jonghun

    2016-06-01

    Interscalene brachial plexus block provides effective anesthesia and analgesia for shoulder surgery. One of the disadvantages of this technique is the risk of hemidiaphragmatic paresis, which can occur as a result of phrenic nerve block and can cause a decrease in the pulmonary function, limiting the use of the block in patients with reduced functional residual capacity or a preexisting pulmonary disease. However, it is generally transient and is resolved over the duration of the local anesthetic's action.We present a case of a patient who experienced prolonged hemidiaphragmatic paresis following a continuous interscalene brachial plexus block for the postoperative pain management of shoulder surgery, and suggest a mechanism that may have led to this adverse effect.Nerve injuries associated with peripheral nerve blocks may be caused by several mechanisms. Our findings suggest that perioperative nerve injuries can occur as a result of combined mechanical and chemical injuries. PMID:27310984

  6. Nature's Autonomous Oscillators

    Science.gov (United States)

    Mayr, H. G.; Yee, J.-H.; Mayr, M.; Schnetzler, R.

    2012-01-01

    Nonlinearity is required to produce autonomous oscillations without external time dependent source, and an example is the pendulum clock. The escapement mechanism of the clock imparts an impulse for each swing direction, which keeps the pendulum oscillating at the resonance frequency. Among nature's observed autonomous oscillators, examples are the quasi-biennial oscillation and bimonthly oscillation of the Earth atmosphere, and the 22-year solar oscillation. The oscillations have been simulated in numerical models without external time dependent source, and in Section 2 we summarize the results. Specifically, we shall discuss the nonlinearities that are involved in generating the oscillations, and the processes that produce the periodicities. In biology, insects have flight muscles, which function autonomously with wing frequencies that far exceed the animals' neural capacity; Stretch-activation of muscle contraction is the mechanism that produces the high frequency oscillation of insect flight, discussed in Section 3. The same mechanism is also invoked to explain the functioning of the cardiac muscle. In Section 4, we present a tutorial review of the cardio-vascular system, heart anatomy, and muscle cell physiology, leading up to Starling's Law of the Heart, which supports our notion that the human heart is also a nonlinear oscillator. In Section 5, we offer a broad perspective of the tenuous links between the fluid dynamical oscillators and the human heart physiology.

  7. Trigeminal autonomic cephalalgias.

    Science.gov (United States)

    Eller, M; Goadsby, P J

    2016-01-01

    The trigeminal autonomic cephalalgias (TACs) are a group of primary headache disorders characterised by lateralized symptoms: prominent headache and ipsilateral cranial autonomic features, such as conjunctival injection, lacrimation and rhinorrhea. The TACs are: cluster headache (CH), paroxysmal hemicrania (PH), short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT)/short-lasting neuralgiform headache attacks with cranial autonomic features (SUNA) and hemicrania continua (HC). Their diagnostic criteria are outlined in the International Classification of Headache Disorders, third edition-beta (ICHD-IIIb). These conditions are distinguished by their attack duration and frequency, as well as response to treatment. HC is continuous and by definition responsive to indomethacin. The main differential when considering this headache is chronic migraine. Other TACs are remarkable for their short duration and must be distinguished from other short-lasting painful conditions, such as trigeminal neuralgia and primary stabbing headache. Cluster headache is characterised by exquisitely painful attacks that occur in discrete episodes lasting 15-180 min a few times a day. In comparison, PH occurs more frequently and is of shorter duration, and like HC is responsive to indomethacin. SUNCT/SUNA is the shortest duration and highest frequency TAC; attacks can occur over a hundred times every day. PMID:24888770

  8. Cranial nerve palsies

    International Nuclear Information System (INIS)

    This paper evaluates the utility of multiplanar reconstructions (MPRs) of three-dimensional (3D) MR angiography data sets in the examination of patients with cranial nerve palsies. The authors hypothesis was that 3D data could be reformatted to highlight the intricate spatial relationships of vessels to adjacent neural tissues by taking advantage of the high vessel-parenchyma contrast in high-resolution 3D time-of-flight sequences. Twenty patients with cranial nerve palsies and 10 asymptomatic patients were examined with coronal T1-weighted and axial T2-weighted imaging plus a gadolinium-enhanced 3D MRA sequence (40/7/15 degrees, axial 60-mm volume, 0.9-mm isotropic resolution). Cranial nerves II-VIII were subsequently evaluated on axial and reformatted coronal and/or sagittal images

  9. COMMUNICATION BETWEEN RADIAL AND ULNAR NERVE AT A HIGH HUMERAL LEVEL

    Directory of Open Access Journals (Sweden)

    Monika Lalit

    2014-06-01

    Full Text Available Various communications between the different branches of brachial plexus have been reported by many authors but the communication between the radial and ulnar nerve; the branches of posterior and medial cords of brachial plexus in the arm is very rare. It features the communicating ramus travelling from proximal radial nerve and distal ulnar nerve at a high humeral level in the right arm of a 56 year old male cadaver. Knowledge of such variations may be of importance in the evaluation of certain entrapment phenomenon of ulnar nerve or unexplained sensory loss after trauma or surgical interventions in that particular area is also of clinical significance in anaesthetic blocks.

  10. A VARIATION IN THE HIGH DIVISION OF THE SCIATIC NERVE AND ITS RELATION WITH PIRIFORMIS MUSCLE

    Directory of Open Access Journals (Sweden)

    Shailesh Patel

    2011-04-01

    Full Text Available The aim of the study was to describe and analyze sciatic nerve variation especially the higher division within the lesser pelvis and its different routes of exit from pelvis. The sciatic nerve (SN separates into its branches, the tibial and common peroneal nerves, outside the pelvis. However, it may rarely be separated within the pelvis. In such cases, the tibial nerve and the common peroneal nerve may leave the pelvis through different routes. These variations may cause nerve compressions under other anatomic structures, resulting in non-discogenic sciatica. 86 gluteal regions were examined in 43 formalin-fixed adult cadavers from different medical colleges of Gujarat region. From the study we found higher division of sciatic nerve bilaterally mainly in the female which is very rare and unilateral higher division of sciatic nerve which is also rare. The differences in the exit routes of these two nerves are important for surgeons, as this is the area of frequent surgical manipulation, nerve injury during deep intramuscular injections in gluteal region, failed sciatic nerve block in anesthesia and injury during posterior hip operations. [National J of Med Res 2011; 1(2.000: 27-30

  11. Nerve Transfers in Tetraplegia.

    Science.gov (United States)

    Fox, Ida K

    2016-05-01

    Hand and upper extremity function is instrumental to basic activities of daily living and level of independence in cervical spinal cord injury (SCI). Nerve transfer surgery is a novel and alternate approach for restoring function in SCI. This article discusses the biologic basis of nerve transfers in SCI, patient evaluation, management, and surgical approaches. Although the application of this technique is not new; recent case reports and case series in the literature have increased interest in this field. The challenges are to improve function, achieve maximal gains in function, avoid complications, and to primum non nocere. PMID:27094894

  12. Pleural effusion and atelectasis during continuous interscalene brachial plexus block -A case report-

    OpenAIRE

    Yang, Chun Woo; Jung, Sung Mee; Cho, Choon Kyu; Kwon, Hee Uk; Kang, Po Soon; Lim, Young Su; Oh, Jin Young; Yi, Jin Woong

    2010-01-01

    An interscalene brachial plexus block is an effective means of providing anesthesia-analgesia for shoulder surgery. However, it has a multitude of potential side effects such as phrenic nerve block. We report a case of a patient who developed atelectasis of the lung, and pleural effusion manifested as chest discomfort during a continuous interscalene brachial plexus block for postoperative analgesia.

  13. The level of the sciatic nerve division and its relations to the piriform muscle

    Directory of Open Access Journals (Sweden)

    Ugrenović Slađana Z.

    2005-01-01

    Full Text Available Background. The sciatic nerve, as the terminal branch of the sacral plexus, leaves the pelvis through the greater sciatic foramen beneath the piriform muscle. Afterwards, it separates into the tibial and the common peroneal nerve, most frequently at the level of the upper angle of the popliteal fossa. Higher level of the sciatic nerve division is a relatively frequent phenomenom and it may be the cause of an incomplete block of the sciatic nerve during the popliteal block anesthesia. There is a possibility of different anatomic relations between the sciatic nerve or its terminal branches and the piriform muscle (piriformis syndrome. The aim of this research was to investigate the level of the sciatic nerve division and its relations to the piriform muscle. It was performed on 100 human fetuses (200 lower extremities which were in various gestational periods and of various sex, using microdissection method. Characteristic cases were photographed. Results. Sciatic nerve separated into the tibial and common peroneal nerve in popliteal fossa in 72.5% of the cases (bilaterally in the 66% of the cases. In the remainder of the cases the sciatic nerve division was high (27.5% of the cases in the posteror femoral or in the gluteal region. Sciatic nerve left the pelvis through the infrapiriform foramen in 192 lower extremities (96% of the cases, while in 8 lower extremities (4% of the cases the variable relations between sciatic nerve and piriform muscle were detected. The common peroneal nerve penetrated the piriform muscle and left the pelvis in 5 lower extremities (2.5% of the cases and the tibial nerve in those cases left the pelvis through the infrapiriform foramen. In 3 lower extremities (1.5% of the cases common peroneal nerve left the pelvis through suprapiriform, and the tibial nerve through the infrapiriform foramen. The high terminal division of sciatic nerve (detected in 1/3 of the cases, must be kept in mind during the performing of popliteal

  14. Neuromuscular Ultrasound of Cranial Nerves

    OpenAIRE

    Tawfik, Eman A.; Walker, Francis O.; Cartwright, Michael S.

    2015-01-01

    Ultrasound of cranial nerves is a novel subdomain of neuromuscular ultrasound (NMUS) which may provide additional value in the assessment of cranial nerves in different neuromuscular disorders. Whilst NMUS of peripheral nerves has been studied, NMUS of cranial nerves is considered in its initial stage of research, thus, there is a need to summarize the research results achieved to date. Detailed scanning protocols, which assist in mastery of the techniques, are briefly mentioned in the few re...

  15. High division of sciatic nerve

    OpenAIRE

    Tripti Shrivastava; Lalit Garg; B. K. Mishra; Neeta Chhabra

    2014-01-01

    Background: The Sciatic nerve is the largest and thickest nerve in the human body with a long course in the inferior extremity. It divides into tibial and common peroneal nerves which can occur at any level from the sacral plexus to the inferior part of the popliteal space. Sciatic nerve variations are relatively common. These variations may contribute to clinical conditions ex sciatica, coccygodynia and piriformis syndrome and have important clinical implications in anaesthesiology, neurolog...

  16. Multispectral photoacoustic imaging of nerves with a clinical ultrasound system

    Science.gov (United States)

    Mari, Jean Martial; West, Simeon; Beard, Paul C.; Desjardins, Adrien E.

    2014-03-01

    Accurate and efficient identification of nerves is of great importance during many ultrasound-guided clinical procedures, including nerve blocks and prostate biopsies. It can be challenging to visualise nerves with conventional ultrasound imaging, however. One of the challenges is that nerves can have very similar appearances to nearby structures such as tendons. Several recent studies have highlighted the potential of near-infrared optical spectroscopy for differentiating nerves and adjacent tissues, as this modality can be sensitive to optical absorption of lipids that are present in intra- and extra-neural adipose tissue and in the myelin sheaths. These studies were limited to point measurements, however. In this pilot study, a custom photoacoustic system with a clinical ultrasound imaging probe was used to acquire multi-spectral photoacoustic images of nerves and tendons from swine ex vivo, across the wavelength range of 1100 to 1300 nm. Photoacoustic images were processed and overlaid in colour onto co-registered conventional ultrasound images that were acquired with the same imaging probe. A pronounced optical absorption peak centred at 1210 nm was observed in the photoacoustic signals obtained from nerves, and it was absent in those obtained from tendons. This absorption peak, which is consistent with the presence of lipids, provides a novel image contrast mechanism to significantly enhance the visualization of nerves. In particular, image contrast for nerves was up to 5.5 times greater with photoacoustic imaging (0.82 +/- 0.15) than with conventional ultrasound imaging (0.148 +/- 0.002), with a maximum contrast of 0.95 +/- 0.02 obtained in photoacoustic mode. This pilot study demonstrates the potential of photoacoustic imaging to improve clinical outcomes in ultrasound-guided interventions in regional anaesthesia and interventional oncology.

  17. Jam avoidance with autonomous systems

    OpenAIRE

    Tordeux, Antoine; Lassarre, Sylvain

    2015-01-01

    Many car-following models are developed for jam avoidance in highways. Two mechanisms are used to improve the stability: feedback control with autonomous models and increasing of the interaction within cooperative ones. In this paper, we compare the linear autonomous and collective optimal velocity (OV) models. We observe that the stability is significantly increased by adding predecessors in interaction with collective models. Yet autonomous and collective approaches are close when the speed...

  18. Chemical Specification of Autonomic Systems

    OpenAIRE

    Banâtre, Jean-Pierre; Fradet, Pascal; Radenac, Yann

    2004-01-01

    Autonomic computing provides a vision of information systems allowing self-management of many predefined properties. Such systems take care of their own behavior and of their interactions with other components without any external intervention. One of the major challenges concerns the expression of properties and constraints of autonomic systems. We believe that the {\\em chemical programming paradigm} (represented here by the Gamma formalism) is well-suited to the specification of autonomic s...

  19. Catecholamines and diabetic autonomic neuropathy

    DEFF Research Database (Denmark)

    Hilsted, J

    1995-01-01

    plasma catecholamine measurements is not due to changes in the clearance of catecholamines in diabetic autonomic neuropathy. The physiological responses to infused adrenaline and to noradrenaline are enhanced, for noradrenaline mainly cardiovascular responses. Adrenoceptors (alpha and beta adrenoceptors......In diabetic patients with autonomic neuropathy plasma noradrenaline concentration, used as an index of sympathetic nervous activity, is low. This decrease is, however, only found in patients with a long duration of diabetes with clinically severe autonomic neuropathy. This apparent insensitivity of...

  20. Progress of peripheral nerve repair

    Institute of Scientific and Technical Information of China (English)

    陈峥嵘

    2002-01-01

    Study on repair of peripheral nerve injury has been proceeding over a long period of time. With the use of microsurgery technique since 1960s,the quality of nerve repair has been greatly improved. In the past 40 years, with the continuous increase of surgical repair methods, more progress has been made on the basic research of peripheral nerve repair.

  1. Tumors of the optic nerve

    DEFF Research Database (Denmark)

    Lindegaard, Jens; Heegaard, Steffen

    2009-01-01

    the nerve (e.g., astrocytes and meningothelial cells). The optic nerve may also be invaded from tumors originating elsewhere (secondary tumors), invading the nerve from adjacent structures (e.g., choroidal melanoma and retinoblastoma) or from distant sites (e.g., lymphocytic infiltration and distant...

  2. 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...

  3. Autonomic control of the pulmonary surfactant system and lung compliance in the lizard.

    Science.gov (United States)

    Wood, P G; Andrew, L K; Daniels, C B; Orgeig, S; Roberts, C T

    1997-01-01

    An increase in body temperature in the bearded dragon, Pogona vitticeps, is accompanied by an increase in the amount of pulmonary surfactant, a mixture of proteins and lipids, with the latter consisting predominantly of phospholipid and cholesterol. This increase may result from a temperature-induced change in autonomic input to the lungs, as perfusing the isolated lungs of P. vitticeps with either acetylcholine or adrenaline increases surfactant phospholipid release. However, whether acetylcholine acts via intrapulmonary sympathetic ganglia or directly on alveolar Type II cells is unknown. Moreover, the relative importance of circulating catecholamines and pulmonary sympathetic nerves on the control of the surfactant system is also obscure. Here, we describe the mechanism of the modulation of the surfactant system and the effect of this modulation on lung compliance. The role of acetylcholine was determined by perfusing isolated lungs with acetylcholine, acetylcholine and the ganglionic antagonist hexamethonium, or acetylcholine, hexamethonium, and the muscarinic antagonist atropine. Perfusing with acetylcholine significantly increased phospholipid release but did not affect cholesterol release. While histological examination of the lung revealed the presence of a large autonomic ganglion at the apex, blocking sympathetic ganglia with hexamethonium did not prevent the acetylcholine-mediated increase in phospholipid. However, the increase was inhibited by blocking muscarinic receptors with atropine, which indicates that acetylcholine acts on muscarinic receptors to stimulate phospholipid release. By increasing pulmonary smooth muscle tone, acetylcholine decreased opening pressure and increased static inflation pressures. Plasma levels of noradrenaline and adrenaline increased with increasing temperature and were accompanied by a greater surfactant content in the lungs. While surfactant content was also higher in animals that exercised, plasma levels of adrenaline

  4. Robotics and Autonomous Systems Laboratory

    Data.gov (United States)

    Federal Laboratory Consortium — FUNCTION: Provides an environment for developing and evaluating intelligent software for both actual and simulated autonomous vehicles. Laboratory computers provide...

  5. Jam avoidance with autonomous systems

    CERN Document Server

    Tordeux, Antoine

    2016-01-01

    Many car-following models are developed for jam avoidance in highways. Two mechanisms are used to improve the stability: feedback control with autonomous models and increasing of the interaction within cooperative ones. In this paper, we compare the linear autonomous and collective optimal velocity (OV) models. We observe that the stability is significantly increased by adding predecessors in interaction with collective models. Yet autonomous and collective approaches are close when the speed difference term is taking into account. Within the linear OV models tested, the autonomous models including speed difference are sufficient to maximise the stability.

  6. Ultrastructure of rat sciatic nerve at the streptozotocin-induced neuropathy conditions under administration of alpha-lipoic acid preparations

    OpenAIRE

    Dronov S.M.

    2014-01-01

    Dronov S.M. Ultrastructure of rat sciatic nerve at the streptozotocin-induced neuropathy conditions under administration of alpha-lipoic acid preparations. ABSTRACT. Background. Diabetic polyneuropathy is one of the most common long-term complications of diabetes. Hyperglycemias caused by ischemia and peroxidation of lipids are the presumed cause of diabetic neuropathy. Appointment of alpha-lipoic acid can restore the function of peripheral nerves, preventing the development of autonomic a...

  7. Collaborating with Autonomous Agents

    Science.gov (United States)

    Trujillo, Anna C.; Cross, Charles D.; Fan, Henry; Hempley, Lucas E.; Motter, Mark A.; Neilan, James H.; Qualls, Garry D.; Rothhaar, Paul M.; Tran, Loc D.; Allen, B. Danette

    2015-01-01

    With the anticipated increase of small unmanned aircraft systems (sUAS) entering into the National Airspace System, it is highly likely that vehicle operators will be teaming with fleets of small autonomous vehicles. The small vehicles may consist of sUAS, which are 55 pounds or less that typically will y at altitudes 400 feet and below, and small ground vehicles typically operating in buildings or defined small campuses. Typically, the vehicle operators are not concerned with manual control of the vehicle; instead they are concerned with the overall mission. In order for this vision of high-level mission operators working with fleets of vehicles to come to fruition, many human factors related challenges must be investigated and solved. First, the interface between the human operator and the autonomous agent must be at a level that the operator needs and the agents can understand. This paper details the natural language human factors e orts that NASA Langley's Autonomy Incubator is focusing on. In particular these e orts focus on allowing the operator to interact with the system using speech and gestures rather than a mouse and keyboard. With this ability of the system to understand both speech and gestures, operators not familiar with the vehicle dynamics will be able to easily plan, initiate, and change missions using a language familiar to them rather than having to learn and converse in the vehicle's language. This will foster better teaming between the operator and the autonomous agent which will help lower workload, increase situation awareness, and improve performance of the system as a whole.

  8. Disorders of the lower cranial nerves

    Directory of Open Access Journals (Sweden)

    Josef Finsterer

    2015-01-01

    Full Text Available Lesions of the lower cranial nerves (LCN are due to numerous causes, which need to be differentiated to optimize management and outcome. This review aims at summarizing and discussing diseases affecting LCN. Review of publications dealing with disorders of the LCN in humans. Affection of multiple LCN is much more frequent than the affection of a single LCN. LCN may be affected solely or together with more proximal cranial nerves, with central nervous system disease, or with nonneurological disorders. LCN lesions have to be suspected if there are typical symptoms or signs attributable to a LCN. Causes of LCN lesions can be classified as genetic, vascular, traumatic, iatrogenic, infectious, immunologic, metabolic, nutritional, degenerative, or neoplastic. Treatment of LCN lesions depends on the underlying cause. An effective treatment is available in the majority of the cases, but a prerequisite for complete recovery is the prompt and correct diagnosis. LCN lesions need to be considered in case of disturbed speech, swallowing, coughing, deglutition, sensory functions, taste, or autonomic functions, neuralgic pain, dysphagia, head, pharyngeal, or neck pain, cardiac or gastrointestinal compromise, or weakness of the trapezius, sternocleidomastoid, or the tongue muscles. To correctly assess manifestations of LCN lesions, precise knowledge of the anatomy and physiology of the area is required.

  9. Interactions between developing nerves and salivary glands.

    Science.gov (United States)

    Ferreira, João N; Hoffman, Matthew P

    2013-01-01

    Our aim is to provide a summary of the field of salivary gland development and regeneration from the perspective of what is known about the function of nerves during these processes. The primary function of adult salivary glands is to produce and secrete saliva. Neuronal control of adult salivary gland function has been a focus of research ever since Pavlov's seminal experiments on salivation in dogs. Less is known about salivary gland innervation during development and how the developing nerves influence gland organogenesis and regeneration. Here, we will review what is known about the communication between the autonomic nervous system and the epithelium of the salivary glands during organogenesis. An important emerging theme is the instructive role of the nervous system on the epithelial stem/progenitor cells during development as well as regeneration after damage. We will provide a brief overview of the neuroanatomy of the salivary glands and discuss recent literature that begins to integrate neurobiology with epithelial organogenesis, which may provide paradigms for exploring these interactions in other organ systems. PMID:23974175

  10. Small nerve fiber pathology in critical illness.

    Directory of Open Access Journals (Sweden)

    Nicola Latronico

    Full Text Available BACKGROUND: Degeneration of intraepidermal nerve fibers (IENF is a hallmark of small fiber neuropathy of different etiology, whose clinical picture is dominated by neuropathic pain. It is unknown if critical illness can affect IENF. METHODS: We enrolled 14 adult neurocritical care patients with prolonged intensive care unit (ICU stay and artificial ventilation (≥ 3 days, and no previous history or risk factors for neuromuscular disease. All patients underwent neurological examination including evaluation of consciousness, sensory functions, muscle strength, nerve conduction study and needle electromyography, autonomic dysfunction using the finger wrinkling test, and skin biopsy for quantification of IENF and sweat gland innervation density during ICU stay and at follow-up visit. Development of infection, sepsis and multiple organ failure was recorded throughout the ICU stay. RESULTS: Of the 14 patients recruited, 13 (93% had infections, sepsis or multiple organ failure. All had severe and non-length dependent loss of IENF. Sweat gland innervation was reduced in all except one patient. Of the 7 patients available for follow-up visit, three complained of diffuse sensory loss and burning pain, and another three showed clinical dysautonomia. CONCLUSIONS: Small fiber pathology can develop in the acute phase of critical illness and may explain chronic sensory impairment and pain in neurocritical care survivors. Its impact on long term disability warrants further studies involving also non-neurologic critical care patients.

  11. Autonomous packaging robot

    OpenAIRE

    Vo, Van Thanh

    2010-01-01

    The objective of the autonomous packaging robot application is to replace manual product packaging in food industry with a fully automatic robot. The objective is achieved by using the combination of machine vision, central computer, sensors, microcontroller and a typical ABB robot. The method is to equip the robot with different sensors: camera as “eyes” of robot, distance sensor and microcontroller as “sense of touch” of the robot, central computer as “brain” of the robot. Because the ro...

  12. 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...... management and efficient system operation. Due to the expected large number of user-deployed cells, centralized network planning becomes unpractical and new scalable alternatives must be sought. In this article, we propose a fully distributed and scalable solution to the interference management problem...

  13. Autonomous mobile robot teams

    Science.gov (United States)

    Agah, Arvin; Bekey, George A.

    1994-01-01

    This paper describes autonomous mobile robot teams performing tasks in unstructured environments. The behavior and the intelligence of the group is distributed, and the system does not include a central command base or leader. The novel concept of the Tropism-Based Cognitive Architecture is introduced, which is used by the robots in order to produce behavior transforming their sensory information to proper action. The results of a number of simulation experiments are presented. These experiments include worlds where the robot teams must locate, decompose, and gather objects, and defend themselves against hostile predators, while navigating around stationary and mobile obstacles.

  14. 超声引导神经阻滞联合右美托咪定在小儿腹股沟区手术的应用%Application of Ultrasound Guidance for Ilioinguinal or Iliohypogastric Nerve Block Plus Dexmedetomidine During Pediatric Inguinal Surgery

    Institute of Scientific and Technical Information of China (English)

    华玉思; 高巨; 欧晓峰

    2015-01-01

    [Objective] To evaluate the efficacy of ultrasound guidance for ilioinguinal oriliohypogastfie nerve block plus dexmedetomidine or ketamine anesthesia during pediatric outpatient inguinal surgery .[Methods] The present study was ap‐proved by the ethics committee of our hospital .Forty children with ASA statusⅠ ~ Ⅱ ,aged (1~6) years old ,scheduled for unilateral inguinal surgery were divided randomly into dexmedetomidine (D) and ketamine (K) groups ( n = 20 each) .The dexmedetomidine plus propofol group (group D) received an infusion over 15 minutes of 1 μg/kg dexmedetomidine and propo‐fol ,(2 .0~2 .5) mg/kg ,as a bolus for induction .Then Group D received an ilioinguinal or iliohypogastric block under ultra‐sonic guidance and an infusion of (0 .2~0 .7)μg/(kg · h) dexmedetomidine and (4~6) mg/(kg · h) propofol for maintenance . The ketamine plus propofol group (group K) received (2 .0~2 .5) mg/kg propofol and 1 mg/kg ketamine for induction and (4~6) mg/(kg · h) propofol and 0 .5 mg/(kg · h) ketamine by infusion for maintenance .Upon entering operation room ,they were monitored by electrocardiography (ECG) ,heart rate (HR) ,respiratory rate (RR) and oxygen saturation (SpO2 ) .Face legs activity cry consolability (FLACC) score was used to assess pain scores postoperatively at recovery time ,2h and 4h posto‐peration respectively .The degrees of parent and doctor's satisfaction were gauged at 2h and 4 h postoperation .And peripostop‐erative adverse events were also recorded .[Results] HR was significantly lower in group D after induction than that in group K ( P <0 .05) .The recovery time was longer in group D than that in group K ( P<0 .05) .The pain scores at recovery time ,2h and 4 h postoperation in group D was significantly lower than those in group K ( P<0 .05) .The degree of parental satisfaction was significantly higher in group D than that in group K ( P<0 .05) .[Conclusion] The method of ultrasonic guidance for ilio‐inguinal or

  15. Pathology of the vestibulocochlear nerve

    Energy Technology Data Exchange (ETDEWEB)

    De Foer, Bert [Department of Radiology, Sint-Augustinus Hospital, Oosterveldlaan 24, 2610 Wilrijk (Belgium)], E-mail: bert.defoer@GZA.be; Kenis, Christoph [Department of Radiology, Sint-Augustinus Hospital, Oosterveldlaan 24, 2610 Wilrijk (Belgium)], E-mail: christophkenis@hotmail.com; Van Melkebeke, Deborah [Department of Neurology, Sint-Augustinus Hospital, Oosterveldlaan 24, 2610 Wilrijk (Belgium)], E-mail: Deborah.vanmelkebeke@Ugent.be; Vercruysse, Jean-Philippe [University Department of ENT, Sint-Augustinus Hospital, Oosterveldlaan 24, 2610 Wilrijk (Belgium)], E-mail: jphver@yahoo.com; Somers, Thomas [University Department of ENT, Sint-Augustinus Hospital, Oosterveldlaan 24, 2610 Wilrijk (Belgium)], E-mail: Thomas.somers@GZA.be; Pouillon, Marc [Department of Radiology, Sint-Augustinus Hospital, Oosterveldlaan 24, 2610 Wilrijk (Belgium)], E-mail: marc.pouillon@GZA.be; Offeciers, Erwin [University Department of ENT, Sint-Augustinus Hospital, Oosterveldlaan 24, 2610 Wilrijk (Belgium)], E-mail: Erwin.offeciers@GZA.be; Casselman, Jan W. [Department of Radiology, AZ Sint-Jan AV Hospital, Ruddershove 10, Bruges (Belgium); Consultant Radiologist, Sint-Augustinus Hospital, Oosterveldlaan 24, 2610 Wilrijk (Belgium); Academic Consultent, University of Ghent (Belgium)], E-mail: jan.casselman@azbrugge.be

    2010-05-15

    There is a large scala of pathology affecting the vestibulocochlear nerve. Magnetic resonance imaging is the method of choice for the investigation of pathology of the vestibulocochlear nerve. Congenital pathology mainly consists of agenesis or hypoplasia of the vestibulocochlear nerve. Tumoral pathology affecting the vestibulocochlear nerve is most frequently located in the internal auditory canal or cerebellopontine angle. Schwannoma of the vestibulocochlear nerve is the most frequently found tumoral lesion followed by meningeoma, arachnoid cyst and epidermoid cyst. The most frequently encountered pathologies as well as some more rare entities are discussed in this chapter.

  16. The importance of phrenic nerve preservation and its effect on long-term postoperative lung function after pneumonectomy

    DEFF Research Database (Denmark)

    Kocher, Gregor J; Poulson, Jannie Lysgaard; Blichfeldt-Eckhardt, Morten Rune;

    2015-01-01

    , decided to investigate the effect of temporary ipsilateral cervical phrenic nerve block on dynamic lung volumes in mid- to long-term pneumonectomy patients. METHODS: We investigated 14 patients after a median of 9 years post pneumonectomy (range: 1-15 years). Lung function testing (spirometry) and...... fluoroscopic and/or sonographic assessment of diaphragmatic motion on the pneumonectomy side were performed before and after ultrasonographic-guided ipsilateral cervical phrenic nerve block by infiltration with lidocaine. RESULTS: Ipsilateral phrenic nerve block was successfully achieved in 12 patients (86......OBJECTIVES: The importance of phrenic nerve preservation during pneumonectomy remains controversial. We previously demonstrated that preservation of the phrenic nerve in the immediate postoperative period preserved lung function by 3-5% but little is known about its long-term effects. We, therefore...

  17. Blinded Observer Evaluation of Distal Skin Temperature for Predicting Lateral Infraclavicular Block Success

    DEFF Research Database (Denmark)

    Asghar, Semera; Lange, Kai H W; Lundstrøm, Lars H

    2015-01-01

    a diagnostic test for predicting a successful lateral infraclavicular block. METHODS: Blinded observers investigated temperature difference between the blocked and the nonblocked hands of 40 patients. Sensitivity, specificity, and predictive values of a positive and a negative test were estimated......BACKGROUND: Changes in digit skin temperature may be used to predict and determine upper limb nerve block success. We investigated whether a temperature difference between the blocked and the nonblocked hands, simply registered by touching the skin of the 5th and 2nd digit was valid and reliable as...... for evaluating the validity of a temperature difference for predicting a successful lateral infraclavicular block defined by sensory and motor block of all 4 major nerves (musculocutaneous, radial, ulnar, and median nerves). κ statistics of interobserver agreement were used for evaluating the...

  18. Towards autonomous vehicular clouds

    Directory of Open Access Journals (Sweden)

    Stephan Olariu

    2011-09-01

    Full Text Available The dawn of the 21st century has seen a growing interest in vehicular networking and its myriad potential applications. The initial view of practitioners and researchers was that radio-equipped vehicles could keep the drivers informed about potential safety risks and increase their awareness of road conditions. The view then expanded to include access to the Internet and associated services. This position paper proposes and promotes a novel and more comprehensive vision namely, that advances in vehicular networks, embedded devices and cloud computing will enable the formation of autonomous clouds of vehicular computing, communication, sensing, power and physical resources. Hence, we coin the term, autonomous vehicular clouds (AVCs. A key feature distinguishing AVCs from conventional cloud computing is that mobile AVC resources can be pooled dynamically to serve authorized users and to enable autonomy in real-time service sharing and management on terrestrial, aerial, or aquatic pathways or theaters of operations. In addition to general-purpose AVCs, we also envision the emergence of specialized AVCs such as mobile analytics laboratories. Furthermore, we envision that the integration of AVCs with ubiquitous smart infrastructures including intelligent transportation systems, smart cities and smart electric power grids will have an enormous societal impact enabling ubiquitous utility cyber-physical services at the right place, right time and with right-sized resources.

  19. Nemesis Autonomous Test System

    Science.gov (United States)

    Barltrop, Kevin J.; Lee, Cin-Young; Horvath, Gregory A,; Clement, Bradley J.

    2012-01-01

    A generalized framework has been developed for systems validation that can be applied to both traditional and autonomous systems. The framework consists of an automated test case generation and execution system called Nemesis that rapidly and thoroughly identifies flaws or vulnerabilities within a system. By applying genetic optimization and goal-seeking algorithms on the test equipment side, a "war game" is conducted between a system and its complementary nemesis. The end result of the war games is a collection of scenarios that reveals any undesirable behaviors of the system under test. The software provides a reusable framework to evolve test scenarios using genetic algorithms using an operation model of the system under test. It can automatically generate and execute test cases that reveal flaws in behaviorally complex systems. Genetic algorithms focus the exploration of tests on the set of test cases that most effectively reveals the flaws and vulnerabilities of the system under test. It leverages advances in state- and model-based engineering, which are essential in defining the behavior of autonomous systems. It also uses goal networks to describe test scenarios.

  20. Learning for Autonomous Navigation

    Science.gov (United States)

    Angelova, Anelia; Howard, Andrew; Matthies, Larry; Tang, Benyang; Turmon, Michael; Mjolsness, Eric

    2005-01-01

    Robotic ground vehicles for outdoor applications have achieved some remarkable successes, notably in autonomous highway following (Dickmanns, 1987), planetary exploration (1), and off-road navigation on Earth (1). Nevertheless, major challenges remain to enable reliable, high-speed, autonomous navigation in a wide variety of complex, off-road terrain. 3-D perception of terrain geometry with imaging range sensors is the mainstay of off-road driving systems. However, the stopping distance at high speed exceeds the effective lookahead distance of existing range sensors. Prospects for extending the range of 3-D sensors is strongly limited by sensor physics, eye safety of lasers, and related issues. Range sensor limitations also allow vehicles to enter large cul-de-sacs even at low speed, leading to long detours. Moreover, sensing only terrain geometry fails to reveal mechanical properties of terrain that are critical to assessing its traversability, such as potential for slippage, sinkage, and the degree of compliance of potential obstacles. Rovers in the Mars Exploration Rover (MER) mission have got stuck in sand dunes and experienced significant downhill slippage in the vicinity of large rock hazards. Earth-based off-road robots today have very limited ability to discriminate traversable vegetation from non-traversable vegetation or rough ground. It is impossible today to preprogram a system with knowledge of these properties for all types of terrain and weather conditions that might be encountered.

  1. Progesterone and peripheral nerve regeneration

    Institute of Scientific and Technical Information of China (English)

    Fei Fan; Haichao Li; Yuwei Wang; Yanglin Zheng; Lianjun Jia; Zhihui Wang

    2006-01-01

    OBJECTIVE: To explore the effect of progesterone on peripheral nerve regeneration.DATA SOURCES: An online search of Medline and OVID databases was under taken to identify articles about progesterone and peripheral nerve regeneration published in English between January 1990 and June 2004 by using the keywords of "peripheral nerve, injury, progesterone, regeneration".STUDY SELECTION: The data were primarily screened, those correlated with progesterone and peripheral nerve regeneration were involved, and their original articles were further searched, the repetitive studies or reviews were excluded.DATA EXTRACTION: Totally 59 articles about progesterone and peripheral nerve regeneration were collected, and 26 of them were involved, the other 33 excluded ones were the repetitive studies or reviews.DATA SYNTHESIS: Recent researches found that certain amount of progesterone could be synthetized in peripheral nervous system, and the expression of progesterone receptor could be found in sensory neurons and Schwann cells. After combined with the receptor, endogenous and exogenous progesterone can accelerate the formation of peripheral nerve myelin sheath, also promote the axonal regeneration.CONCLUSION: Progesterone plays a role in protecting neurons, increasing the sensitivity of nerve tissue to nerve growth factor, and accelerating regeneration of nerve in peripheral nerve regeneration, which provides theoretical references for the treatment of demyelinated disease and nerve injury, as well as the prevention of neuroma, especially that the in vivo level of progesterone should be considered for the elderly people accompanied by neuropathy and patients with congenital luteal phase defect, which is of positive significance in guiding the treatment.

  2. Spinal myoclonus following a peripheral nerve injury: a case report

    Directory of Open Access Journals (Sweden)

    Erkol Gokhan

    2008-08-01

    Full Text Available Abstract Spinal myoclonus is a rare disorder characterized by myoclonic movements in muscles that originate from several segments of the spinal cord and usually associated with laminectomy, spinal cord injury, post-operative, lumbosacral radiculopathy, spinal extradural block, myelopathy due to demyelination, cervical spondylosis and many other diseases. On rare occasions, it can originate from the peripheral nerve lesions and be mistaken for peripheral myoclonus. Careful history taking and electrophysiological evaluation is important in differential diagnosis. The aim of this report is to evaluate the clinical and electrophysiological characteristics and treatment results of a case with spinal myoclonus following a peripheral nerve injury without any structural lesion.

  3. Expanded Perspectives on Autonomous Learners

    Science.gov (United States)

    Oxford, Rebecca L.

    2015-01-01

    This paper explores two general perspectives on autonomous learners: psychological and sociocultural. These perspectives introduce a range of theoretically grounded facets of autonomous learners, facets such as the self-regulated learner, the emotionally intelligent learner, the self-determined learner, the mediated learner, the socioculturally…

  4. Effects of different nerve autografts on greater auricular nerve deficit in rabbits

    Institute of Scientific and Technical Information of China (English)

    Shaozong Chen

    2007-01-01

    and 12 weeks, 2μ m sections were prepared, each stained with either HE or methylene blue to assess axon number and density, cross-section area, and myelin sheath thickness. ③Electrophysidogical tests: At 12 weeks, the bilateral GAN along with the nerve grafts of 4 animals in each group were exposed. Points A, B and C were marked on each specimen: point A: at the proximal GAN segment, 7 cm from the proximal anastomosis; point B: 0.5 cm from the proximal anastomosis; point C: at the distal GAN segment, 0.5 cm from the distal anastomosis. The whole nerve including nerve graft and proximal and distal GAN segments, as a block, was harvested and immersed in Ren's solution for several minutes until its excitability was stabilized. The specimen was then placed on the electrodes of the shield box to examine the action potential and conduction velocity on segment AB and AC with BL-420E+biologic function testing system. AC/AB would be the recovery rate of action potential on segment AC. ④Horseradish peroxidase (HRP) fascicle: At 12 weeks, at the site on the distal segment of GAN 1.0 cm from the distal anastomosis of nerve graft, the GAN was crushed by a pair of haemostatic forceps and HRP water solution was injected into the nerve. Two rabbits in GAN group, SN group and LFCN group, after having survived for 24 hours, 36 hours and 48 hours were selected. The C2 ganglion was exposed and the distance from C2 ganglion to HRP injection site was taken as the axoplasmic transport distance, from which, the axoplasmic transport velocity and the mean density of the labeled C2 ganglion cells were calculated.MAIN OUTCOME MEASURES: ①The greatest distance of nerve regeneration; ②the axon number and density, cross-section area, and myelin sheath thickness; ③the action potential and conduction velocity; ④the axoplasmic transport velocity and the mean density of the labeled C2 ganglion cells. RESULTS: All 42 experimental rabbits were involved in the final analysis. ①The greatest

  5. Diabetic neuropathy increases stimulation threshold during popliteal sciatic nerve block†

    Science.gov (United States)

    Heschl, S.; Hallmann, B.; Zilke, T.; Gemes, G.; Schoerghuber, M.; Auer-Grumbach, M.; Quehenberger, F.; Lirk, P.; Hogan, Q.; Rigaud, M.

    2016-01-01

    Background Peripheral nerve stimulation is commonly used for nerve localization in regional anaesthesia, but recommended stimulation currents of 0.3–0.5 mA do not reliably produce motor activity in the absence of intraneural needle placement. As this may be particularly true in patients with diabetic neuropathy, we examined the stimulation threshold in patients with and without diabetes. Methods Preoperative evaluation included a neurological exam and electroneurography. During ultrasound-guided popliteal sciatic nerve block, we measured the current required to produce motor activity for the tibial and common peroneal nerve in diabetic and non-diabetic patients. Proximity to the nerve was evaluated post-hoc using ultrasound imaging. Results Average stimulation currents did not differ between diabetic (n=55) and non-diabetic patients (n=52). Although the planned number of patients was not reached, the power goal for the mean stimulation current was met. Subjects with diminished pressure perception showed increased thresholds for the common peroneal nerve (median 1.30 vs. 0.57 mA in subjects with normal perception, P=0.042), as did subjects with decreased pain sensation (1.60 vs. 0.50 mA in subjects with normal sensation, P=0.038). Slowed ulnar nerve conduction velocity predicted elevated mean stimulation current (r=−0.35, P=0.002). Finally, 15 diabetic patients required more than 0.5 mA to evoke a motor response, despite intraneural needle placement (n=4), or required currents ≥2 mA despite needle-nerve contact, vs three such patients (1 intraneural, 2 with ≥2 mA) among non-diabetic patients (P=0.003). Conclusions These findings suggest that stimulation thresholds of 0.3–0.5 mA may not reliably determine close needle-nerve contact during popliteal sciatic nerve block, particularly in patients with diabetic neuropathy. Clinical trial registration NCT01488474 PMID:26994231

  6. Short-Term Autonomic Denervation of the Atria Using Botulinum Toxin

    OpenAIRE

    Oh, Seil; Choi, Eue-Keun; Choi, Yun-Shik

    2010-01-01

    Background and Objectives Major epicardial fat pads contain cardiac ganglionated plexi (GP) of the autonomic nervous system. Autonomic denervation may improve the success rate of atrial fibrillation (AF) ablation. This study was designed to elucidate the acute effects of blocking the right atrium-pulmonary vein (RA-PV) and left atrium-inferior vena cava (LA-IVC) fat pads on the electrophysiologic characteristics of the atrium and AF inducibility with a botulinum toxin injection. Materials and...

  7. Evolutionary Autonomous Health Monitoring System (EAHMS) Project

    Data.gov (United States)

    National Aeronautics and Space Administration — For supporting NASA's Robotics, Tele-Robotics and Autonomous Systems Roadmap, we are proposing the "Evolutionary Autonomous Health Monitoring System" (EAHMS) for...

  8. Optic nerve hypoplasia

    Directory of Open Access Journals (Sweden)

    Savleen Kaur

    2013-01-01

    Full Text Available Optic nerve hypoplasia (ONH is a congenital anomaly of the optic disc that might result in moderate to severe vision loss in children. With a vast number of cases now being reported, the rarity of ONH is obviously now refuted. The major aspects of ophthalmic evaluation of an infant with possible ONH are visual assessment, fundus examination, and visual electrophysiology. Characteristically, the disc is small, there is a peripapillary double-ring sign, vascular tortuosity, and thinning of the nerve fiber layer. A patient with ONH should be assessed for presence of neurologic, radiologic, and endocrine associations. There may be maternal associations like premature births, fetal alcohol syndrome, maternal diabetes. Systemic associations in the child include endocrine abnormalities, developmental delay, cerebral palsy, and seizures. Besides the hypoplastic optic nerve and chiasm, neuroimaging shows abnormalities in ventricles or white- or gray-matter development, septo-optic dysplasia, hydrocephalus, and corpus callosum abnormalities. There is a greater incidence of clinical neurologic abnormalities in patients with bilateral ONH (65% than patients with unilateral ONH. We present a review on the available literature on the same to urge caution in our clinical practice when dealing with patients with ONH. Fundus photography, ocular coherence tomography, visual field testing, color vision evaluation, neuroimaging, endocrinology consultation with or without genetic testing are helpful in the diagnosis and management of ONH. (Method of search: MEDLINE, PUBMED.

  9. Optic nerve hypoplasia.

    Science.gov (United States)

    Kaur, Savleen; Jain, Sparshi; Sodhi, Harsimrat B S; Rastogi, Anju; Kamlesh

    2013-05-01

    Optic nerve hypoplasia (ONH) is a congenital anomaly of the optic disc that might result in moderate to severe vision loss in children. With a vast number of cases now being reported, the rarity of ONH is obviously now refuted. The major aspects of ophthalmic evaluation of an infant with possible ONH are visual assessment, fundus examination, and visual electrophysiology. Characteristically, the disc is small, there is a peripapillary double-ring sign, vascular tortuosity, and thinning of the nerve fiber layer. A patient with ONH should be assessed for presence of neurologic, radiologic, and endocrine associations. There may be maternal associations like premature births, fetal alcohol syndrome, maternal diabetes. Systemic associations in the child include endocrine abnormalities, developmental delay, cerebral palsy, and seizures. Besides the hypoplastic optic nerve and chiasm, neuroimaging shows abnormalities in ventricles or white- or gray-matter development, septo-optic dysplasia, hydrocephalus, and corpus callosum abnormalities. There is a greater incidence of clinical neurologic abnormalities in patients with bilateral ONH (65%) than patients with unilateral ONH. We present a review on the available literature on the same to urge caution in our clinical practice when dealing with patients with ONH. Fundus photography, ocular coherence tomography, visual field testing, color vision evaluation, neuroimaging, endocrinology consultation with or without genetic testing are helpful in the diagnosis and management of ONH. (Method of search: MEDLINE, PUBMED). PMID:24082663

  10. Nerve conduction and excitability studies in peripheral nerve disorders

    DEFF Research Database (Denmark)

    Krarup, Christian; Moldovan, Mihai

    2009-01-01

    counterparts in the peripheral nervous system, in some instances without peripheral nervous system symptoms. Both hereditary and acquired demyelinating neuropathies have been studied and the effects on nerve pathophysiology have been compared with degeneration and regeneration of axons. SUMMARY: Excitability....... Studies of different metabolic neuropathies have assessed the influence of uremia, diabetes and ischemia, and the use of these methods in toxic neuropathies has allowed pinpointing damaging factors. Various mutations in ion channels associated with central nervous system disorders have been shown to have......PURPOSE OF REVIEW: The review is aimed at providing information about the role of nerve excitability studies in peripheral nerve disorders. It has been known for many years that the insight into peripheral nerve pathophysiology provided by conventional nerve conduction studies is limited. Nerve...

  11. Autonomous Gaussian Decomposition

    CERN Document Server

    Lindner, Robert R; Murray, Claire E; Stanimirović, Snežana; Babler, Brian L; Heiles, Carl; Hennebelle, Patrick; Goss, W M; Dickey, John

    2014-01-01

    We present a new algorithm, named Autonomous Gaussian Decomposition (AGD), for automatically decomposing spectra into Gaussian components. AGD uses derivative spectroscopy and machine learning to provide optimized guesses for the number of Gaussian components in the data, and also their locations, widths, and amplitudes. We test AGD and find that it produces results comparable to human-derived solutions on 21cm absorption spectra from the 21cm SPectral line Observations of Neutral Gas with the EVLA (21-SPONGE) survey. We use AGD with Monte Carlo methods to derive the HI line completeness as a function of peak optical depth and velocity width for the 21-SPONGE data, and also show that the results of AGD are stable against varying observational noise intensity. The autonomy and computational efficiency of the method over traditional manual Gaussian fits allow for truly unbiased comparisons between observations and simulations, and for the ability to scale up and interpret the very large data volumes from the up...

  12. Autonomous Flying Controls Testbed

    Science.gov (United States)

    Motter, Mark A.

    2005-01-01

    The Flying Controls Testbed (FLiC) is a relatively small and inexpensive unmanned aerial vehicle developed specifically to test highly experimental flight control approaches. The most recent version of the FLiC is configured with 16 independent aileron segments, supports the implementation of C-coded experimental controllers, and is capable of fully autonomous flight from takeoff roll to landing, including flight test maneuvers. The test vehicle is basically a modified Army target drone, AN/FQM-117B, developed as part of a collaboration between the Aviation Applied Technology Directorate (AATD) at Fort Eustis,Virginia and NASA Langley Research Center. Several vehicles have been constructed and collectively have flown over 600 successful test flights.

  13. Mobile Intelligent Autonomous Systems

    Directory of Open Access Journals (Sweden)

    Jitendra R. Raol

    2010-01-01

    Full Text Available Mobile intelligent autonomous systems (MIAS is a fast emerging research area. Although it can be regarded as a general R&D area, it is mainly directed towards robotics. Several important subtopics within MIAS research are:(i perception and reasoning, (ii mobility and navigation,(iii haptics and teleoperation, (iv image fusion/computervision, (v modelling of manipulators, (vi hardware/software architectures for planning and behaviour learning leadingto robotic architecture, (vii vehicle-robot path and motionplanning/control, (viii human-machine interfaces for interaction between humans and robots, and (ix application of artificial neural networks (ANNs, fuzzy logic/systems (FLS,probabilistic/approximate reasoning (PAR, Bayesian networks(BN and genetic algorithms (GA to the above-mentioned problems. Also, multi-sensor data fusion (MSDF playsvery crucial role at many levels of the data fusion process:(i kinematic fusion (position/bearing tracking, (ii imagefusion (for scene recognition, (iii information fusion (forbuilding world models, and (iv decision fusion (for tracking,control actions. The MIAS as a technology is useful for automation of complex tasks, surveillance in a hazardousand hostile environment, human-assistance in very difficultmanual works, medical robotics, hospital systems, autodiagnosticsystems, and many other related civil and military systems. Also, other important research areas for MIAScomprise sensor/actuator modelling, failure management/reconfiguration, scene understanding, knowledge representation, learning and decision-making. Examples ofdynamic systems considered within the MIAS would be:autonomous systems (unmanned ground vehicles, unmannedaerial vehicles, micro/mini air vehicles, and autonomousunder water vehicles, mobile/fixed robotic systems, dexterousmanipulator robots, mining robots, surveillance systems,and networked/multi-robot systems, to name a few.Defence Science Journal, 2010, 60(1, pp.3-4,

  14. Brief reports: a clinical evaluation of block characteristics using one milliliter 2% lidocaine in ultrasound-guided axillary brachial plexus block.

    LENUS (Irish Health Repository)

    O'Donnell, Brian

    2010-09-01

    We report onset and duration of ultrasound-guided axillary brachial plexus block using 1 mL of 2% lidocaine with 1:200,000 epinephrine per nerve (total local anesthetic volume 4 mL). Block performance time, block onset time, duration of surgery, and block duration were measured. Seventeen consecutive patients were recruited. The mean (SD) block performance and onset times were 271 (67.9) seconds and 9.7 (3.7) minutes, respectively. Block duration was 160.8 (30.7) minutes. All operations were performed using regional anesthesia alone. The duration of anesthesia obtained is sufficient for most ambulatory hand surgery.

  15. Repair of sciatic nerve defects using tissue engineered nerves

    OpenAIRE

    Zhang, Caishun; Lv, Gang

    2013-01-01

    In this study, we constructed tissue-engineered nerves with acellular nerve allografts in Sprague-Dawley rats, which were prepared using chemical detergents-enzymatic digestion and mechanical methods, in combination with bone marrow mesenchymal stem cells of Wistar rats cultured in vitro, to repair 15 mm sciatic bone defects in Wistar rats. At postoperative 12 weeks, electrophysiological detection results showed that the conduction velocity of regenerated nerve after repair with tissue-engine...

  16. Effect of warmed ropivacaine solution on onset and duration of axillary block

    OpenAIRE

    Lee, Rippy; Kim, Young Mi; Choi, Eun Mi; Choi, Young Ryong; Chung, Mi Hwa

    2012-01-01

    Background Bicarbonate, as an adjunct increasing the non-ionized form of local anesthetics, can reduce latency and prolong duration of regional nerve block. Warming of local anesthetics decreases pKa and also increases the non-ionized form of local anesthetics. We warmed ropivacaine to body temperature (37℃) and evaluated the sensory block onset time, motor block onset time and analgesic duration of axillary block. Methods Patients were consecutively allocated to two groups of 22 patients eac...

  17. Efeitos do bloqueio pudendo, peridural e subaracnóideo sobre a coagulação sangüínea de gestantes Efectos del bloqueo pudendo, peridural y subaracnoideo sobre la coagulación sanguínea de embarazadas Effects of pudendal nerve, epidural and subarachnoid block on coagulation of pregnant women

    Directory of Open Access Journals (Sweden)

    Alberto Vasconcelos

    2008-04-01

    influenciaron en la coagulación en embarazadas sometidas a la anestesia peridural, subaracnoidea o Bloqueo pudendo.BACKGROUND AND OBJECTIVES: The significant reduction in postoperative thromboembolic complications has been attributed to the use of regional block, probably due to attenuation of the neuroendocrine-metabolic response. Pregnant women, who demonstrate important hypercoagulability, can in theory benefit from this effect during labor. The objective of this study was to determine the effects of regional block on coagulation of pregnant women. METHODS: Thirty patients in the 3rd trimester were enrolled; ten patients underwent epidural block for cesarean section with 150 mg of 0.5% bupivacaine without epinephrine and 2 mg of morphine (PD group; ten underwent subarachnoid block for cesarean section with 15 mg of 0.5% hyperbaric bupivacaine and 0,2 mg of morphine (SA group; and ten, pudendal block for vaginal delivery with up to 100 mg of 0.5% bupivacaine without epinephrine (BP group. Coagulation tests (prothrombin time, thrombin time, activated partial thromboplastin time and thromboelastography (r-time, k-time, r+k-time, alpha-angle, maximum amplitude were performed in the following moments: before and after the blockade, after delivery, and 24 hours after the blockade in PD and SA groups. In the BP group, the evaluation was done before the blockade, after delivery, and 24 hours after the blockade. RESULTS: The results indicate that the anesthetic technique did not influence coagulation of pregnant women. They also demonstrate that coagulation is activated during labor, which is responsible for the changes seen in all the study groups. CONCLUSIONS: In the conditions of the present study, the sympathetic blockade and the local anesthetic did not have any influence on the coagulation of pregnant women at term undergoing epidural, subarachnoid, or pudendal nerve block.

  18. Cybersecurity for aerospace autonomous systems

    Science.gov (United States)

    Straub, Jeremy

    2015-05-01

    High profile breaches have occurred across numerous information systems. One area where attacks are particularly problematic is autonomous control systems. This paper considers the aerospace information system, focusing on elements that interact with autonomous control systems (e.g., onboard UAVs). It discusses the trust placed in the autonomous systems and supporting systems (e.g., navigational aids) and how this trust can be validated. Approaches to remotely detect the UAV compromise, without relying on the onboard software (on a potentially compromised system) as part of the process are discussed. How different levels of autonomy (task-based, goal-based, mission-based) impact this remote characterization is considered.

  19. Ultrasound guided supraclavicular block.

    LENUS (Irish Health Repository)

    Hanumanthaiah, Deepak

    2013-09-01

    Ultrasound guided regional anaesthesia is becoming increasingly popular. The supraclavicular block has been transformed by ultrasound guidance into a potentially safe superficial block. We reviewed the techniques of performing supraclavicular block with special focus on ultrasound guidance.

  20. Trigeminal nerve schwannoma

    Directory of Open Access Journals (Sweden)

    Prashant Kashyap

    2016-05-01

    Full Text Available Trigeminal schwannomas are uncommon slow growing encapsulated tumours composed of schwann cells. Trigeminal schwannomas are the second most common type of schwannoma, after the far more common acoustic schwannoma. In this case definite diagnosis could not be made after 1 CT (computerized tomography scan and 3 MRI (magnetic resonance imaging (outside hospital but finally after proper clinical examination and discussion with radiologist about the best diagnostic imaging in this case we reached to a diagnosis of trigeminal nerve schwannoma after MRI brain with contrast. [Int J Res Med Sci 2016; 4(5.000: 1739-1741

  1. Study of Variations in the Divisions, Course and Termination of the Sciatic Nerve

    Directory of Open Access Journals (Sweden)

    B. N. Umarji

    2013-01-01

    Full Text Available Background: The sciatic nerve is the large stand thickest branch of lumbosacral plexus. It has a long course in the pelvic cavity and in the lower extremity. It separates into its two branches, the tibial and common peroneal nerves outside the pelvis. But the division can occur at any level from the sacral plexus to the inferior part of the popliteal fossa. These anatomical variations in division may cause nerve compression resulting in sciatica, piriformis syndrome, and coccygodynia. Aim: The aim of this study is to observe the variations in division of sciatic nerve as compared to known facts. Methods: The study was performed on cadavers. The inferior extremities of 45 cadavers were examined and variations of division of sciatic nerve were noted and classified. Results: The highest incidence of sciatic nerve variation was observed in its termination. In 11.11% of cases the sciatic nerve was found to be divided in the gluteal region. In 11.11%specimens, the common peroneal nerve pierced the piriformis muscle. Conclusion: The higher division of sciatic nerve can result in the involvement of only one out of the two divisions for the sciatic neuropathy. It is important to consider the higher divisions while performing opliteal block anaesthesia.

  2. Comparação das técnicas transarterial e de estimulação de múltiplos nervos para bloqueio do plexo braquial por via axilar usando lidocaína com epinefrina Comparación de las técnicas transarterial y de estimulación de múltiples nervios para bloqueo del plexo braquial por vía axilar usando lidocaína con epinefrina Comparison of transarterial and multiple nerve stimulation techniques for axillary block using lidocaine with epinephrine

    Directory of Open Access Journals (Sweden)

    Luiz Eduardo Imbelloni

    2005-02-01

    resulta en alta efectividad para el bloqueo axilar del plexo braquial. La técnica de utilizar múltiples estímulos exige más tiempo y mayor experiencia. Este estudio prospectivo compara la latencia y el índice de éxito del bloqueo del plexo braquial usando dos técnicas de localización: transarterial o múltipla estimulación de los nervios. MÉTODO: La lidocaína con epinefrina, 800 mg, fue usada inicialmente para el bloqueo axilar. En el grupo transarterial, 30 mL de lidocaína a 1,6% con epinefrina fueron inyectados profundamente y 20 mL superficialmente a la arteria axilar. En el grupo de múltipla estimulación, tres nervios fueron localizados eléctricamente y bloqueados con volúmenes 20 mL, 20 mL y 10 mL de la solución. El bloqueo fue considerado efectivo cuando la analgesia estaba presente en todos los nervios en la área distal al codo. RESULTADOS: El tiempo de latencia (8,8 ± 2,3 min versus 10,2 ± 2,4 min; p-valor = 0,010 fue significativamente menor en el grupo transarterial. Bloqueos sensitivos completos en los cuatro nervios (mediano, ulnar, radial y musculocutáneo fueron logrados en un 92,5% versus 83,3% en el grupo de múltipla estimulación y acceso transarterial, respectivamente sin diferencia significativa (p-valor = 0,68. El nervio musculocutáneo fue significativamente más fácil de bloquear con el estimulador de nervio periférico (p = 0,034. CONCLUSIONES: La técnica de múltipla estimulación para el bloqueo axilar usando estimulador de nervios (3 inyecciones y la técnica transarterial (2 inyecciones producen resultados semejantes en la calidad del bloqueo. El nervio musculocutáneo es más facilmente bloqueado con el uso del estimulador del nervio periférico. La técnica de múltipla estimulación necesitó menor suplementación del bloqueo y aumentó el tiempo para el inicio de la cirugía.BACKGROUND AND OBJECTIVES: High-dose transarterial technique results in highly effective axillary block. The multiple nerve stimulation technique

  3. An unusual ulnar nerve-median nerve communicating branch.

    OpenAIRE

    Hoogbergen, M M; Kauer, J M

    1992-01-01

    Branching of the ulnar nerve distal to the origin of the dorsal cutaneous branch was investigated in 25 hands in one of which an anatomical variation was observed. This finding may be of importance in the evaluation of certain entrapment phenomena of the ulnar nerve or unexplained sensory loss after trauma or surgical intervention in that particular area.

  4. Autonomic Dysregulation in Multiple Sclerosis.

    Science.gov (United States)

    Pintér, Alexandra; Cseh, Domonkos; Sárközi, Adrienn; Illigens, Ben M; Siepmann, Timo

    2015-01-01

    Multiple sclerosis (MS) is a chronic, progressive central neurological disease characterized by inflammation and demyelination. In patients with MS, dysregulation of the autonomic nervous system may present with various clinical symptoms including sweating abnormalities, urinary dysfunction, orthostatic dysregulation, gastrointestinal symptoms, and sexual dysfunction. These autonomic disturbances reduce the quality of life of affected patients and constitute a clinical challenge to the physician due to variability of clinical presentation and inconsistent data on diagnosis and treatment. Early diagnosis and initiation of individualized interdisciplinary and multimodal strategies is beneficial in the management of autonomic dysfunction in MS. This review summarizes the current literature on the most prevalent aspects of autonomic dysfunction in MS and provides reference to underlying pathophysiological mechanisms as well as means of diagnosis and treatment. PMID:26213927

  5. Framework for Autonomous Optimization Project

    Data.gov (United States)

    National Aeronautics and Space Administration — Phoenix Integration and MIT propose to create a novel autonomous optimization tool and application programming interface (API). The API will demonstrate the ability...

  6. Genetic manipulation of intraspinal plasticity after spinal cord injury alters the severity of autonomic dysreflexia

    OpenAIRE

    Cameron, Adrian A.; Smith, George M.; David C. Randall; Brown, David R; Alexander G. Rabchevsky

    2006-01-01

    Severe spinal cord injuries above mid-thoracic levels can lead to a potentially life-threatening hypertensive condition termed autonomic dysreflexia that is often triggered by painful distension of pelvic viscera (bladder or bowel) and consequent sensory fiber activation, including nociceptive C-fibers. Interruption of tonically active medullo-spinal pathways after injury causes disinhibition of thoracolumbar sympathetic preganglionic neurons, and intraspinal sprouting of nerve growth factor ...

  7. Small Fiber Neuropathy Associated with Hyperlipidemia: Utility of Cutaneous Silent Periods and Autonomic Tests

    OpenAIRE

    Morkavuk, G.; Leventoglu, A.

    2014-01-01

    Background. Established electrophysiological methods have limited clinical utility in the diagnosis of small fiber neuropathy. The cutaneous silent period (CSP) may be useful as a method for the evaluation of smaller and unmyelinated fiber dysfunctions. Hyperlipidemia is a very rare cause of small fiber neuropathy. In this study, hyperlipidemia and small fiber neuropathy in symptomatic patients with normal nerve conduction studies were evaluated with autonomic tests and cutaneous silent perio...

  8. Highly abnormal thermotests in familial dysautonomia suggest increased cardiac autonomic risk

    OpenAIRE

    Hilz, M; Kolodny, E.; Neuner, I; Stemper, B; Axelrod, F

    1998-01-01

    OBJECTIVE—Patients with familial dysautonomia have an increased risk of sudden death. In some patients with familial dysautonomia, sympathetic cardiac dysfunction is indicated by prolongation of corrected QT (QTc) interval, especially during stress tests. As many patients do not tolerate physical stress, additional indices are needed to predict autonomic risk. In familial dysautonomia there is a reduction of both sympathetic neurons and peripheral small nerve fibres which...

  9. Analgesia pós-operatória em correção cirúrgica de pé torto congênito: comparação entre bloqueio nervoso periférico e bloqueio peridural caudal Analgesia postoperatoria en corrección quirúrgica de pie jorobado congénito: comparación entre bloqueo nervioso periférico y bloqueo epidural caudal Postoperative analgesia for the surgical correction of congenital clubfoot: comparison between peripheral nerve block and caudal epidural block

    Directory of Open Access Journals (Sweden)

    Monica Rossi Rodrigues

    2009-12-01

    severe postoperative pain. Caudal epidural block associated with general anesthesia is the anesthetic technique used more often in children, but it is limited by the short duration of the postoperative analgesia. Peripheral nerve blocks are associated with a low incidence of complications and prolonged analgesia. The objective of this study was to compare the duration of analgesia in peripheral nerve blocks and caudal block, as well as morphine consumption in the first 24 hours after correction of CCF in children. METHODS: This is a randomized, double-blind study with children undergoing surgeries for posteromedial release of CCF, who were divided in four groups according to the anesthetic technique: caudal (ACa, sciatic and femoral block (IF, sciatic and saphenous block (IS, and sciatic block and local anesthesia (IL, associated with general anesthesia. In the first 24 hours, patients received oral dypirone and acetaminophen, and they were evaluated by anesthesiologists who were unaware of the technique used. Oral morphine (0.19 mg.kg¹ per day was administered according to the scores of the CHIPPS (Children's and infants' postoperative pain scale scale. RESULTS: One hundred and eighteen children separated into four groups: ACa (30, IF (32, IS (28, and IL (28 participated in this study. The mean time between the blockade and the first dose of morphine was 6.16 hours in group ACa, 7.05 hours in group IF, 7.58 in IS, and 8.18 hours in IL. Morphine consumption was 0.3 mg.kg-1 per day in all four groups. Significant differences were not observed among the groups. CONCLUSIONS: peripheral nerve blocks did not promote longer lasting analgesia or a decrease in morphine consumption in the first 24 hours in children undergoing CCF correction when compared to caudal epidural block.

  10. Autonomous Mission Operations Roadmap

    Science.gov (United States)

    Frank, Jeremy David

    2014-01-01

    As light time delays increase, the number of such situations in which crew autonomy is the best way to conduct the mission is expected to increase. However, there are significant open questions regarding which functions to allocate to ground and crew as the time delays increase. In situations where the ideal solution is to allocate responsibility to the crew and the vehicle, a second question arises: should the activity be the responsibility of the crew or an automated vehicle function? More specifically, we must answer the following questions: What aspects of mission operation responsibilities (Plan, Train, Fly) should be allocated to ground based or vehicle based planning, monitoring, and control in the presence of significant light-time delay between the vehicle and the Earth?How should the allocated ground based planning, monitoring, and control be distributed across the flight control team and ground system automation? How should the allocated vehicle based planning, monitoring, and control be distributed between the flight crew and onboard system automation?When during the mission should responsibility shift from flight control team to crew or from crew to vehicle, and what should the process of shifting responsibility be as the mission progresses? NASA is developing a roadmap of capabilities for Autonomous Mission Operations for human spaceflight. This presentation will describe the current state of development of this roadmap, with specific attention to in-space inspection tasks that crews might perform with minimum assistance from the ground.

  11. Autonomous Gaussian Decomposition

    Science.gov (United States)

    Lindner, Robert R.; Vera-Ciro, Carlos; Murray, Claire E.; Stanimirović, Snežana; Babler, Brian; Heiles, Carl; Hennebelle, Patrick; Goss, W. M.; Dickey, John

    2015-04-01

    We present a new algorithm, named Autonomous Gaussian Decomposition (AGD), for automatically decomposing spectra into Gaussian components. AGD uses derivative spectroscopy and machine learning to provide optimized guesses for the number of Gaussian components in the data, and also their locations, widths, and amplitudes. We test AGD and find that it produces results comparable to human-derived solutions on 21 cm absorption spectra from the 21 cm SPectral line Observations of Neutral Gas with the EVLA (21-SPONGE) survey. We use AGD with Monte Carlo methods to derive the H i line completeness as a function of peak optical depth and velocity width for the 21-SPONGE data, and also show that the results of AGD are stable against varying observational noise intensity. The autonomy and computational efficiency of the method over traditional manual Gaussian fits allow for truly unbiased comparisons between observations and simulations, and for the ability to scale up and interpret the very large data volumes from the upcoming Square Kilometer Array and pathfinder telescopes.

  12. Semantic Web Meets Autonomic Ubicomp

    OpenAIRE

    Belecheanu, R A; Jawaheer, G; Hoskins, A.; McCann, J; Payne, T.

    2004-01-01

    The placement of autonomic systems’ management functionality into a ubiquitous computing environment is a difficult task due to the lack of systems’ resources and the need for ‘intelligence’ to ensure that the system is selfhealing/ organising or configuring. For such systems to adapt to changes to their current environment they need to be able to (re) configure the workflow of their services. In this paper, we propose the ANS, an autonomic middleware for ubicomp devices. We briefly describe ...

  13. Design of Autonomous Gel Actuators

    OpenAIRE

    Shuji Hashimoto; Shingo Maeda; Yusuke Hara; Satoshi Nakamaru

    2011-01-01

    In this paper, we introduce autonomous gel actuators driven by chemical energy. The polymer gels prepared here have cyclic chemical reaction networks. With a cyclic reaction, the polymer gels generate periodical motion. The periodic motion of the gel is produced by the chemical energy of the oscillatory Belouzov-Zhabotinsky (BZ) reaction. We have succeeded in making synthetic polymer gel move autonomously like a living organism. This experimental fact represents the great possibility of the c...

  14. Design of Autonomous Gel Actuators

    Directory of Open Access Journals (Sweden)

    Shuji Hashimoto

    2011-01-01

    Full Text Available In this paper, we introduce autonomous gel actuators driven by chemical energy. The polymer gels prepared here have cyclic chemical reaction networks. With a cyclic reaction, the polymer gels generate periodical motion. The periodic motion of the gel is produced by the chemical energy of the oscillatory Belouzov-Zhabotinsky (BZ reaction. We have succeeded in making synthetic polymer gel move autonomously like a living organism. This experimental fact represents the great possibility of the chemical robot.

  15. Build Autonomic Agents with ABLE

    Institute of Scientific and Technical Information of China (English)

    吴吉义

    2007-01-01

    The IBM Agent Building and Learning Environment(ABLE) provides a lightweight Java~(TM) agent frame- work,a comprehensive JavaBeansTM library of intelligent software components,a set of development and test tools, and an agent platform.After the introduction to ABLE,classes and interfaces in the ABLE agent framework were put forward.At last an autonomic agent that is an ABLE-based architecture for incrementally building autonomic systems was discussed.

  16. Autonomous vertical profiler data management

    Digital Repository Service at National Institute of Oceanography (India)

    Afzulpurkar, S.; Navelkar, G.S.; Desa, E.S.; Madhan, R.; Dabholkar, N.; Prabhudesai, S.P.; Mascarenhas, A.A.M.Q.

    and reduced data �� Ease in operation and one man deployable 2 Fig.1. Autonomous Vertical Profiler Table 1. Autonomous Vertical Profiler Specifications 2. Communication Communication with the AVP is through the satellite modem... Aluminum alloy, Acetal nose & tail cones Propulsion Single DC thruster Electronics 8051 and ARM7 microcontroller based Communication Radio modem (2.4 GHz) & Satellite Transmission (Iridium) GUI Labview based Energy Source Lithium Ion Polymer batteries...

  17. Acrylamide inhibits nerve sprouting induced by botulinum toxin type A

    OpenAIRE

    Jiang, Hong; Xiang, Yi; Hu, XingYue; Cai, Huaying

    2014-01-01

    Botulinum toxin type A is a potent muscle relaxant that blocks the transmission and release of acetylcholine at the neuromuscular junction. Intramuscular injection of botulinum toxin type A has served as an effective and safe therapy for strabismus and focal dystonia. However, muscular weakness is temporary and after 3–4 months, muscle strength usually recovers because functional recovery is mediated by nerve sprouting and reconstruction of the neuromuscular junction. Acrylamide may produce n...

  18. Release of endogenous ATP during sympathetic nerve stimulation.

    OpenAIRE

    Lew, M. J.; White, T. D.

    1987-01-01

    1 Vas deferens from guinea-pig was stimulated with a suction electrode and both contractions and release of endogenous ATP monitored 2 Release of ATP was tetrodotoxin-sensitive and increased when the number of stimuli was increased. 3 Release of ATP was not due to contraction of the muscle and persisted following block of contractions with prazosin and alpha, beta-methylene ATP. 4 These results indicate that stimulation of the sympathetic nerves in the vas deferens releases endogenous ATP pre...

  19. Ultrasound-Guided Infraorbital Nerve Pulsed Radiofrequency Treatment for Intractable Postherpetic Neuralgia - A Case Report -

    OpenAIRE

    Lim, Seung Mo; Park, Hae Lang; Moon, Hyong Yong; Kang, Kyung Ho; Kang, Hyun; Baek, Chong Hwa; Jung, Yong Hun; Kim, Jin Yun; Koo, Gill Hoi; Shin, Hwa Yong

    2013-01-01

    A 60-year-old man presented with pain on the left cheek and lateral nose. The patient had been diagnosed with facial herpes zoster in the left V2 area 6 months previously. Medical treatment was prescribed for 6 months but it had little effect. We blocked the left infraorbital nerve under ultrasound guidance, but pain relief was short term. Therefore, we performed pulsed radiofrequency treatment on the left infraorbital nerve under ultrasound guidance. Six months after the procedure, the reduc...

  20. Pulsed Radiofrequency Lesioning of the Axillary and Suprascapular Nerve in Calcific Tendinitis

    OpenAIRE

    Kim, Jun Sik; Nahm, Francis Sahngun; Choi, Eun Joo; Lee, Pyung Bok; Lee, Guen Young

    2012-01-01

    The patient was a 45-year-female who presented with pain at right shoulder and right upper arm. The patient suffered from right shoulder and arm pain for 3 years and had pain management which was performed using medication and conservative management after she had been diagnosed with calcific tendinitis. However, substantial pain relief was not consistently achieved, and recurrence of pain was reported. Therefore, we performed right axillary nerve and suprascapular nerve block through pulsed ...