EnviroAtlas - Fresno, CA - Potential Window Views of Water by Block Group

Data.gov (United States)

U.S. Environmental Protection Agency — This EnviroAtlas dataset describes the block group population and the percentage of the block group population that has potential views of water bodies. A potential...

EnviroAtlas - Memphis, TN - Potential Window Views of Water by Block Group

Data.gov (United States)

U.S. Environmental Protection Agency — This EnviroAtlas dataset describes the block group population and the percentage of the block group population that has potential views of water bodies. A potential...

Liposomal bupivacaine versus interscalene nerve block for pain control after shoulder arthroplasty: A meta-analysis.

Science.gov (United States)

Yan, Zeng; Chen, Zong; Ma, Chuangen

2017-07-01

Postoperative pain control after total shoulder arthroplasty (TSA) can be challenging. Liposomal bupivacaine and interscalene nerve block are 2 common pain control protocol for TSA patients. However, whether liposomal bupivacaine was superior than interscalene nerve block was unknown. This meta-analysis aimed to illustrate the efficacy liposomal bupivacaine versus interscalene nerve block for pain control in patients undergoing TSA. In May 2017, a systematic computer-based search was conducted in PubMed, EMBASE, Web of Science, Cochrane Database of Systematic Reviews, and Google database. Data on patients prepared for TSA in studies that compared liposomal bupivacaine versus interscalene nerve block were retrieved. The endpoints were the visual analogue scale (VAS) at 4 hours, 8 hours, 12 hours, 24 hours, and 2 weeks, total morphine consumption at 24 hours, and the length of hospital stay. Software of Stata 12.0 was used for pooling the final outcomes. Five clinical studies with 573 patients (liposomal bupivacaine group = 239, interscalene nerve block group = 334) were ultimately included in the meta-analysis. There was no significant difference between the VAS at 4 hours, 8 hours, and 2 weeks between liposomal bupivacaine group and interscalene nerve block group (P > .05). Compared with interscalene nerve block group, liposomal bupivacaine was associated with a reduction of VAS score at 12 hours, 24 hours by appropriately 3.31 points and 6.42 points respectively on a 100-point VAS. Furthermore, liposomal bupivacaine was associated with a significantly reduction of the length of hospital stay by appropriately by 0.16 days compared with interscalene nerve block group. Current meta-analysis indicates that compared with interscalene nerve block, liposomal bupivacaine had comparative effectiveness on reducing both pain scores and the length of hospital stay. However, studies with more patients and better-designed methods are needed to

Impact of pectoral nerve block on postoperative pain and quality of recovery in patients undergoing breast cancer surgery: A randomised controlled trial.

Science.gov (United States)

Kamiya, Yoshinori; Hasegawa, Miki; Yoshida, Takayuki; Takamatsu, Misako; Koyama, Yu

2018-03-01

In recent years, thoracic wall nerve blocks, such as the pectoral nerve (PECS) block and the serratus plane block have become popular for peri-operative pain control in patients undergoing breast cancer surgery. The effect of PECS block on quality of recovery (QoR) after breast cancer surgery has not been evaluated. To evaluate the ability of PECS block to decrease postoperative pain and anaesthesia and analgesia requirements and to improve postoperative QoR in patients undergoing breast cancer surgery. Randomised controlled study. A tertiary hospital. Sixty women undergoing breast cancer surgery between April 2014 and February 2015. The patients were randomised to receive a PECS block consisting of 30 ml of levobupivacaine 0.25% after induction of anaesthesia (PECS group) or a saline mock block (control group). The patients answered a 40-item QoR questionnaire (QoR-40) before and 1 day after breast cancer surgery. Numeric Rating Scale score for postoperative pain, requirement for intra-operative propofol and remifentanil, and QoR-40 score on postoperative day 1. PECS block combined with propofol-remifentanil anaesthesia significantly improved the median [interquartile range] pain score at 6 h postoperatively (PECS group 1 [0 to 2] vs. Control group 1 [0.25 to 2.75]; P = 0.018]. PECS block also reduced propofol mean (± SD) estimated target blood concentration to maintain bispectral index (BIS) between 40 and 50 (PECS group 2.65 (± 0.52) vs. Control group 3.08 (± 0.41) μg ml; P PECS group 10.5 (± 4.28) vs. Control group 10.4 (± 4.68) μg kg h; P = 0.95). PECS block did not improve the QoR-40 score on postoperative day 1 (PECS group 182 [176 to 189] vs. Control group 174.5 [157.75 to 175]). In patients undergoing breast cancer surgery, PECS block combined with general anaesthesia reduced the requirement for propofol but not that for remifentanil, due to the inability of the PECS block to reach the internal mammary area. Further, PECS

A randomised controlled trial investigating the analgesic efficacy of transversus abdominis plane block for adult laparoscopic appendicectomy.

Science.gov (United States)

Tupper-Carey, Darell Alexander; Fathil, Shahridan Mohd; Tan, Yin Kiat Glenn; Kan, Yuk Man; Cheong, Chern Yuen; Siddiqui, Fahad Javaid; Assam, Pryseley Nkouibert

2017-08-01

We conducted a single-centre, prospective randomised clinical trial to investigate the analgesic efficacy of transversus abdominis plane (TAP) block in adult patients undergoing laparoscopic appendicectomy. Patients undergoing urgent laparoscopic appendicectomy under general anaesthesia alone (control group) and general anaesthesia supplemented by TAP block (TAP intervention group) were compared. All patients received a multimodal analgesia regime, which included postoperative morphine via a patient-controlled analgesia device. The primary endpoints were morphine consumption at 12 hours and 24 hours postoperatively. Secondary endpoints included pain scores, incidence of nausea and vomiting, and time to hospital discharge. A total of 58 patients were recruited, with 29 patients in each group. Mean postoperative morphine consumption at 12 hours (control group: 11.45 ± 7.64 mg, TAP intervention group: 9.79 ± 8.09 mg; p = 0.4264) and 24 hours (control group: 13.38 ± 8.72 mg, TAP intervention group: 11.31 ± 8.66 mg; p = 0.3686) for the control and TAP intervention groups were not statistically different. Secondary outcomes were also not different between the two groups. Length of stay in the post-anaesthesia care unit was significantly shorter for the TAP intervention group, with a trend toward faster hospital discharge being observed. TAP block, a regional anaesthetic procedure performed immediately prior to skin incision for laparoscopic appendicectomy, did not significantly improve postoperative analgesia outcomes. Copyright: © Singapore Medical Association

Controlled specific placement of nanoparticles into microdomains of block copolymer thin films

Energy Technology Data Exchange (ETDEWEB)

Bae, Joonwon, E-mail: joonwonbae@gmail.com [Department of Applied Chemistry, Dongduk Women' s University, Seoul 136-714 (Korea, Republic of); Kim, Jungwook [Department of Chemical and Biomolecular Engineering, Sogang University, Seoul 121-742 (Korea, Republic of); Park, Jongnam, E-mail: jnpark@unist.ac.kr [Interdisciplinary School of Green Energy, Ulsan National Institute of Science and Technology (UNIST), Ulsan 689-798 (Korea, Republic of)

2014-07-01

Conceptually attractive hybrid materials composed of nanoparticles and elegant block copolymers have become important for diverse applications. In this work, controlled specific placement of nanoparticles such as gold (Au) and titania (TiO{sub 2}) into microphase separated domains in poly(styrene)-b-poly(2-vinylpyridine) (PS-b-P2VP) block copolymer thin films was demonstrated. The effect of nanoparticle surface functionality on the spatial location of particles inside polymer film was observed by transmission electron microscopy. It was revealed that the location of nanoparticles was highly dependent on the surface ligand property of nanoparticle. In addition, the microphase separation behavior of thin block copolymer film was also affected by the nanoparticle surface functional groups. This study might provide a way to understand the properties and behaviors of numerous block copolymer/nanoparticle hybrid systems. - Highlights: • Controlled location of nanoparticles in the block copolymer matrix • Tailoring surface functionality of metal nanocrystals • Fabrication of homogeneous nanocomposites using organic inorganic components • Possibility for the preparation of nanohybrids.

Controlled specific placement of nanoparticles into microdomains of block copolymer thin films

International Nuclear Information System (INIS)

Bae, Joonwon; Kim, Jungwook; Park, Jongnam

2014-01-01

Conceptually attractive hybrid materials composed of nanoparticles and elegant block copolymers have become important for diverse applications. In this work, controlled specific placement of nanoparticles such as gold (Au) and titania (TiO 2 ) into microphase separated domains in poly(styrene)-b-poly(2-vinylpyridine) (PS-b-P2VP) block copolymer thin films was demonstrated. The effect of nanoparticle surface functionality on the spatial location of particles inside polymer film was observed by transmission electron microscopy. It was revealed that the location of nanoparticles was highly dependent on the surface ligand property of nanoparticle. In addition, the microphase separation behavior of thin block copolymer film was also affected by the nanoparticle surface functional groups. This study might provide a way to understand the properties and behaviors of numerous block copolymer/nanoparticle hybrid systems. - Highlights: • Controlled location of nanoparticles in the block copolymer matrix • Tailoring surface functionality of metal nanocrystals • Fabrication of homogeneous nanocomposites using organic inorganic components • Possibility for the preparation of nanohybrids

EnviroAtlas - New Bedford, MA - Potential Window Views of Water by Block Group

Data.gov (United States)

U.S. Environmental Protection Agency — This EnviroAtlas dataset describes the block group population and the percentage of the block group population that has potential views of water bodies. A potential...

EnviroAtlas - Des Moines, IA - Potential Window Views of Water by Block Group

Data.gov (United States)

U.S. Environmental Protection Agency — This EnviroAtlas dataset describes the block group population and the percentage of the block group population that has potential views of water bodies. A potential...

EnviroAtlas - Green Bay, WI - Potential Window Views of Water by Block Group

Data.gov (United States)

U.S. Environmental Protection Agency — This EnviroAtlas dataset describes the block group population and the percentage of the block group population that has potential views of water bodies. A potential...

EnviroAtlas - New York, NY - Potential Window Views of Water by Block Group

Data.gov (United States)

U.S. Environmental Protection Agency — This EnviroAtlas dataset describes the block group population and the percentage of the block group population that has potential views of water bodies. A potential...

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

Directory of Open Access Journals (Sweden)

Luigi Laino

2014-01-01

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

Fluorosilicone multi-block copolymers tethering quaternary ammonium salt groups for antimicrobial purpose

Energy Technology Data Exchange (ETDEWEB)

Zhou, Fang; Qin, Xiaoshuai; Li, Yancai; Ren, Lixia; Zhao, Yunhui, E-mail: zhaoyunhui@tju.edu.cn; Yuan, Xiaoyan

2015-08-30

Highlights: • QAS-containing fluorosilicone multi-block copolymers were synthesized. • The block length of PHFBMA in the copolymers was tailored via RAFT polymerization. • Surface roughness of the copolymers decreased with the increased PHFBMA content. • A certain length of PHFBMA block enhanced C−N{sup +} percentage on the surface. - Abstract: Symmetrically structured fluorosilicone multi-block copolymers containing poly(2-(dimethylamino)ethyl methacrylate) (PDMAEMA) and poly(hexafluorobutyl methacrylate) (PHFBMA) were sequentially synthesized via reversible addition–fragmentation chain transfer polymerization, using a polydimethylsiloxane (PDMS) chain transfer agent with dithiocarbonate groups at both ends. Then, the CBABC-type block copolymers were quaternized with n-octyliodide to tether quaternary ammonium salt (QAS) groups in the PDMAEMA blocks for the antimicrobial use. The obtained fluorosilicone copolymers showed clear variations in the C-N{sup +} composition and surface morphology on their films depending on the content of the PHFBMA blocks, which were characterized by X-ray photoelectron spectroscopy and atomic force microscopy, respectively. The results indicated that the symmetrical CBABC structure favored PDMS and QAS tethered blocks migrating to the film surface. With the mass percentage of the PHFBMA increased from 0 to 32.5%, the surface roughness of the copolymer film decreased gradually with a tendency to form a smooth surface. Owing to the surface properties, fluorosilicone multi-block copolymers containing a certain amount of PHFBMA with higher C-N{sup +} content and relatively smooth morphology demonstrated obvious antimicrobial activity against Gram-positive bacteria, Bacillus subtilis and Gram-negative bacteria, Escherichia coli. The functionalized multi-block copolymers based on fluorosilicone and QAS groups would have potential applications in antimicrobial coatings.

Fluorosilicone multi-block copolymers tethering quaternary ammonium salt groups for antimicrobial purpose

International Nuclear Information System (INIS)

Zhou, Fang; Qin, Xiaoshuai; Li, Yancai; Ren, Lixia; Zhao, Yunhui; Yuan, Xiaoyan

2015-01-01

Highlights: • QAS-containing fluorosilicone multi-block copolymers were synthesized. • The block length of PHFBMA in the copolymers was tailored via RAFT polymerization. • Surface roughness of the copolymers decreased with the increased PHFBMA content. • A certain length of PHFBMA block enhanced C−N + percentage on the surface. - Abstract: Symmetrically structured fluorosilicone multi-block copolymers containing poly(2-(dimethylamino)ethyl methacrylate) (PDMAEMA) and poly(hexafluorobutyl methacrylate) (PHFBMA) were sequentially synthesized via reversible addition–fragmentation chain transfer polymerization, using a polydimethylsiloxane (PDMS) chain transfer agent with dithiocarbonate groups at both ends. Then, the CBABC-type block copolymers were quaternized with n-octyliodide to tether quaternary ammonium salt (QAS) groups in the PDMAEMA blocks for the antimicrobial use. The obtained fluorosilicone copolymers showed clear variations in the C-N + composition and surface morphology on their films depending on the content of the PHFBMA blocks, which were characterized by X-ray photoelectron spectroscopy and atomic force microscopy, respectively. The results indicated that the symmetrical CBABC structure favored PDMS and QAS tethered blocks migrating to the film surface. With the mass percentage of the PHFBMA increased from 0 to 32.5%, the surface roughness of the copolymer film decreased gradually with a tendency to form a smooth surface. Owing to the surface properties, fluorosilicone multi-block copolymers containing a certain amount of PHFBMA with higher C-N + content and relatively smooth morphology demonstrated obvious antimicrobial activity against Gram-positive bacteria, Bacillus subtilis and Gram-negative bacteria, Escherichia coli. The functionalized multi-block copolymers based on fluorosilicone and QAS groups would have potential applications in antimicrobial coatings

Transversus abdominis plane block vs. wound infiltration in Caesarean section: a randomised controlled trial.

Science.gov (United States)

Telnes, A; Skogvoll, E; Lonnée, H

2015-04-01

Multiple studies suggest that transversus abdominis plane (TAP) block (without intrathecal morphine) after Caesarean section (CS) reduces post-operative morphine consumption. In our study, we wanted to compare the analgesic effect of TAP block with infiltration of the wound after CS. We included 60 pregnant women scheduled for elective CS under spinal anaesthesia in a randomised, single-centre, double-blind study. Thirty patients received ultrasound-guided TAP block using 20 ml bupivacaine 0.25% with adrenaline 5 μg/ml bilaterally and 20 ml normal saline as wound infiltration (TAP group). The other 30 patients (the control group) received normal saline 20 ml bilaterally in the TAP, and 20 ml bupivacaine 0.25% with adrenaline 5 μg/ml as wound infiltration. The main outcome was cumulative morphine consumption at 48 h after surgery. In addition, continuous morphine consumption, pain scores and side effects were registered. Fifty-seven patients completed the study. Cumulative morphine consumption at 48 h (mean±standard deviation) was 41±34 mg in the TAP group and 38±27 mg in the control group (P=0.7); a difference of 3 mg (95% confidence interval -13 to 19 mg). Morphine consumption at any time up to 48 h was virtually identical in both groups. Side effects were similar, except for a higher degree of sedation in the TAP group (P=0.04). Compared with wound infiltration with local anaesthetics, TAP block did not reduce cumulative morphine consumption following CS. The TAP block was associated with more pronounced sedation. © 2015 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

EnviroAtlas - Portland, ME - Ecosystem Services by Block Group

Data.gov (United States)

U.S. Environmental Protection Agency — This EnviroAtlas dataset presents environmental benefits of the urban forest in 146 block groups in Portland, Maine. Carbon attributes, temperature reduction,...

EnviroAtlas - Austin, TX - Ecosystem Services by Block Group

Data.gov (United States)

U.S. Environmental Protection Agency — This EnviroAtlas dataset presents environmental benefits of the urban forest in 750 block groups in Austin, Texas. Carbon attributes, temperature reduction,...

EnviroAtlas - Memphis, TN - Ecosystem Services by Block Group

Data.gov (United States)

U.S. Environmental Protection Agency — This EnviroAtlas dataset presents environmental benefits of the urban forest in 703 block groups in Memphis, Tennessee. Carbon attributes, temperature reduction,...

EnviroAtlas - Pittsburgh, PA - Ecosystem Services by Block Group

Data.gov (United States)

U.S. Environmental Protection Agency — This EnviroAtlas dataset presents environmental benefits of the urban forest in 1,089 block groups in Pittsburgh, Pennsylvania. Carbon attributes, temperature...

EnviroAtlas - Fresno, CA - Ecosystem Services by Block Group

Data.gov (United States)

U.S. Environmental Protection Agency — This EnviroAtlas dataset presents environmental benefits of the urban forest in 405 block groups in Fresno, California. Carbon attributes, temperature reduction,...

EnviroAtlas - Portland, OR - Ecosystem Services by Block Group

Data.gov (United States)

U.S. Environmental Protection Agency — This EnviroAtlas dataset presents environmental benefits of the urban forest in 1176 block groups in Portland, Oregon. Carbon attributes, temperature reduction,...

Comparison of the Effect of Continuous Femoral Nerve Block and Adductor Canal Block after Primary Total Knee Arthroplasty.

Science.gov (United States)

Seo, Seung Suk; Kim, Ok Gul; Seo, Jin Hyeok; Kim, Do Hoon; Kim, Youn Gu; Park, Beyoung Yun

2017-09-01

This study aimed to compare the effects of femoral nerve block and adductor canal block on postoperative pain, quadriceps strength, and walking ability after primary total knee arthroplasty. Between November 2014 and February 2015, 60 patients underwent primary total knee arthroplasty. Thirty patients received femoral nerve block and the other 30 received adductor canal block for postoperative pain control. Before spinal anesthesia, the patients received nerve block via a catheter (20 mL 0.75% ropivacaine was administered initially, followed by intermittent bolus injection of 10 mL 0.2% ropivacaine every 6 hours for 3 days). The catheters were maintained in the exact location of nerve block in 24 patients in the femoral nerve block group and in 19 patients in the adductor canal block group. Data collection was carried out from these 43 patients. To evaluate postoperative pain control, the numerical rating scale scores at rest and 45° flexion of the knee were recorded. To evaluate quadriceps strength, manual muscle testing was performed. Walking ability was assessed using the Timed Up and Go test. We also evaluated analgesic consumption and complications of peripheral nerve block. No significant intergroup difference was observed in the numerical rating scale scores at rest and 45° flexion of the knee on postoperative days 1, 2, 3, and 7. The adductor canal block group had significantly greater quadriceps strength than did the femoral nerve block group, as assessed by manual muscle testing on postoperative days 1, 2, and 3. The 2 groups showed no difference in walking ability on postoperative day 1, but on postoperative days 2, 3, walking ability was significantly better in the adductor canal block group than in the femoral nerve block group. No significant intergroup difference was observed in analgesic consumption. The groups showed no difference in postoperative pain control. Adductor canal block was superior to femoral nerve block in preserving quadriceps

EnviroAtlas - Paterson, NJ - Ecosystem Services by Block Group

Data.gov (United States)

U.S. Environmental Protection Agency — This EnviroAtlas dataset presents environmental benefits of the urban forest in 107 block groups in Paterson, New Jersey. Carbon attributes, temperature reduction,...

EnviroAtlas - Woodbine, IA - Ecosystem Services by Block Group

Data.gov (United States)

U.S. Environmental Protection Agency — This EnviroAtlas dataset presents environmental benefits of the urban forest in 1 block group in Woodbine, Iowa. Carbon attributes, temperature reduction, pollution...

EnviroAtlas - Durham, NC - Ecosystem Services by Block Group

Data.gov (United States)

U.S. Environmental Protection Agency — This EnviroAtlas dataset presents environmental benefits of the urban forest in 193 block groups in Durham, North Carolina. Carbon attributes, temperature reduction,...

EnviroAtlas - Milwaukee, WI - Ecosystem Services by Block Group

Data.gov (United States)

U.S. Environmental Protection Agency — This EnviroAtlas dataset presents environmental benefits of the urban forest in 1,175 block groups in Milwaukee, Wisconsin. Carbon attributes, temperature reduction,...

EnviroAtlas - Cleveland, OH - Ecosystem Services by Block Group

Data.gov (United States)

U.S. Environmental Protection Agency — This EnviroAtlas dataset presents environmental benefits of the urban forest in 1,442 block groups in Cleveland, Ohio. Carbon attributes, temperature reduction,...

EnviroAtlas - Tampa, FL - Land Cover by Block Group

Data.gov (United States)

U.S. Environmental Protection Agency — This EnviroAtlas dataset describes the percentage of each block group that is classified as impervious, forest, green space, wetland, and agriculture. Impervious is...

EnviroAtlas - Portland, ME - Land Cover by Block Group

Data.gov (United States)

U.S. Environmental Protection Agency — This EnviroAtlas dataset describes the percentage of each block group that is classified as impervious, forest, green space, wetland, and agriculture. Impervious is...

EnviroAtlas - Tampa, FL - Ecosystem Services by Block Group

Data.gov (United States)

U.S. Environmental Protection Agency — This EnviroAtlas dataset presents environmental benefits of the urban forest in 1,833 block groups in Tampa Bay, Florida. Carbon attributes, temperature reduction,...

EnviroAtlas - Memphis, TN - Land Cover by Block Group

Data.gov (United States)

U.S. Environmental Protection Agency — This EnviroAtlas dataset describes the percentage of each block group that is classified as impervious, forest, green space, agriculture, and wetlands. Forest is...

EnviroAtlas - Phoenix, AZ - Ecosystem Services by Block Group

Data.gov (United States)

U.S. Environmental Protection Agency — This dataset presents environmental benefits of the urban forest in 2,434 block groups in Phoenix, Arizona. Carbon attributes, pollution removal and value, and...

EnviroAtlas - Phoenix, AZ - Land Cover by Block Group

Data.gov (United States)

U.S. Environmental Protection Agency — This EnviroAtlas dataset describes the percentage of each block group that is classified as impervious, forest, agriculture, and green space. Forest is combination...

EnviroAtlas - Austin, TX - Land Cover by Block Group

Data.gov (United States)

U.S. Environmental Protection Agency — This EnviroAtlas dataset describes the percentage of each block group that is classified as impervious, forest, green space, and agriculture. Forest is defined as...

EnviroAtlas - Cleveland, OH - Land Cover by Block Group

Data.gov (United States)

U.S. Environmental Protection Agency — This EnviroAtlas dataset describes the percentage of each block group that is classified as impervious, forest, green space, and wetlands. In this community, forest...

EnviroAtlas - Portland, OR - Land Cover by Block Group

Data.gov (United States)

U.S. Environmental Protection Agency — This EnviroAtlas dataset describes the percentage of each block group that is classified as impervious, forest, and green space. Forest is combination of trees and...

EnviroAtlas - Fresno, CA - Land Cover by Block Group

Data.gov (United States)

U.S. Environmental Protection Agency — This EnviroAtlas dataset describes the percentage of each block group that is classified as impervious, forest, and green space. Forest is combination of trees and...

EnviroAtlas - Woodbine, IA - Land Cover by Block Group

Data.gov (United States)

U.S. Environmental Protection Agency — This EnviroAtlas dataset describes the percentage of each block group that is classified as impervious, forest, and green space. Forest is combination of trees and...

EnviroAtlas - Paterson, NJ - Land Cover by Block Group

Data.gov (United States)

U.S. Environmental Protection Agency — This EnviroAtlas dataset describes the percentage of each block group that is classified as impervious, forest, and green space. Forest is just trees and forest....

EnviroAtlas - Pittsburgh, PA - Land Cover by Block Group

Data.gov (United States)

U.S. Environmental Protection Agency — This EnviroAtlas dataset describes the percentage of each block group that is classified as impervious, forest, and green space. Forest is combination of trees and...

Randomized clinical trial of transversus abdominis plane block versus placebo control in live-donor nephrectomy.

Science.gov (United States)

Hosgood, Sarah A; Thiyagarajan, Umasanker M; Nicholson, Harriet F L; Jeyapalan, Inthira; Nicholson, Michael L

2012-09-15

Laparoscopic surgery reduces pain after donor nephrectomy; however, most patients still require a significant amount of postoperative parenteral opiate analgesia. Therefore, there is a need to investigate techniques that might further reduce postoperative pain. This study assessed the safety and efficacy of using a transversus abdominis plane (TAP) block in a randomized, double-blind, placebo-controlled trial. Forty-six patients were analyzed in the trial and were randomized to undergo the TAP block procedure with either bupivacaine (n=24) or saline placebo (Control n=22) injected into the muscle plane. Prefilled syringes were dispensed with the group allocation concealed to maintain blinding. After surgery, the amount of morphine, level of pain, and measures of recovery were recorded. The amount of morphine used 6 hr after surgery was significantly lower in patients receiving TAP block with bupivacaine compared with the control (presented as mean [SD], 12.4 [8.4] vs. 21.2 [14.0] mg; P=0.015). However, the total amount of morphine used was similar in both groups 45.6 [31.4] vs. 52.7 [28.8] mg; P=0.771. Patients in the bupivacaine group experienced significantly less pain on postoperative days 1 (score, 19 [15] vs. 37 [20]; P=0.003) and 2 (score, 11 [10] vs. 19 [13]; P=0.031). Recovery and postoperative hospital stay were similar in both groups. There were no complications associated with the procedure. The TAP block procedure is beneficial in reducing postoperative pain and early morphine requirements in laparoscopic live-donor nephrectomy.

EnviroAtlas - Portland, ME - Park Access by Block Group

Data.gov (United States)

U.S. Environmental Protection Agency — This EnviroAtlas dataset shows the block group population that is within and beyond an easy walking distance (500m) of a park entrance. Park entrances were included...

A comparison of the fascia iliaca block to the lumbar plexus block in providing analgesia following arthroscopic hip surgery: A randomized controlled clinical trial.

Science.gov (United States)

Badiola, Ignacio; Liu, Jiabin; Huang, Stephanie; Kelly, John D; Elkassabany, Nabil

2018-05-31

This randomized controlled single blinded clinical trial compared the fascia iliaca block (FIB) and the lumbar plexus block (LPB) in patients with moderate to severe pain following hip arthroscopic surgery. Single blinded randomized trial. Postoperative recovery area, postoperative days 0 and 1. Fifty patients undergoing hip arthroscopy were approached in the Post Anesthesia Care Unit (PACU) if they had moderate to severe pain (defined as > or equal 4/10 on the numeric rating scale). Twenty-five patients were allocated to the FIB and twenty-five patients to the LPB. Fascia iliaca block or lumbar plexus block. A blinded observer recorded pain scores just prior to the block, 15 min following the block (primary endpoint), and then every 15 min for 2 h (or until the patient was discharged). Total PACU time and opioid use were recorded. Pain scores and analgesic use on postoperative day (POD) 0, and POD 1 were recorded. At 24 h post block the Quality of Recovery 9 questionnaire was administered. The mean pre-block pain scores were comparable between the two groups (P = 0.689). There was no difference in mean post block pain scores between the two groups at 15 min (P = 0.054). In the PACU patients who underwent a LPB consumed less opioids compared to FIB patients (P = 0.02), however no differences were noted between the two groups in PACU length of stay, or POD 0 or 1 opioid use. A fascia iliaca block is not inferior to a lumbar plexus block in reducing PACU pain scores in patients with moderate to severe pain following hip arthroscopic surgery and is a viable option to help manage postoperative pain following hip arthroscopic surgery. Copyright © 2018. Published by Elsevier Inc.

Precise synthesis of thermoreversible block copolymers containing reactive furfuryl groups via living anionic polymerization: the countercation effect on block copolymerization behavior

Energy Technology Data Exchange (ETDEWEB)

Kang, Beom-Goo [ORNL; Pramanik, Nabendu [Indian Institute of Technology, Kharagpur; Singha, Nikhil K [ORNL; Lee, Jae-Suk [ORNL; Mays, Jimmy [University of Tennessee, Knoxville (UTK)

2015-08-07

The anionic block copolymerization of 4,4' -vinylphenyl-N,N-bis(4-tert-butylphenyl)benzenamine (A) with furfuryl isocyanate (B) was carried out using potassium naphthalenide (K-Naph) in tetrahydrofuran at -78 and -98 °C to prepare well-defined block copolymers containing furan groups for the formation of thermoreversible networks via a Diels Alder (DA) reaction. While no block copolymerization was observed in the absence of sodium tetraphenylborate (NaBPh₄) due to side reactions, well-defined poly-(B-b-A-b-B) (PBAB) copolymers with controlled molecular weights (M_n = 18 700 19 500 g mol ^-1) and narrow molecular weight distributions (M_w/M_n = 1.08 -1.17) were successfully synthesized in the presence of excess NaBPh₄. We prevented the occurrence of the undesirable side reactions during polymerization of B of NaBPh₄, which results in the change in the countercation from K⁺ to Na⁺ for further polymerization of B. Moreover, the cross-linking via the DA reaction between the furan groups of PBAB and bismaleimide was proved by FT-IR and differential scanning calorimetry (DSC), and the thermoreversible properties of the cross-linked polymer were subsequently investigated using DSC and solubility testing.

EnviroAtlas - Durham, NC - Residents with Potential Window Views of Water by Block Group

Data.gov (United States)

U.S. Environmental Protection Agency — This EnviroAtlas dataset describes the block group population and the percentage of the block group population that has potential views of water bodies. A potential...

EnviroAtlas - Woodbine, IA - Residents with Potential Window Views of Water by Block Group

Data.gov (United States)

U.S. Environmental Protection Agency — This EnviroAtlas dataset describes the block group population and the percentage of the block group population that has potential views of water bodies. A potential...

EnviroAtlas - Phoenix, AZ - Residents with Potential Window Views of Water by Block Group

Data.gov (United States)

U.S. Environmental Protection Agency — This EnviroAtlas dataset describes the block group population and the percentage of the block group population that has potential views of water bodies. A potential...

EnviroAtlas - Milwaukee, WI - Residents with Potential Window Views of Water by Block Group

Data.gov (United States)

U.S. Environmental Protection Agency — This EnviroAtlas dataset describes the block group population and the percentage of the block group population that has potential views of water bodies. A potential...

EnviroAtlas - Minneapolis/St. Paul, MN - Potential Window Views of Water by Block Group

Data.gov (United States)

U.S. Environmental Protection Agency — This EnviroAtlas dataset describes the block group population and the percentage of the block group population that has potential views of water bodies. A potential...

EnviroAtlas - Paterson, NJ - Residents with Potential Window Views of Trees by Block Group

Data.gov (United States)

U.S. Environmental Protection Agency — This EnviroAtlas dataset shows the total block group population and the percentage of the block group population that has little access to potential window views of...

Transversus abdominal plane block for postoperative analgesia: a systematic review and meta-analysis of randomized-controlled trials.

Science.gov (United States)

Brogi, Etrusca; Kazan, Roy; Cyr, Shantale; Giunta, Francesco; Hemmerling, Thomas M

2016-10-01

The transversus abdominal plane (TAP) block has been described as an effective pain control technique after abdominal surgery. We performed a systematic review and meta-analysis of randomized-controlled trials (RCTs) to account for the increasing number of TAP block studies appearing in the literature. The primary outcome we examined was the effect of TAP block on the postoperative pain score at six, 12, and 24 hr. The secondary outcome was 24-hr morphine consumption. We searched the United States National Library of Medicine database, the Excerpta Medica database, and the Cochrane Central Register of Controlled Clinical Studies and identified RCTs focusing on the analgesic efficacy of TAP block compared with a control group [i.e., placebo, epidural analgesia, intrathecal morphine (ITM), and ilioinguinal nerve block after abdominal surgery]. Meta-analyses were performed on postoperative pain scores at rest at six, 12, and 24 hr (visual analogue scale, 0-10) and on 24-hr opioid consumption. In the 51 trials identified, compared with placebo, TAP block reduced the VAS for pain at six hours by 1.4 (95% confidence interval [CI], -1.9 to -0.8; P consumption at 24 hr after surgery (mean difference, -14.7 mg; 95% CI, -18.4 to -11.0; P consumption in the TAP block group after gynecological surgery, appendectomy, inguinal surgery, bariatric surgery, and urological surgery. Nevertheless, separate analysis of the studies comparing ITM with TAP block revealed that ITM seemed to have a greater analgesic efficacy. The TAP block can play an important role in the management of pain after abdominal surgery by reducing both pain scores and 24-hr morphine consumption. It may have particular utility when neuraxial techniques or opioids are contraindicated.

Blocks of finite groups and their invariants

CERN Document Server

Sambale, Benjamin

2014-01-01

Providing a nearly complete selection of up-to-date methods and results on block invariants with respect to their defect groups, this book covers the classical theory pioneered by Brauer, the modern theory of fusion systems introduced by Puig, the geometry of numbers developed by Minkowski, the classification of finite simple groups, and various computer assisted methods. In a powerful combination, these tools are applied to solve many special cases of famous open conjectures in the representation theory of finite groups. Most of the material is drawn from peer-reviewed journal articles, but there are also new previously unpublished results. In order to make the text self-contained, detailed proofs are given whenever possible. Several tables add to the text's usefulness as a reference. The book is aimed at experts in group theory or representation theory who may wish to make use of the presented ideas in their research.

A new block cipher based on chaotic map and group theory

International Nuclear Information System (INIS)

Yang Huaqian; Liao Xiaofeng; Wong Kwokwo; Zhang Wei; Wei Pengcheng

2009-01-01

Based on the study of some existing chaotic encryption algorithms, a new block cipher is proposed. In the proposed cipher, two sequences of decimal numbers individually generated by two chaotic piecewise linear maps are used to determine the noise vectors by comparing the element of the two sequences. Then a sequence of decimal numbers is used to define a bijection map. The modular multiplication operation in the group Z 2 8 +1 * and permutations are alternately applied on plaintext with block length of multiples of 64 bits to produce ciphertext blocks of the same length. Analysis show that the proposed block cipher does not suffer from the flaws of pure chaotic cryptosystems.

EnviroAtlas - New Bedford, MA - Ecosystem Services by Block Group

Data.gov (United States)

U.S. Environmental Protection Agency — This EnviroAtlas dataset presents environmental benefits of the urban forest in 128 block group in New Bedford, Massachusetts. Carbon attributes, temperature...

Arthroscopic medial meniscus trimming or repair under nerve blocks: Which nerves should be blocked?

Science.gov (United States)

Taha, AM; Abd-Elmaksoud, AM

2016-01-01

Background: This study aimed to determine the role of the sciatic and obturator nerve blocks (in addition to femoral block) in providing painless arthroscopic medial meniscus trimming/repair. Materials and Methods: One hundred and twenty patients with medial meniscus tear, who had been scheduled to knee arthroscopy, were planned to be included in this controlled prospective double-blind study. The patients were randomly allocated into three equal groups; FSO, FS, and FO. The femoral, sciatic, and obturator nerves were blocked in FSO groups. The femoral and sciatic nerves were blocked in FS group, while the femoral and obturator nerves were blocked in FO group. Intraoperative pain and its causative surgical maneuver were recorded. Results: All the patients (n = 7, 100%) in FO group had intraoperative pain. The research was terminated in this group but completed in FS and FSO groups (40 patients each). During valgus positioning of the knee for surgical management of the medial meniscus tear, the patients in FS group experienced pain more frequently than those in FSO group (P = 0.005). Conclusion: Adding a sciatic nerve block to the femoral nerve block is important for painless knee arthroscopy. Further adding of an obturator nerve block may be needed when a valgus knee position is required to manage the medial meniscus tear. PMID:27375382

The efficacy of oblique subcostal transversus abdominis plane block in laparoscopic cholecystectomy - a prospective, placebo controlled study.

Science.gov (United States)

Breazu, Caius Mihai; Ciobanu, Lidia; Hadade, Adina; Bartos, Adrian; Mitre, Călin; Mircea, Petru Adrian; Ionescu, Daniela

2016-04-01

Pain control after a laparoscopic cholecystectomy can represent a challenge, considering the side effects due to standard analgesia methods. Recently the transversus abdominis plane block (TAP Block) has been used as a part of multimodal analgesia with promising results. The subcostal approach (OSTAP Block), a variant on the TAP block, produces reliable unilateral supraumbilical analgesia. This study evaluated the efficacy of the OSTAP block with bupivacaine in laparoscopic cholecystectomy compared with the placebo OSTAP block. Sixty ASA I/II adult patients listed for elective laparoscopic cholecystectomy were randomly allocated in one of two groups: Group A (OSTAP placebo) received preoperatively bilateral OSTAP block with sterile normal saline and Group B (OSTAP bupivacaine) received bilateral preoperatively OSTAP block with the same volumes of 0.25% bupivacaine. Twenty-four hours postoperative opioid consumption, the dose of opioid required during surgery, opioid dose in the recovery unit (PACU) and PACU length of stay were evaluated. The quality of analgesia was assessed by the Visual Analogue Scale (VAS) at specific interval hours during 24 h, at rest and with movement. The mean intraoperative opioid consumption showed a significant difference between the two groups, (385 ± 72.52 mg in group A vs 173.67 ± 48.60 mg in group B, p consumption showed a statistically significant difference between groups (32 ± 26.05 mg vs 79 ± 16.68 mg, p < 0.001). PACU length of stay was significantly lower for group B patients compared with group A patients (20.67 ± 11.27 min vs 41.67 ± 12.41 min, p < 0.001). The OSTAP bupivacaine group had a statistically significant lower pain score than the OSTAP placebo group at 0, 2, 4, 6, 12, 24 h, both at rest and with movement. No signs or symptoms of local anaesthetic systemic toxicity or other complications were detected. OSTAP block with bupivacaine 0.25% can provide effective analgesia up to 24 hours after laparoscopic

Thermal-stress analysis of HTGR fuel and control rod fuel blocks in in-block carbonization and annealing furnace

International Nuclear Information System (INIS)

Gwaltney, R.C.; McAfee, W.J.

1977-01-01

The equivalent solid plate method, in conjunction with two-dimensional plane stress and plane strain analyses, was used in assessing the thermal stress behavior of HTGR fuel and control rod fuel blocks. For the control rod fuel blocks, particular attention was given to ascertaining the effects of the reserve shutdown hole and the control rod channel holes. The assumed safety factor of 2 on the failure criteria was considered adequate to account for neglecting the axial temperature gradient in the plane analyses of the ends of the blocks. The analyses indicated that the maximum calculated tensile stress values were smaller than the criteria values except for the plane strain analysis of the control rod fuel block end surfaces and the axisymmetric analysis of the fuel block as a circular cylinder. However, most of the maximum calculated strain values were greater than the criteria values

EnviroAtlas - Green Bay, WI - Ecosystem Services by Block Group

Data.gov (United States)

U.S. Environmental Protection Agency — This EnviroAtlas dataset presents environmental benefits of the urban forest in 155 block groups in Green Bay, Wisconsin. Carbon attributes, temperature reduction,...

EnviroAtlas - Des Moines, IA - Ecosystem Services by Block Group

Data.gov (United States)

U.S. Environmental Protection Agency — This EnviroAtlas dataset presents environmental benefits of the urban forest in 312 block groups in Des Moines, IA. Carbon attributes, temperature reduction,...

Prospective double blind randomized placebo-controlled clinical trial of the pectoral nerves (Pecs) block type II.

Science.gov (United States)

Versyck, Barbara; van Geffen, Geert-Jan; Van Houwe, Patrick

2017-08-01

The aim of this clinical trial was to test the hypothesis whether adding the pectoral nerves (Pecs) block type II to the anesthetic procedure reduces opioid consumption during and after breast surgery. A prospective randomized double blind placebo-controlled study. A secondary hospital. 140 breast cancer stage 1-3 patients undergoing mastectomy or tumorectomy with sentinel node or axillary node dissection. Patients were randomized to receive either a Pecs block with levobupivacaine 0.25% (n=70) or placebo block with saline (n=70). The pain levels were evaluated by Numeric Rating Scale (NRS) pain scores at 15-minute intervals during the post anesthesia care unit stay time (PACU), at 2-hour intervals for the first 24h on the ward and at 4-hour intervals for the next 24h. Intraoperative and postoperative opioid consumption were recorded during the full stay. Patient satisfaction was evaluated upon discharge using a 10-point scale. Intraoperative sufentanil requirements were comparable for the Pecs and placebo group (8.0±3.5μg and 7.8±3.0μg, P=0.730). Patients in the Pecs group experienced significantly less pain than patients in the control group (P=0.048) during their PACU stay. Furthermore, patients in the Pecs group required significant less postoperative opioids (9.16±10.15mg and 14.97±14.38mg morphine equivalent, P=0.037) and required significant fewer postsurgical opioid administration interventions than patients in the control group (P=0.045). Both patient-groups were very satisfied about their management (9.6±0.6 and 9.1±1.8 on a 10-point scale, P=0.211). The Pecs block reduces postsurgical opioid consumption during the PACU stay time for patients undergoing breast surgery. Copyright © 2017 Elsevier Inc. All rights reserved.

EnviroAtlas - Durham, NC - Land Cover Summaries by Block Group

Data.gov (United States)

U.S. Environmental Protection Agency — This EnviroAtlas dataset describes the percentage of each block group that is classified as impervious, forest, green space, wetland, and agriculture. Impervious is...

EnviroAtlas - New York, NY - Ecosystem Services by Block Group

Data.gov (United States)

U.S. Environmental Protection Agency — This EnviroAtlas dataset presents environmental benefits of the urban forest in 6,378 block groups in New York City, New York. Carbon attributes, temperature...

EnviroAtlas - Memphis, TN - BenMAP Results by Block Group

Data.gov (United States)

U.S. Environmental Protection Agency — This EnviroAtlas dataset demonstrates the effect of changes in pollution concentration on local populations in 703 block groups in Memphis, Tennessee. The US EPA's...

EnviroAtlas - Portland, ME - BenMAP Results by Block Group

Data.gov (United States)

U.S. Environmental Protection Agency — This EnviroAtlas dataset demonstrates the effect of changes in pollution concentration on local populations in 146 block groups in Portland, Maine. The US EPA's...

EnviroAtlas - Milwaukee, WI - BenMAP Results by Block Group

Data.gov (United States)

U.S. Environmental Protection Agency — This EnviroAtlas dataset demonstrates the effect of changes in pollution concentration on local populations in 1,175 block groups in Milwaukee, Wisconsin. The US...

EnviroAtlas - Durham, NC - BenMAP Results by Block Group

Data.gov (United States)

U.S. Environmental Protection Agency — This EnviroAtlas dataset demonstrates the effect of changes in pollution concentration on local populations in 193 block groups in Durham, North Carolina. The US...

EnviroAtlas - Austin, TX - BenMAP Results by Block Group

Data.gov (United States)

U.S. Environmental Protection Agency — This EnviroAtlas dataset demonstrates the effect of changes in pollution concentration on local populations in 750 block groups in Austin, Texas. The US EPA's...

EnviroAtlas - Portland, OR - BenMAP Results by Block Group

Data.gov (United States)

U.S. Environmental Protection Agency — This EnviroAtlas dataset demonstrates the effect of changes in pollution concentration on local populations in 1176 block groups in Portland, Oregon. The US EPA's...

EnviroAtlas - Woodbine, IA - BenMAP Results by Block Group

Data.gov (United States)

U.S. Environmental Protection Agency — This EnviroAtlas dataset demonstrates the effect of changes in pollution concentration on local populations in 1 block group in Woodbine, Iowa. The US EPA's...

EnviroAtlas - Fresno, CA - BenMAP Results by Block Group

Data.gov (United States)

U.S. Environmental Protection Agency — This EnviroAtlas dataset demonstrates the effect of changes in pollution concentration on local populations in 405 block groups in Fresno, California. The US EPA's...

A comparison of oblique subcostal transversus abdominis plane block versus thoracic paravertebral block for postoperative analgesia after open cholecystectomy

Directory of Open Access Journals (Sweden)

Ghada Kamhawy

2017-10-01

Full Text Available Background: A major challenge in the postoperative period is pain management which, if not adequately controlled, may contribute to patient discomfort and decreased patient satisfaction, and possibly increased morbidity and mortality. Both Thoracic paravertebral block and oblique subcostal transversus abdominis plane block can be used as analgesic techniques for abdominal surgeries. Our aim in this research was comparison of cumulative 24-h post-operative morphine consumption between ultrasound-guided oblique subcostal transversus abdominis plane block and ultrasound-guided thoracic paravertebral block in patients who underwent an open cholecystectomy under general anesthesia. Patients and methods: This study was performed on 46 patients who underwent open cholecystectomy under general anesthesia. All patients were randomly allocated alternatively to one of two equal groups to either undergo ultrasound-guided unilateral oblique subcostal transversus abdominis plane block Group (I or to undergo ultrasound-guided unilateral thoracic paravertebral block Group (II. Both groups were subjected to a similar analgesic regimen in the immediate post-operative period that involved intravenous patient-controlled morphine analgesia which was used in both groups. Results: The total morphine consumption in the first postoperative 24 h was lower in thoracic paravertebral block Group (II (9.9 mg in thoracic paravertebral block group vs. 15.4 mg in oblique subcostal transversus abdominis plane block Group (I with p < 0.001. The mean time of first request of analgesia in Group (I was 248.7 min compared to 432.1 for Group (II with p < 0.001. Conclusions: Both ultrasound-guided oblique subcostal transversus abdominis plain block and single injection ultrasound guided thoracic paravertebral block are effective analgesic techniques for upper abdominal surgeries and reduces postoperative opioid requirements. However, thoracic paravertebral block is more

EnviroAtlas - Pittsburgh, PA - BenMAP Results by Block Group

Data.gov (United States)

U.S. Environmental Protection Agency — This EnviroAtlas dataset demonstrates the effect of changes in pollution concentration on local populations in 1,089 block groups in Pittsburgh, PA. The US EPA's...

EnviroAtlas - Phoenix, AZ - BenMAP Results by Block Group

Data.gov (United States)

U.S. Environmental Protection Agency — This EnviroAtlas dataset demonstrates the effect of changes in pollution concentration on local populations in 2,434 block groups in Phoenix, AZ. The US EPA's...

EnviroAtlas - Paterson, NJ - BenMAP Results by Block Group

Data.gov (United States)

U.S. Environmental Protection Agency — This EnviroAtlas dataset demonstrates the effect of changes in pollution concentration on local populations in 107 block groups in Paterson, New Jersey. The US EPA's...

EnviroAtlas - Phoenix, AZ - Historic Places by Census Block Group

Data.gov (United States)

U.S. Environmental Protection Agency — This EnviroAtlas dataset portrays the total number of historic places located within each Census Block Group (CBG). The historic places data were compiled from the...

EnviroAtlas - Pittsburgh, PA - Historic Places by Census Block Group

Data.gov (United States)

U.S. Environmental Protection Agency — This EnviroAtlas dataset portrays the total number of historic places located within each Census Block Group (CBG). The historic places data were compiled from the...

EnviroAtlas - Fresno, CA - Historic Places by Census Block Group

Data.gov (United States)

U.S. Environmental Protection Agency — This EnviroAtlas dataset portrays the total number of historic places located within each Census Block Group (CBG). The historic places data were compiled from the...

EnviroAtlas - Durham, NC - Historic Places by Census Block Group

Data.gov (United States)

U.S. Environmental Protection Agency — This EnviroAtlas dataset portrays the total number of historic places located within each Census Block Group (CBG). The historic places data were compiled from the...

EnviroAtlas - Paterson, NJ - Historic Places by Census Block Group

Data.gov (United States)

U.S. Environmental Protection Agency — This EnviroAtlas dataset portrays the total number of historic places located within each Census Block Group (CBG). The historic places data were compiled from the...

EnviroAtlas - Portland, OR - Historic Places by Census Block Group

Data.gov (United States)

U.S. Environmental Protection Agency — This EnviroAtlas dataset portrays the total number of historic places located within each Census Block Group (CBG). The historic places data were compiled from the...

EnviroAtlas - Memphis, TN - Historic Places by Census Block Group

Data.gov (United States)

U.S. Environmental Protection Agency — This EnviroAtlas dataset portrays the total number of historic places located within each Census Block Group (CBG). The historic places data were compiled from the...

EnviroAtlas - New Bedford, MA - Land Cover by Block Group

Data.gov (United States)

U.S. Environmental Protection Agency — This EnviroAtlas dataset describes the percentage of each block group that is classified as impervious, forest, green space, and wetlands. Forest is a combination of...

EnviroAtlas - Tampa, FL - Historic Places by Census Block Group

Data.gov (United States)

U.S. Environmental Protection Agency — This EnviroAtlas dataset portrays the total number of historic places located within each Census Block Group (CBG). The historic places data were compiled from the...

EnviroAtlas - Woodbine, IA - Historic Places by Census Block Group

Data.gov (United States)

U.S. Environmental Protection Agency — This EnviroAtlas dataset portrays the total number of historic places located within each Census Block Group (CBG). The historic places data were compiled from the...

EnviroAtlas - Portland, ME - Historic Places by Census Block Group

Data.gov (United States)

U.S. Environmental Protection Agency — This EnviroAtlas dataset portrays the total number of historic places located within each Census Block Group (CBG). The historic places data were compiled from the...

EnviroAtlas - Milwaukee, WI - Historic Places by Census Block Group

Data.gov (United States)

U.S. Environmental Protection Agency — This EnviroAtlas dataset portrays the total number of historic places located within each Census Block Group (CBG). The historic places data were compiled from the...

EnviroAtlas - Austin, TX - Historic Places by Census Block Group

Data.gov (United States)

U.S. Environmental Protection Agency — This EnviroAtlas dataset portrays the total number of historic places located within each Census Block Group (CBG). The historic places data were compiled from the...

EnviroAtlas - Cleveland, OH - Historic Places by Census Block Group

Data.gov (United States)

U.S. Environmental Protection Agency — This EnviroAtlas dataset portrays the total number of historic places located within each Census Block Group (CBG). The historic places data were compiled from the...

EnviroAtlas - Cleveland, OH - BenMAP Results by Block Group

Data.gov (United States)

U.S. Environmental Protection Agency — This EnviroAtlas dataset demonstrates the effect of changes in pollution concentration on local populations in 1,442 block groups in Cleveland, Ohio. The US EPA's...

EnviroAtlas - Green Bay, WI - Land Cover by Block Group

Data.gov (United States)

U.S. Environmental Protection Agency — This EnviroAtlas dataset describes the percentage of each block group that is classified as impervious, forest, and green space. Forest is combination of trees and...

EnviroAtlas - New York, NY - Land Cover by Block Group

Data.gov (United States)

U.S. Environmental Protection Agency — This EnviroAtlas dataset describes the percentage of each block group that is classified as impervious, forest, and green space. In this community, forest is defined...

Comparison of Paravertebral Block by Anatomic Landmark Technique to Ultrasound-Guided Paravertebral Block for Breast Surgery Anesthesia: A Randomized Controlled Trial.

Science.gov (United States)

Patnaik, Rupali; Chhabra, Anjolie; Subramaniam, Rajeshwari; Arora, Mahesh K; Goswami, Devalina; Srivastava, Anurag; Seenu, Vuthaluru; Dhar, Anita

2018-05-01

Paravertebral block (PVB) is an established technique for providing anesthesia for breast surgery. The primary objective was to compare anatomical landmark technique (ALT) to the ultrasound-guided (USG) PVB block for providing surgical anesthesia. Secondary objectives included comparison of perioperative analgesia and complications. This randomized, controlled, observer-blinded study included 72 females, aged 18 to 65 years, American Society of Anesthesiologists physical status I or II, undergoing elective unilateral breast surgery. Study participants were randomized to the ALT group or USG group. Ipsilateral PVB was performed with the respective technique from T1 to T6. Five milliliters of local anesthetic mixture (0.5% ropivacaine, 5 μg/mL adrenaline, 1 μg/kg clonidine) was administered at each level. Paravertebral catheter was inserted at T4/T3 level. After confirming sensory loss, patients were taken up for surgery with propofol sedation (20-50 μg/kg per minute). More patients in the USG group (34/36 [94.44%]) had a successful block as compared with the ALT group (26/36 [72.22%]) (P = 0.024). Difference in proportion was 18.1 (95% confidence interval, 0.15-36.0) (P = 0.024) after adjustment for age. More dermatomes were blocked in the USG group (P = 0.0018) with less sparing of upper T2 and T3 dermatomes (P = 0.003, P = 0.006, respectively). Median time to first postoperative analgesic requirement was 502.5 minutes (range, 195-1440 minutes) in the USG group versus 377.5 minutes (range, 215-1440 minutes) in the ALT group. Pain at rest and movement 2 and 4 hours postoperatively and number of catheter top-ups in 24 hours postoperatively were lesser in the USG group (P = 0.012). Complications were comparable. Ultrasound-guided PVB provided better anesthesia and perioperative analgesia than the landmark technique for breast surgery. The trial was registered retrospectively at the Clinical Trial Registry of India, CTRI/2015/05/005774.

EnviroAtlas - Green Bay, WI - Residents with Potential Window Views of Trees by Block Group

Data.gov (United States)

U.S. Environmental Protection Agency — This EnviroAtlas dataset shows the total block group population and the percentage of the block group population that has little access to potential window views of...

Comparison of Postoperative Pain Relief by Intercostal Block Between Pre-rib Harvest and Post-rib Harvest Groups

International Nuclear Information System (INIS)

Bashir, M. M.; Shahzad, M. A.; Yousaf, M. N.; Khan, B. A.; Khan, F. A.

2014-01-01

Objective: To compare intercostal nerve block before and after rib harvest in terms of mean postoperative pain score and mean postoperative tramadol usage. Study Design: Randomized controlled trial. Place and Duration of Study: Department of Plastic Surgery, Mayo Hospital, KEMU, Lahore, from January 2011 to July 2012. Methodology: Patients (n = 120) of either gender with ASA class-I and II requiring autogenous costal cartilage graft were inducted. Patients having history of local anaesthetic hypersensitivity and age 60 years were excluded. Subjects were randomly assigned to pre-rib harvest (group-1) and post-rib harvest (group-2). Local anaesthetic mixture was prepared by adding 10 milliliters 2% lidocaine to 10 milliliters 0.5% bupivacaine to obtain a total 20 ml solution. Group-1 received local anaesthetic infiltration along the proposed incision lines and intercostals block before the rib harvest. Group-2 received the infiltration and block after rib harvest. Postoperative consumption of tramadol and pain scores were measured at 6 and 12 hours postoperatively using VAS. Results: Mean age was 31.43 A +- 10.78 years. The mean pain scores at 6 hours postoperatively were 1.033 A +- 0.609 and 2.4667 A +- 0.812 in pre-rib harvest and post-rib harvest groups respectively (p < 0.0001). The mean pain scores at 12 hours postoperatively were 1.45 A +- 0.565 and 3.65 A +- 0.633 in pre-rib harvest and post-rib harvest groups respectively (p < 0.0001). The mean tramadol used postoperatively in first 24 hours was 169 A +- 29.24 mg and 255 A +- 17.70 mg in prerib harvest and post-rib harvest groups respectively (p < 0.0001). Conclusion: Intercostal block administered before rib harvest as preemptive strategy result in decreased postoperative pain scores and narcotic use. (author)

EnviroAtlas - Tampa, FL - BenMAP Results by Block Group

Data.gov (United States)

U.S. Environmental Protection Agency — This EnviroAtlas dataset demonstrates the effect of changes in pollution concentration on local populations in 1,833 block groups in Tampa Bay, Florida. The US EPA's...

[The effects of transversus abdominis plane block on analgesic and anesthetic consumption during total abdominal hysterectomy: a randomized controlled study].

Science.gov (United States)

Karaman, Tugba; Ozsoy, Asker Zeki; Karaman, Serkan; Dogru, Serkan; Tapar, Hakan; Sahin, Aynur; Dogru, Hatice; Suren, Mustafa

A transversus abdominis plane block is a peripheral block method that has been used successfully for pain relief after total abdominal hysterectomy. However, the effects of the combination of the transversus abdominis plane block and general anesthesia on analgesic and anesthetic requirements remain unclear. This randomized placebo-controlled study is aimed to evaluate the effects of transversus abdominis plane block on analgesic and anesthetic consumption during total abdominal hysterectomy under general anesthesia. Sixty-six women undergoing total abdominal hysterectomy were randomized into two groups to receive general anesthesia alone (control group) or with transversus abdominis plane block using 20mL of 0.25% bupivacaine (transversus abdominis plane group). Intraoperative remifentanil and sevoflurane consumption were recorded. We also evaluated the postoperative pain, nausea, quality of recovery scores and rescue analgesic requirement during postoperative 24hours. The total remifentanil and sevoflurane consumption is significantly lower in transversus abdominis plane group; respectively mean (SD) 0.130 (0.25) vs. 0.094 (0.02) mcg.kg -1 .min -1 ; pplane group soon after surgery; median (range) 6 (2-10) vs. 3 (0-5); pplane group had significantly higher QoR-40 scores 190.5 (175-197) vs. 176.5 (141-187); pplane block with general anesthesia can provide reduced opioid and anesthetic consumption and can improve postoperative pain and quality of recovery scores in patients undergoing total abdominal hysterectomy. Copyright © 2018 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

EnviroAtlas - New York, NY - Park Access by Block Group

Data.gov (United States)

U.S. Environmental Protection Agency — This EnviroAtlas dataset shows the block group population that is within and beyond an easy walking distance (500m) of a park entrance. Park entrances were included...

Postoperative Analgesic Efficacy of Bilateral Transversus Abdominis Plane Block in Patients Undergoing Midline Colorectal Surgeries Using Ropivacaine: A Randomized, Double-blind, Placebo-controlled Trial.

Science.gov (United States)

Qazi, Nahida; Bhat, Wasim Mohammad; Iqbal, Malik Zaffar; Wani, Anisur Rehman; Gurcoo, Showkat A; Rasool, Sahir

2017-01-01

Ultrasound-guided transversus abdominis plane (TAP) block is done as a part of multimodal analgesia for pain relief after abdominal surgeries. This prospective randomized, double-blind, placebo-controlled trial was conducted to evaluate the postoperative analgesic efficacy of bilateral TAP block in patients undergoing midline colorectal surgeries using ropivacaine. Eighty patients scheduled for elective colorectal surgeries involving midline abdominal wall incision under general anesthesia were enrolled in this prospective randomized controlled trial. Group A received TAP block with 20 ml of 0.2% ropivacaine on either side of the abdominal wall, and Group B received 20 ml of normal saline. The time to request for rescue analgesia, total analgesic consumption in 24 h, and satisfaction with the anesthetic technique were assessed. The mean visual analog scale scores at rest and on coughing were higher in control group ( P > 0.05). Time (min) to request for the first rescue analgesia was prolonged in study group compared to control group ( P consumption in 24 h postoperatively was significantly high in control group ( P 0.05). The level of satisfaction concerning postoperative pain control/anesthetic technique was higher in study group ( P < 0.001). TAP block produces effective and prolonged postoperative analgesia in patients undergoing midline colorectal surgery. It is a technically simple block to perform with a high margin of safety. It produces a considerable reduction in mean intravenous postoperative tramadol requirements, reduction in postoperative pain scores, and increased time to first request for further analgesia, both at rest and on movement.

EnviroAtlas - Portland, OR - Greenspace Around Schools by Block Group

Data.gov (United States)

U.S. Environmental Protection Agency — This EnviroAtlas data set shows the number of schools in each block group in the EnviroAtlas community boundary as well as the number of schools where less than 25%...

EnviroAtlas - Tampa, FL - Greenspace Around Schools by Block Group

Data.gov (United States)

U.S. Environmental Protection Agency — This EnviroAtlas data set shows the number of schools in each block group in the EnviroAtlas community boundary as well as the number of schools where less than 25%...

EnviroAtlas - Portland, ME - Greenspace Around Schools by Block Group

Data.gov (United States)

U.S. Environmental Protection Agency — This EnviroAtlas data set shows the number of schools in each block group in the EnviroAtlas community boundary, as well as the number of schools where less than 25%...

EnviroAtlas - Pittsburgh, PA - Greenspace Around Schools by Block Group

Data.gov (United States)

U.S. Environmental Protection Agency — This EnviroAtlas data set shows the number of schools in each block group in the EnviroAtlas community boundary as well as the number of schools where less than 25%...

EnviroAtlas - Fresno, CA - Greenspace Around Schools by Block Group

Data.gov (United States)

U.S. Environmental Protection Agency — This EnviroAtlas data set shows the number of schools in each block group in the EnviroAtlas community boundary as well as the number of schools where less than 25%...

EnviroAtlas - Phoenix, AZ - Greenspace Around Schools by Block Group

Data.gov (United States)

U.S. Environmental Protection Agency — This EnviroAtlas data set shows the number of schools in each block group in the EnviroAtlas community boundary as well as the number of schools where less than 25%...

EnviroAtlas - Memphis, TN - Greenspace Around Schools by Block Group

Data.gov (United States)

U.S. Environmental Protection Agency — This EnviroAtlas data set shows the number of schools in each block group in the EnviroAtlas community boundary as well as the number of schools where less than 25%...

EnviroAtlas - Cleveland, OH - Greenspace Around Schools by Block Group

Data.gov (United States)

U.S. Environmental Protection Agency — This EnviroAtlas data set shows the number of schools in each block group in the EnviroAtlas community boundary as well as the number of schools where less than 25%...

EnviroAtlas - Woodbine, IA - Greenspace Around Schools by Block Group

Data.gov (United States)

U.S. Environmental Protection Agency — This EnviroAtlas data set shows the number of schools in each block group in the EnviroAtlas community boundary as well as the number of schools where less than 25%...

EnviroAtlas - Austin, TX - Greenspace Around Schools by Block Group

Data.gov (United States)

U.S. Environmental Protection Agency — This EnviroAtlas data set shows the number of schools in each block group in the EnviroAtlas community boundary as well as the number of schools where less than 25%...

Bidding for blocks and environmental control; Licitacao de blocos e o controle ambiental

Energy Technology Data Exchange (ETDEWEB)

Agostinho, Magila Maria [Universidade Federal do Rio Grande do Norte (UFRN), Natal, RN (Brazil). Faculdade de Direito; Silveira Neto, Otacilio dos Santos [Universidade Federal do Rio Grande do Norte (UFRN), Natal, RN (Brazil). Programa de Recursos Humanos da ANP em Direito do Petroleo e Gas Natural, PRH-36

2004-07-01

With the coming of the Constitutional Emend n. 9/95, the Brazilian market of oil and natural gas stopped being monopolized by PETROBRAS. Since then, the concession of blocks began to be preceded by the public tender procedure realized by ANP- National Agency of Oil. The activities of oil exploration and production are potentially damaging to environment, what brings necessary the environmental licence and the previous study of the environmental impacts caused in this activity. Considering that the environmental licence must be done after the tender process, the enterprises that bought the blocks would assume the risk of not being allowed to practice their activities because of the absence of the environmental licence. To avoid that the It's offered blocks in not viable areas for oil exploration, the ANP, responsible for the public tender must accomplish a previous environmental control, to assure to the enterprises involved the environmental viability of the blocks offered. This project will touch the question of how has been realized the previous environmental control of the blocks offered by ANP into the public tender process, detaching, the control done at the 6. Round. (author)

Efficacy of an energy block containing Duddingtonia flagrans in the control of gastrointestinal nematodes of sheep.

Science.gov (United States)

Sagüés, María F; Fusé, Luis A; Fernández, Alicia S; Iglesias, Lucía E; Moreno, Fabiana C; Saumell, Carlos A

2011-09-01

The efficacy of the nematode-trapping fungus Duddingtonia flagrans incorporated into an energy block was evaluated for the control of gastrointestinal nematodes in sheep. Four naturally parasitised sheep with average nematode egg counts of 2,470 eggs per gram grazed by pairs on two similar parasite-free paddocks for 30 days. During that period, one pair of sheep (treated animals, T1) received an energy block containing chlamydospores of D. flagrans at a dose of 200,000 chlamydopores/kg bw/day, while the second pair (control animals, C1) received a fungus-free energy block. The animals in both groups were taken off the paddocks after contaminating the pastures for a month with either nematode eggs plus fungal chlamydospores (T1) or nematode eggs alone (C1). Twelve parasite-free sheep were divided into two groups of six animals each, the treated group (T2) was placed on the paddock previously contaminated with parasites and fungus, while the control group (C2) was placed on the parasite-only paddock. These two groups grazed on their respective paddocks during 30 days and were then housed for 15 days, after which period they were slaughtered in order to determine the parasite burden present in each animal. Results showed that animals in group T2 harboured significantly less nematodes than their counterpart in group C2. The efficacy of D. flagrans was 92% against the total parasite burden, 100% against Haemonchus contortus and Teladorsagia circumcincta, 89.9% against Trichostrongylus colubriformis, 87.5% against Cooperia onchopora, and 90% against Trichostrongylus axei. No efficacy was detected against Nematodirus spathiger, Trichuris ovis and T. skrjabini.

EnviroAtlas - Minneapolis/St. Paul, MN - Ecosystem Services by Block Group

Data.gov (United States)

U.S. Environmental Protection Agency — This EnviroAtlas dataset presents environmental benefits of the urban forest in 1,772 block groups in Minneapolis/St. Paul, Minnesota. Carbon attributes, temperature...

EnviroAtlas - New Bedford, MA - BenMAP Results by Block Group

Data.gov (United States)

U.S. Environmental Protection Agency — This EnviroAtlas dataset demonstrates the effect of changes in pollution concentration on local populations in 128 block group in New Bedford, Massachusetts. The US...

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

Directory of Open Access Journals (Sweden)

Lihua Peng

2014-01-01

Full Text Available 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 scores for knee and incidence of chronic postoperative pain at 3, 6, and 12 months postoperatively were compared. postoperative pain and salvage medication at rest or during mobilization 24 hours, 48 hours, and 7 days postoperatively were also recorded. Results. After discharge from the hospital and rehabilitation of joint function, patients in group CFNB reported significantly improved knee flexion and less incidence of chronic postoperative pain at 3 months and 6 months postoperatively (P<0.05. Analgesic rescue medications were significantly reduced in patients receiving CFNB (P<0.001 and P=0.031, resp.. Conclusion. With standardized rehabilitation therapy, continuous femoral nerve block analgesia reduced the incidence of chronic postoperative pain, improved motility of replaced joints, and reduced the dosages of rescue analgesic medications, suggesting a recovery-enhancing effect of peripheral nerve block analgesia.

EnviroAtlas - Des Moines, IA - BenMAP Results by Block Group

Data.gov (United States)

U.S. Environmental Protection Agency — This EnviroAtlas dataset demonstrates the effect of changes in pollution concentration on local populations in 312 block groups in Des Moines, Iowa. The US EPA's...

EnviroAtlas - Green Bay, WI - BenMAP Results by Block Group

Data.gov (United States)

U.S. Environmental Protection Agency — This EnviroAtlas dataset demonstrates the effect of changes in pollution concentration on local populations in 155 block groups in Green Bay, Wisconsin. The US EPA's...

EnviroAtlas - New York, NY - Historic Places by Census Block Group

Data.gov (United States)

U.S. Environmental Protection Agency — This EnviroAtlas dataset portrays the total number of historic places located within each Census Block Group (CBG). The historic places data were compiled from the...

EnviroAtlas - Des Moines, IA - Historic Places by Census Block Group

Data.gov (United States)

U.S. Environmental Protection Agency — This EnviroAtlas dataset portrays the total number of historic places located within each Census Block Group (CBG). The historic places data were compiled from the...

EnviroAtlas - New Bedford, MA - Historic Places by Census Block Group

Data.gov (United States)

U.S. Environmental Protection Agency — This EnviroAtlas dataset portrays the total number of historic places located within each Census Block Group (CBG). The historic places data were compiled from the...

EnviroAtlas - Green Bay, WI - Historic Places by Census Block Group

Data.gov (United States)

U.S. Environmental Protection Agency — This EnviroAtlas dataset portrays the total number of historic places located within each Census Block Group (CBG). The historic places data were compiled from the...

EnviroAtlas - New York, NY - BenMAP Results by Block Group

Data.gov (United States)

U.S. Environmental Protection Agency — This EnviroAtlas dataset demonstrates the effect of changes in pollution concentration on local populations in 6,378 block groups in New York City, New York. The US...

Supraclavicular block versus interscalene brachial plexus block for shoulder surgery: A meta-analysis of clinical control trials.

Science.gov (United States)

Guo, C W; Ma, J X; Ma, X L; Lu, B; Wang, Y; Tian, A X; Sun, L; Wang, Y; Dong, B C; Teng, Y B

2017-09-01

The ultrasound-guided interscalene block (ISB) has been considered a standard technique in managing pain after shoulder surgery. However, this method was associated with the incidence of hemi-diaphragmatic paresis. In contrast to ISB, supraclavicular block (SCB) was suggested to provide effective anaesthesia for shoulder surgery with a low rate of side-effects. Thus, we performed a meta-analysis of randomised controlled trials (RCTs) to compare SCB with ISB for evaluating the efficacy and safety. The literature was searched from PubMed, Wiley Online Library, EMBASE, and the Cochrane Library by two reviewers up to April 2017. All available RCTs written in English that met the criteria were included. Two authors pulled data from relevant articles and assessed the quality with the Cochrane Handbook. Review Manager 5.3 software was used to analyse the data. Five RCTs and one prospective clinical study met the eligibility criteria and were included in the meta-analysis. We considered that there were no statistically significant differences between supraclavicular and interscalene groups in procedural time (P = 0.81), rescue analgesia (P = 0.53), and dyspnoea (P = 0.6). The incidence of hoarseness and Horner syndrome was statistically lower in the SCB group than in the ISB group (P = 0.0002 and P < 0.00001, respectively). The meta-analysis showed that ultrasound-guided SCB could become a feasible alternative technique to the ISB in shoulder surgery. Copyright © 2017. Published by Elsevier Ltd.

Quantifying private benefits of control from a structural model of block trades

NARCIS (Netherlands)

Albuquerque, R.; Schroth, E.

2009-01-01

We study the determinants of private benefits of control in negotiated block transactions. We estimate the block pricing model in Burkart, Gromb, and Panunzi (2000) explicitly accounting for both block premia and block discounts in the data. The evidence suggests that the occurrence of a block

EnviroAtlas - New York, NY - Greenspace Around Schools by Block Group

Data.gov (United States)

U.S. Environmental Protection Agency — This EnviroAtlas data set shows the number of schools in each block group in the EnviroAtlas community boundary as well as the number of schools where less than 25%...

EnviroAtlas - Green Bay, WI - Greenspace Around Schools by Block Group

Data.gov (United States)

U.S. Environmental Protection Agency — This EnviroAtlas data set shows the number of schools in each block group in the EnviroAtlas community boundary as well as the number of schools where less than 25%...

EnviroAtlas - Des Moines, IA - Greenspace Around Schools by Block Group

Data.gov (United States)

U.S. Environmental Protection Agency — This EnviroAtlas data set shows the number of schools in each block group in the EnviroAtlas community boundary as well as the number of schools where less than 25%...

Effects of arthroscopy-guided suprascapular nerve block combined with ultrasound-guided interscalene brachial plexus block for arthroscopic rotator cuff repair: a randomized controlled trial.

Science.gov (United States)

Lee, Jae Jun; Hwang, Jung-Taek; Kim, Do-Young; Lee, Sang-Soo; Hwang, Sung Mi; Lee, Na Rea; Kwak, Byung-Chan

2017-07-01

The aim of this study was to compare the pain relieving effect of ultrasound-guided interscalene brachial plexus block (ISB) combined with arthroscopy-guided suprascapular nerve block (SSNB) with that of ultrasound-guided ISB alone within the first 48 h after arthroscopic rotator cuff repair. Forty-eight patients with rotator cuff tears who had undergone arthroscopic rotator cuff repair were enrolled. The 24 patients in group 1 received ultrasound-guided ISB and arthroscopy-guided SSNB; the remaining 24 patients in group 2 underwent ultrasound-guided ISB alone. Visual analogue scale pain score and patient satisfaction score were checked at 1, 3, 6, 12, 18, 24, and 48 h post-operatively. Group 1 had a lower visual analogue scale pain score at 3, 6, 12, 18, 24, and 48 h post-operatively (1.7  6.0, 6.2 > 4.3, 6.4 > 5.1, 6.9 > 5.9, 7.9 > 7.1). Six patients in group 1 developed rebound pain twice, and the others in group 1 developed it once. All of the patients in group 2 had one rebound phenomenon each (p = 0.010). The mean timing of rebound pain in group 1 was later than that in group 2 (15.5 > 9.3 h, p  4.0, p = 0.001). Arthroscopy-guided SSNB combined with ultrasound-guided ISB resulted in lower visual analogue scale pain scores at 3-24 and 48 h post-operatively, and higher patient satisfaction scores at 6-36 h post-operatively with the attenuated rebound pain compared to scores in patients who received ultrasound-guided ISB alone after arthroscopic rotator cuff repair. The combined blocks may relieve post-operative pain more effectively than the single block within 48 h after arthroscopic cuff repair. Randomized controlled trial, Level I. ClinicalTrials.gov Identifier: NCT02424630.

TIGER/Line Shapefile, 2014, Series Information File for the Current Tribal Block Group National Shapefile

Data.gov (United States)

US Census Bureau, Department of Commerce — A tribal block group is a cluster of census tabulation blocks within a single tribal census tract delineated by American Indian tribal participants or the Census...

Reduction of snapshots for MIMO radar detection by block/group orthogonal matching pursuit

KAUST Repository

Ali, Hussain El Hosiny

2014-10-01

Multiple-input multiple-output (MIMO) radar works on the principle of transmission of independent waveforms at each element of its antenna array and is widely used for surveillance purposes. In this work, we investigate MIMO radar target localization problem with compressive sensing. Specifically, we try to solve the problem of estimation of target location in MIMO radar by group and block sparsity algorithms. It will lead us to a reduced number of snapshots required and also we can achieve better radar resolution. We will use group orthogonal matching pursuit (GOMP) and block orthogonal matching pursuit (BOMP) for our problem. © 2014 IEEE.

The determinants of the block premium and of private benefits of control

NARCIS (Netherlands)

Albuquerque, R.A.; Schroth, E.J.

2008-01-01

We study the determinants of private benefits of control in negotiated block transactions. We estimate the block pricing model in Burkart, Gromb, and Panunzi (2000) explicitly dealing with the existence of both block premia and block discounts in the data. We find evidence that the occurrence of

EnviroAtlas - Minneapolis/St. Paul, MN - BenMAP Results by Block Group

Data.gov (United States)

U.S. Environmental Protection Agency — This EnviroAtlas dataset demonstrates the effect of changes in pollution concentration on local populations in 1,772 block groups in Minneapolis/St. Paul, Minnesota....

Pectoralis-serratus interfascial plane block vs thoracic paravertebral block for unilateral radical mastectomy with axillary evacuation.

Science.gov (United States)

Hetta, Diab Fuad; Rezk, Khalid Mohammed

2016-11-01

The aim of this study was to evaluate the analgesic efficacy and safety of pectoralis-serratus interfascial plane block in comparison with thoracic paravertebral block for postmastectomy pain. A prospective randomized controlled study. Tertiary center, university hospital. Sixty-four adult women, American Society of Anesthesiologists physical status classes I, II, and III, scheduled for unilateral modified radical mastectomy with axillary evacuation. Patients were randomized to receive either pectoralis-serratus interfascial plane block, PS group (n=32), or thoracic paravertebral block, PV group (n=32). Twenty-four-hour morphine consumption and the time to rescue analgesic were recorded. The pain intensity evaluated by visual analog scale (VAS) score at 0, 2, 4, 8, 16, and 24hours postoperatively was also recorded. The median (interquartile range) postoperative 24-hour morphine consumption was significantly increased in PS group in comparison to PV group (PS vs PV), 20 mg (16-23 mg) vs 12 mg (10-14 mg) (Pplane block was safe and easy to perform and decreased intensity of postmastectomy pain, but it was inferior to thoracic paravertebral block. Copyright © 2016 Elsevier Inc. All rights reserved.

EnviroAtlas - Minneapolis/St. Paul, MN - Historic Places by Census Block Group

Data.gov (United States)

U.S. Environmental Protection Agency — This EnviroAtlas dataset portrays the total number of historic places located within each Census Block Group (CBG). The historic places data were compiled from the...

The analgesic efficacy of ultrasound-guided transversus abdominis plane block for retroperitoneoscopic donor nephrectomy: A randomized controlled study

Directory of Open Access Journals (Sweden)

Beena K Parikh

2013-01-01

Full Text Available Background: Transversus abdominis plane (TAP block is suitable for lower abdominal surgeries. Blind TAP block has many complications and uncertainty of its effects. Use of ultrasonography increases the safety and efficacy. This study was conducted to evaluate the analgesic efficacy of ultrasound (USG-guided TAP block for retroperitoneoscopic donor nephrectomy (RDN. Methods: In a prospective randomized double-blind study, 60 patients undergoing laparoscopic donor nephrectomy were randomly divided into two groups by closed envelope method. At the end of surgery, USG-guided TAP block was given to the patients of both the groups. Study group (group S received inj. Bupivacaine (0.375%, whereas control group (group C received normal saline. Inj. Tramadol (1 mg/kg was given as rescue analgesic at visual analog scale (VAS more than 3 in any group at rest or on movement. The analgesic efficacy was judged by VAS both at rest and on movement, time to first dose of rescue analgesic, cumulative dose of tramadol, sedation score, and nausea score, which were also noted at 30 min, 2, 4, 6, 12, 18, and 24 h postoperatively. Total tramadol consumption at 24 h was also assessed. Results: Patients in group S had significantly lower VAS score, longer time to first dose of rescue analgesic (547.13±266.96 min vs. 49.17±24.95 min and lower tramadol consumption (103.8±32.18 mg vs. 235.8±47.5 mg in 24 h. Conclusion: The USG-guided TAP block is easy to perform and effective as a postoperative analgesic regimen in RDN, with opioids-sparing effect and without any complications.

Ilioinguinal-iliohypogastric nerve block with intravenous dexketoprofen improves postoperative analgesia in abdominal hysterectomies.

Science.gov (United States)

Yucel, Evren; Kol, Iclal Ozdemir; Duger, Cevdet; Kaygusuz, Kenan; Gursoy, Sinan; Mimaroglu, Caner

2013-01-01

In this study, our aim was to evaluate the effects of intravenous dexketoprofen trometamol with ilioinguinal and iliohypogastric nerve block on analgesic quality and morphine consumption after total abdominal hysterectomy operations. We conducted this randomized controlled clinical study on 61 patients. The study was conducted in the operation room, post-anesthesia care unit, and inpatient clinic. We randomly grouped the 61 patients into control group (group C), block group (group B) and dexketoprofen-block group (group DB). Before the skin incision performed after anesthesia induction, we performed ilioinguinal iliohypogastric block (group C given saline and group P and DB given levobupivacaine). In contrast to group C and B, group DB was given dexketoprofen. We administered morphine analgesia to all patients by patient-controlled analgesia (PCA) during the postoperative 24 hours. We recorded Visual Analogue Scale (VAS), satisfaction scores, morphine consumption and side effects during postoperative 24 hours. We found the DB group's VAS scores to be lower than the control group and block group's (p dexketoprofen increases patient satisfaction by decreasing opioid consumption, increasing patient satisfaction, which suggests that dexketoprofen trometamol is an effective non-steroidal anti-inflammatory analgesic in postoperative analgesia. Copyright © 2013 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.

Comparison of Arthroscopically Guided Suprascapular Nerve Block and Blinded Axillary Nerve Block vs. Blinded Suprascapular Nerve Block in Arthroscopic Rotator Cuff Repair: A Randomized Controlled Trial.

Science.gov (United States)

Ko, Sang Hun; Cho, Sung Do; Lee, Chae Chil; Choi, Jang Kyu; Kim, Han Wook; Park, Seon Jae; Bae, Mun Hee; Cha, Jae Ryong

2017-09-01

The purpose of this study was to compare the results of arthroscopically guided suprascapular nerve block (SSNB) and blinded axillary nerve block with those of blinded SSNB in terms of postoperative pain and satisfaction within the first 48 hours after arthroscopic rotator cuff repair. Forty patients who underwent arthroscopic rotator cuff repair for medium-sized full thickness rotator cuff tears were included in this study. Among them, 20 patients were randomly assigned to group 1 and preemptively underwent blinded SSNB and axillary nerve block of 10 mL 0.25% ropivacaine and received arthroscopically guided SSNB with 10 mL of 0.25% ropivacaine. The other 20 patients were assigned to group 2 and received blinded SSNB with 10 mL of 0.25% ropivacaine. Visual analog scale (VAS) score for pain and patient satisfaction score were assessed 4, 8, 12, 24, 36, and 48 hours postoperatively. The mean VAS score for pain was significantly lower 4, 8, 12, 24, 36, and 48 hours postoperatively in group 1 (group 1 vs. group 2; 5.2 vs. 7.4, 4.1 vs. 6.1, 3.0 vs. 5.1, 2.1 vs. 4.2, 0.9 vs. 3.9, and 1.3 vs. 3.3, respectively). The mean patient satisfaction score was significantly higher at postoperative 4, 8, 12, 24, 36, and 48 hours in group 1 (group 1 vs. group 2; 6.7 vs. 3.9, 7.4 vs. 5.1, 8.8 vs. 5.9, 9.2 vs. 6.7, 9.5 vs. 6.9, and 9.0 vs. 7.2, respectively). Arthroscopically guided SSNB and blinded axillary nerve block in arthroscopic rotator cuff repair for medium-sized rotator cuff tears provided more improvement in VAS for pain and greater patient satisfaction in the first 48 postoperative hours than blinded SSNB.

The effects of transversus abdominis plane block on analgesic and anesthetic consumption during total abdominal hysterectomy: a randomized controlled study

Directory of Open Access Journals (Sweden)

Tugba Karaman

Full Text Available Abstract Background and objectives: A transversus abdominis plane block is a peripheral block method that has been used successfully for pain relief after total abdominal hysterectomy. However, the effects of the combination of the transversus abdominis plane block and general anesthesia on analgesic and anesthetic requirements remain unclear. This randomized placebo-controlled study is aimed to evaluate the effects of transversus abdominis plane block on analgesic and anesthetic consumption during total abdominal hysterectomy under general anesthesia. Methods: Sixty-six women undergoing total abdominal hysterectomy were randomized into two groups to receive general anesthesia alone (control group or with transversus abdominis plane block using 20 mL of 0.25% bupivacaine (transversus abdominis plane group. Intraoperative remifentanil and sevoflurane consumption were recorded. We also evaluated the postoperative pain, nausea, quality of recovery scores and rescue analgesic requirement during postoperative 24 hours. Results: The total remifentanil and sevoflurane consumption is significantly lower in transversus abdominis plane group; respectively mean (SD 0.130 (0.25 vs. 0.094 (0.02 mcg.kg-1.min-1; p < 0.01 and 0.295 (0.05 vs. 0.243 (0.06 mL.min-1; p < 0.01. In the postoperative period, pain scores were significantly reduced in transversus abdominis plane group soon after surgery; median (range 6 (2-10 vs. 3 (0-5; p < 0.001, at 2 h (5 [3-9] vs. 2.5 [0-6]; p < 0.001, at 6 h (4 [2-7] vs. 3[0-6], p < 0.001, at 12 h (3.5 [1-6] vs. 2 [1-5]; p = 0.003. The patients in the transversus abdominis plane group had significantly higher QoR-40 scores 190.5 (175-197 vs. 176.5 (141-187; p < 0.001. Conclusion: Combining transversus abdominis plane block with general anesthesia can provide reduced opioid and anesthetic consumption and can improve postoperative pain and quality of recovery scores in patients undergoing total abdominal hysterectomy.

Efficacy of Pectoral Nerve Block Type II for Breast-Conserving Surgery and Sentinel Lymph Node Biopsy: A Prospective Randomized Controlled Study

Directory of Open Access Journals (Sweden)

Doo-Hwan Kim

2018-01-01

Full Text Available Objectives. The pectoral nerve block type II (PECS II block is widely used for postoperative analgesia after breast surgery. This study evaluated the analgesic efficacy of PECS II block in patients undergoing breast-conserving surgery (BCS and sentinel lymph node biopsy (SNB. Methods. Patients were randomized to the control group (n=40 and the PECS II group (n=40. An ultrasound-guided PECS II block was performed after induction of anesthesia. The primary outcome measure was opioid consumption, and the secondary outcome was pain at the breast and axillary measured using the Numerical Rating Scale (NRS 24 hours after surgery. Opioid requirement was assessed according to tumor location. Results. Opioid requirement was lower in the PECS II than in the control group (43.8 ± 28.5 µg versus 77.0 ± 41.9 µg, p<0.001. However, the frequency of rescue analgesics did not differ between these groups. Opioid consumption in the PECS II group was significantly lower in patients with tumors in the outer area than that in patients with tumors in the inner area (32.5 ± 23.0 µg versus 58.0 ± 29.3 µg, p=0.007. The axillary NRS was consistently lower through 24 hr in the PECS II group. Conclusion. Although the PECS II block seemed to reduce pain intensity and opioid requirements for 24 h after BCS and SNB, these reductions may not be clinically significant. This trial is registered with Clinical Research Information Service KCT0002509.

Lateral femoral cutaneous nerve block after total hip arthroplasty

DEFF Research Database (Denmark)

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

2016-01-01

in this prospective, randomised, blinded, placebo-controlled trial. Group A received an LFCN block with 8 ml of 0.75% ropivacaine followed after 45 min by an additional LFCN block with 8 ml of saline. Group B received an LFCN block with 8 ml of saline followed after 45 min by an additional LFCN block with 8 ml of 0.......75% ropivacaine. RESULTS: We found a difference of 17 mm (95% CI, 4-31 mm; P

Opioid-sparing effects of the thoracic interfascial plane blocks: A meta-analysis of randomized controlled trials.

Science.gov (United States)

Singh, Preet Mohinder; Borle, Anuradha; Kaur, Manpreet; Trikha, Anjan; Sinha, Ashish

2018-01-01

Thoracic interfascial plane blocks and modification (PECS) have recently gained popularity for analgesic potential during breast surgery. We evaluate/consolidate the evidence on opioid-sparing effect of PECS blocks in comparison with conventional intravenous analgesia (IVA) and paravertebral block (PVB). Prospective, randomized controlled trials comparing PECS block to conventional IVA or PVB in patients undergoing breast surgery published till June 2017 were searched in the medical database. Comparisons were made for 24-h postoperative morphine consumption and intraoperative fentanyl-equivalent consumption. Final analysis included nine trials (PECS vs. IVA 4 trials and PECS vs. PVB 5 trials). PECS block showed a decreased intraoperative fentanyl consumption over IVA by 49.20 mcg (95% confidence interval [CI] =42.67-55.74) ( I 2 = 98.47%, P consumption with PECS block was lower than IVA by 7.66 mg (95% CI being 6.23-9.10) ( I 2 = 63.15, P < 0.001) but was higher than PVB group by 1.26 mg (95% CI being 0.91-1.62) ( I 2 = 99.53%, P < 0.001). Two cases of pneumothorax were reported with PVB, and no complication was reported in any other group. Use of PECS block and its modifications with general anesthesia for breast surgery has significant opioid-sparing effect intraoperatively and during the first 24 h after surgery. It also has higher intraoperative opioid-sparing effect when compared to PVB. During the 1 st postoperative day, PVB has slightly more morphine sparing potential that may however be associated with higher complication rates. The present PECS block techniques show marked interstudy variations and need standardization.

Axillary brachial plexus block duration with mepivacaine in patients with chronic renal failure. Case-control study.

Science.gov (United States)

Mojica, V; Nieuwveld, D; Herrera, A E; Mestres, G; López, A M; Sala-Blanch, X

2017-04-01

Regional anaesthesia is commonly preferred for arteriovenous fistula (AVF) creation. Previous studies suggest a shorter block duration in patients with chronic renal failure, maybe because of the changes in regional blood flow. The aim of our study was to evaluate the duration of the axillary block with 1.5% mepivacaine in patients with chronic renal failure scheduled for AVF compared with healthy controls. Patients scheduled for AVF creation for the first time (GIRC) were included. They were compared with patients without renal failure (GC), with similar anthropometric characteristics. Ultrasound-guided axillary blocks with 20mL of 1.5% mepivacaine were performed on all patients. We evaluated onset time, humeral artery diameter and blood flow before and after the block, as well as the block duration. Twenty-three patients (GIRC: 12 and GC: 11) were included. No differences between groups were observed in block duration (GIRC: 227±43min vs GC: 229±27min; P=.781), or in onset time (GIRC: 13±5min vs GC: 12.2±3min; P=.477). The humeral blood flow before and after block was significantly lower in the GIRC (pre-block: GIRC: 52±21ml/min GC: 100±62ml/min; P=.034 and p ost block: GIRC: 130±57ml/min and GC: 274±182ml/min; P=.010). There was no significant correlation between the duration of the block and the preblock humeral blood flow (Spearman Rho: 0.106; P=.657) or the postblock humeral blood flow (Spearman Rho: 0.267; P=.254). The duration of the axillary block with 1.5% mepivacaine in patients with chronic renal failure was similar to that of the control patients. The duration of axillary brachial plexus block seems not to be related to changes in regional blood flow. Copyright © 2016 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.

Controlling block copolymer phase behavior using ionic surfactant

Energy Technology Data Exchange (ETDEWEB)

Ray, D.; Aswal, V. K. [Solid State Physics Division, Bhabha Atomic Research Centre, Mumbai 400 085, India E-mail: debes.phys@gmail.com (India)

2016-05-23

The phase behavior of poly(ethylene oxide)-poly(propylene oxide-poly(ethylene oxide) PEO-PPO-PEO triblock copolymer [P85 (EO{sub 26}PO{sub 39}EO{sub 26})] in presence of anionic surfactant sodium dodecyl sulfate (SDS) in aqueous solution as a function of temperature has been studied using dynamic light scattering (DLS) and small-angle neutron scattering (SANS). The measurements have been carried out for fixed concentrations (1 wt%) of block copolymer and surfactants. Each of the individual components (block copolymer and surfactant) and the nanoparticle–surfactant mixed system have been examined at varying temperature. The block copolymer P85 forms spherical micelles at room temperature whereas shows sphere-to-rod like micelle transition at higher temperatures. On the other hand, SDS surfactant forms ellipsoidal micelles over a wide temperature range. Interestingly, it is found that phase behavior of mixed micellar system (P85 + SDS) as a function of temperature is drastically different from that of P85, giving the control over the temperature-dependent phase behavior of block copolymers.

Infinite-degree-corrected stochastic block model

DEFF Research Database (Denmark)

Herlau, Tue; Schmidt, Mikkel Nørgaard; Mørup, Morten

2014-01-01

In stochastic block models, which are among the most prominent statistical models for cluster analysis of complex networks, clusters are defined as groups of nodes with statistically similar link probabilities within and between groups. A recent extension by Karrer and Newman [Karrer and Newman...... corrected stochastic block model as a nonparametric Bayesian model, incorporating a parameter to control the amount of degree correction that can then be inferred from data. Additionally, our formulation yields principled ways of inferring the number of groups as well as predicting missing links...

Ultrasound-guided subcostal-posterior transversus abdominis plane block for pain control following laparoscopic sleeve gastrectomy

Directory of Open Access Journals (Sweden)

Dilek E. Arı

2017-12-01

Full Text Available Objectives: To investigate the analgesic effect of a subcostal-posterior transversus abdominis plane (TAP block combination following laparoscopic sleeve gastrectomy. Methods: This study was conducted at Fatih Sultan Mehmet Educational and Research Hospital, Istanbul, Turkey, between March 2014 and June 2015. A total of 40 patients with a body mass index of 40-60 kg/m2 scheduled for laparoscopic sleeve gastrectomy were randomly allocated into 2 groups. Patients in Group I (n=20 received a bilateral subcostal TAP block, and patients in Group II (n=20 received a bilateral subcostal and posterior TAP block. Pain intensity was assessed at rest and during coughing using the visual analog scale (VAS prior to and at various time points after TAP block (0 min, 30 min, 2 hours, 4 hours, 6 hours, 12 hours, and 24 hours. Morphine consumption over 24 hours and time to first morphine requirement were recorded. Results: There was no difference in VAS scores between groups. Morphine consumption was 6.78±5.95 mg in Group I, and 7.28±5.95 mg in Group II (p=0.795. Time to first morphine requirement was 267.22±303.84 min for Group I, and 207.80±209.81 min for Group II (p=0.154. Conclusions: Subcostal-posterior TAP block provided equivalent analgesia to subcostal TAP block alone following laparoscopic sleeve gastrectomy.

Revitalisation of the control system of Shoshtanj TPP - Block 3 and TP 1 (Croatia)

International Nuclear Information System (INIS)

Shprem, Davor

1997-01-01

Block 3 of the Shoshtanj Thermal Power Plant was put into operation in 1960. With its 75 MW rated output on the Oerlikon turbine and the generation of 150 t/h of steam per each of the two Sulzer boilers fired by coal from the nearby Velenje mines, with Blocks I and 2, it was one of the biggest thermal power plants in Slovenia and in the former Yugoslavia. Although today, after the construction of much bigger Blocks 4 and 5, its share in the generation of electric and heating energy in the Republic of Slovenia is not so big, owing to its flexibility and reliability in operation, it is still a very important thermal power plant. Its importance conditioned numerous reconstructions with a view to increasing the efficiency of the block, extending its service life and increasing its ecological acceptability. A number of changes and upgradings were done, and ATM, Zagreb, today SIEMENS d.d. had an important share therein. This article deals with the revitalization of the control and monitoring system of Block 3 and Heating Station I of the Shoshtanj Thermal Power Plant. An emphasis is put on the installation of modern TELEPERM ME - AS220 EAI automation system and OS 525 operation and monitoring system. With the installation of the new automatic control system for Block 3 and TP I the main purpose of the reconstruction was achieved - the extension of the service life of the plant with an increased efficiency of its control. With the installation of the modem microprocessor automatic control system and the operation and monitoring system, a solid basis was ensured also for further upgrading and additions at later stages of reconstruction of Block 3, which would be finished by the complete replacement of the hydraulic oil control system and the relocation of the control of Block 3 and TP I in the new joint control room for Blocks 1, 2 and 3. The first stage of these extensive works starts with the reconstruction of the automatic control system of Blocks I and 2 which will be

Superior perioperative analgesia with combined femoral-obturator-sciatic nerve block in comparison with posterior lumbar plexus and sciatic nerve block for ACL reconstructive surgery.

Science.gov (United States)

Bareka, Metaxia; Hantes, Michael; Arnaoutoglou, Eleni; Vretzakis, George

2018-02-01

The purpose of this randomized controlled study is to compare and evaluate the intraoperative and post-operative outcome of PLPS nerve block and that of femoral, obturator and sciatic (FOS) nerve block as a method of anaesthesia, in performing ACL reconstruction. Patients referred for elective arthroscopic ACL reconstruction using hamstring autograft were divided in two groups. The first group received combined femoral-obturator-sciatic nerve block (FOS Group) under dual guidance, whereas the second group received posterior lumbar plexus block under neurostimulation and sciatic nerve block (PLPS Group) under dual guidance. The two groups were comparable in terms of age, sex, BMI and athletic activity. The time needed to perform the nerve blocks was significantly shorter for the FOS group (p block under dual guidance for arthroscopic ACL reconstructive surgery is a safe and tempting anaesthetic choice. The success rate of this technique is higher in comparison with PLPS and results in less peri- and post-operative pain with less opioid consumption. This study provides support for the use of peripheral nerve blocks as an exclusive method for ACL reconstructive surgery in an ambulatory setting with almost no complications. I.

Effects of opium addiction on level of sensory block in spinal anesthesia with bupivacaine for lower abdomen and limb surgery: a case-control study.

Science.gov (United States)

Karbasy, Seyyed Hasan; Derakhshan, Pooya

2014-12-01

In clinical practice, the level of sensory block in spinal anesthesia in opium abusers is lower than that in non-abusers because of adaptive changes caused by opium use. The aim of this study was to investigate the level of sensory block resulting from the intrathecal administration of 0.5% bupivacaine in opium abuser patients undergoing lower extremity and lower abdominal surgeries. A total of 100 patients who were candidates of elective lower extremity orthopedic and lower abdominal surgeries were recruited and assigned to two groups based on their history of opium addiction (Case or control). Both groups underwent the same anesthesia procedure and pinprick test was used to assess the level of anesthesia. No statistically significant difference was observed between groups regarding age, duration of the surgery, and type of surgery. The frequency of addiction was higher in males than in females. The level of sensory block at three minutes was significantly lower in the opium abuser group (P = 0.006). The mean time to achieve T10 sensory block was 10.33 ± 5.79 minutes in the opium abusers and 6.89 ± 3.88 minutes in the controls (P = 0.001). The level of the highest sensory block was lower in the opium abuser group (P = 0.002). The findings of this study suggested that after induction of spinal anesthesia with intrathecal administration of bupivacaine, chronic opium abusers would have a lower level of sensory block in comparison with patients without a history of opium abuse.

Social Vulnerability Index (SoVI) for Delaware based on 2000 Census Block Groups

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — This data depicts the social vulnerability of Delaware census block groups to environmental hazards. Data were culled primarily from the 2000 Decennial Census.

Social Vulnerability Index (SoVI) for Alabama based on 2000 Census Block Groups

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National Oceanic and Atmospheric Administration, Department of Commerce — This data depicts the social vulnerability of Alabama census block groups to environmental hazards. Data were culled primarily from the 2000 Decennial Census.

Social Vulnerability Index (SoVI) for Washington based on 2000 Census Block Groups

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — This data depicts the social vulnerability of Washington census block groups to environmental hazards. Data were culled primarily from the 2000 Decennial Census.

Social Vulnerability Index (SoVI) for Hawaii based on 2000 Census Block Groups

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — This data depicts the social vulnerability of Hawaii census block groups to environmental hazards. Data were culled primarily from the 2000 Decennial Census.

Social Vulnerability Index (SoVI) for Mississippi based on 2000 Census Block Groups

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — This data depicts the social vulnerability of Mississippi census block groups to environmental hazards. Data were culled primarily from the 2000 Decennial Census.

Social Vulnerability Index (SoVI) for Louisiana based on 2000 Census Block Groups

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — This data depicts the social vulnerability of Louisiana census block groups to environmental hazards. Data were culled primarily from the 2000 Decennial Census.

Social Vulnerability Index (SoVI) for Wisconsin based on 2000 Census Block Groups

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — This data depicts the social vulnerability of Wisconsin census block groups to environmental hazards. Data were culled primarily from the 2000 Decennial Census.

Social Vulnerability Index (SoVI) for Georgia based on 2000 Census Block Groups

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — This data depicts the social vulnerability of Georgia census block groups to environmental hazards. Data were culled primarily from the 2000 Decennial Census.

Social Vulnerability Index (SoVI) for Michigan based on 2000 Census Block Groups

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — This data depicts the social vulnerability of Michigan census block groups to environmental hazards. Data were culled primarily from the 2000 Decennial Census.

Social Vulnerability Index (SoVI) for Virginia based on 2000 Census Block Groups

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — This data depicts the social vulnerability of Virginia census block groups to environmental hazards. Data were culled primarily from the 2000 Decennial Census.

Social Vulnerability Index (SoVI) for Maryland based on 2000 Census Block Groups

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — This data depicts the social vulnerability of Maryland census block groups to environmental hazards. Data were culled primarily from the 2000 Decennial Census.

Social Vulnerability Index (SoVI) for Maine based on 2000 Census Block Groups

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — This data depicts the social vulnerability of Maine census block groups to environmental hazards. Data were culled primarily from the 2000 Decennial Census.

Social Vulnerability Index (SoVI) for Alaska based on 2000 Census Block Groups

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — This data depicts the social vulnerability of Alaska census block groups to environmental hazards. Data were culled primarily from the 2000 Decennial Census.

Social Vulnerability Index (SoVI) for Illinois based on 2000 Census Block Groups

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — This data depicts the social vulnerability of Illinois census block groups to environmental hazards. Data were culled primarily from the 2000 Decennial Census.

Social Vulnerability Index (SoVI) for Ohio based on 2000 Census Block Groups

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — This data depicts the social vulnerability of Ohio census block groups to environmental hazards. Data were culled primarily from the 2000 Decennial Census.

Social Vulnerability Index (SoVI) for Pennsylvania based on 2000 Census Block Groups

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — This data depicts the social vulnerability of Pennsylvania census block groups to environmental hazards. Data were culled primarily from the 2000 Decennial Census.

Social Vulnerability Index (SoVI) for Connecticut based on 2000 Census Block Groups

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — This data depicts the social vulnerability of Connecticut census block groups to environmental hazards. Data were culled primarily from the 2000 Decennial Census.

Social Vulnerability Index (SoVI) for Massachusetts based on 2000 Census Block Groups

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — This data depicts the social vulnerability of Massachusetts census block groups to environmental hazards. Data were culled primarily from the 2000 Decennial Census.

Social Vulnerability Index (SoVI) for Texas based on 2000 Census Block Groups

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — This data depicts the social vulnerability of Texas census block groups to environmental hazards. Data were culled primarily from the 2000 Decennial Census.

Social Vulnerability Index (SoVI) for Indiana based on 2000 Census Block Groups

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — This data depicts the social vulnerability of Indiana census block groups to environmental hazards. Data were culled primarily from the 2000 Decennial Census.

Social Vulnerability Index (SoVI) for Oregon based on 2000 Census Block Groups

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — This data depicts the social vulnerability of Oregon census block groups to environmental hazards. Data were culled primarily from the 2000 Decennial Census.

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.

Thermal-stress analysis of HTGR fuel and control rod fuel blocks in in-block carbonization and annealing furnace

International Nuclear Information System (INIS)

Gwaltney, R.C.; McAfee, W.J.

1977-01-01

A new method for performing thermal stress analyses in structures with multiple penetrations was applied to these analyses. This method couples the development of an equivalent thermal conductivity for the blocks, a technique that has been used extensively for modeling the thermal characteristics of reactor cores, with the use of the equivalent solid plate method for stress analysis. Using this equivalent thermal conductivity, which models as one material the heat transfer characteristics of the fuel, coolant, and graphite two-dimensional, steady-state thermal analyses of the fuel and control rod fuel blocks were performed to establish all temperature boundaries required for the stress analyses. In applying the equivalent solid plate method, the region of penetrations being modeled was replaced by a pseudo material having the same dimensions but whose materials properties were adjusted to account for the penetration. The peak stresses and strains were determined by applying stress and strain intensification factors to the calculated distributions. The condition studied was where the blocks were located near the center of the furnace. In this position, the axial surface of the block is heated near one end and cooled near the other. The approximate axial surface temperatures ranged from 1521 0 C at both the heated and the cooled ends to a peak of 1800 0 C near the center. Five specific cases were analyzed: plane (two-dimensional thermal, plane stress strain) analyses of each end of a standard fuel block (2 cases), plane analyses of each end of a control rod fuel block (2 cases), and a two-dimensional analysis of a fuel block treated as an axisymmetric cylind

Optically controlled three-dimensional assembly of microfabricated building blocks

DEFF Research Database (Denmark)

Rodrigo, Peter John; Kelemen, Lorand; Palima, Darwin

2009-01-01

We demonstrate a system for constructing reconfigurable microstructures using multiple, real-time configurable counterpropagating-beam traps. We optically assemble geometrically complementary microstructures with complex three-dimensional (3D) topologies produced by two-photon polymerization....... This demonstrates utilization of controllable 3D optical traps for building hierarchical structures from microfabricated building blocks. Optical microassembly with translational and tip-tilt control in 3D achieved by dynamic multiple CB traps can potentially facilitate the construction of functional microdevices...... and may also lead to the future realization of optically actuated micromachines. Fabricating morphologically complex microstructures and then optically manipulating these archetypal building blocks can also be used to construct reconfigurable microenvironments that can aid in understanding cellular...

31 CFR 595.301 - Blocked account; blocked property.

Science.gov (United States)

2010-07-01

... (Continued) OFFICE OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY TERRORISM SANCTIONS REGULATIONS General Definitions § 595.301 Blocked account; blocked property. The terms blocked account and blocked...

Effects of preoperative ultrasound-guided transversus abdominis plane block on pain after laparoscopic surgery for colorectal cancer: a double-blind randomized controlled trial.

Science.gov (United States)

Oh, Tak Kyu; Yim, Jiyeon; Kim, Jaehyun; Eom, Woosik; Lee, Soon Ae; Park, Sung Chan; Oh, Jae Hwan; Park, Ji Won; Park, Boram; Kim, Dae Hyun

2017-01-01

Although laparoscopic colorectal surgery decreases postoperative pain and facilitates a speedier recovery compared with laparotomy, postoperative pain at trocar insertion sites remains a clinical concern. The objective of this study was to assess the effects of a preoperative ultrasound-guided transversus abdominis plane (TAP) block on pain after laparoscopic surgery for colorectal cancer. In total, 58 patients scheduled to undergo laparoscopic surgery following a diagnosis of colorectal cancer were included in this study. The patients were randomized into TAP and control groups; the TAP group patients received a preoperative ultrasound-guided bilateral TAP block with 0.5 mL/kg of 0.25 % bupivacaine, while the control patients received the block with an equal amount of saline. Pain on coughing and at rest was assessed during postanesthetic recovery (PAR; 1 h after surgery) and on postoperative days (PODs) 1 (24 h), 2 (48 h), and 3 (72 h) by an investigator blinded to group allocations using the numeric rating scale (NRS). The primary outcome was pain on coughing on postoperative day (POD) 1. Fifty-five patients were included in the final analysis, including 28 in the TAP and 27 in the control groups. The pain intensity on coughing and at rest during PAR and on PODs 1, 2, and 3 showed no significant differences between groups. Furthermore, there was no significant difference in postoperative opioid consumption, sedation scores, nausea scores at the four time points, complication rates, and length of hospital stay between groups. In colorectal cancer patients undergoing laparoscopic colorectal surgery, a TAP block did not offer enough benefit for clinical efficacy in terms of postoperative pain or analgesic consumption.

Petroleum resource appraisal of lower group play, badin block, lower Indus basin, Pakistan

International Nuclear Information System (INIS)

Afzal, J.

1996-01-01

Badin Block is a concession area granted to Union Texas Pakistan (UTP). The petroleum resource appraisal of the lower Goru play of Badin Block has been carried out through the 'Discovery Process Model' of a software developed by John R. Lacey International Ltd. in association with Prass Consultants of Canada. The Early gas producing reservoir rocks of this block. These sandstones can be divided into five discrete sand bodies; however, the uppermost and the lowermost sands of the sequence are often considered the primary reservoirs. Exploration in the Lower Indus Basin started in 1939 and the first discovery of oil, in the Badin block, was made by UTP Group in May, 1981 at Khaskheli. Until December, 1992, UTP has discovered 31 oil and gas fields in Badin Block, and the recoverable reserves of these 31 oil and gas pools provide the basis for the estimation of recoverable reserves of oil and gas of the whole Badin Block. The analysis show that about 31% of the total recoverable oil reserves i.e. 35.5 mm bbl still remain to be discovered out of the additional 105 expected pools in the play. Similarly, it has been estimated that about 47% of the total recoverable gas reserves i.e. 520.5 Bcf still remain to be discovered out of the additional 124 expected pools. (author)

Comparison of ultrasound-guided posterior transversus abdominis plane block and lateral transversus abdominis plane block for postoperative pain management in patients undergoing cesarean section: a randomized double-blind clinical trial study.

Science.gov (United States)

Faiz, Seyed Hamid Reza; Alebouyeh, Mahmoud Reza; Derakhshan, Pooya; Imani, Farnad; Rahimzadeh, Poupak; Ghaderi Ashtiani, Maryam

2018-01-01

Due to the importance of pain control after abdominal surgery, several methods such as transversus abdominis plane (TAP) block are used to reduce the pain after surgery. TAP blocks can be performed using various ultrasound-guided approaches. Two important approaches to do this are ultrasound-guided lateral and posterior approaches. This study aimed to compare the two approaches of ultrasound-guided lateral and posterior TAP blocks to control pain after cesarean section. In this double-blind clinical trial study, 76 patients scheduled for elective cesarean section were selected and randomly divided into two groups of 38 and underwent spinal anesthesia. For pain management after the surgery, one group underwent lateral TAP block and the other group underwent posterior TAP block using 20cc of ropivacaine 0.2% on both sides. Pain intensity was evaluated based on Numerical Analog Scale (NAS) at rest and when coughing, 2, 4, 6, 12, 24 and 36 hours after surgery. The pain at rest in the posterior group at all hours post surgery was lower than the lateral group, especially at 6, 12 and 24 hours after the surgery and the difference was statistically significant ( p =0.03, p block compared with the lateral TAP block was more effective in pain control after cesarean section.

Transversus abdominis plane block after ambulatory total laparoscopic hysterectomy: randomized controlled trial.

Science.gov (United States)

Calle, Gustavo A; López, Claudia C; Sánchez, Enrique; De Los Ríos, José F; Vásquez, Elsa M; Serna, Eduardo; Arango, Adriana M; Castañeda, Juan D; Vásquez, Ricardo A; González, Antonio; Escobar, Alvaro; Almanza, Luis A

2014-04-01

To determine if transversus abdominis plane anesthetic blockage (TAP block) diminishes early postoperative pain scores and facilitates ambulatory management following total laparoscopic hysterectomy. Randomized triple blind trial. Gynecological endoscopy unit at a referral center for laparoscopic surgery. A total of 197 patients. Comparison of a treatment group receiving TAP block with bupivacaine 0.25% and placebo group with comparably placed bilateral injection of sterile saline solution. Pain scores at discharge 24, 48 and 72 h after surgery, opioid requirement after procedure. Patients who had TAP block had a significant reduction in their pain score at discharge compared with the placebo group (p = 0.017). There were no significant differences in the pain scores between groups at 24 h (95% CI 1.36-0.133, p = 0.237), 48 h (95% CI 0.689-0.465, p = 0.702) and 72 h (95% CI -0.631 to 0.223, p = 0.347). No differences were found between the groups regarding opioid requirements following the procedure (χ(2)  = 3.62, p = 0.46). Although TAP block after a total laparoscopic hysterectomy reduced the pain score at discharge compared with placebo, its role in this setting is debatable due to the possible lack of clinical significance of the small difference found. © 2014 Nordic Federation of Societies of Obstetrics and Gynecology.

Efficacy of Exclusive Lingual Nerve Block versus Conventional Inferior Alveolar Nerve Block in Achieving Lingual Soft-tissue Anesthesia.

Science.gov (United States)

Balasubramanian, Sasikala; Paneerselvam, Elavenil; Guruprasad, T; Pathumai, M; Abraham, Simin; Krishnakumar Raja, V B

2017-01-01

The aim of this randomized clinical trial was to assess the efficacy of exclusive lingual nerve block (LNB) in achieving selective lingual soft-tissue anesthesia in comparison with conventional inferior alveolar nerve block (IANB). A total of 200 patients indicated for the extraction of lower premolars were recruited for the study. The samples were allocated by randomization into control and study groups. Lingual soft-tissue anesthesia was achieved by IANB and exclusive LNB in the control and study group, respectively. The primary outcome variable studied was anesthesia of ipsilateral lingual mucoperiosteum, floor of mouth and tongue. The secondary variables assessed were (1) taste sensation immediately following administration of local anesthesia and (2) mouth opening and lingual nerve paresthesia on the first postoperative day. Data analysis for descriptive and inferential statistics was performed using SPSS (IBM SPSS Statistics for Windows, Version 22.0, Armonk, NY: IBM Corp. Released 2013) and a P nerve block in achieving selective anesthesia of lingual soft tissues. It is technically simple and associated with minimal complications as compared to IAN block.

Controlling light oxidation flavor in milk by blocking riboflavin excitation wavelengths by interference.

Science.gov (United States)

Webster, J B; Duncan, S E; Marcy, J E; O'Keefe, S F

2009-01-01

Milk packaged in glass bottles overwrapped with iridescent films (treatments blocked either a single visible riboflavin [Rb] excitation wavelength or all visible Rb excitation wavelengths; all treatments blocked UV Rb excitation wavelengths) was exposed to fluorescent lighting at 4 degrees C for up to 21 d and evaluated for light-oxidized flavor. Controls consisted of bottles with no overwrap (light-exposed treatment; represents the light barrier properties of the glass packaging) and bottles overwrapped with aluminum foil (light-protected treatment). A balanced incomplete block multi-sample difference test, using a ranking system and a trained panel, was used for evaluation of light oxidation flavor intensity. Volatiles were evaluated by gas chromatography and Rb degradation was evaluated by fluorescence spectroscopy. Packaging overwraps limited production of light oxidation flavor over time but not to the same degree as the complete light block. Blocking all visible and UV Rb excitation wavelengths reduced light oxidation flavor better than blocking only a single visible excitation wavelength plus all UV excitation wavelengths. Rb degraded over time in all treatments except the light-protected control treatment and only minor differences in the amount of degradation among treatments was observed. Hexanal production was significantly higher in the light-exposed control treatment compared to the light-protected control treatment from day 7; it was only sporadically significantly higher in the 570 nm and 400 nm block treatments. Pentanal, heptanal, and an unidentified volatile compound also increased in concentration over time, but there were no significant differences in concentration among the packaging overwrap treatments for these compounds.

ANALYSIS OF EXISTING AND PROSPECTIVE TECHNICAL CONTROL SYSTEMS OF NUMERIC CODES AUTOMATIC BLOCKING

Directory of Open Access Journals (Sweden)

A. M. Beznarytnyy

2013-09-01

Full Text Available Purpose. To identify the characteristic features of the engineering control measures system of automatic block of numeric code, identifying their advantages and disadvantages, to analyze the possibility of their use in the problems of diagnosing status of the devices automatic block and setting targets for the development of new diagnostic systems. Methodology. In order to achieve targets the objective theoretical and analytical method and the method of functional analysis have been used. Findings. The analysis of existing and future facilities of the remote control and diagnostics automatic block devices had shown that the existing systems of diagnosis were not sufficiently informative, designed primarily to control the discrete parameters, which in turn did not allow them to construct a decision support subsystem. In developing of new systems of technical diagnostics it was proposed to use the principle of centralized distributed processing of diagnostic data, to include a subsystem support decision-making in to the diagnostics system, it will reduce the amount of work to maintain the devices blocking and reduce recovery time after the occurrence injury. Originality. As a result, the currently existing engineering controls facilities of automatic block can not provide a full assessment of the state distillation alarms and locks. Criteria for the development of new systems of technical diagnostics with increasing amounts of diagnostic information and its automatic analysis were proposed. Practical value. These results of the analysis can be used in practice in order to select the technical control of automatic block devices, as well as the further development of diagnostic systems automatic block that allows for a gradual transition from a planned preventive maintenance service model to the actual state of the monitored devices.

Block generators for the similarity renormalization group

Energy Technology Data Exchange (ETDEWEB)

Huether, Thomas; Roth, Robert [TU Darmstadt (Germany)

2016-07-01

The Similarity Renormalization Group (SRG) is a powerful tool to improve convergence behavior of many-body calculations using NN and 3N interactions from chiral effective field theory. The SRG method decouples high and low-energy physics, through a continuous unitary transformation implemented via a flow equation approach. The flow is determined by a generator of choice. This generator governs the decoupling pattern and, thus, the improvement of convergence, but it also induces many-body interactions. Through the design of the generator we can optimize the balance between convergence and induced forces. We explore a new class of block generators that restrict the decoupling to the high-energy sector and leave the diagonalization in the low-energy sector to the many-body method. In this way one expects a suppression of induced forces. We analyze the induced many-body forces and the convergence behavior in light and medium-mass nuclei in No-Core Shell Model and In-Medium SRG calculations.

Does using a femoral nerve block for total knee replacement decrease postoperative delirium?

Directory of Open Access Journals (Sweden)

Kinjo Sakura

2012-03-01

Full Text Available Abstract Background The effect of peripheral nerve blocks on postoperative delirium in older patients has not been studied. Peripheral nerve blocks may reduce the incidence of postoperative opioid use and its side effects such as delirium via opioid-sparing effect. Methods A prospective cohort study was conducted in patients who underwent total knee replacement. Baseline cognitive function was assessed using the Telephone Interview for Cognitive Status. Postoperative delirium was measured using the Confusion Assessment Method postoperatively. Incidence of postoperative delirium was compared in two postoperative management groups: femoral nerve block ± patient-controlled analgesia and patient-controlled analgesia only. In addition, pain levels (using numeric rating scales and opioid use were compared in two groups. Results 85 patients were studied. The overall incidence of postoperative delirium either on postoperative day one or day two was 48.1%. Incidence of postoperative delirium in the femoral nerve block group was lower than patient controlled analgesia only group (25% vs. 61%, P = 0.002. However, there was no significant difference between the groups with respect to postoperative pain level or the amount of intravenous opioid use. Conclusions Femoral nerve block reduces the incidence of postoperative delirium. These results suggest that a larger randomized control trial is necessary to confirm these preliminary findings.

Blocking Reduction of Span Restoration Requests in GMPLS Controlled WDM Optical Networks

DEFF Research Database (Denmark)

Buron, Jakob Due; Ruepp, Sarah Renée; Andriolli, N.

2006-01-01

The proposed label preference scheme reduces blocking of span restoration requests in GMPLS optical networks with limited wavelength conversion. By minimizing resource contention and conversion usage, it increases recovery percentage and reduces control plane load.......The proposed label preference scheme reduces blocking of span restoration requests in GMPLS optical networks with limited wavelength conversion. By minimizing resource contention and conversion usage, it increases recovery percentage and reduces control plane load....

Two injection digital block versus single subcutaneous palmar injection block for finger lacerations.

Science.gov (United States)

Okur, O M; Şener, A; Kavakli, H Ş; Çelik, G K; Doğan, N Ö; Içme, F; Günaydin, G P

2017-12-01

We aimed to compare two digital nerve block techniques in patients due to traumatic digital lacerations. This was a randomized-controlled study designed prospectively in the emergency department of a university-based training and research hospital. Randomization was achieved by sealed envelopes. Half of the patients were randomised to traditional (two-injection) digital nerve block technique while single-injection digital nerve block technique was applied to the other half. Score of pain due to anesthetic infiltration and suturing, onset time of total anesthesia, need for an additional rescue injection were the parameters evaluated with both groups. Epinephrin added lidocaine hydrochloride preparation was used for the anesthetic application. Visual analog scale was used for the evaluation of pain scores. Outcomes were compared by using Mann-Whitney U test and Student t-test. Fifty emergency department patients ≥18 years requiring digital nerve block were enrolled in the study. Mean age of the patients was 33 (min-max: 19-86) and 39 (78 %) were male. No statistically significant difference was found between the two groups in terms of our main parameters; anesthesia pain score, suturing pain score, onset time of total anesthesia and rescue injection need. Single injection volar digital nerve block technique is a suitable alternative for digital anesthesias in emergency departments.

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.

Reduction of snapshots for MIMO radar detection by block/group orthogonal matching pursuit

KAUST Repository

Ali, Hussain El Hosiny; Ahmed, Sajid; Al-Naffouri, Tareq Y.; Alouini, Mohamed-Slim

2014-01-01

localization problem with compressive sensing. Specifically, we try to solve the problem of estimation of target location in MIMO radar by group and block sparsity algorithms. It will lead us to a reduced number of snapshots required and also we can achieve

31 CFR 594.301 - Blocked account; blocked property.

Science.gov (United States)

2010-07-01

... (Continued) OFFICE OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY GLOBAL TERRORISM SANCTIONS REGULATIONS General Definitions § 594.301 Blocked account; blocked property. The terms blocked account and...

The Influence of Sub-Block Position on Performing Integrated Sensor Orientation Using In Situ Camera Calibration and Lidar Control Points

Directory of Open Access Journals (Sweden)

Felipe A. L. Costa

2018-02-01

Full Text Available The accuracy of photogrammetric and Lidar dataset integration is dependent on the quality of a group of parameters that models accurately the conditions of the system at the moment of the survey. In this sense, this paper aims to study the effect of the sub-block position in the entire image block to estimate the interior orientation parameters (IOP in flight conditions to be used in integrated sensor orientation (ISO. For this purpose, five sub-blocks were extracted in different regions of the entire block. Then, in situ camera calibrations were performed using sub-blocks and sets of Lidar control points (LCPs, computed by a three planes’ intersection extracted from the Lidar point cloud on building roofs. The ISO experiments were performed using IOPs from in situ calibrations, the entire image block, and the exterior orientation parameters (EOP from the direct sensor orientation (DSO. Analysis of the results obtained from the ISO experiments performed show that the IOP from the sub-block positioned at the center of the entire image block can be recommended.

Social Vulnerability Index (SoVI) for Coastal States based on 2000 Census Block Groups

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — This data depicts the social vulnerability of coastal states census block groups to environmental hazards. Data were culled primarily from the 2000 Decennial Census.

Social Vulnerability Index (SoVI) for Rhode Island based on 2000 Census Block Groups

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — This data depicts the social vulnerability of Rhode Island census block groups to environmental hazards. Data were culled primarily from the 2000 Decennial Census.

Social Vulnerability Index (SoVI) for New Hampshire based on 2000 Census Block Groups

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — This data depicts the social vulnerability of New Hampshire census block groups to environmental hazards. Data were culled primarily from the 2000 Decennial Census.

Social Vulnerability Index (SoVI) for New Jersey based on 2000 Census Block Groups

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — This data depicts the social vulnerability of New Jersey census block groups to environmental hazards. Data were culled primarily from the 2000 Decennial Census.

Social Vulnerability Index (SoVI) for New York based on 2000 Census Block Groups

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — This data depicts the social vulnerability of New York census block groups to environmental hazards. Data were culled primarily from the 2000 Decennial Census.

Social Vulnerability Index (SoVI) for South Carolina based on 2000 Census Block Groups

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — This data depicts the social vulnerability of South Carolina census block groups to environmental hazards. Data were culled primarily from the 2000 Decennial Census.

Manipulating Interfaces through Surface Confinement of Poly(glycidyl methacrylate)-block-poly(vinyldimethylazlactone), a Dually Reactive Block Copolymer

International Nuclear Information System (INIS)

Lokitz, Bradley S.; Wei, Jifeng; Hinestrosa Salazar, Juan P.; Ivanov, Ilia N.; Browning, James B.; Ankner, John Francis; Kilbey, S. Michael II; Messman, Jamie M.

2012-01-01

The assembly of dually reactive, well-defined diblock copolymers incorporating the chemoselective/functional monomer, 4,4-dimethyl-2-vinylazlactone (VDMA) and the surface-reactive monomer glycidyl methacrylate (GMA) is examined to understand how competition between surface attachment and microphase segregation influences interfacial structure. Reaction of the PGMA block with surface hydroxyl groups not only anchors the copolymer to the surface, but limits chain mobility, creating brush-like structures comprising PVDMA blocks, which contain reactive azlactone groups. The block copolymers are spin coated at various solution concentrations and annealed at elevated temperature to optimize film deposition to achieve a molecularly uniform layer. The thickness and structure of the polymer thin films are investigated by ellipsometry, infrared spectroscopy, and neutron reflectometry. The results show that deposition of PGMA-b-PVDMA provides a useful route to control film thickness while preserving azlactone groups that can be further modified with biotin-poly(ethylene glycol)amine to generate designer surfaces. The method described herein offers guidance for creating highly functional surfaces, films, or coatings through the use of dually reactive block copolymers and postpolymerization modification.

Blocked Randomization with Randomly Selected Block Sizes

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Jimmy Efird

2010-12-01

Full Text Available When planning a randomized clinical trial, careful consideration must be given to how participants are selected for various arms of a study. Selection and accidental bias may occur when participants are not assigned to study groups with equal probability. A simple random allocation scheme is a process by which each participant has equal likelihood of being assigned to treatment versus referent groups. However, by chance an unequal number of individuals may be assigned to each arm of the study and thus decrease the power to detect statistically significant differences between groups. Block randomization is a commonly used technique in clinical trial design to reduce bias and achieve balance in the allocation of participants to treatment arms, especially when the sample size is small. This method increases the probability that each arm will contain an equal number of individuals by sequencing participant assignments by block. Yet still, the allocation process may be predictable, for example, when the investigator is not blind and the block size is fixed. This paper provides an overview of blocked randomization and illustrates how to avoid selection bias by using random block sizes.

Nalbuphine as an adjuvant to 0.25% levobupivacaine in ultrasound-guided supraclavicular block provided prolonged sensory block and similar motor block durations (RCT).

Science.gov (United States)

Abdelhamid, Bassant Mohamed; Omar, Heba

2018-05-28

Prolonged postoperative analgesia with early motor recovery for early rehabilitation is a challenge in regional block. The purpose of this study is to evaluate the effect of adding 20 mg nalbuphine to 25 ml of 0.25% levobupivacaine in supraclavicular brachial plexus block. One hundred thirty-five (135) patients scheduled for hand and forearm surgeries with supraclavicular block were randomly allocated into three equal groups. Group L received 25 ml of 0.5% levobupivacaine + 1 ml normal saline; group H received 25 ml of 0.25% levobupivacaine + 1 ml normal saline; and group N received 25 ml of 0.25% levobupivacaine + 1 ml (20 mg) nalbuphine. Onset time and duration of sensory and motor block, and time to first analgesic dose were recorded. Sensory block onset was comparable between the three groups. Motor block onset in group L and group N was comparable (13.16 ± 3.07 and 13.84 ± 3.05 min, respectively) and was shorter than that in group H (15.71 ± 2 0.91 min). Sensory block duration in group L and group N was comparable (522.22 ± 69.57 and 533.78 ± 66.03 min, respectively) and was longer than that in group H (342.67 ± 92.80 min). Motor block duration in group N and group H was comparable (272.00 ± 59.45 and 249.78 ± 66.01 min, respectively) and was shorter than that in group L (334.67 ± 57.90 min). Time to first analgesic dose was significantly longer in group N (649.78 ± 114.76 min) than that of group L and group H (575.56 ± 96.85 and 375.56 ± 84.49 min, respectively) and longer in group L when compared to group H. Adding 20 mg nalbuphine to 25 ml of 0.25% levobupivacaine in supraclavicular block provided prolonged duration of sensory block with similar duration of motor block.

Dexmedetomidine in a surgically inserted catheter for transversus abdominis plane block in donor hepatectomy: A prospective randomized controlled study.

Science.gov (United States)

Aboelela, Mohamed Adel; Kandeel, Al-Refaey; Elsayed, Usama; Elmorshedi, Mohamed; Elsarraf, Waleed; Elsayed, Eman; Elgawalby, Ahmed; Sultan, Ahmed Mohamed; Wahab, Mohamed Abdel; Yassen, Amr

2018-01-01

Transversus abdominis plane (TAP) block is a promising technique for analgesia after abdominal surgery. This prospective, randomized controlled trial assessed the effect of adding dexmedetomidine to bupivacaine in TAP block for donor hepatectomy. We hypothesized that this would improve postoperative morphine consumption and reduce analgesia related complication and inflammation. A total of 50 donor hepatectomy were enrolled in this study. Patients divided into two equal groups according to drugs used for TAP block. Group (B) received 20 ml of bupivacaine hydrochloride 0.25%, Group (BD) received 20 ml of bupivacaine hydrochloride 0.25% and 0.3 μg/kg dexmedetomidine, on both sides at the end of surgery and every 8 h for 48 h at right side only through inserted catheter. Primary outcome objective was morphine consumption at first 72 h. Secondary outcome objectives were morphine requirement, numbers of intake, time to first intake, pain score numerical analog scale (NAS), postoperative analgesia related complications, recovery of intestinal motility, and inflammatory markers. Data were analyzed, rescue morphine analgesia was significantly lower in (BD) group compared with (B) groups as considering total morphine consumption (B 4 ± 1.9, BD 1.5 ± 0.5, P = 0.03), numbers of morphine intake ( P = 0.04), morphine requirement ( P = 0.03), and first time of analgesia intake ( P = 0.04). NAS was significantly lower in group (BD) compared with group (B) group in the first 12 h (NAS 0 - P = 0.001, NAS 1 - P = 0.03). Adding dexmedetomidine improved gut motility, first oral intake without detectable anti-inflammatory effect. Adding dexmedetomidine to bupivacine in a surgically inserted catheter for TAP block in donor hepatectomy reduced morphine consumption without detectable anti-inflammatory effect.

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...... was used. Outcomes were changes in pain ratings, sensory mapping, and QST compared with preblock values. Lidocaine responders were a priori defined by a pain reduction of =80% after lidocaine block and =25% after placebo block, nonresponders by pain reduction of 25% after placebo block.Results:One of 12...... pain patients was a lidocaine responder, 6 patients were nonresponders, and 5 patients were placebo responders. No consistent QST changes were observed in patients after the lidocaine block. In 10 of 12 healthy controls, a cool hypoesthesia area developed in the groin after the lidocaine block...

Effect of adding dexamethasone to bupivacaine on transversus abdominis plane block for abdominal hysterectomy: A prospective randomized controlled trial

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Amany S Ammar

2012-01-01

Full Text Available Purpose: Different adjuvants have been used to improve the quality and increase the duration of local anesthetics during various nerve block techniques. The current study was aimed to evaluate the effect of adding dexamethasone to bupivacaine on the quality and duration of transversus abdominis plane (TAP block. Methods: Sixty adult patients undergoing elective open abdominal hysterectomy were randomly allocated to receive TAP block using 20 mL of bupivacaine hydrochloride 0.25% + 2 mL saline 0.9% (control group, n=30 or 20 mL of bupivacaine hydrochloride 0.25% + 2 mL dexamethasone "8 mg" (dexamethasone group, n=30. The primary outcome was postoperative pain, as evaluated by visual analog scale (VAS for pain scoring at 1, 2, 4, 12, 24 and 48 h postoperatively, whereas the secondary outcomes were time to first analgesia (TFA, morphine consumption and the occurrence of nausea, vomiting or somnolence. Results: The pain VAS score was significantly lower at the postoperative 2 h (4.9 vs. 28.1, P=0.01, 4 h (12.2 vs. 31.1, P=0.01 and 12 h (15.7 vs. 25.4, P=0.02. Furthermore, TFA was significantly longer in the dexamethasone group (459.8 vs. 325.4 min, P=0.002, with lesser morphine requirements in the postoperative 48 h (4.9 vs. 21.2 mg, P=0.003 and lower incidence of nausea and vomiting (6 vs. 14, P=0.03. No complications attributed to the block were recorded. Conclusion: Addition of dexamethasone to bupivacaine in TAP block prolonged the duration of the block and decreased the incidence of nausea and vomiting.

Treadmill sideways gait training with visual blocking for patients with brain lesions.

Science.gov (United States)

Kim, Tea-Woo; Kim, Yong-Wook

2014-09-01

[Purpose] The aim of this study was to verify the effect of sideways treadmill training with and without visual blocking on the balance and gait function of patients with brain lesions. [Subjects] Twenty-four stroke and traumatic brain injury subjects participated in this study. They were divided into two groups: an experimental group (12 subjects) and a control group (12 subjects). [Methods] Each group executed a treadmill training session for 20 minutes, three times a week, for 6 weeks. The sideways gait training on the treadmill was performed with visual blocking by the experimental group and with normal vision by the control group. A Biodex Gait Trainer 2 was used to assess the gait function. It was used to measure walking speed, walking distance, step length, and stance time on each foot. The Five-Times-Sit-To-Stand test (FTSST) and Timed Up and Go test (TUG) were used as balance measures. [Results] The sideways gait training with visual blocking group showed significantly improved walking speed, walking distance, step length, and stance time on each foot after training; FTSST and TUG times also significantly improved after training in the experimental group. Compared to the control group, the experimental group showed significant increases in stance time on each foot. [Conclusion] Sideways gait training on a treadmill with visual blocking performed by patients with brain lesions significantly improved their balance and gait function.

Transversus Abdominis Plane Block Versus Wound Infiltration for Analgesia After Cesarean Delivery: A Randomized Controlled Trial.

Science.gov (United States)

Tawfik, Mohamed Mohamed; Mohamed, Yaser Mohamed; Elbadrawi, Rania Elmohamadi; Abdelkhalek, Mostafa; Mogahed, Maiseloon Mostafa; Ezz, Hanaa Mohamed

2017-04-01

Transversus abdominis plane (TAP) block and local anesthetic wound infiltration provide analgesia after cesarean delivery. Studies comparing the 2 techniques are scarce, with conflicting results. This double-blind, randomized controlled trial aimed to compare bilateral ultrasound-guided TAP block with single-shot local anesthetic wound infiltration for analgesia after cesarean delivery performed under spinal anesthesia. We hypothesized that the TAP block would decrease postoperative cumulative fentanyl consumption at 24 hours. Eligible subjects were American Society of Anesthesiologists physical status II parturients with full-term singleton pregnancies undergoing elective cesarean delivery under spinal anesthesia. Exclusion criteria were: 40 years of age; height consumption at 24 hours. Secondary outcomes were the time to the first postoperative fentanyl dose, cumulative fentanyl consumption at 2, 4, 6, and 12 hours, pain scores at rest and on movement at 2, 4, 6, 12, and 24 hours, the deepest level of sedation, the incidence of side effects (nausea and vomiting and pruritis), and patient satisfaction. Data from 78 patients (39 patients in each group) were analyzed. The mean ± SD of cumulative fentanyl consumption at 24 hours was 157.4 ± 63.4 μg in the infiltration group and 153.3 ± 68.3 μg in the TAP group (difference in means [95% confidence interval] is 4.1 [-25.6 to 33.8] μg; P = .8). There were no significant differences between the 2 groups in the time to the first postoperative fentanyl dose, cumulative fentanyl consumption at 2, 4, 6, and 12 hours, pain scores at rest and on movement at 2, 4, 6, 12, and 24 hours, the deepest level of sedation, and patient satisfaction. The incidence of side effects (nausea and vomiting and pruritis) was low in the 2 groups. TAP block and wound infiltration did not significantly differ regarding postoperative fentanyl consumption, pain scores, and patient satisfaction in parturients undergoing cesarean delivery under

A Signal Coordination Control Based on Traversing Empty between Mid-Block Street Crossing and Intersection

Directory of Open Access Journals (Sweden)

Changjiang Zheng

2012-01-01

Full Text Available To solve the problem in pedestrian Mid-Block street crossing, the method of signal coordination control between mid-block street crossing and intersection is researched in this paper. The paper proposes to use “distance-flow rate-time” graph as the tool for building coordination control system model which is for different situations of traffic control. Through alternating the linear optimization model, the system outputs the distribution of signal timing and system operational factors (delays in vehicles and mid-block street crossing. Finally, taking one section on the Taiping North Road in Nanjing as an example, the signal coordination control is carried out. And the results which are delays in the vehicles and mid-block street crossing are compared to those in the current distribution of signal timing.

Transversus abdominis plane block as a component of multimodal analgesia for laparoscopic cholecystectomy.

Science.gov (United States)

Oksar, Menekse; Koyuncu, Onur; Turhanoglu, Selim; Temiz, Muhyittin; Oran, Mustafa Cemil

2016-11-01

To evaluate and compare intercostal-iliac transversus abdominis plane (TAP) and oblique subcostal TAP (OSTAP) blocks for multimodal analgesia in patients receiving laparoscopic cholecystectomy. A prospective, randomized, double-blinded clinical study. Operating room, postoperative recovery area, and ward. In total, 60 laparoscopic cholecystectomy patients (43 women, 17 men, American Society of Anesthesiologists grades I-II) were enrolled from the general surgery department of our tertiary care center. The patients were assigned to 1 of the 3 groups. Group 1 received TAP blocks (n=20), group 2 received OSTAP blocks (n=20), and group 3 patients were used as controls and received patient-controlled analgesia (PCA) only (n=20). After the induction of anesthesia, blocks were performed bilaterally in study groups 1 and 2, using 20mL of lidocaine (5mg/mL). PCA with intravenous tramadol was routinely provided for all patients during the first 24hours. The intraoperative use of remifentanil, postoperative visual analog scale (VAS) scores, demand for PCA, and total analgesic consumption were recorded. The patients in the control group had greater analgesic demands and analgesic consumption than did those in groups 1 and 2. However, patients in the OSTAP group had lower VAS scores than did those in groups 1 and 3. The demand for analgesia was greater in the control group than in groups 1 and 2. Moreover, lower VAS scores were recorded in the OSTAP group than in groups 1 and 3 and were positively correlated with total PCA consumption among all patients. However, postoperative VAS scores were negatively correlated with the total intraoperative consumption of remifentanil at 24hours. TAP and OSTAP blocks improved postoperative analgesia in patients receiving laparoscopic cholecystectomy, which resulted in lower VAS scores and reduction in total analgesic consumption. Copyright © 2016 Elsevier Inc. All rights reserved.

Comparison between Epidural Block vs. High Intensity Laser Therapy for Controlling Chronic Low Back Pain

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Badiozaman Radpay

2016-01-01

Full Text Available Background: Chronic low back pain is among a wide spread musculoskeletal conditions that is related to disability with high economy cost. There are several treatment modalities for controlling chronic low back pain (CLBP, among them high intensity laser therapy (HILT and epidural blocks (EB use more commonly. This study aimed to evaluate the benefits and hazards of each of these two methods.Materials and Methods: We designed a randomized controlled double blind study during 24 months.101 patients divided in 2 groups (52 in EB and 49 in HILT group. Pain intensity was assessed by using faces pain scales (FPS and LINKERT questionaries' before procedure and during one, four, 12, and 24 weeks after beginning the procedures.Results: There were no differences between two groups in FPS lumber tenderness, straight leg rising test (SLRT, paresthesia, deep tendon reflex (DTR, and imaging changes. Motor problems seem was less in HILT group comparing EB.Conclusion: This study showed both EB and HILT approaches can control the pain intensity and motor activities in CLBP patients. Future studies will clarify the precise importance of each these methods.

Thermal stress analysis of HTGR fuel and control rod fuel blocks in the HTGR in-block carbonization and annealing furnace

International Nuclear Information System (INIS)

Gwaltney, R.C.; McAfee, W.J.

1977-01-01

A new approach that utilizes the equivalent solid plate method has been applied to the thermal stress analysis of HTGR fuel and control rod fuel blocks. Cases were considered where these blocks, loaded with reprocessed HTGR fuel pellets, were being cured at temperatures up to 1800 0 C. A two-dimensional segment of a fuel block cross section including fuel, coolant holes, and graphite matrix was analyzed using the ORNL HEATING3 heat transfer code to determine the temperature-dependent effective thermal conductivity for the perforated region of the block. Using this equivalent conductivity to calculate the temperature distributions through different cross sections of the blocks, two-dimensional thermal-stress analyses were performed through application of the equivalent solid plate method. In this approach, the perforated material is replaced by solid homogeneous material of the same external dimensions but whose material properties have been modified to account for the perforations

Analgesic efficacy of ultrasound-guided paravertebral block versus serratus plane block for modified radical mastectomy: A randomised, controlled trial

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Kapil Gupta

2017-01-01

Full Text Available Background and Aims: Modified radical mastectomy (MRM may be associated with severe post-operative pain, leading to chronic pain syndrome. We compared the post-operative analgesic profile of two ultrasound-guided nerve blocks: Paravertebral block (PVB and serratus plane block (SPB. Methods: This double-blind, randomised study was conducted on fifty adult females, scheduled for MRM with axillary dissection. After inducing general anaesthesia with intravenous midazolam 1 mg, fentanyl 1.5 mcg/kg, propofol 1–2 mg/kg and vecuronium 0.1 mg/kg, patients were administered either ultrasound-guided thoracic PVB at T4 (n = 25 or SPB at 5th rib (n = 25 with 20 ml of 0.5% bupivacaine, both as a single level injection. Time to first rescue analgesia and morphine consumption in 4, 6, 24, 48 and 72 h by PCA pump, visual analogue scale score and any adverse effects were recorded. Quantitative variables were compared using the unpaired t-test or the Mann–Whitney U test between the two groups. Qualitative variables were compared using the Chi-square test or Fisher's exact test. Results: The duration of analgesia (mean ± Standard deviation [SD] was significantly longer in the PVB group compared to SPB group (346 ± 57 min vs. 245.6 ± 58 min, P< 0.001. The post-operative 24 h morphine consumption (mean ± SD was significantly higher in the SPB group (9.7 ± 2.1 mg compared to PVB group (6.5 ± 1.5 mg (P < 0.001. Conclusion: Ultrasound-guided SPB is an alternative analgesic technique to thoracic PVB for MRM although PVB provides a longer duration of analgesia.

Universal block diagram based modeling and simulation schemes for fractional-order control systems.

Science.gov (United States)

Bai, Lu; Xue, Dingyü

2017-05-08

Universal block diagram based schemes are proposed for modeling and simulating the fractional-order control systems in this paper. A fractional operator block in Simulink is designed to evaluate the fractional-order derivative and integral. Based on the block, the fractional-order control systems with zero initial conditions can be modeled conveniently. For modeling the system with nonzero initial conditions, the auxiliary signal is constructed in the compensation scheme. Since the compensation scheme is very complicated, therefore the integrator chain scheme is further proposed to simplify the modeling procedures. The accuracy and effectiveness of the schemes are assessed in the examples, the computation results testify the block diagram scheme is efficient for all Caputo fractional-order ordinary differential equations (FODEs) of any complexity, including the implicit Caputo FODEs. Copyright © 2017 ISA. Published by Elsevier Ltd. All rights reserved.

Performance of the block-Krylov energy group solvers in Jaguar

Energy Technology Data Exchange (ETDEWEB)

Watson, A. M.; Kennedy, R. A. [Knolls Atomic Power Laboratory, Bechtel Marine Propulsion Corporation, P.O. Box 1072, Schenectady, NY 12301-1072 (United States)

2012-07-01

A new method of coupling the inner and outer iterations for deterministic transport problems is proposed. This method is termed the Multigroup Energy Blocking Method (MEBM) and has been implemented in the deterministic transport solver Jaguar, which is currently under development at KAPL. The method is derived for both fixed-source and eigenvalue problems. The method is then applied to a PWR pin cell model, both in fixed-source mode and eigenvalue mode. The results show that the MEBM improves the convergence of both types of problems when applied to the thermal (up-scattering) groups. (authors)

Effect of dexmedetomidine as adjuvant in ropivacaine-induced supraclavicular brachial plexus block: A prospective, double-blinded and randomized controlled study

Directory of Open Access Journals (Sweden)

Anjan Das

2014-01-01

Full Text Available Background and Aims: Different additives have been used to prolong brachial plexus block. We evaluated the effect of adding dexmedetomidine to ropivacaine for supraclavicular brachial plexus blockade. The primary endpoints were the onset and duration of sensory and motor block and duration of analgesia. Materials and Methods: A total of 84 patients (20-50 years posted for elective forearm and hand surgery under supraclavicular brachial plexus block were divided into two equal groups (Group R and RD in a randomized, double-blind fashion. In group RD (n = 42 30 ml 0.5% ropivacaine +1 ml (100 μg of dexmedetomidine and group R (n = 42 30 ml 0.5% ropivacaine +1 ml normal saline were administered in supraclavicular block. Sensory and motor block onset times and block durations, time to first analgesic use, total analgesic need, postoperative visual analog scale (VAS, hemodynamics and side-effects were recorded for each patient. Results: Though with similar demographic profile in both groups, sensory and motor block in group RD (P < 0.05 was earlier than group R. Sensory and motor block duration and time to first analgesic use were significantly longer and the total need for rescue analgesics was lower in group RD (P < 0.05 than group R. Post-operative VAS value at 12 h were significantly lower in group RD (P < 0.05. Intra-operative hemodynamics were significantly lower in group RD (P < 0.05 without any appreciable side-effects. Conclusion: It can be concluded that adding dexmedetomidine to supraclavicular brachial plexus block increases the sensory and motor block duration and time to first analgesic use, and decreases total analgesic use with no side-effects.

Control of systems with I/O delay via reduction to a one-block problem

NARCIS (Netherlands)

Meinsma, Gjerrit; Mirkin, Leonid; Zhong, Qing-Chang

2002-01-01

In this paper, the standard (four-block) H/sup /spl infin// control problem for systems with a single delay in the feedback loop is studied. A simple procedure of the reduction of the problem to an equivalent one-block problem having particularly simple structure is proposed. The one-block problem

Comparison of liposomal bupivacaine infiltration versus interscalene nerve block for pain control in total shoulder arthroplasty: A meta-analysis of randomized control trails.

Science.gov (United States)

Cao, Xiuling; Pan, Fang

2017-09-01

This meta-analysis aimed to compare the efficiency and safety of liposomal bupivacaine infiltration and interscalene nerve block for pain control after total shoulder arthroplasty. A systematic search was performed in Medline (1966 to May 2017), PubMed (1966 to May 2017), Embase (1980 to May 2017), ScienceDirect (1985 to May 2017) and the Cochrane Library. Only randomized controlled trials (RCTs) were included. Reported surgical outcomes, including visual analogue scale (VAS) scores, opioid consumption, length of stay, and postoperative adverse effects including the risk of nausea and vomiting. Meta-analysis was performed using Stata 11.0 software. Four RCTs including 510 patients met the inclusion criteria. The present meta-analysis indicated that there were no significant differences between groups in terms of VAS score at 12 hours (standard mean difference [SMD] = 0.272, 95% CI: -0.150 to 0.695, P = .207), 24 hours (SMD = -0.056, 95% CI: -0.458 to 0.346, P = 0.785), and 48 hours (SMD = 0.183, 95% CI: -0.148 to 0.513, P = .278). Liposomal bupivacaine infiltration groups required an equivalent amount of opioids at postoperative 12 hours (SMD = -0.039, 95% CI: -0.222 to 0.143, P = .672), 24 hours (SMD = 0.046, 95% CI: -0.136 to 0.228, P = .618) and 48 hours (SMD = -0.025, 95% CI: -0.207 to 0.157, P = .785). Liposomal bupivacaine infiltration provides equivalent postoperative pain control compared with interscalene nerve block following total shoulder arthroplasty. Both of them can reduce the consumption of opioids without severe adverse effects. More high-quality RCTs with long follow-up period are necessary for proper comparisons of the efficacy and safety of liposomal bupivacaine infiltration with interscalene nerve block.

Effectiveness of paracervical block for pain relief in women undergoing hysterosalpingography

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Shikha Jain

2016-01-01

Full Text Available Objectives: To evaluate the potential benefit, in terms of pain relief, of the paracervical block with 2% lignocaine in women undergoing hysterosalpingography (HSG. Study Design: This study was a prospective randomized controlled study. Settings: This study was conducted in infertility clinic of a tertiary care center. Materials and Methods: Four hundred and six patients undergoing HSG as a part of infertility evaluation were included in the study. These women were randomized into two groups: Group I received paracervical block with 2% lignocaine at the time of HSG (n = 53 and Group II (n = 53 served as control. Hyoscine (10 mg oral tablet was given to all the patients 30 min before the procedure. Pain perception during the procedure was analyzed by the patient between 0 and 10 on a numeric rating scale, immediately after HSG. Results: The baseline demographic characteristics of participants in two groups were similar. Mean pain score immediately after HSG in the study group and control group was 4.84 ± 2.56 and 5.21 ± 1.89, respectively (P = 0.21. Conclusions : There is no benefit of paracervical block with 2% lignocaine, in terms of pain relief, in women undergoing HSG.

Frequency of inter-atrial blocks in patients with ischemic stroke

International Nuclear Information System (INIS)

Manzar, A.; Iftikhar, R.; Qadir, A.

2012-01-01

Objective: To determine the frequency and association of Interatrial block in hospitalized patients with Ischemic Stroke. Study Design: A case control study. Place and Duration of Study: Department of medicine, Military Hospital, Rawalpindi from 1 January 2009 to 30 December 2009. Methodology: It included 64 patients, 32 cases of diagnosed ischemic stroke and 32 patients were taken as controls not suffering from ischemic stroke or ischemic heart disease. ECG findings of both selected groups were evaluated for presence or absence of interatrial block. Results: Out of 32 ischemic stroke patients, 14 (43.85%) were found to have interatrial block on electrocardiogram (ECG). Whereas only 6 (18.80%) controls were found to have interatrial block on ECG. Odds ratio was 1.66. Conclusion: Interatrial block is more frequent in ischemic stroke patients and may represent a risk factor for such stroke. (author)

EnviroAtlas - Commute Time to Work by Census Block Group for the Conterminous United States

Data.gov (United States)

U.S. Environmental Protection Agency — This EnviroAtlas dataset portrays the commute time of workers to their workplace for each Census Block Group (CBG) during 2008-2012. Data were compiled from the...

Group art therapy as an adjunctive treatment for people with schizophrenia: a randomised controlled trial (MATISSE).

OpenAIRE

Crawford, MJ; Killaspy, H; Barnes, TR; Barrett, B; Byford, S; Clayton, K; Dinsmore, J; Floyd, S; Hoadley, A; Johnson, T; Kalaitzaki, E; King, M; Leurent, B; Maratos, A; O'Neill, FA

2012-01-01

OBJECTIVE To examine the clinical effectiveness and cost-effectiveness of referral to group art therapy plus standard care, compared with referral to an activity group plus standard care and standard care alone, among people with schizophrenia. DESIGN A three-arm, parallel group, single-blind, pragmatic, randomised controlled trial. Participants were randomised via an independent and remote telephone randomisation service using permuted blocks, stratified by study centre. SETTING Study partic...

Ultrasound-guided rectus sheath and transversus abdominis plane blocks for perioperative analgesia in upper abdominal surgery: A randomized controlled study

Directory of Open Access Journals (Sweden)

Khaled Abdelsalam

2016-01-01

Full Text Available Background: Regional anesthetic techniques can be used to alleviate postoperative pain in patients undergoing major upper abdominal surgery. Our aim was to evaluate the efficacy of bilateral ultrasound (US-guided rectus sheath (RS and transversus abdominis plane (TAP blocks for better perioperative analgesia. Patients and Methods: It is a prospective, observer-blinded, randomized clinical study. 40 eligible patients undergoing elective liver resection or Whipple procedure were included. All patients received a standardized anesthetic technique. Group 1 (n = 20 received preincisional US-guided bilateral RS and TAP blocks using 20 ml volume of bupivacaine 0.25% for each, and group 2 (n = 20 received local wound infiltration at end of surgery with 40 ml of bupivacaine 0.25%. A standardized postoperative analgesic regimen composed of intravenous paracetamol and a morphine patient-controlled analgesia (PCA. The use of intraoperative fentanyl and recovery room morphine boluses, PCA-administered morphine, pain scores as well as number of patients′ experienced postoperative nausea and vomiting in the ward at 6 and 24 h were recorded. Results: Group 1 patients received a significantly lower cumulative intraoperative fentanyl, significantly lesser boluses of morphine in postanesthesia care unit, as well, significantly lower cumulative 24 h postoperative morphine dosage than the group 2 patients. Pain visual analog scale scores were significantly lower at both 6 and 24 h postoperatively in TAP group when compared with the no-TAP group. There were no complications related to the TAP block procedures. No signs or symptoms of local anesthetic systemic toxicity were detected. Conclusion: The combination of bilateral US-guided RS and TAP blocks provides excellent perioperative analgesia for major upper abdominal surgery.

Pore pressure control on faulting behavior in a block-gouge system

Science.gov (United States)

Yang, Z.; Juanes, R.

2016-12-01

Pore fluid pressure in a fault zone can be altered by natural processes (e.g., mineral dehydration and thermal pressurization) and industrial operations involving subsurface fluid injection/extraction for the development of energy and water resources. However, the effect of pore pressure change on the stability and slip motion of a preexisting geologic fault remain poorly understood; yet they are critical for the assessment of seismic risk. In this work, we develop a micromechanical model to investigate the effect of pore pressure on faulting behavior. The model couples pore network fluid flow and mechanics of the solid grains. We conceptualize the fault zone as a gouge layer sandwiched between two blocks; the block material is represented by a group of contact-bonded grains and the gouge is composed of unbonded grains. A pore network is extracted from the particulate pack of the block-gouge system with pore body volumes and pore throat conductivities calculated rigorously based on the geometry of the local pore space. Pore fluid exerts pressure force onto the grains, the motion of which is solved using the discrete element method (DEM). The model updates the pore network regularly in response to deformation of the solid matrix. We study the fault stability in the presence of a pressure inhomogeneity (gradient) across the gouge layer, and compare it with the case of homogeneous pore pressure. We consider both normal and thrust faulting scenarios with a focus on the onset of shear failure along the block-gouge interfaces. Numerical simulations show that the slip behavior is characterized by intermittent dynamics, which is evident in the number of slipping contacts at the block-gouge interfaces and the total kinetic energy of the gouge particles. Numerical results also show that, for the case of pressure inhomogeneity, the onset of slip occurs earlier for the side with higher pressure, and that this onset appears to be controlled by the maximum pressure of both sides

Paravertebral Block Plus Thoracic Wall Block versus Paravertebral Block Alone for Analgesia of Modified Radical Mastectomy: A Retrospective Cohort Study.

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Nai-Liang Li

Full Text Available Paravertebral block placement was the main anesthetic technique for modified radical mastectomy in our hospital until February 2014, when its combination with blocks targeting the pectoral musculature was initiated. We compared the analgesic effects of paravertebral blocks with or without blocks targeting the pectoral musculature for modified radical mastectomy.We retrospectively collected data from a single surgeon and anesthesiologist from June 1, 2012, to May 31, 2015. Intraoperative sedatives and analgesic requirements, time to the first analgesic request, postoperative analgesic doses, patient satisfaction, and complications were compared.Fifty-four patients received a paravertebral block alone (PECS 0, and 46 received a paravertebral block combined with blocks targeting the pectoral musculature (PECS 1. The highest intraoperative effect-site concentration of propofol was significantly lower in the PECS 1 group than in the PECS 0 group [2.3 (1.5, 2.8 vs 2.5 (1.5, 4 μg/mL, p = 0.0014]. The intraoperative rescue analgesic dose was significantly lower in the PECS 1 group [0 (0, 25 vs 0 (0, 75 mg of ketamine, p = 0.0384]. Furthermore, the PECS 1 group had a significantly longer time to the first analgesic request [636.5 (15, 720 vs 182.5 (14, 720 min, p = 0.0001]. After further adjustment for age, body mass index, American Society of Anesthesiologists Physical Status classification, chronic pain history, incidence of a superficial cervical plexus block placement, and operation duration, blocks targeting the pectoral musculature were determined to be the only significant factor (hazard ratio, 0.36; 95% confidence interval, 0.23-0.58; p < 0.0001. Very few patients used potent analgesics including morphine and ketorolac; the cumulative use of morphine or ketorolac was similar in the study groups. However, the incidence of all analgesic use, namely morphine, ketorolac, acetaminophen, and celecoxib, was significantly lower in the PECS 1 group [3

Role of dexamethasone in brachial plexus block

International Nuclear Information System (INIS)

Dawood, M.

2015-01-01

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)

Bilateral sphenopalatine ganglion block reduces blood pressure in never treated patients with essential hypertension. A randomized controlled single-blinded study.

Science.gov (United States)

Triantafyllidi, Helen; Arvaniti, Chrysa; Schoinas, Antonios; Benas, Dimitris; Vlachos, Stefanos; Palaiodimos, Leonidas; Pavlidis, George; Ikonomidis, Ignatios; Batistaki, Chrysanthi; Voumvourakis, Costas; Lekakis, John

2018-01-01

Sympathetic fibers connect sphenopalatine ganglion (SPG) with the central nervous system. We aimed to study the effect of SPG block in blood pressure (BP) in never treated patients with stage I-II essential hypertension. We performed bilateral SPG block with lidocaine 2% in 33 hypertensive patients (mean age 48±12years, 24 men) and a sham operation with water for injection in 11 patients who served as the control group (mean age 51±12years, 8 men). All patients have been subjected to 24h ambulatory blood pressure monitoring prior and a month after the SBG block in order to estimate any differences in blood pressure parameters. We defined as responders to SBG block those patients with a 24h SBP decrease ≥5mmHg. We found that 24h and daytime DBP (p=0.02) as well as daytime DBP load (p=0.03) were decreased in the study group a month after SPG block. In addition, a significant response was noted in 12/33 responders (36%) regarding: a. SBP and DBP during overall 24h and daytime (pblock is a promising, minimally invasive option of BP decrease in hypertensives, probably through SNS modulation. Additionally, due to its anesthetic effect, SPG block might act as a method of selection for those hypertensive patients with an activated SNS before any other invasive antihypertensive procedure. Copyright © 2017 Elsevier B.V. All rights reserved.

Are cellular phone blocking applications effective for novice teen drivers?

Science.gov (United States)

Creaser, Janet I; Edwards, Christopher J; Morris, Nichole L; Donath, Max

2015-09-01

Distracted driving is a significant concern for novice teen drivers. Although cellular phone bans are applied in many jurisdictions to restrict cellular phone use, teen drivers often report making calls and texts while driving. The Minnesota Teen Driver Study incorporated cellular phone blocking functions via a software application for 182 novice teen drivers in two treatment conditions. The first condition included 92 teens who ran a driver support application on a smartphone that also blocked phone usage. The second condition included 90 teens who ran the same application with phone blocking but which also reported back to parents about monitored risky behaviors (e.g., speeding). A third control group consisting of 92 novice teen drivers had the application and phone-based software installed on the phones to record cellular phone (but not block it) use while driving. The two treatment groups made significantly fewer calls and texts per mile driven compared to the control group. The control group data also demonstrated a higher propensity to text while driving rather than making calls. Software that blocks cellular phone use (except 911) while driving can be effective at mitigating calling and texting for novice teen drivers. However, subjective data indicates that some teens were motivated to find ways around the software, as well as to use another teen's phone while driving when they were unable to use theirs. Cellular phone bans for calling and texting are the first step to changing behaviors associated with texting and driving, particularly among novice teen drivers. Blocking software has the additional potential to reduce impulsive calling and texting while driving among novice teen drivers who might logically know the risks, but for whom it is difficult to ignore calling or texting while driving. Copyright © 2015 Elsevier Ltd and National Safety Council. All rights reserved.

Kinetic control of block copolymer self-assembly into multicompartment and novel geometry nanoparticles

Science.gov (United States)

Chen, Yingchao; Wang, Xiaojun; Zhang, Ke; Wooley, Karen; Mays, Jimmy; Percec, Virgil; Pochan, Darrin

2012-02-01

Micelles with the segregation of hydrophobic blocks trapped in the same nanoparticle core have been produced through co-self-assembly of two block copolymers in THF/water dilute solution. The dissolution of two block copolymer sharing the same polyacrylic acid PAA blocks in THF undergoes consequent aggregation and phase separation through either slow water titration or quick water addition that triggers the micellar formation. The combination and comparison of the two water addition kinetic pathways are the keys of forming multicompartment structures at high water content. Importantly, the addition of organic diamine provides for acid-base complexation with the PAA side chains which, in turn, plays the key role of trapping unlike hydrophobic blocks from different block copolymers into one nanoparticle core. The kinetic control of solution assembly can be applied to other molecular systems such as dendrimers as well as other block copolymer molecules. Transmission electron microscopy, cryogenic transmission electron microscopy, light scattering have been applied to characterize the micelle structures.

Transversus Abdominis Plane Versus Ilioinguinal and Iliohypogastric Nerve Blocks for Analgesia Following Open Inguinal Herniorrhaphy

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Anatoli Stav

2016-07-01

Full Text Available Objectives We hypothesized that preoperative (pre-op ultrasound (US-guided posterior transversus abdominis plane block (TAP and US-guided ilioinguinal and iliohypogastric nerve block (ILI+IHG will produce a comparable analgesia after Lichtenstein patch tension-free method of open inguinal hernia repair in adult men. The genital branch of the genitofemoral nerve will be blocked separately. Methods This is a prospective, randomized, controlled, and observer-blinded clinical study. A total of 166 adult men were randomly assigned to one of three groups: a pre-op TAP group, a pre-op ILI+IHG group, and a control group. An intraoperative block of the genital branch of the genitofemoral nerve was performed in all patients in all three groups, followed by postoperative patient-controlled intravenous analgesia with morphine. The pain intensity and morphine consumption immediately after surgery and during the 24 hours after surgery were compared between the groups. Results A total of 149 patients completed the study protocol. The intensity of pain immediately after surgery and morphine consumption were similar in the two “block” groups; however, they were significantly decreased compared with the control group. During the 24 hours after surgery, morphine consumption in the ILI+IHG group decreased compared with the TAP group, as well as in each “block” group versus the control group. Twenty-four hours after surgery, all evaluated parameters were similar. Conclusion Ultrasound-guided ILI+IHG provided better pain control than US-guided posterior TAP following the Lichtenstein patch tension-free method of open inguinal hernia repair in men during 24 hours after surgery. (ClinicalTrials.gov number: NCT01429480.

DIAGRAM SOLVE THE USE OF SIMULINK BLOCK DIAGRAM TO SOLVE MATHEMA THEMATICAL CONTROL EQU MATHEMATICAL MODELS AND CONTROL EQUATIONS

Directory of Open Access Journals (Sweden)

N.M. Ghasem

2003-12-01

Full Text Available In this paper, the simulink block diagram is used to solve a model consists of a set of ordinary differential and algebraic equations to control the temperature inside a simple stirred tank heater. The flexibility of simulink block diagram gives students a better understanding of the control systems. The simulink also allows solution of mathematical models and easy visualization of the system variables. A polyethylene fluidized bed reactor is considered as an industrial example and the effect of the Proportional, Integral and Derivative control policy is presented for comparison.

Vagal Blocking for Obesity Control

DEFF Research Database (Denmark)

Johannessen, Helene; Revesz, David; Kodama, Yosuke

2017-01-01

: VBLOC reduced body weight and food intake, which was associated with increased satiety but not with decreased hunger. Brain activities in response to VBLOC included increased gene expression of leptin and CCKb receptors, interleukin-1β, tumor necrosis factor, and transforming growth factor β1......BACKGROUND: Recently, the US FDA has approved "vagal blocking therapy or vBLoc® therapy" as a new treatment for obesity. The aim of the present study was to study the mechanism-of-action of "VBLOC" in rat models. METHODS: Rats were implanted with VBLOC, an intra-abdominal electrical device...... with leads placed around gastric vagal trunks through an abdominal incision and controlled by wireless device. Body weight, food intake, hunger/satiety, and metabolic parameters were monitored by a comprehensive laboratory animal monitoring system. Brain-gut responses were analyzed physiologically. RESULTS...

Block diagrams of the radar interface and control unit

Science.gov (United States)

Collier, J. W.

1989-01-01

The Interface and Control Unit is the heart of the radar module, which occupies one complex channel of the High-Speed Data Acquisition System of the Goldstone Solar System Radar. Block diagrams of the interface unit are presented as an aid to understanding its operation and interconnections to the rest of the radar module.

A double-blind randomized controlled trial comparing dexamethasone and clonidine as adjuvants to a ropivacaine sciatic popliteal block for foot surgery

Directory of Open Access Journals (Sweden)

Vermeylen K

2016-05-01

Full Text Available Kris Vermeylen,1 Joris De Puydt,2 Stefan Engelen,3 Eva Roofthooft,3 Filiep Soetens,1 Arne Neyrinck,4 Marc Van de Velde4 1Department of Anesthesia and Intensive Care, AZ Turnhout, Turnhout, 2Department of Anesthesia, University Hospital Antwerp, Antwerp, 3Department of Anesthesia, ZNA Hospital Network Antwerp, Antwerp, 4Department of Cardiovascular Sciences and Anesthesiology, Catholic University Hospitals, Louvain, Belgium Background and aims: A popliteal block is effective in managing postoperative pain for foot surgery, but since the duration of analgesia is limited following a single-shot popliteal fossa block technique, methods to prolong effective postoperative analgesia are mandatory. The aim of this study was to assess the effect of adjuvants to ropivacaine on the duration of sensory and motor block.Methods: In this double-blind randomized placebo-controlled study, we evaluated the analgesic effect of clonidine or dexamethasone (DXM when added to ropivacaine for hallux valgus surgery. After obtaining institutional ethics research board approval and written informed consent, a total of 72 patients were randomly allocated. Fifty-seven of these patients were statistically analyzed. All patients received an ultrasound-guided single-shot popliteal fossa block with 30 mL of ropivacaine 0.75%, supplemented with saline, clonidine 100 µg, or DXM 5 mg. The primary end point was time to first pain sensation. Secondary end points were time to complete sensory and motor block regression.Results: Compared to saline, duration to first pain sensation was prolonged by 9 hours (mean ± standard deviation: 31±9 hours (42% in the DXM group (P=0.024 and by 6 hours (28±10 hours (27% in the clonidine group (P=0.024. Compared to saline, DXM prolonged both complete sensory and motor blockade by 12 hours (25±7 hours (46% and 13 hours (36±6 hours (55%, respectively, while clonidine prolonged complete sensory and motor blockade by 7 hours (30±7 hours (27% and

Facile synthesis and characterization of novel biodegradable amphiphilic block copolymers bearing pendant hydroxyl groups

Energy Technology Data Exchange (ETDEWEB)

Hu, Gaicen; Fan, Xiaoshan; Xu, Bingcan; Zhang, Delong; Hu, Zhiguo, E-mail: zghu@htu.cn

2014-10-01

Novel amphiphilic block copolymers bearing pendant hydroxyl groups polylactide-b–poly(3,3-bis(Hydroxymethyl–triazolylmethyl) oxetane)-b–polylactide (PLA-b–PHMTYO-b–PLA) were synthesized via a facile and efficient method. First, the block copolymer intermediates polylactide-b–poly(3,3-Diazidomethyloxetane)-b–polylactide (PLA-b–PBAMO-b–PLA) were synthesized through ring-opening polymerization of lactide using PBAMO as a macroinitiator. Following “Click” reaction of PLA-b–PBAMO-b–PLA with propargyl alcohol provided the targeted amphiphilic block copolymers PLA-b–PHMTYO-b–PLA with pendant hydroxyl groups. The composition and structure of prepared copolymers were characterized by {sup 1}H nuclear magnetic resonance ({sup 1}H NMR) spectroscopy, Fourier transform infrared (FT-IR) and gel permeation chromatography (GPC). The self-assembly behavior of the copolymers in water was investigated by transmission electron microscope (TEM), dynamic light scattering (DLS) and static light scattering (SLS). The results showed that the novel copolymers PLA-b–PHMTYO-b–PLA self-assembled into spherical micelles with diameters ranging from 100 nm to 200 nm in aqueous solution. These copolymers also exhibited low critical micellar concentrations (CMC: 6.9 × 10{sup −4} mg/mL and 3.9 × 10{sup −5} mg/mL, respectively). In addition, the in vitro cytotoxicity of these copolymers was determined in the presence of L929 cells. The results showed that the block copolymers PLA-b–PHMTYO-b–PLA exhibited better biocompatibility. Therefore, these well-defined copolymers are expected to find some applications in drug delivery or tissue engineering. - Highlights: • The method to synthesize PLA-b–PHMTYO-b–PLA is relatively facile and efficient. • PLA-b–PHMTYO-b–PLA self-assembles into spherical micelles with low CMC in water. • PLA-b–PHMTYO-b–PLA exhibits better biocompatibility and biodegradability.

Facile synthesis and characterization of novel biodegradable amphiphilic block copolymers bearing pendant hydroxyl groups

International Nuclear Information System (INIS)

Hu, Gaicen; Fan, Xiaoshan; Xu, Bingcan; Zhang, Delong; Hu, Zhiguo

2014-01-01

Novel amphiphilic block copolymers bearing pendant hydroxyl groups polylactide-b–poly(3,3-bis(Hydroxymethyl–triazolylmethyl) oxetane)-b–polylactide (PLA-b–PHMTYO-b–PLA) were synthesized via a facile and efficient method. First, the block copolymer intermediates polylactide-b–poly(3,3-Diazidomethyloxetane)-b–polylactide (PLA-b–PBAMO-b–PLA) were synthesized through ring-opening polymerization of lactide using PBAMO as a macroinitiator. Following “Click” reaction of PLA-b–PBAMO-b–PLA with propargyl alcohol provided the targeted amphiphilic block copolymers PLA-b–PHMTYO-b–PLA with pendant hydroxyl groups. The composition and structure of prepared copolymers were characterized by 1 H nuclear magnetic resonance ( 1 H NMR) spectroscopy, Fourier transform infrared (FT-IR) and gel permeation chromatography (GPC). The self-assembly behavior of the copolymers in water was investigated by transmission electron microscope (TEM), dynamic light scattering (DLS) and static light scattering (SLS). The results showed that the novel copolymers PLA-b–PHMTYO-b–PLA self-assembled into spherical micelles with diameters ranging from 100 nm to 200 nm in aqueous solution. These copolymers also exhibited low critical micellar concentrations (CMC: 6.9 × 10 −4 mg/mL and 3.9 × 10 −5 mg/mL, respectively). In addition, the in vitro cytotoxicity of these copolymers was determined in the presence of L929 cells. The results showed that the block copolymers PLA-b–PHMTYO-b–PLA exhibited better biocompatibility. Therefore, these well-defined copolymers are expected to find some applications in drug delivery or tissue engineering. - Highlights: • The method to synthesize PLA-b–PHMTYO-b–PLA is relatively facile and efficient. • PLA-b–PHMTYO-b–PLA self-assembles into spherical micelles with low CMC in water. • PLA-b–PHMTYO-b–PLA exhibits better biocompatibility and biodegradability

Postoperative analgesic efficiency of transversus abdominis plane block after ventral hernia repair: a prospective, randomized, controlled clinical trial.

Science.gov (United States)

Chesov, Ion; Belîi, Adrian

2017-10-01

Effective postoperative analgesia is a key element in reducing postoperative morbidity, accelerating recovery and avoiding chronic postoperative pain. The aim of this study was to evaluate the effectiveness of ultrasound-guided Transversus Abdominis Plane (TAP) block, performed before surgical incision, in providing postoperative analgesia for patients undergoing open ventral hernia repair under general anaesthesia. Seventy elective patients scheduled for open ventral hernia repair surgery under general anaesthesia were divided randomly into two equal groups: Group I received bilateral TAP block performed before surgical incision (n = 35); Group II received systemic postoperative analgesia with parenteral opioid (morphine) alone (n = 35). Postoperatively pain scores at rest and with movement, total morphine consumption and opioid related side effects were recorded. Postoperative pain scores at rest and mobilization/cough were significantly higher in patients without TAP block (p consumption was comparable between the two groups: 0.75 ± 0.31 mg in group I (TAP) and 0.86 ± 0.29 mg in group II (MO), p = 0.1299. Patients undergoing preincisional TAP block had reduced morphine requirements during the first 24 hours after surgery, compared to patients from group II, without TAP block (p = 0.0001). There was no difference in the incidence of opioid related side effects (nausea, vomiting) in the both groups during the first 24 postoperative hours. The use of preincisional ultrasound guided TAP block reduced the pain scores at rest and with movement/cough, opioid consumption and opioid-related side effects after ventral hernia repair when compared with opioid-only analgesia.

Comparison of Continuous Femoral Nerve Block with and Without Combined Sciatic Nerve Block after Total Hip Arthroplasty: A Prospective Randomized Study.

Science.gov (United States)

Nishio, Shoji; Fukunishi, Shigeo; Fukui, Tomokazu; Fujihara, Yuki; Okahisa, Shohei; Takeda, Yu; Yoshiya, Shinichi

2017-06-23

In association with the growing interests in pain management, several modalities to control postoperative pain have been proposed and examined for the efficacy in the recent studies. Various modes of peripheral nerve block have been proposed and the effectiveness and safety have been examined for each of those techniques. We have described our clinical experiences, showing that continuous femoral nerve block could provide a satisfactory analgesic effect after total hip arthroplasty (THA) procedure. In this study, we compared the effectiveness and safety of continuous femoral nerve block with and without sciatic nerve blockade on pain control after THA. Forty patients scheduled for THA were included in the study and randomly divided into 2 groups. Postoperative analgesic measure was continuous femoral nerve block alone, while the identical regimen of continuous femoral nerve block was combined with sciatic nerve block. The amount of postoperative pain was evaluated in the immediate postoperative period, 6 hours, and 12 hours after surgery. Moreover, postoperative complications as well as requirement of supplemental analgesics during the initial 12 hours after surgery were reviewed in the patient record. The obtained study results showed that the supplemental sciatic nerve blockade provided no significant effect on arrival at the postoperative recovery room, while the NRS pain score was significantly reduced by the combined application of sciatic nerve blockade at 6 and 12 hours after surgery. In the investigation of postoperative analgesiarelated complications, no major complication was encountered without significant difference in complication rate between the groups.

Oncoplastic round block technique has comparable operative parameters as standard wide local excision: a matched case-control study.

Science.gov (United States)

Lim, Geok-Hoon; Allen, John Carson; Ng, Ruey Pyng

2017-08-01

Although oncoplastic breast surgery is used to resect larger tumors with lower re-excision rates compared to standard wide local excision (sWLE), criticisms of oncoplastic surgery include a longer-albeit, well concealed-scar, longer operating time and hospital stay, and increased risk of complications. Round block technique has been reported to be very suitable for patients with relatively smaller breasts and minimal ptosis. We aim to determine if round block technique will result in operative parameters comparable with sWLE. Breast cancer patients who underwent a round block procedure from 1st May 2014 to 31st January 2016 were included in the study. These patients were then matched for the type of axillary procedure, on a one to one basis, with breast cancer patients who had undergone sWLE from 1st August 2011 to 31st January 2016. The operative parameters between the 2 groups were compared. 22 patients were included in the study. Patient demographics and histologic parameters were similar in the 2 groups. No complications were reported in either group. The mean operating time was 122 and 114 minutes in the round block and sWLE groups, respectively (P=0.64). Length of stay was similar in the 2 groups (P=0.11). Round block patients had better cosmesis and lower re-excision rates. A higher rate of recurrence was observed in the sWLE group. The round block technique has comparable operative parameters to sWLE with no evidence of increased complications. Lower re-excision rate and better cosmesis were observed in the round block patients suggesting that the round block technique is not only comparable in general, but may have advantages to sWLE in selected cases.

Thoracic paravertebral block versus intravenous patient-controlled analgesia for pain treatment in patients with multiple rib fractures.

Science.gov (United States)

Yeying, Ge; Liyong, Yuan; Yuebo, Chen; Yu, Zhang; Guangao, Ye; Weihu, Ma; Liujun, Zhao

2017-12-01

Objectives To assess the effect of thoracic paravertebral block (PVB) on pain management and preservation of pulmonary function compared with intravenous, patient-controlled analgesia (IVPCA) in patients with multiple rib fractures (MRFs). Methods Ninety patients with unilateral MRFs were included in this prospective study and randomly assigned to the TPVB or IVPCA group. The visual analogue scale (VAS) pain score, blood gas analysis, and bedside spirometry were measured and recorded at different time points after analgesia. Results TPVB and IVPCA provided good pain relief. VAS scores were significantly lower in the TPVB group than in the IVPCA group at rest and during coughing ( P pain relief and preservation of pulmonary function in patients with MRFs.

Topology and Shape Control for Assemblies of Block Copolymer Blends in Solution

KAUST Repository

Moreno Chaparro, Nicolas; Nunes, Suzana Pereira; Peinemann, Klaus-Viktor; Calo, Victor M.

2015-01-01

We study binary blends of asymmetric diblock copolymers (AB/AC) in selective solvents with a mesoscale model. We investigate the morphological transitions induced by the concentration of the AC block copolymer and the difference in molecular weight between the AB and AC copolymers, when segments B and C exhibit hydrogen-bonding interactions. To the best of our knowledge, this is the first work modeling mixtures of block copolymers with large differences in molecular weight. The coassembly mechanism localizes the AC molecules at the interface of A and B domains and induces the swelling of the B-rich domains. The coil size of the large molecular weight block copolymer depends only on the concentration of the short block copolymer (AC or AB), regardless of the B–C interactions. However, the B–C interactions control the morphological transitions that occur in these blends.

Topology and Shape Control for Assemblies of Block Copolymer Blends in Solution

KAUST Repository

Moreno Chaparro, Nicolas

2015-10-27

We study binary blends of asymmetric diblock copolymers (AB/AC) in selective solvents with a mesoscale model. We investigate the morphological transitions induced by the concentration of the AC block copolymer and the difference in molecular weight between the AB and AC copolymers, when segments B and C exhibit hydrogen-bonding interactions. To the best of our knowledge, this is the first work modeling mixtures of block copolymers with large differences in molecular weight. The coassembly mechanism localizes the AC molecules at the interface of A and B domains and induces the swelling of the B-rich domains. The coil size of the large molecular weight block copolymer depends only on the concentration of the short block copolymer (AC or AB), regardless of the B–C interactions. However, the B–C interactions control the morphological transitions that occur in these blends.

EnviroAtlas - Commute Modes and Working from Home by Block Group for the Conterminous United States

Data.gov (United States)

U.S. Environmental Protection Agency — This EnviroAtlas dataset portrays the percent of workers who commute to work using various modes, and the percent who work from home within each Census Block Group...

Analgesic effect of continuous femoral nerve block combined with infiltration anesthesia after total knee replacement

Directory of Open Access Journals (Sweden)

Jian-Guo Tan

2016-06-01

Full Text Available Objective: To study the analgesic effect of continuous femoral nerve block combined with infiltration anesthesia after total knee replacement. Methods: Patients who received unilateral total knee replacement in our hospital from May 2012 to August 2015 were included for study and randomly divided into experimental group who received continuous femoral nerve block combined with infiltration anesthesia and control group who received continuous femoral nerve block, and then the contents of postoperative serum pain-promoting-related mediators, painsuppressing-related mediators and pain-related signal molecules were detected. Results: Serum CGRP, PS, Hist, 5-HT, AM and BK contents of experimental group were significantly lower than those of control group, AEA, β-EP, RvE1, LXA4 and LXB4 contents were significantly higher than those of control group, and P2X2, P2X7, P2X3, P2X4, P2Y1, P2Y2, P2Y4, P2Y6, P2Y 13, P2Y14, p38MAPK and PI3K contents were significantly lower than those of control group. Conclusions: Continuous femoral nerve block combined with infiltration anesthesia after total knee replacement can increase the generation of pain-suppressing mediators, decrease the generation of pain-promoting mediators and achieve more exact analgesic effect.

Performance in a blocked versus randomized emotional Stroop task in an aged, early traumatized group with and without posttraumatic stress symptoms.

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Wittekind, Charlotte E; Muhtz, Christoph; Moritz, Steffen; Jelinek, Lena

2017-03-01

Attentional biases (AB) for trauma-related stimuli have been examined in many studies assessing different trauma samples. In emotional Stroop tasks (EST), blocked and single-trial formats are used almost interchangeably in clinical research. There is reason to believe that different designs yield different results and assess different processes, which, however, has been hardly examined in studies. Furthermore, there is a dearth of information about AB in older trauma survivors with posttraumatic stress symptoms. Older adults with (n = 20) and without PTSD symptoms (n = 26) as well as non-traumatized controls (n = 21) completed an EST, in which words were presented both blocked and randomized. Analyses revealed that individuals with PTSD symptoms showed AB for trauma- and depression-related words; however, mode of administration did not significantly influence reaction times. The emotional Stroop task cannot disentangle the underlying cognitive mechanism (i.e., facilitation, interference, avoidance). PTSD symptoms in older trauma survivors are associated with AB. Overall, participants with PTSD symptoms did not show greater impairment of cognitive control in comparison to both control groups. Results also illustrate that methodological differences between task versions need to be considered more thoroughly. Copyright © 2016 Elsevier Ltd. All rights reserved.

The Presence of Thyroid-Stimulation Blocking Antibody Prevents High Bone Turnover in Untreated Premenopausal Patients with Graves' Disease.

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Cho, Sun Wook; Bae, Jae Hyun; Noh, Gyeong Woon; Kim, Ye An; Moon, Min Kyong; Park, Kyoung Un; Song, Junghan; Yi, Ka Hee; Park, Do Joon; Chung, June-Key; Cho, Bo Youn; Park, Young Joo

2015-01-01

Osteoporosis-related fractures are one of the complications of Graves' disease. This study hypothesized that the different actions of thyroid-stimulating hormone receptor (TSHR) antibodies, both stimulating and blocking activities in Graves' disease patients might oppositely impact bone turnover. Newly diagnosed premenopausal Graves' disease patients were enrolled (n = 93) and divided into two groups: patients with TSHR antibodies with thyroid-stimulating activity (stimulating activity group, n = 83) and patients with TSHR antibodies with thyroid-stimulating activity combined with blocking activity (blocking activity group, n = 10). From the stimulating activity group, patients who had matched values for free T4 and TSH binding inhibitor immunoglobulin (TBII) to the blocking activity group were further classified as stimulating activity-matched control (n = 11). Bone turnover markers BS-ALP, Osteocalcin, and C-telopeptide were significantly lower in the blocking activity group than in the stimulating activity or stimulating activity-matched control groups. The TBII level showed positive correlations with BS-ALP and osteocalcin levels in the stimulating activity group, while it had a negative correlation with the osteocalcin level in the blocking activity group. In conclusion, the activation of TSHR antibody-activated TSH signaling contributes to high bone turnover, independent of the actions of thyroid hormone, and thyroid-stimulation blocking antibody has protective effects against bone metabolism in Graves' disease.

The Presence of Thyroid-Stimulation Blocking Antibody Prevents High Bone Turnover in Untreated Premenopausal Patients with Graves' Disease.

Directory of Open Access Journals (Sweden)

Sun Wook Cho

Full Text Available Osteoporosis-related fractures are one of the complications of Graves' disease. This study hypothesized that the different actions of thyroid-stimulating hormone receptor (TSHR antibodies, both stimulating and blocking activities in Graves' disease patients might oppositely impact bone turnover. Newly diagnosed premenopausal Graves' disease patients were enrolled (n = 93 and divided into two groups: patients with TSHR antibodies with thyroid-stimulating activity (stimulating activity group, n = 83 and patients with TSHR antibodies with thyroid-stimulating activity combined with blocking activity (blocking activity group, n = 10. From the stimulating activity group, patients who had matched values for free T4 and TSH binding inhibitor immunoglobulin (TBII to the blocking activity group were further classified as stimulating activity-matched control (n = 11. Bone turnover markers BS-ALP, Osteocalcin, and C-telopeptide were significantly lower in the blocking activity group than in the stimulating activity or stimulating activity-matched control groups. The TBII level showed positive correlations with BS-ALP and osteocalcin levels in the stimulating activity group, while it had a negative correlation with the osteocalcin level in the blocking activity group. In conclusion, the activation of TSHR antibody-activated TSH signaling contributes to high bone turnover, independent of the actions of thyroid hormone, and thyroid-stimulation blocking antibody has protective effects against bone metabolism in Graves' disease.

Polydimethylsiloxane-polymethacrylate block copolymers tethering quaternary ammonium salt groups for antimicrobial coating

Energy Technology Data Exchange (ETDEWEB)

Qin, Xiaoshuai; Li, Yancai; Zhou, Fang; Ren, Lixia; Zhao, Yunhui, E-mail: zhaoyunhui@tju.edu.cn; Yuan, Xiaoyan

2015-02-15

Highlights: • A series of PDMS-b-QPDMAEMA block copolymers were synthesized via RAFT polymerization. • The composition and morphology of the copolymer films strongly depended on the content of QPDMAEMA. • Migration of QPDMAEMA blocks toward surface was promoted when contacting with water. • Heterogeneous film surfaces with higher N{sup +} content exhibited more obvious antimicrobial activity. - Abstract: Block copolymers PDMS-b-PDMAEMA were synthesized via reversible addition-fragmentation chain transfer (RAFT) polymerization involving N,N-dimethylaminoethyl methacrylate (DMAEMA) by using poly(dimethylsiloxane) (PDMS) macro-chain transfer agent. And, the tertiary amino groups in PDMAEMA were quaternized with n-octyliodide to provide quaternary ammonium salts (QPDMAEMA). The well-defined copolymers generated composition variation and morphology evolvement on film surfaces, which were characterized by X-ray photoelectron spectroscopy, atomic force microscopy, and contact angle measurements. The results indicated that the enrichment of QPDMAEMA brought about lower elemental ratios of Si/N on the film surfaces. The surface morphologies evolved with the variations of QPDMAEMA content, and the variation trend of film roughness was exactly opposite to that of water contact angle hysteresis. With regard to structure-antimicrobial relationships, the copolymer films had more evident antimicrobial activity against Gram-positive, Bacillus subtilis, and the surfaces with heterogeneous morphology and higher N{sup +} content presented better antimicrobial activity. The functionalized copolymers based PDMS and quaternary ammonium salts materials have the potential applications as antimicrobial coatings.

Block backstepping design of nonlinear state feedback control law for underactuated mechanical systems

CERN Document Server

Rudra, Shubhobrata; Maitra, Madhubanti

2017-01-01

This book presents a novel, generalized approach to the design of nonlinear state feedback control laws for a large class of underactuated mechanical systems based on application of the block backstepping method. The control law proposed here is robust against the effects of model uncertainty in dynamic and steady-state performance and addresses the issue of asymptotic stabilization for the class of underactuated mechanical systems. An underactuated system is defined as one for which the dimension of space spanned by the configuration vector is greater than that of the space spanned by the control variables. Control problems concerning underactuated systems currently represent an active field of research due to their broad range of applications in robotics, aerospace, and marine contexts. The book derives a generalized theory of block backstepping control design for underactuated mechanical systems, and examines several case studies that cover interesting examples of underactuated mechanical systems. The math...

Analgesic effect of continuous femoral nerve block combined with infiltration anesthesia after total knee replacement

OpenAIRE

Jian-Guo Tan

2016-01-01

Objective: To study the analgesic effect of continuous femoral nerve block combined with infiltration anesthesia after total knee replacement. Methods: Patients who received unilateral total knee replacement in our hospital from May 2012 to August 2015 were included for study and randomly divided into experimental group who received continuous femoral nerve block combined with infiltration anesthesia and control group who received continuous femoral nerve block, and then the co...

Experiential Virtual Scenarios With Real-Time Monitoring (Interreality) for the Management of Psychological Stress: A Block Randomized Controlled Trial

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Pallavicini, Federica; Morganti, Luca; Serino, Silvia; Scaratti, Chiara; Briguglio, Marilena; Crifaci, Giulia; Vetrano, Noemi; Giulintano, Annunziata; Bernava, Giuseppe; Tartarisco, Gennaro; Pioggia, Giovanni; Raspelli, Simona; Cipresso, Pietro; Vigna, Cinzia; Grassi, Alessandra; Baruffi, Margherita; Wiederhold, Brenda; Riva, Giuseppe

2014-01-01

Background The recent convergence between technology and medicine is offering innovative methods and tools for behavioral health care. Among these, an emerging approach is the use of virtual reality (VR) within exposure-based protocols for anxiety disorders, and in particular posttraumatic stress disorder. However, no systematically tested VR protocols are available for the management of psychological stress. Objective Our goal was to evaluate the efficacy of a new technological paradigm, Interreality, for the management and prevention of psychological stress. The main feature of Interreality is a twofold link between the virtual and the real world achieved through experiential virtual scenarios (fully controlled by the therapist, used to learn coping skills and improve self-efficacy) with real-time monitoring and support (identifying critical situations and assessing clinical change) using advanced technologies (virtual worlds, wearable biosensors, and smartphones). Methods The study was designed as a block randomized controlled trial involving 121 participants recruited from two different worker populations—teachers and nurses—that are highly exposed to psychological stress. Participants were a sample of teachers recruited in Milan (Block 1: n=61) and a sample of nurses recruited in Messina, Italy (Block 2: n=60). Participants within each block were randomly assigned to the (1) Experimental Group (EG): n=40; B1=20, B2=20, which received a 5-week treatment based on the Interreality paradigm; (2) Control Group (CG): n=42; B1=22, B2=20, which received a 5-week traditional stress management training based on cognitive behavioral therapy (CBT); and (3) the Wait-List group (WL): n=39, B1=19, B2=20, which was reassessed and compared with the two other groups 5 weeks after the initial evaluation. Results Although both treatments were able to significantly reduce perceived stress better than WL, only EG participants reported a significant reduction (EG=12% vs CG=0

Experiential virtual scenarios with real-time monitoring (interreality) for the management of psychological stress: a block randomized controlled trial.

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Gaggioli, Andrea; Pallavicini, Federica; Morganti, Luca; Serino, Silvia; Scaratti, Chiara; Briguglio, Marilena; Crifaci, Giulia; Vetrano, Noemi; Giulintano, Annunziata; Bernava, Giuseppe; Tartarisco, Gennaro; Pioggia, Giovanni; Raspelli, Simona; Cipresso, Pietro; Vigna, Cinzia; Grassi, Alessandra; Baruffi, Margherita; Wiederhold, Brenda; Riva, Giuseppe

2014-07-08

The recent convergence between technology and medicine is offering innovative methods and tools for behavioral health care. Among these, an emerging approach is the use of virtual reality (VR) within exposure-based protocols for anxiety disorders, and in particular posttraumatic stress disorder. However, no systematically tested VR protocols are available for the management of psychological stress. Our goal was to evaluate the efficacy of a new technological paradigm, Interreality, for the management and prevention of psychological stress. The main feature of Interreality is a twofold link between the virtual and the real world achieved through experiential virtual scenarios (fully controlled by the therapist, used to learn coping skills and improve self-efficacy) with real-time monitoring and support (identifying critical situations and assessing clinical change) using advanced technologies (virtual worlds, wearable biosensors, and smartphones). The study was designed as a block randomized controlled trial involving 121 participants recruited from two different worker populations-teachers and nurses-that are highly exposed to psychological stress. Participants were a sample of teachers recruited in Milan (Block 1: n=61) and a sample of nurses recruited in Messina, Italy (Block 2: n=60). Participants within each block were randomly assigned to the (1) Experimental Group (EG): n=40; B1=20, B2=20, which received a 5-week treatment based on the Interreality paradigm; (2) Control Group (CG): n=42; B1=22, B2=20, which received a 5-week traditional stress management training based on cognitive behavioral therapy (CBT); and (3) the Wait-List group (WL): n=39, B1=19, B2=20, which was reassessed and compared with the two other groups 5 weeks after the initial evaluation. Although both treatments were able to significantly reduce perceived stress better than WL, only EG participants reported a significant reduction (EG=12% vs. CG=0.5%) in chronic "trait" anxiety. A similar

Survey of how different groups of veterinarians manage the use of neuromuscular blocking agents in anesthetized dogs.

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Martin-Flores, Manuel; Sakai, Daniel M; Campoy, Luis; Gleed, Robin D

2018-03-23

To analyze practice habits associated with the use, reversal and monitoring of nondepolarizing neuromuscular blocking agents (NMBAs) in dogs by different groups of veterinarians. Online anonymous survey to veterinarians. Data from 390 answered surveys. A questionnaire was sent to e-mail list servers of the American College of Veterinary Anesthesia and Analgesia (ACVAA-list), Sociedad Española de Anestesia y Analgesia Veterinaria (SEEAV-list), Colégio Brasileiro de Anestesiologia Veterinária (Brazilian College of Veterinary Anesthesiology; CBAV-list) and American College of Veterinary Ophthalmologists (ACVO-list) to elicit information regarding use of NMBAs and reversal agents, monitoring techniques, criteria for redosing, reversing and assessing adequacy of recovery of neuromuscular function. Binomial logistic regression was used to test for association between responses and group of veterinarians in selected questions. Veterinarians of the ACVO-list use NMBAs on a higher fraction of their caseload than other groups (all p < 0.0001). Subjective assessment (observation) of spontaneous movement, including spontaneous breathing, is the most common method for assessing neuromuscular function (43% of pooled responses); 18% of participants always reverse NMBAs, whereas 16% never reverse them. Restoration of neuromuscular function is assessed subjectively by 35% of respondents. Residual neuromuscular block is the most common concern regarding the use of NMBAs for all groups of veterinarians. Side effects of reversal agents (anticholinesterases) were of least concern for all groups. While most veterinarians are concerned about residual neuromuscular block, relatively few steps are implemented to reduce the risks of this complication, such as routine use of quantitative neuromuscular monitoring or routine reversal of NMBAs. These results suggest a limitation in transferring information among groups of veterinarians, or in implementing techniques suggested by scientific

Ankle Block vs Single-Shot Popliteal Fossa Block as Primary Anesthesia for Forefoot Operative Procedures: Prospective, Randomized Comparison.

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Schipper, Oliver N; Hunt, Kenneth J; Anderson, Robert B; Davis, W Hodges; Jones, Carroll P; Cohen, Bruce E

2017-11-01

Postoperative pain is often difficult to control with oral medications, requiring large doses of opioid analgesia. Regional anesthesia may be used for primary anesthesia, reducing the need for general anesthetic and postoperative pain medication requirements in the immediate postoperative period. The purpose of this study was to compare the analgesic effects of an ankle block (AB) to a single-shot popliteal fossa block (PFB) for patients undergoing orthopedic forefoot procedures. All patients having elective outpatient orthopedic forefoot procedures were invited to participate in the study. Patients were prospectively randomized to receive either an ultrasound-guided AB or PFB by a board-certified anesthesiologist prior to their procedure. Intraoperative conversion to general anesthesia and postanesthesia care unit (PACU) opioid requirements were recorded. Postoperative pain was assessed using the visual analog scale (VAS) at regular time intervals until 8 am on postoperative day (POD) 2. Patients rated the effectiveness of the block on a 1 to 5 scale, with 5 being very effective. A total of 167 patients participated in the study with 88 patients (53%) receiving an AB and 79 (47%) receiving a single-shot PFB. There was no significant difference in the rate of conversion to general anesthesia between the 2 groups (13.6% [12/88] AB vs 12.7% [10/79] PFB). PACU morphine requirements and doses were significantly reduced in the PFB group ( P = .004) when compared to the AB group. The VAS was also significantly lower for the PFB patients at 10 pm on POD 0 (4.6 vs 1.6, P block site pain and/or erythema (AB 6.9% [6/88] vs PFB 5.1% [4/79], P = .44). The analgesic effect of the PFB lasted significantly longer when compared to the ankle block (AB 14.5 hours vs PFB 20.9 hours, P block between the 2 groups, with both blocks being highly effective (AB 4.79/5 vs PFB 4.82/5, P = .68). Regional anesthesia was a safe and reliable adjunct to perioperative pain management and highly

The analgesic efficacy of ultrasound-guided transversus abdominis plane block on postoperative pain and morphine consumption in varicocelectomy.

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Ömür, Dilek; Oğuzalp, Hüseyin; Kiraz, Hasan A; Ekin, Serpil; Alan, Cabir; Ersay, Ahmet R; Hancı, Volkan

2016-06-01

To evaluate the analgesic effect of transversus abdominis plane (TAP) block administered before varicocele surgery. This study was completed at the Faculty of Medicine, Çanakkale Onsekiz Mart University, Çanakkale, Turkey, between January 2011 and April 2013. In a prospective, double blind, randomized, placebo controlled clinical study, 40 male patients scheduled for elective varicocele operations were randomized to group T (treatment group) or group C (controls). After receiving general anesthesia, group T received a TAP block using 20 mL 0.25% bupivacaine on the operation side, whereas group C received a control block using 20 mL 0.9% Sodium chloride. During the first 24 hours after surgery, the patient pain was evaluated using the visual analogue scale (VAS) at rest and while coughing. Postoperative patient controlled analgesia morphine consumption, VAS scores, and side effects were recorded. Of 34 patients, Group T (n=18) had significantly lower VAS pain scores than Group C (n=16) both at rest and while coughing. The total morphine consumed was  lower (7.7 ± 4.0) versus 21.6 ± 12.4 mg, p less than 0.001) in the 24 hours after surgery. As part of a multimodal analgesic regime after varicocelectomy surgery, morphine consumption and VAS pain scores were significantly lower among those receiving 20 mL 0.25% bupivacaine administered for a TAP block than among controls.

The Organization of Nanoporous Structure Using Controlled Micelle Size from MPEG-b-PDLLA Block Copolymers

International Nuclear Information System (INIS)

Chang, Jeong Ho; Kim, Kyung Ja; Shin, Young Kook

2004-01-01

Selected MPEG-b-PDLLA block copolymers have been synthesized by ring-opening polymerization with systematic variation of the chain lengths of the resident hydrophilic and hydrophobic blocks. The size and shape of the micelles that spontaneously form in solution are then controlled by the characteristics of the block copolymer template. All the materials prepared in this study showed the tunable pore size of 20-80 A with the increase of hydrophobic chain lengths and up to 660 m 2 /g of specific surface area. The formation mechanism of these nanoporous structures obtained by controlling the micelle size has been confirmed using both liquid and solid state 13 C and 29 Si NMR techniques. This work verifies the formation mechanism of nanoporous structures in which the pore size and wall thickness are closely dependent on the size of hydrophobic cores and hydrophilic shells of the block copolymer templates

Thermoablation of Liver Metastases: Efficacy of Temporary Celiac Plexus Block

International Nuclear Information System (INIS)

Beck, A.N.; Schaefer, M.; Werk, M.; Pech, M.; Wieners, G.; Cho, C.; Ricke, J.

2005-01-01

Purpose. To determine the efficacy of celiac plexus block during thermoablation of liver metastases. Methods. Fifty-five consecutive patients underwent thermoablation therapy of liver tumors by laser-induced thermotherapy. Twenty-nine patients received a temporary celiac plexus block, 26 patients acted as control group. In both groups fentanyl and midazolam were administered intravenously upon request of the patient. The duration of the intervention, consumption of opiates, and individual pain sensations were documented. Results. No complications resulting from the celiac plexus block were recorded. Celiac plexus block significantly reduced the amount of pain medication used during thermoablation therapy of liver tumors (with block, 2.45 μg fentanyl per kg body weight; without block, 3.58 μg fentanyl per kg body weight, p < 0.05; midazolam consumption was not reduced) in patients with metastases ≤5 mm from the liver capsule. For metastases farther away from the capsule no significant differences in opiate consumption were seen. Celiac plexus block reduced the time for thermoablation significantly (178 min versus 147 min, p < 0.05) no matter how far the metastases were from the liver capsule. Average time needed to set the block was 12 min (range 9-15 min); additional costs for the block were marginal. As expected (as pain medications were given according to individual patients' needs) pain indices did not differ significantly between the two groups. Conclusion. In patients with liver metastases ≤5 mm from the liver capsule, celiac plexus block reduces the amount of opiates necessary, simplifying patient monitoring. In addition celiac plexus block reduces intervention time, with positive effects on overall workflow for all patients

Comparison of Articaine and Lidocaine for Buccal Infiltration After Inferior Alveolar Nerve Block For Intraoperative Pain Control During Impacted Mandibular Third Molar Surgery.

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da Silva-Junior, Geraldo Prisco; de Almeida Souza, Liane Maciel; Groppo, Francisco Carlos

In order to compare the efficacy of lidocaine and articaine for pain control during third molar surgery, 160 patients presenting bilateral asymptomatic impacted mandibular third molars were selected. They received 1.8 mL of 2% lidocaine with epinephrine 1:100,000 during inferior alveolar nerve block. In group 1 (n = 80), an infiltrative injection of 0.9 mL of 2% lidocaine with epinephrine 1:100,000 was performed in buccal-distal mucosa of the third molar. Group 2 (n = 80) received 0.9 mL of 4% articaine with epinephrine 1:100,000 in the contralateral side. All procedures were performed at the same visit, by a single operator, in a double-blind and parallel design. The duration of each surgery and the moment when the patient expressed pain were noted. Data were analyzed by nonpaired t test and chi-square test (alpha = 5%). Duration of surgery did not differ (p = .83) between Groups 1 (19.8 ± 2.3 minutes) and 2 (19.7 ± 3.0 minutes). Pain was expressed more in group 1 (26.3%) than in group 2 (10%) (odds ratio = 3.2, p = .0138). In both groups, tooth sectioning was the most painful event (p inferior alveolar nerve block in controlling intraoperative pain related to impacted mandibular third molar surgery.

Dose-response studies of Ropivacaine in blood flow of upper extremity after supraclavicular block: a double-blind randomized controlled study.

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Li, Ting; Ye, Qiguang; Wu, Daozhu; Li, Jun; Yu, Jingui

2017-12-02

The sympathetic block of upper limb leading to increased blood flow has important clinical implication in microvascular surgery. However, little is known regarding the relationship between concentration of local anesthetic and blood flow of upper limb. The aim of this dose-response study was to determine the ED 50 and ED 95 of ropivacaine in blood flow after supraclavicular block (SB). Patients undergoing upper limb surgery and supraclavicular block were randomly assigned to receive 30ml ropivacaine in concentrations of 0.125%(A Group), 0.2%(B Group), 0.25%(C Group), 0.375%(D Group), 0.5%(E Group), or 0.75%(F Group) (n=13 per group). All patients received supraclavicular block (SB). Time average maximum velocity (TAMAX), cross-sectional area (CSA) of brachial artery and skin temperatures (T s ) were measured repeatedly at the same marked points, they were taken at baseline (before block, t 0 ) and at 30min after SB (t 1 ). Blood flow(BF) = TAMAX× CSA×60 sec.. Relative blood flow (ΔBF) = BF t1 / BF t0 . Success of SB was assessed simultaneously. Supplementary anesthesia and other adverse events (AE) were recorded. Significant increase in TAMAX, CSA, BF and T s were seen in all concentration groups at t 1 comparing with t 0 (Pblock were 0.18/0.33% (0.15-0.21/0.27-0.51), R 2 =0.904. The dose-response curve between SB ropivacaine and the changes of BF was determined. The ED 50 /ED 95 of ropivacaine of ΔBF are 0.35/1.94% (0.25-0.45/0.83-4.52). TAMAX, CSA and BF consistently increased with ropivacaine concentration. The maximal sympathetic block needs higher concentration than that complete sensation block needs which may benefit for microvascular surgery. Clinicaltrials.gov NCT02139982 . Retrospectively registered (Date of registration: May, 2014).

Group control of elevators

Energy Technology Data Exchange (ETDEWEB)

Umeda, Yasukazu; Hikita, Shiro; Tuji, Sintaro (Mitsubishi Electric Corp., Tokyo (Japan))

1988-09-05

Items to be evaluated in the group control of elevators, and a typical control system are described. A new system in which the fuzzy rule base is employed is introduced together with the configuration. The items to be evaluated are waiting time, riding time, accuracy of forecasting, energy saving, and ease of usage. The everage waiting time of less than 20 seconds with less than 3% waiting rate of more than 60 seconds is accepted as a satisfactory service condition. There are many conflicting matters in group-controlling, and the study for the controlling must deal with the optimization of multi-purpose problems. The standards for group-control evaluation differ according to building structures and the tastes of users, and an important problem is where to give emphasis of the evaluation. The TRAFFIC PATTERN LEARNING METHOD has been applied in the system for careful control to accommodate the traffic. No specific function is provided for the evaluation, but the call allocation is made by fuzzy rule-base. The configuration of a new group-control system is introduced. 7 references, 7 figures, 1 table.

Intravenous patient-controlled fentanyl with and without transversus abdominis plane block in cirrhotic patients post liver resection

Directory of Open Access Journals (Sweden)

Serag Eldin M

2014-05-01

Full Text Available Manar Serag Eldin,1 Fatma Mahmoud,1 Rabab El Hassan,2 Mohamed Abdel Raouf,1 Mohamed H Afifi,2 Khaled Yassen,1 Wesam Morad31Department of Anaesthesia, Liver Institute, 2Department of Anaesthesia, Faculty of Medicine, 3Department of Community Medicine and Public Health, Liver Institute, Menoufiya University, Shebin El-Kom, EgyptBackground: Coagulation changes can complicate liver resection, particularly in patients with cirrhosis. The aim of this prospective hospital-based comparative study was to compare the postoperative analgesic efficacy of intravenous fentanyl patient-controlled analgesia (IVPCA with and without transversus abdominis plane (TAP block.Methods: Fifty patients with Child’s A cirrhosis undergoing liver resection were randomly divided into two groups for postoperative analgesia, ie, an IVPCA group receiving a 10 µg/mL fentanyl bolus of 15 µg with a 10-minute lockout and a maximum hourly dose of 90 µg, and an IVPCA + TAP group that additionally received TAP block (15 mL of 0.375% bupivacaine on both sides via a posterior approach with ultrasound guidance before skin incision. Postoperatively, bolus injections of bupivacaine 0.375% were given every 8 hours through a TAP catheter inserted by the surgeon in the open space during closure of the inverted L-shaped right subcostal with midline extension (subcostal approach guided by the visual analog scale score (<3, 5 mL; 3 to <6, 10 mL; 6–10, 15–20 mL according to weight (maximum 2 mg/kg. The top-up dosage of local anesthetic could be omitted if the patient was not in pain. Coagulation was monitored using standard coagulation tests.Results: Age, weight, and sex were comparable between the groups (P<0.05. The visual analog scale score was significantly lower at 12, 18, 24, 48, and 72 hours (P<0.01 in IVPCA + TAP group. The Ramsay sedation score was lower only after 72 hours in the IVPCA + TAP group when compared with the IVPCA group (1.57±0.74 versus 2.2±0.41, respectively, P

A randomised controlled study of the post-operative analgesic efficacy of ultrasound-guided pectoral nerve block in the first 24 h after modified radical mastectomy

Directory of Open Access Journals (Sweden)

Satish Kumar

2018-01-01

Full Text Available Background and Aims: Breast cancer has become the most common cancer in women worldwide. Acute post-operative pain following mastectomy remains a challenge for the anaesthesiologist despite a range of treatment options available. The present study aimed to compare the post-operative analgesic efficacy of pectoral nerve (Pecs block performed under ultrasound with our standard practice of opioids and non-steroidal anti-inflammatory drugs for mastectomy. Methods: This randomised controlled study was conducted at a tertiary care teaching hospital in India, after obtaining ethical clearance. Fifty adult female patients posted for elective unilateral modified radical mastectomy were divided into two groups as follows: Group I (general anaesthesia only and Group II (general anaesthesia plus ultrasound-guided Pecs block, each comprising 25 patients. Post-randomisation, patients in Group I received general anaesthesia, while Group II patients received ultrasound-guided Pecs block followed by general anaesthesia after 20 min. The primary outcome was measured as patient-reported pain intensity using Visual Analogue Scale (VAS at rest. Statistical analysis was performed using Student's t-test and Mann–Whitney U-test. Data were entered into MS Excel spreadsheet and analysis was performed using the Statistical Package for the Social Sciences version 23.0. Results: VAS score was significantly lower in Group II at rest and on abduction post-operatively at all time intervals (P < 0.001. The 24-h tramadol consumption was significantly less in Group II compared to Group I (114.4 ± 4.63 mg vs. 402.88 ± 74.22, P < 0.0001. Conclusion: Pecs block provided excellent post-operative analgesia in the first 24 h.

Evaluation of Effect of Pudendal Nerve Block on Post Hemmorrhoidectomy Pain

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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.

Transversus abdominis plane block reduces morphine consumption in the early postoperative period following microsurgical abdominal tissue breast reconstruction: a double-blind, placebo-controlled, randomized trial.

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Zhong, Toni; Ojha, M; Bagher, Shaghayegh; Butler, Kate; Srinivas, Coimbatore; McCluskey, Stuart A; Clarke, Hance; O'Neill, Anne C; Novak, Christine B; Hofer, Stefan O P

2014-11-01

The analgesic efficacy of the transversus abdominis plane peripheral nerve block following abdominal tissue breast reconstruction has not been studied in a randomized controlled trial. The authors conducted a double-blind, placebo-controlled, 1:1 allocation, two-arm parallel group, superiority design, randomized controlled trial in patients undergoing microsurgical abdominally based breast reconstruction. Intraoperatively, epidural catheters were inserted under direct vision through the triangle of Petit on both sides of the abdomen into the transversus abdominis plane just before rectus fascial closure. Patients received either bupivacaine (study group) or saline (placebo group) through the catheters for 2 postoperative days. All patients received hydromorphone by means of a patient-controlled analgesic pump. The primary outcome was the difference in the parenteral opioid consumption on each postoperative day between the groups. The secondary outcome measures included the following: total in-hospital opioid; antinausea medication; pain, nausea, and sedation scores; Quality of Recovery Score; time to ambulation; and hospital stay duration. Between September of 2011 and June of 2013, 93 patients were enrolled: 49 received bupivacaine and 44 received saline. There were 11 postoperative complications (13 percent); none were related to the catheter. Primary outcomes were completed by 85 of 93 patients (91.3 percent); the mean parenteral morphine consumption was significantly reduced on postoperative day 1 in the bupivacaine group (20.7±20.1 mg) compared with 30.0±19.1 mg in the control group (p=0.02). There were no significant differences in secondary outcomes. Following abdominally based breast reconstruction, transversus abdominis plane peripheral nerve block is safe and significantly reduces morphine consumption in the early postoperative period. Therapeutic, II.

Fascia iliaca compartment block versus no block for pain control after lower limb surgery: a meta-analysis

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Yang L

2017-12-01

Full Text Available Linyi Yang, Min Li, Chen Chen, Jiang Shen, Xiaoxuan Bu Department of Anesthesiology, The Third Affiliated Hospital of Soochow University, Changzhou, China Background: The analgesic effect of fascia iliaca compartment block (FICB versus no block (NB after lower limb surgery (LLS is still controversial, so we performed this meta-analysis.Materials and methods: By searching the PubMed, Embase and the Cochrane Library (last update by July 20, 2017, randomized controlled trials comparing the analgesic effect of FICB versus NB in patients receiving LLS were identified. The primary outcome was the pain scores at 4, 12, and 24 h after LLS. The dosage of morphine at 24 h was also collected. The side effect of anesthesia was assessed according to the occurrence rate of postoperative nausea and vomiting.Results: Data from 7 clinical trials that included 508 patients were summarized. The results showed that patients receiving FICB had lower pain scores at 4 h (mean difference [MD]=−1.17; 95% CI=−2.30 to −0.05; P=0.041, 12 h (MD=−0.41; 95% CI=−0.76 to −0.05; P=0.026 and 24 h (MD=−0.96; 95% CI=−1.77 to −0.15; P=0.020 after LLS. Besides, FICB could reduce the dosage of morphine at 24 h (MD=−2.06; 95% CI=−3.82 to −0.30; P=0.022 and the incidence of postoperative nausea and vomiting (relative risk rate=0.44, 95% CI=0.24–0.80, P=0.008.Conclusion: Compared with NB, FICB is an effective and safe method for alleviating the pain after LLS. More high-quality randomized controlled trials are needed to confirm this finding. Keywords: fascia iliaca compartment block, lower limb surgery, meta-analysis, RCTs 

Which Ultrasound-Guided Sciatic Nerve Block Strategy Works Faster? Prebifurcation or Separate Tibial-Peroneal Nerve Block? A Randomized Clinical Trial.

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Faiz, Seyed Hamid Reza; Imani, Farnad; Rahimzadeh, Poupak; Alebouyeh, Mahmoud Reza; Entezary, Saeed Reza; Shafeinia, Amineh

2017-08-01

Peripheral nerve block is an accepted method in lower limb surgeries regarding its convenience and good tolerance by the patients. Quick performance and fast sensory and motor block are highly demanded in this method. The aim of the present study was to compare 2 different methods of sciatic and tibial-peroneal nerve block in lower limb surgeries in terms of block onset. In this clinical trial, 52 candidates for elective lower limb surgery were randomly divided into 2 groups: sciatic nerve block before bifurcation (SG; n = 27) and separate tibial-peroneal nerve block (TPG; n = 25) under ultrasound plus nerve stimulator guidance. The mean duration of block performance, as well as complete sensory and motor block, was recorded and compared between the groups. The mean duration of complete sensory block in the SG and TPG groups was 35.4 ± 4.1 and 24.9 ± 4.2 minutes, respectively, which was significantly lower in the TPG group (P = 0.001). The mean duration of complete motor block in the SG and TPG groups was 63.3 ± 4.4 and 48.4 ± 4.6 minutes, respectively, which was significantly lower in the TPG group (P = 0.001). No nerve injuries, paresthesia, or other possible side effects were reported in patients. According to the present study, it seems that TPG shows a faster sensory and motor block than SG.

Effect of dexamethasone in low volume supraclavicular brachial plexus block: A double-blinded randomized clinical study

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Arun Kumar Alarasan

2016-01-01

Full Text Available Background and Aims: With the use of ultrasound, a minimal effective volume of 20 ml has been described for supraclavicular brachial plexus block. However achieving a long duration of analgesia with this minimal volume remains a challenge. We aimed to determine the effect of dexamethasone on onset and duration of analgesia in low volume supraclavicular brachial plexus block. Material and Methods: Sixty patients were randomly divided into two groups of 30 each. Group C received saline (2 ml + 20 ml of 0.5% bupivacaine and Group D received dexamethasone (8 mg + 20 ml of 0.5% bupivacaine in supraclavicular brachial plexus block. Hemodynamic variables and visual analog scale (VAS score were noted at regular intervals until 450 min. The onset and duration of sensory and motor block were measured. The incidence of "Halo" around brachial plexus was observed. Student′s t-test and Chi-square test were used for statistical analysis. Results: The onset of sensory and motor block was significantly earlier in dexamethasone group (10.36 ± 1.99 and 12 ± 1.64 minutes compared to control group (12.9 ± 2.23 and 18.03 ± 2.41 minutes. The duration of sensory and motor block was significantly prolonged in dexamethasone group (366 ± 28.11 and 337.33 ± 28.75 minutes compared to control group (242.66 ± 26.38 and 213 ± 26.80 minutes. The VAS score was significantly lower in dexamethasone group after 210 min. "Halo" was present around the brachial plexus in all patients in both the groups. Conclusion: Dexamethasone addition significantly increases the duration of analgesia in patients receiving low volume supraclavicular brachial plexus block. No significant side-effects were seen in patients receiving dexamethasone as an adjunct.

Intraoperative Nerve Blocks Fail to Improve Quality of Recovery after Tissue Expander Breast Reconstruction: A Prospective, Double-Blinded, Randomized, Placebo-Controlled Clinical Trial.

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Lanier, Steven T; Lewis, Kevin C; Kendall, Mark C; Vieira, Brittany L; De Oliveira, Gildasio; Nader, Anthony; Kim, John Y S; Alghoul, Mohammed

2018-03-01

The authors' study represents the first level I evidence to assess whether intraoperative nerve blocks improve the quality of recovery from immediate tissue expander/implant breast reconstruction. A prospective, randomized, double-blinded, placebo-controlled clinical trial was conducted in which patients undergoing immediate tissue expander/implant breast reconstruction were randomized to either (1) intraoperative intercostal and pectoral nerve blocks with 0.25% bupivacaine with 1:200,000 epinephrine and 4 mg of dexamethasone or (2) sham nerve blocks with normal saline. The 40-item Quality of Recovery score, pain score, and opioid use in the postoperative period were compared statistically between groups. Power analysis ensured 80 percent power to detect a 10-point (clinically significant) difference in the 40-item Quality of Recovery score. Forty-seven patients were enrolled. Age, body mass index, laterality, mastectomy type, and lymph node dissection were similar between groups. There were no statistical differences in quality of recovery, pain burden as measured by visual analogue scale, opioid consumption, antiemetic use, or length of hospital stay between groups at 24 hours after surgery. Mean global 40-item Quality of Recovery scores were 169 (range, 155 to 182) for the treatment arm and 165 (range, 143 to 179) for the placebo arm (p = 0.36), indicating a high quality of recovery in both groups. Although intraoperative nerve blocks can be a safe adjunct to a comprehensive postsurgical recovery regimen, the authors' results indicate no effect on overall quality of recovery from tissue expander/implant breast reconstruction. Therapeutic, I.

Comparative study between ultrasound guided tap block and paravertebral block in upper abdominal surgeries. Randomized controlled trial

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Ruqaya M. Elsayed

2017-01-01

Conclusion: We concluded that ultrasound guided transversus abdominis plane block and thoracic paravertebral block were safe and effective anesthetic technique for upper abdominal surgery with longer and potent postoperative analgesia in thoracic paravertebral block than transversus abdominis block.

Transportable Payload Operations Control Center reusable software: Building blocks for quality ground data systems

Science.gov (United States)

Mahmot, Ron; Koslosky, John T.; Beach, Edward; Schwarz, Barbara

1994-01-01

The Mission Operations Division (MOD) at Goddard Space Flight Center builds Mission Operations Centers which are used by Flight Operations Teams to monitor and control satellites. Reducing system life cycle costs through software reuse has always been a priority of the MOD. The MOD's Transportable Payload Operations Control Center development team established an extensive library of 14 subsystems with over 100,000 delivered source instructions of reusable, generic software components. Nine TPOCC-based control centers to date support 11 satellites and achieved an average software reuse level of more than 75 percent. This paper shares experiences of how the TPOCC building blocks were developed and how building block developer's, mission development teams, and users are all part of the process.

Comparison of interscalene brachial plexus block and intra-articular local anesthetic administration on postoperative pain management in arthroscopic shoulder surgery

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Recep Aksu

2015-06-01

Full Text Available BACKGROUND AND OBJECTIVES: In this study, the aim was to compare postoperative analgesia effects of the administration of ultrasound-guided interscalene brachial plexus block and intra-articular bupivacaine carried out with bupivacaine. METHODS: In the first group of patients 20 mL 0.25% bupivacaine and ultrasound-guided interscalene brachial plexus block (ISPB were applied, while 20 mL 0.25% bupivacaine was given via intra-articular (IA administration to the second group patients after surgery. Patients in the third group were considered the control group and no block was performed. Patient-controlled analgesia (PCA with morphine was used in all three groups for postoperative analgesia. RESULTS: In the ISPB group, morphine consumption in the periods between 0-4, 6-12 and 12-24 postoperative hours and total consumption within 24 h was lower than in the other two groups. Morphine consumption in the IA group was lower than in the control group in the period from 0 to 6 h and the same was true for total morphine consumption in 24 h. Postoperative VASr scores in the ISPB group were lower than both of the other groups in the first 2 h and lower than the control group in the 4th and 6th hours (p < 0.05. In the IA group, VASr and VASm scores in the 2nd, 4th and 6th hours were lower than in the control group (p < 0.05. CONCLUSION: Interscalene brachial plexus block was found to be more effective than intra-articular local anesthetic injection for postoperative analgesia.

A Triple-Masked, Randomized Controlled Trial Comparing Ultrasound-Guided Brachial Plexus and Distal Peripheral Nerve Block Anesthesia for Outpatient Hand Surgery

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Nicholas C. K. Lam

2014-01-01

Full Text Available Background. For hand surgery, brachial plexus blocks provide effective anesthesia but produce undesirable numbness. We hypothesized that distal peripheral nerve blocks will better preserve motor function while providing effective anesthesia. Methods. Adult subjects who were scheduled for elective ambulatory hand surgery under regional anesthesia and sedation were recruited and randomly assigned to receive ultrasound-guided supraclavicular brachial plexus block or distal block of the ulnar and median nerves. Each subject received 15 mL of 1.5% mepivacaine at the assigned location with 15 mL of normal saline injected in the alternate block location. The primary outcome (change in baseline grip strength measured by a hydraulic dynamometer was tested before the block and prior to discharge. Subject satisfaction data were collected the day after surgery. Results. Fourteen subjects were enrolled. Median (interquartile range [IQR] strength loss in the distal group was 21.4% (14.3, 47.8%, while all subjects in the supraclavicular group lost 100% of their preoperative strength, P = 0.001. Subjects in the distal group reported greater satisfaction with their block procedures on the day after surgery, P = 0.012. Conclusion. Distal nerve blocks better preserve motor function without negatively affecting quality of anesthesia, leading to increased patient satisfaction, when compared to brachial plexus block.

Pudendal nerve stimulation and block by a wireless-controlled implantable stimulator in cats.

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Yang, Guangning; Wang, Jicheng; Shen, Bing; Roppolo, James R; de Groat, William C; Tai, Changfeng

2014-07-01

The study aims to determine the functionality of a wireless-controlled implantable stimulator designed for stimulation and block of the pudendal nerve. In five cats under α-chloralose anesthesia, the stimulator was implanted underneath the skin on the left side in the lower back along the sacral spine. Two tripolar cuff electrodes were implanted bilaterally on the pudendal nerves in addition to one bipolar cuff electrode that was implanted on the left side central to the tripolar cuff electrode. The stimulator provided high-frequency (5-20 kHz) biphasic stimulation waveforms to the two tripolar electrodes and low-frequency (1-100 Hz) rectangular pulses to the bipolar electrode. Bladder and urethral pressures were measured to determine the effects of pudendal nerve stimulation (PNS) or block. The maximal (70-100 cmH2O) urethral pressure generated by 20-Hz PNS applied via the bipolar electrode was completely eliminated by the pudendal nerve block induced by the high-frequency stimulation (6-15 kHz, 6-10 V) applied via the two tripolar electrodes. In a partially filled bladder, 20-30 Hz PNS (2-8 V, 0.2 ms) but not 5 Hz stimulation applied via the bipolar electrode elicited a large sustained bladder contraction (45.9 ± 13.4 to 52.0 ± 22 cmH2O). During cystometry, the 5 Hz PNS significantly (p < 0.05) increased bladder capacity to 176.5 ± 27.1% of control capacity. The wireless-controlled implantable stimulator successfully generated the required waveforms for stimulation and block of pudendal nerve, which will be useful for restoring bladder functions after spinal cord injury. © 2013 International Neuromodulation Society.

A controlled human malaria infection model enabling evaluation of transmission-blocking interventions

NARCIS (Netherlands)

Collins, K.A.; Wang, C.Y.; Adams, M.; Mitchell, H.; Rampton, M.; Elliott, S.; Reuling, I.J.; Bousema, T.; Sauerwein, R.; Chalon, S.; Mohrle, J.J.; McCarthy, J.S.

2018-01-01

BACKGROUND: Drugs and vaccines that can interrupt the transmission of Plasmodium falciparum will be important for malaria control and elimination. However, models for early clinical evaluation of candidate transmission-blocking interventions are currently unavailable. Here, we describe a new model

Effect of addition of dexamethasone to ropivacaine on post-operative analgesia in ultrasonography-guided transversus abdominis plane block for inguinal hernia repair: A prospective, double-blind, randomised controlled trial.

Science.gov (United States)

Sharma, Uma Datt; Prateek; Tak, Himani

2018-05-01

Ultrasonography (USG)-guided transversus abdominis plane (TAP) block is an abdominal field block with high efficacy. This study was undertaken with the aim of determining the effect of the addition of dexamethasone to 0.5% ropivacaine on post-operative analgesia in USG-guided TAP block for inguinal hernia repair. A double-blind randomised control study was conducted on sixty patients posted for inguinal hernia repair with the American Society of Anesthesiologists physical Status I or II, who were allocated two groups of 30 each. Patients in Group RS received 0.5% ropivacaine (20 ml) and normal saline (2 ml) whereas patients in Group RD received 0.5% ropivacaine (20 ml) and dexamethasone (2 ml, i.e., 8 mg), in USG-guided TAP Block on the same side, after repair of inguinal hernia under spinal anaesthesia. Visual analogue scale (VAS) scores, time for request of first analgesia and total tramadol consumption in first 24 h were compared. Unpaired Student's t -test and Mann-Whitney U-test were performed using SPSS 23 Software. Patients in Group RD had significantly lower VAS scores as compared to Group RS from 4 th to 12 th h, postoperatively. Duration of analgesia was significantly more in Group RD (547.50 [530,530] min) when compared with Group RS (387.50 [370,400] min) ( P consumption.

COMPARISON OF THE EFFECTS OF INTERCOSTAL NERVE BLOCK WITH ROPIVACAINE AND INTRAVENOUS PARACETAMOL INFUSION TO INTRAVENOUS PARACETAMOL INFUSION ALONE FOR PAIN CONTROL AFTER OPEN CHOLECYSTECTOMY

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Somnath Dey

2017-11-01

Full Text Available BACKGROUND Postoperative pain after open cholecystectomy is associated with respiratory dysfunction, increased stress response and prolonged hospital stay. We compare intravenous paracetamol (7.5 mg/kg plus intercostal nerve block with local anaesthetic ropivacaine 0.5% to intravenous paracetamol (15 mg/kg on pain control after open cholecystectomy. MATERIALS AND METHODS 140 patients, who underwent for open cholecystectomy, were randomly divided into two groups of 70. The patients were randomly allocated to any of the following two groups depending upon the drug used for analgesia (Group P or Group I Intravenous paracetamol 15 mg/kg was given to patients of group P and paracetamol 7.5 mg/kg with Intercostal nerve block in right side 6-10 intercostal nerves with 2 ml local anaesthetic ropivacaine 0.5% in each space was given to patients of group I just after intubation before incision. When the patients were transferred to postoperative recovery room, intensity of pain was recorded by response from the patients using 100 mm linear visual analogue scale ranging from 0 to 100. The pain scoring was done in the immediate postoperative period (when the patient was able to communicate in the post anaesthesia care unit, at 30 minutes, 1 hr. then hourly up to 24 hrs. till patient complained of pain with VAS score 40 or more. RESULTS The severity of pain in VAS score was lower in immediate postoperative period, at 30 minutes, 1 hour and 2 hours postoperatively in group I than the group P and those were statistically significant (p<0.001. Duration of analgesia also significantly lower in group I. Mean duration of analgesia in group P is 161.9 ± 42.6 min and in group I is 241.3 ± 44.2 min (p<0.001. CONCLUSION Adding Intercostal nerve block to intravenous infusion of Paracetamol infusion (7.5 mg/kg is better than sole intravenous infusion of Paracetamol (15 mg/kg in controlling pain severity even after reducing dose of paracetamol after open

Fentanyl supplement expedites the onset time of sensory and motor blocking in interscalene lidocaine anesthesia

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RS Moharari

2010-12-01

Full Text Available Background and the purpose of the study: Opioids are usually used in regional anesthesia, with or without local anesthetics to improve the regional block or postoperative pain control. Since no data are available on fentanyl's effect on the onset time of lidocaine interscalene anesthesia, the purpose of this study was to examine its effect on the onset time of sensory and motor blockade during interscalene anesthesia.  Methods: In a prospective, randomized, double-blind study, ninety patients scheduled for elective shoulder, arm and forearm surgeries under an  interscalene brachial plexus block .They were randomly allocated to receive either 30 ml of  1.5 % lidocaine with 1.5 ml of isotonic saline  (control group, n = 39 or 30 ml of 1.5%  lidocaine with 1.5 ml (75µg of  fentanyl (fentanyl group,n=41. Then the onset time of sensory and motor blockades of the shoulder, arm and forearm were evaluated every 60 sec. The onset time of the sensory and motor blockades was defined as the time between the last injection and the total abolition of the pinprick response and complete paralysis. The duration of sensory blocks were considered as the time interval between the administration of the local anesthetic and the first postoperative pain sensation. Results: Ten patients were excluded because of unsuccessful blockade or unbearable pain during the surgery. The onset time of the sensory block was significantly faster in the fentanyl group (186.54± 62.71sec compared with the control group (289.51± 81.22, P < 0.01. The onset times of the motor block up to complete paralysis in forearm flexion was significantly faster in the fentanyl group (260.61± 119.91sec than the control group (367.08± 162.43sec, P < 0.01 There was no difference in the duration of the sensory block between two groups. Conclusion: Results of the study showed that the combination of 75 µg fentanyl and 1.5% lidocaine solution accelerated the onset of sensory and motor

A dose-finding randomised controlled trial of magnesium sulphate as an adjuvant in ultrasound-guided supraclavicular brachial plexus block

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Versha Verma

2017-01-01

Full Text Available Background and Aim: Magnesium sulphate (MgSO4 has been used as an adjuvant in brachial plexus block with encouraging results; however, there is no consensus regarding its optimal dose. Thereby, we compared the efficacy of two doses of MgSO4 as an adjuvant in ultrasound (USG guided supraclavicular brachial plexus block. Methods: Ninety patients, aged 20–60 years, belonging to American Society of Anesthesiologists physical status 1 or 2, were given USG-guided supraclavicular block. Group B (n = 30 received 20 ml of 0.5%bupivacaine + 5 ml normal saline (NS, Group BM0.5(n = 30 received 20 ml of 0.5%bupivacaine + 3.75 ml NS and 125 mg MgSO4 (1.25 ml and Group BM1(n = 30 received 20 ml of 0.5%bupivacaine + 2.5 ml NS and 250 mg MgSO4 (2.5 ml. The primary outcome of study was the duration of post-operative analgesia. The normally distributed data were analysed using analysis of variance and categorical data analysed using Chi-square test. Results: Duration of post-operative analgesia was prolonged in Groups BM1 and BM0.5 (665.13 ± 97.874, 475.10 ± 53.294 min respectively as compared to Group B (272.03 ± 40.404 min: P = 0.00. The onset times of sensory and motor block were shorter in Group BM1 (5.17 ± 2.2 minas compared to Groups BM0.5 and B (8.9 ± 2.3 and 17.7 ± 5.1 min: P = 0.00 respectively. Sensory and motor block durations were prolonged in Group BM1 as compared to BM0.5 and B (P = 0.00. Conclusions: MgSO4 as adjuvant in brachial plexus block increases the duration of post-operative analgesia. MgSO4 in the dose of 250mg has greater efficacy as compared to 125 mg.

A Block Randomized Controlled Trial of a Brief Smoking Cessation Counselling and Advice through Short Message Service on Participants Who Joined the Quit to Win Contest in Hong Kong

Science.gov (United States)

Chan, Sophia S. C.; Wong, David C. N.; Cheung, Yee Tak Derek; Leung, Doris Y. P.; Lau, Lisa; Lai, Vienna; Lam, Tai-Hing

2015-01-01

The present trial examined the effectiveness of brief interventions for smokers who joined the Hong Kong Quit to Win Contest to quit smoking. A block randomized controlled trial allocated 1003 adult daily smokers to three groups: (i) The TEL group (n = 338) received a 5-min nurse-led telephone counselling; (ii) The SMS group (n = 335) received…

[Postoperative analgesia in knee arthroplasty using an anterior sciatic nerve block and a femoral nerve block].

Science.gov (United States)

del Fresno Cañiaveras, J; Campos, A; Galiana, M; Navarro-Martínez, J A; Company, R

2008-11-01

To evaluate the efficacy of a nerve block as an alternative technique for analgesia after knee arthroplasty and to indicate the usefulness and advantages of the anterior approach to the sciatic nerve block. Between April 2004 and March 2006, we studied a series of consecutive patients undergoing knee arthroplasty in which a subarachnoid block was used as the anesthetic technique and postoperative analgesia was provided by means of a combined peripheral femoral nerve block and an anterior sciatic nerve block. We evaluated the mean length of time free from pain, quality of analgesia, and length of stay in hospital. Seventy-eight patients were included in the study. The mean (SD) length of time free from pain for the group was 42.1 (3.9) hours. Patients reported mild pain after 34.8 (4.1) hours and moderate to severe pain after 42.4 (3.5) hours. By the third day, 62.8% of patients were able to bend the knee to 90 degrees. There were no complications resulting from the technique and the level of patient satisfaction was high. A combined femoral-sciatic nerve block is effective in knee arthroplasty. It controls postoperative pain and allows for early rehabilitation. The anterior approach to the sciatic nerve is relatively simple to perform without removing the pressure bandaging from the thigh after surgery. This approach also makes it unnecessary to move the patient.

Functional polymers as nanoscopic building blocks

International Nuclear Information System (INIS)

Hernandez-Lopez, J.L.; Bauer, R.E.; Chang, W.-S.; Glasser, G.; Grebel-Koehler, D.; Klapper, M.; Kreiter, M.; Leclaire, J.; Majoral, J.-P.; Mittler, S.; Muellen, K.; Vasilev, K.; Weil, T.; Wu, J.; Zhu, T.; Knoll, W.

2003-01-01

Polyphenylene dendrimers are introduced as polymeric building blocks--with a strictly monodisperse particle size distribution within the nanometer range--for the construction of nanostructured materials and devices. The possibility for the introduction of different functionalities in the core, the scaffold or the periphery of the dendrimers offer their use as interesting modules for photonic, electronic or bioactive structures and supramolecular functional assemblies. Thus, dendrimers complement the available set of nanoscopic building blocks made from metals, e.g., Au nanoclusters and semiconductors, e.g., luminescent quantum dots. In a first set of experiments, we describe the fabrication of multilayer architectures using dendrimers with chargeable groups at the surface. This way, the polyelectrolyte deposition technique can be applied for the construction of hybrid layered assemblies with a control of the internal supramolecular structure at the nanometer level. Surface plasmon field-enhanced fluorescence spectroscopy is used to monitor the luminescent properties of dendrimers with a phthalocyanine core integrated into such a multilayer assembly. AFM and SEM micrographs demonstrate the use of surface-functionalized dendrimers (exposing sulfur groups at the periphery) in combination with Au nanoparticles for the controlled assembly of hybrid aggregates as nanoscopic functional devices

The analgesic efficacy of transversus abdominis plane block after abdominal surgery: a prospective randomized controlled trial.

LENUS (Irish Health Repository)

McDonnell, John G

2007-01-01

The transversus abdominis plane (TAP) block is a novel approach for blocking the abdominal wall neural afferents via the bilateral lumbar triangles of Petit. We evaluated its analgesic efficacy in patients during the first 24 postoperative hours after abdominal surgery, in a randomized, controlled, double-blind clinical trial.

Analgesic effect of bilateral subcostal tap block after laparoscopic cholecystectomy

International Nuclear Information System (INIS)

Karam, K.; Khan, B.I.

2018-01-01

Pain after laparoscopic cholecystectomy is mild to moderate in intensity. Several modalities are employed for achieving safe and effective postoperative analgesia, the benefits of which adds to the early recovery of the patients. As a part of multimodal analgesia, various approaches of Transversus abdominis plane (TAP) block has been used for management of parietal and incisional components of pain after laparoscopic cholecystectomy. This study was designed to compare the analgesic efficacy of two different approaches of ultrasound guided TAP block, i.e., Subcostal-TAP block technique with ultrasound guided Posterior-TAP block for post-operative pain management in patients undergoing laparoscopic cholecystectomy under general anaesthesia. Methods: In this double blinded randomized controlled study, consecutive nonprobability sampling was done and a total of 126 patients admitted for elective laparoscopic cholecystectomy fulfilling the inclusion criteria were selected. After induction of general anaesthesia, patients were randomized through draw method and received either ultrasound guided posterior TAP block with 0.375% bupivacaine (20ml volume) on each side of the abdomen or subcostal TAP block bilaterally with the same. Up to 24 hours postoperatively, static and dynamic numeric rating pain scores were assessed. Results: We found statistically significant difference in mean static pain scores over 24 hours postoperatively in subcostal TAP group, suggesting improved analgesia. However, mean dynamic postoperative pain scores were comparable between the two groups. Whereas, patients in both groups were satisfied with pain management. Conclusions: Ultrasound guided subcostal TAP block provides better postoperative analgesia as compared to the Posterior TAP block in laparoscopic cholecystectomy. Otherwise both of the approaches improve patient outcomes towards early recovery and discharge from hospital. (author)

Development of Universal Controller Architecture for SiC Based Power Electronic Building Blocks

Science.gov (United States)

2017-10-30

SiC Based Power Electronic Building Blocks Award Number Title of Research 30 October 2017 SUBMITTED BY D R. HERBERT L. G INN, Pl DEPT. OF...Naval Research , Philadelphia PA, Aug. 2017. • Ginn, H.L. Bakos J., "Development of Universal Controller Architecture for SiC Based Power Electronic...Controller Implementation for MMC Converters", Workshop on Control Architectures for Modular Power Conversion Systems, Office of Naval Research , Arlington VA

EnviroAtlas - Household income metrics related to emotional well-being by Census Block Group for the Conterminous United States

Data.gov (United States)

U.S. Environmental Protection Agency — This EnviroAtlas dataset portrays the percentage of population within different household income ranges for each Census Block Group (CBG), a threshold estimated to...

Group performance and group learning at dynamic system control tasks

International Nuclear Information System (INIS)

Drewes, Sylvana

2013-01-01

Proper management of dynamic systems (e.g. cooling systems of nuclear power plants or production and warehousing) is important to ensure public safety and economic success. So far, research has provided broad evidence for systematic shortcomings in individuals' control performance of dynamic systems. This research aims to investigate whether groups manifest synergy (Larson, 2010) and outperform individuals and if so, what processes lead to these performance advantages. In three experiments - including simulations of a nuclear power plant and a business setting - I compare the control performance of three-person-groups to the average individual performance and to nominal groups (N = 105 groups per experiment). The nominal group condition captures the statistical advantage of aggregated group judgements not due to social interaction. First, results show a superior performance of groups compared to individuals. Second, a meta-analysis across all three experiments shows interaction-based process gains in dynamic control tasks: Interacting groups outperform the average individual performance as well as the nominal group performance. Third, group interaction leads to stable individual improvements of group members that exceed practice effects. In sum, these results provide the first unequivocal evidence for interaction-based performance gains of groups in dynamic control tasks and imply that employers should rely on groups to provide opportunities for individual learning and to foster dynamic system control at its best.

Effect of addition of dexamethasone to ropivacaine on post-operative analgesia in ultrasonography-guided transversus abdominis plane block for inguinal hernia repair: A prospective, double-blind, randomised controlled trial

Directory of Open Access Journals (Sweden)

Uma Datt Sharma

2018-01-01

Full Text Available Background and Aims: Ultrasonography (USG-guided transversus abdominis plane (TAP block is an abdominal field block with high efficacy. This study was undertaken with the aim of determining the effect of the addition of dexamethasone to 0.5% ropivacaine on post-operative analgesia in USG-guided TAP block for inguinal hernia repair. Methods: A double-blind randomised control study was conducted on sixty patients posted for inguinal hernia repair with the American Society of Anesthesiologists physical Status I or II, who were allocated two groups of 30 each. Patients in Group RS received 0.5% ropivacaine (20 ml and normal saline (2 ml whereas patients in Group RD received 0.5% ropivacaine (20 ml and dexamethasone (2 ml, i.e., 8 mg, in USG-guided TAP Block on the same side, after repair of inguinal hernia under spinal anaesthesia. Visual analogue scale (VAS scores, time for request of first analgesia and total tramadol consumption in first 24 h were compared. Unpaired Student's t-test and Mann–Whitney U-test were performed using SPSS 23 Software. Results: Patients in Group RD had significantly lower VAS scores as compared to Group RS from 4th to 12th h, postoperatively. Duration of analgesia was significantly more in Group RD (547.50 [530,530] min when compared with Group RS (387.50 [370,400] min (P < 0.001. The demand for intravenous tramadol was significantly low in Group RD (223.33 ± 56.83 mg as compared to Group RS (293.33 ± 25.71 mg (P < 0.001. Conclusion: Addition of dexamethasone to ropivacaine in USG-guided TAP block significantly reduces post-operative pain and prolongs the duration of post-operative analgesia, thereby reducing analgesic consumption.

Analgesic effect of ultrasound-guided transversus abdominis plane block after total abdominal hysterectomy: a randomized, double-blind, placebo-controlled trial.

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Røjskjaer, Jesper O; Gade, Erik; Kiel, Louise B; Lind, Morten N; Pedersen, Lars M; Kristensen, Billy B; Rasmussen, Yvonne H; Foss, Nicolai B

2015-03-01

To assess the effect of bilateral ultrasound-guided transversus abdominis plane block with ropivacaine compared with placebo as part of a multimodal analgesic regimen. A randomized, double-blind, placebo-controlled trial following the CONSORT criteria. Hvidovre University Hospital. Forty-six women scheduled for total abdominal hysterectomy. Women received either ropivacaine 0.75%, 20 mL (n = 24) or 0.9% saline, 20 mL (n = 24) in the transversus abdominis plane on each side. Primary outcome was the 24-h postoperative morphine consumption. Secondary outcomes were pain scores at rest and during coughing, postoperative nausea and vomiting at 1, 2, 4, 6, 8, and 24 h, and time to first mobilization. There was no difference in the mean 24-h postoperative morphine consumption between the two groups (p = 0.733). The ropivacaine group had significantly lower median pain scores at 1 h (p = 0.008) and 2 h (p = 0.027) postoperatively at rest and at 8 h (p = 0.028) during coughing. There was no significant difference in other secondary outcomes. There was no reduction in 24-h morphine consumption when using an ultrasound-guided transversus abdominis plane block in women undergoing total abdominal hysterectomy. As part of a multimodal regimen the transversus abdominis plane block showed some effect on pain scores at rest only in the early postoperative period. © 2014 Nordic Federation of Societies of Obstetrics and Gynecology.

Synthesis by ATRP of triblock copolymers with densely grafted styrenic end blocks from a polyisobutylene macroinitiator

DEFF Research Database (Denmark)

Truelsen, Jens Høg; Kops, Jørgen; Pedersen, Walther Batsberg

2000-01-01

A macroinitiator was prepared from a triblock copolymer of polyisobutylene (PIB) with end blocks of poly(p-methylstyrene) (P(p-MeS)) by bromination to obtain initiating bromomethyl groups for atom transfer radical polymerization (ATRP). Controlled polymerization of styrene and p-acetoxystyrene yi......A macroinitiator was prepared from a triblock copolymer of polyisobutylene (PIB) with end blocks of poly(p-methylstyrene) (P(p-MeS)) by bromination to obtain initiating bromomethyl groups for atom transfer radical polymerization (ATRP). Controlled polymerization of styrene and p...

Census Tracts & Block Groups, 2004, East Baton Rouge, Louisiana

Data.gov (United States)

Louisiana Geographic Information Center — This is a graphical polygon dataset depicting the polygon boundaries of 107 semi-permanent census tracts and the census blocks within the Parish of East Baton Rouge....

Effect of Dexamethasone on Characteristics of Supraclavicular Nerve Block with Bupivacaine and Ropivacaine: A Prospective, Double-blind, Randomized Control Trial.

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Bindal, Deeksha; Narang, Neeraj; Mahindra, Rekha; Gupta, Himanshu; Kubre, Jyotsna; Saxena, Anudeep

2018-01-01

Dexamethasone as an adjuvant to bupivacaine and ropivacaine for supraclavicular brachial plexus (SCBP) block prolongs motor and sensory blockade. However, comparison of effect of dexamethasone (8 mg) when added to these two local anesthetics has not been well studied. This study was conducted to compare analgesic efficacy of dexamethasone as adjuvant to bupivacaine and ropivacaine in SCBP block. Nerve stimulator-guided SCBP block was given to 120 patients, randomly assigned to one of four groups: ( n = 30 in each group) Group B, BD, R, and RD received 30 ml (0.5%) bupivacaine + 2 ml saline, 30 ml (0.5%) bupivacaine + dexamethasone 8 mg, 30 ml (0.5%) ropivacaine + 2 ml saline, and 30 ml (0.5%) ropivacaine + dexamethasone 8 mg, respectively. Time for request of the first rescue analgesic, 24-h analgesic consumption, and different block characteristics were assessed. Student's t -test, Chi-square test, ANOVA were used for statistical analysis. Dexamethasone significantly prolonged time for request of the first rescue analgesic of both ropivacaine (1211.83 ± 32.86 vs. 283.17 ± 7.71 min){ p R, RD block. The addition of dexamethasone to bupivacaine and ropivacaine in SCBP block prolonged time for first rescue analgesia and reduced the requirement of rescue analgesics with faster onset and prolonged duration of sensory and motor block, with the effect being stronger with ropivacaine.

Onset response of bupivacaine 0.5% which has been added with sodium bicarbonate on epidural block

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Marwoto Marwoto

2005-03-01

Full Text Available There are many advantages in using epidural anesthesia technique. However, there are also some constraints, such as the relatively long onset, particularly in the case of bupivacaine. Whereas the need of a rapid onset of anesthesia technique for emergency cares is increasing lately. The objective of this study was to find a method to hasten the onset of bupivacaine. This is a cross sectional randomized double blind controlled clinical trial performed on 40 patients who would undergo lower abdomen and extremity surgery with epidural block. We evaluated the onset of action of bupivacaine which has been added with sodium bicarbonate. Consecutive sampling method was applied to get the sample. The criteria of sample are ASA I – II patient, aged of 20-60 years old, 50-60 kg of weight, 150-170 cm of height. Patients were allocated randomly into two groups. The treatment group would get epidural block using mixture of 20 cc of bupivacaine 0,5 % + 0.5 cc of sodium bicarbonate 1.4 %, whereas the control group received 20 cc bupivacaine 0.5 % + 0.5 cc aqua bides. Time to reach sensoric block at the level of thoracal 10 dermatome using the pinprick method and time to reach motoric blockade using the bromage scale was recorded. The result of this study showed a significant shortening of the onset of sensory blockade (p<0.05 in the treatment group (10.2±1.4 minutes compared with the control group (19.5±1.3 minutes. The onset of motor blockade had also a significant shortening (p<0.05 in the treatment group(13.3±1.6 minutes compared with the control group (23.0±1.2 minutes. It was concluded that the addition of sodium bicarbonate can hasten the onset of bupivacaine on epidural block. (Med J Indones 2005; 14: 7-10Keywords : onset response, bupivacaine 0.5%, sodium bicarbonate, epidural block

Does the Addition of Tramadol and Ketamine to Ropivacaine Prolong the Axillary Brachial Plexus Block?

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Ahmet Can Senel

2014-01-01

Full Text Available Background and Objectives. A prospective, randomized, controlled, double-blind clinical trial to assess the effect of tramadol and ketamine, 50 mg, added to ropivacaine in brachial plexus anesthesia. Methods. Thirty-six ASA physical statuses I and II patients, between 18 and 60 years of age, scheduled for forearm and hand surgery under axillary brachial plexus block, were allocated to 3 groups. Group R received 0.375% ropivacaine in 40 mL, group RT received 0.375% ropivacaine in 40 mL with 50 mg tramadol, and group RK received 0.375% ropivacaine in 40 mL with 50 mg ketamine for axillary brachial plexus block. The onset times and the duration of sensory and motor blocks, duration of analgesia, hemodynamic parameters, and adverse events (nausea, vomiting, and feeling uncomfortable were recorded. Results. The onset time of sensorial block was the fastest in ropivacaine + tramadol group. Duration of sensorial and motor block was the shortest in the ropivacaine + tramadol group. Duration of analgesia was significantly longer in ropivacaine + tramadol group. Conclusion. We conclude that when added to brachial plexus analgesia at a dose of 50 mg, tramadol extends the onset and duration time of the block and improves the quality of postoperative analgesia without any side effects.

Tailor-made polyfluoroacrylate and its block copolymer by RAFT polymerization in miniemulsion; improved hydrophobicity in the core-shell block copolymer.

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Chakrabarty, Arindam; Singha, Nikhil K

2013-10-15

Controlled/living radical polymerization (CRP) of a fluoroacrylate was successfully carried out in miniemulsion by Reversible Addition Fragmentation chain Transfer (RAFT) process. In this case, 2,2,3,3,4,4,4-heptafluorobutyl acrylate (HFBA) was polymerized using 2-cyanopropyl dodecyl trithiocarbonate (CPDTC) as RAFT agent, Triton X-405 and sodium dodecyl sulfonate (SDS) as surfactant, and potassium persulphate (KPS) or 2,2'-azobis isobutyronitrile (AIBN) as initiator. Being compatible with hydrophobic fluoroacrylate, this RAFT agent offered very high conversion and good control over the molecular weight of the polymer. The miniemulsion was stable without any costabilizer. The long chain dodecyl group (-C12H25) (Z-group in the RAFT agent) had beneficial effect in stabilizing the miniemulsion. When 2-cyano 2-propyl benzodithioate (CPBD) (Z=-C6H5) was used as RAFT agent, the conversion was less and particle size distribution was very broad. Block copolymerization with butyl acrylate (BA) using PHFBA as macro-RAFT agent showed core-shell morphology with the aggregation of PHFBA segment in the shell. GPC as well as DSC analysis confirmed the formation of block copolymer. The core-shell morphology was confirmed by TEM analysis. The block copolymers (PHFBA-b-PBA) showed significantly higher water contact angle (WCA) showing much better hydrophobicity compared to PHFBA alone. Copyright © 2013 Elsevier Inc. All rights reserved.

Liposomal bupivacaine infiltration versus femoral nerve block for pain control in total knee arthroplasty: A systematic review and meta-analysis.

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Ma, Jianbing; Zhang, Weijie; Yao, Shuxin

2016-12-01

Total knee arthroplasty (TKA) usually results in postoperative pain. The objective of this meta-analysis was to compare the effectiveness and safety of liposomal bupivacaine (LB) infiltration and femoral nerve block (FNB) for pain control in total knee arthroplasty. We systemically searched electronic databases, including Embase (1980-2016.7), MEDLINE (1966-2016.7), PubMed (1966-2016.7), ScienceDirect (1985-2016.7), Web of Science (1950-2016.7) and Cochrane Library for potentially relevant articles. All calculations were conducted using Stata 11.0. One randomized controlled trials (RCTs) and five non-RCTs involving 1289 participants met the inclusion criteria. The result of the meta-analysis revealed that there were no significant differences in terms of postoperative pain scores at POD 0 (SMD = -0.047, 95% CI: -0.276 to 0.182, P = 0.688), POD1 (SMD = -0.038, 95% CI: -0.273 to 0.197, P = 0.749) or POD 2 (SMD = -0.043, 95% CI: -0.192 to 0.107, P = 0.575). Significant differences were found between groups in morphine equivalent consumption at POD 1 (SMD = 0.625, 95% CI: 0.068 to 1.183, P = 0.028) and POD 2 (SMD = 0.410, 95% CI: 0.024 to 0.796, P = 0.037) between groups. There were no significant differences regarding the incidence of adverse effects such as nausea (RD = -0.01, 95% CI: -0.04 to -0.075, P = 0.914) or vomiting (RD = 0.006, 95% CI: -0.049 to 0.062, P = 0.821). Liposomal bupivacaine infiltration provides similar postoperative pain relief to femoral nerve block following total knee arthroplasty. In addition, liposomal bupivacaine infiltration could significantly reduce the consumption of morphine equivalents compared to femoral nerve block without an increased risk of adverse events. Copyright © 2016 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

Hydrogen Bond Induces Hierarchical Self-Assembly in Liquid-Crystalline Block Copolymers.

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Huang, Shuai; Pang, Linlin; Chen, Yuxuan; Zhou, Liming; Fang, Shaoming; Yu, Haifeng

2018-03-01

Microphase-separated structures of block copolymers (BCs) with a size of sub-10 nm are usually obtained by hydrogen-bond-induced self-assembly of BCs through doping with small molecules as functional additives. Here, fabrication of hierarchically self-assembled sub-10 nm structures upon microphase separation of amphiphilic liquid-crystalline BCs (LCBCs) at the existence of hydrogen bonds but without any dopants is reported. The newly introduced urethane groups in the side chain of the hydrophobic block of LCBCs interact with the ether groups of the hydrophilic poly(ethylene oxide) (PEO) block, leading to imperfect crystallization of the PEO blocks. Both crystalline and amorphous domains coexist in the separated PEO phase, enabling a lamellar structure to appear inside the PEO nanocylinders. This provides an elegant method to fabricate controllable sub-10 nm microstructures in well-defined polymer systems without the introduction of any dopants. © 2018 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

RESULTS OF DIAGNOSTICAL BLOCK OF LONG DORSAL SACROILIAC LIGAMENT UNDER SONOGRAPHIC CONTROL IN PATIENTS WITH LOW BACK PAIN

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Yurkovskiy A. M.

2018-02-01

Full Text Available Purpose: to improve effectiveness of diagnostic block of long dorsal sacroiliac ligament performed under sonographic control in patients with low back pain caused by pathology of this ligament. Material and methods: the research included 35 patients (average age 46,2±12,5 years with symptoms of low back pain caused by pathology of long dorsal sacroiliac ligament. Diagnostical block of the given ligament was made under ultrasound control. Results: significant pain syndrome reduction was observed in all patients with ligamentopathy of long dorsal sacroiliac ligament. Conclusion: compared to "blind" technique, long dorsal sacroiliac ligament block performed under sonographic control is a more efficient method of verification and treatment for low back pain syndrome in case of long dorsal sacroiliac ligament injury.

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

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Susmita Bhattacharyya

2015-01-01

Full Text Available 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 scheduled for TURP were randomly allocated into 2 groups of 45 in each group. Group A patients were received spinal (2 ml of hyperbaric bupivacaine and Group B were received saddle block (2 ml of hyperbaric bupivacaine. Baseline systolic, diastolic and mean arterial pressure, heart rate, oxygen saturation were recorded and measured subsequently. The height of block was noted in both groups. Hypotension was corrected by administration of phenylephrine 50 mcg bolus and total requirement of vasopressor was noted. Complications (volume overload, TURP syndrome etc. were noted. Results: Incidence of hypotension and vasopressor requirement was less (P < 0.01 in Gr B patients.Adequate surgical condition was achieved in both groups. There was no incidence of volume overload, TURP syndrome, and bladder perforation. Conclusion: TURP can be safely performed under saddle block without hypotension and less vasopressor requirement.

Ultrasound-guided transversus abdominis plane blocks for patients undergoing laparoscopic hand-assisted nephrectomy: a randomized, placebo-controlled trial

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Aniskevich S

2014-04-01

Full Text Available Stephen Aniskevich,1 C Burcin Taner,2 Dana K Perry,2 Christopher B Robards,3 Steven B Porter,3 Colleen S Thomas,4 Ilana I Logvinov,5 Steven R Clendenen41Department of Anesthesia, Division of Transplant Anesthesia, 2Department of Transplantation, 3Department of Anesthesia, Division of Regional Anesthesia, 4Division of Health Sciences Research, Section of Biostatistics, 5Department of Anesthesia, Mayo Clinic Florida, Jacksonville, FL, USAAbstract: Postoperative pain is a common complaint following living kidney donation or tumor resection using the laparoscopic hand-assisted technique. To evaluate the potential analgesic benefit of transversus abdominis plane blocks, we conducted a randomized, double-blind, placebo-controlled study in 21 patients scheduled to undergo elective living-donor nephrectomy or single-sided nephrectomy for tumor. Patients were randomized to receive either 20 mL of 0.5% ropivacaine or 20 mL of 0.9% saline bilaterally to the transversus abdominis plane under ultrasound guidance. We found that transversus abdominis plane blocks reduced overall pain scores at 24 hours, with a trend toward decreased total morphine consumption. Nausea, vomiting, sedation, and time to discharge were not significantly different between the two study groups.Keywords: transversus abdominis plane block, nephrectomy, kidney donor, ultrasound guidance

Stabilization of colloidal palladium particles by a block copolymer of polystyrene and a block containing amide sidegroups

NARCIS (Netherlands)

Roescher, G.A.; Roescher, A.; Hempenius, Mark A.; Klok, H.A.; Moller, M.; Möller, M.

1996-01-01

A block copolymer of polystyrene and poly(tert-butylmethacrylate) was prepared by anionic polymerization. The ester groups of the poly(tert-butylmethacrylate) were hydrolyzed, after wich the remaining carboxyl groups were reacted with pyrrolidine. The resulting block copolymer with amide sidegroups

The comparison of combined femoral-sciatic nerve block with spinal anesthesia at lower extremity surgery

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Selim Almaz

2014-06-01

Full Text Available Introduction: In this study, we aimed to compare the spinal anesthesia technique with combined femoral-sciatic block technique in patients undergoing lower limb surgery. Methods: In this study, after obtaining the approval of the Dicle University Faculty of Medicine Ethics Committee, scheduled for elective lower extremity surgery, the ASA 1-2 groups, between the ages of 18-65, 60 patients were enrolled. Study was planned as a prospective, randomized and controlled. Patients were randomly divided into 2 groups as the spinal anesthesia (Group S and combined sciatic-femoral nerve block (Group CSF to be. Results: Demographic data similar between the groups (p> 0.05. The implementation period of the technique was long in the Group CSF compared with in the Group S (p <0.001. Surgery delivery time was shorter in the Group S compared with in the Group CSF (p <0.001. The time of motor block occurrence was longer in the Group CSF compared with in the Group S (p <0.001. The duration of motor block was long in the Group CSF compared with in the Group S (p <0.001. Conclusion: The each of two methods is safe and effective in lower extremity orthopedic surgery, but the application of peripheral nerve block to provide the long-term advantages such as postoperative analgesia and reducing postoperative analgesic consumption. J Clin Exp Invest 2014; 5 (2: 443-446

Extrapunitive and intropunitive individuals activate different parts of the prefrontal cortex under an ego-blocking frustration.

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Minamoto, Takehiro; Osaka, Mariko; Yaoi, Ken; Osaka, Naoyuki

2014-01-01

Different people make different responses when they face a frustrating situation: some punish others (extrapunitive), while others punish themselves (intropunitive). Few studies have investigated the neural structures that differentiate extrapunitive and intropunitive individuals. The present fMRI study explored these neural structures using two different frustrating situations: an ego-blocking situation which blocks a desire or goal, and a superego-blocking situation which blocks self-esteem. In the ego-blocking condition, the extrapunitive group (n = 9) showed greater activation in the bilateral ventrolateral prefrontal cortex, indicating that these individuals prefer emotional processing. On the other hand, the intropunitive group (n = 9) showed greater activation in the left dorsolateral prefrontal cortex, possibly reflecting an effortful control for anger reduction. Such patterns were not observed in the superego-blocking condition. These results indicate that the prefrontal cortex is the source of individual differences in aggression direction in the ego-blocking situation.

Density matrix renormalization group for a highly degenerate quantum system: Sliding environment block approach

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Schmitteckert, Peter

2018-04-01

We present an infinite lattice density matrix renormalization group sweeping procedure which can be used as a replacement for the standard infinite lattice blocking schemes. Although the scheme is generally applicable to any system, its main advantages are the correct representation of commensurability issues and the treatment of degenerate systems. As an example we apply the method to a spin chain featuring a highly degenerate ground-state space where the new sweeping scheme provides an increase in performance as well as accuracy by many orders of magnitude compared to a recently published work.

High-dose versus low-dose local anaesthetic for transversus abdominis plane block post-Caesarean delivery analgesia: a meta-analysis.

Science.gov (United States)

Ng, S C; Habib, A S; Sodha, S; Carvalho, B; Sultan, P

2018-02-01

The optimal local-anaesthetic (LA) dose for transversus-abdominis-plane (TAP) block is unclear. In this meta-analysis, we aimed to determine whether TAP blocks for Caesarean delivery (CD) with low-dose (LD) LA demonstrated non-inferiority in terms of analgesic efficacy, compared with high-dose (HD) LA. A literature search was performed for randomised controlled trials examining the analgesic efficacy of TAP blocks vs control after CD. The different dosing used in these studies was classified as HD or LD (bupivacaine equivalents >50 or ≤50 mg per block side, respectively). The pooled results of each dose group vs control were indirectly compared using the Q test. The primary outcome was 24 h opioid consumption. Secondary outcomes included 6 and 24 h postoperative pain scores, time to first analgesia, 6 h opioid consumption, opioid-related side-effects, and maternal satisfaction. Fourteen studies consisting of 770 women (389 TAP and 381 control) were included. Compared with controls, the 24 h opioid consumption (milligram morphine equivalents) was lower in HD [mean difference (MD) 95% confidence interval (CI) -22.41 (-38.56, -6.26); P=0.007; I 2 =93%] and LD [MD 95% CI -16.29 (-29.74, -2.84); P=0.02; I 2 =98%] TAP groups. However, no differences were demonstrated between the HD and LD groups (P=0.57). There were also no differences between the HD and LD groups for the 6 h opioid consumption, time to first analgesia, 6 and 24 h pain scores, postoperative nausea and vomiting, pruritus, and maternal satisfaction. Low-dose TAP blocks for Caesarean delivery provide analgesia and opioid-sparing effects comparable with the high-dose blocks. This suggests that lower doses can be used to reduce local anaesthetic toxicity risk without compromising the analgesic efficacy. Copyright © 2017 British Journal of Anaesthesia. Published by Elsevier Ltd. All rights reserved.

Efficacy of trans abdominis plane block for post cesarean delivery analgesia: A double-blind, randomized trial

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Uma Srivastava

2015-01-01

Full Text Available Background: The transverse abdominis plane (TAP block, a regional block provides effective analgesia after lower abdominal surgeries if used as part of multimodal analgesia. In this prospective, randomized double-blind study, we determined the efficacy of TAP block in patients undergoing cesarean section. Materials and Methods: Totally, 62 parturients undergoing cesarean section were randomized in a double-blind manner to receive either bilateral TAP block at the end of surgery with 20 ml of 0.25% bupivacaine or no TAP block, in addition to standard analgesic comprising 75 mg diclofenac 8 hourly and intravenous patient-controlled analgesia (PCA tramadol. Each patient was assessed at 0, 4, 8, 12, 24, 36, and 48 h after surgery by an independent observer for pain at rest and on movement using numeric rating scale of 0-10, time of 1 st demand for tramadol, total consumption of PCA tramadol, satisfaction with pain management and side effects. Results: Use of tramadol was reduced in patients given TAP block by 50% compared to patients given no block during 48 h after surgery (P < 0.001. Pain scores were lower both on rest and activity at each time point for 24 h in study group (P < 0.001, time of first analgesia was significantly longer, satisfaction was higher, and side effects were less in study group compared to control group. Conclusion: Transverse abdominis plane block was effective in providing analgesia with a substantial reduction in tramadol use during 48 h after cesarean section when used as adjunctive to standard analgesia.

Phrenic nerve block caused by interscalene brachial plexus block: breathing effects of different sites of injection.

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Bergmann, Lars; Martini, Stefan; Kesselmeier, Miriam; Armbruster, Wolf; Notheisen, Thomas; Adamzik, Michael; Eichholz, Rϋdiger

2016-07-29

Interscalene brachial plexus (ISB) block is often associated with phrenic nerve block and diaphragmatic paresis. The goal of our study was to test if the anterior or the posterior ultrasound guided approach of the ISB is associated with a lower incidence of phrenic nerve blocks and impaired lung function. This was a prospective, randomized and single-blinded study of 84 patients scheduled for elective shoulder surgery who fullfilled the inclusion and exclusion critereria. Patients were randomized in two groups to receive either the anterior (n = 42) or the posterior (n = 42) approach for ISB. Clinical data were recorded. In both groups patients received ISB with a total injection volume of 15 ml of ropivacaine 1 %. Spirometry was conducted at baseline (T0) and 30 min (T30) after accomplishing the block. Changes in spirometrical variables between T0 and T30 were investigated by Wilcoxon signed-rank test for each puncture approach. The temporal difference between the posterior and the anterior puncture approach groups were again analyzed by the Wilcoxon-Mann-Whitney test. The spirometric results showed a significant decrease in vital capacity, forced expiratory volume per second, and maximum nasal inspiratory breathing after the Interscalene brachial plexus block; indicating a phrenic nerve block (p Wilcoxon signed-rank). A significant difference in the development of the spirometric parameters between the anterior and the posterior group could not be identified (Wilcoxon-Mann-Whitney test). Despite the changes in spirometry, no cases of dyspnea were reported. A different site of injection (anterior or posterior) did not show an effect in reducing the cervical block spread of the local anesthetic and the incidence of phrenic nerve blocks during during ultrasound guided Interscalene brachial plexus block. Clinical breathing effects of phrenic nerve blocks are, however, usually well compensated, and subjective dyspnea did not occur in our patients. German

Effect of dexamethasone added to lidocaine in supraclavicular brachial plexus block: A prospective, randomised, double-blind study

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Prashant A Biradar

2013-01-01

Full Text Available Background: Different additives have been used to prolong brachial plexus block. We performed a prospective, randomised, double-blind study to evaluate the effect of dexamethasone added to lidocaine on the onset and duration of supraclavicular brachial plexus block as this is the most common type of brachial block performed in our institute. Methods: Sixty American Society of Anaesthesiologist′s physical status I and II patients undergoing elective hand, forearm and elbow surgery under brachial plexus block were randomly allocated to receive either 1.5% lidocaine (7 mg/kg with adrenaline (1:200,000 and 2 ml of normal saline (group C, n=30 or 1.5% lidocaine (7 mg/kg with adrenaline (1:200,000 and 2 ml of dexamethasone (8 mg (group D, n=30. The block was performed using a nerve stimulator. Onset and duration of sensory and motor blockade were assessed. The sensory and motor blockade of radial, median, ulnar and musculocutaneous nerves were evaluated and recorded at 5, 10, 20, 120 min, and at every 30 min thereafter. Results: Two patients were excluded from the study because of block failure. The onset of sensory and motor blockade (13.4±2.8 vs. 16.0±2.3 min and 16.0±2.7 vs. 18.7±2.8 min, respectively were significantly more rapid in the dexamethasone group than in the control group ( P=0.001. The duration of sensory and motor blockade (326±58.6 vs. 159±20.1 and 290.6±52.7 vs. 135.5±20.3 min, respectively were significantly longer in the dexamethasone group than in the control group ( P=0.001. Conclusion: Addition of dexamethasone to 1.5% lidocaine with adrenaline in supraclavicular brachial plexus block speeds the onset and prolongs the duration of sensory and motor blockade.

Pre-operative brachial plexus block compared with an identical block performed at the end of surgery: a prospective, double-blind, randomised clinical trial.

Science.gov (United States)

Holmberg, A; Sauter, A R; Klaastad, Ø; Draegni, T; Raeder, J C

2017-08-01

We evaluated whether pre-emptive analgesia with a pre-operative ultrasound-guided infraclavicular brachial plexus block resulted in better postoperative analgesia than an identical block performed postoperatively. Fifty-two patients undergoing fixation of a fractured radius were included. All patients received general anaesthesia with remifentanil and propofol. Patients were randomly allocated into two groups: a pre-operative block or a postoperative block with 0.5 ml.kg -1 ropivacaine 0.75%. After surgery, all patients received regular paracetamol plus opioids for breakthrough pain. Mean (SD) time to first rescue analgesic after emergence from general anaesthesia was 544 (217) min in the pre-operative block group compared with 343 (316) min in the postoperative block group (p = 0.015). Postoperative pain scores were higher and more patients required rescue analgesia during the first 4 h after surgery in the postoperative block group. There were no significant differences in plasma stress mediators between the groups. Analgesic consumption was lower at day seven in the pre-operative block group. Pain was described as very strong at block resolution in 27 (63%) patients and 26 (76%) had episodes of mild pain after 6 months. We conclude that a pre-operative ultrasound-guided infraclavicular brachial plexus block provides longer and better analgesia in the acute postoperative period compared with an identical postoperative block in patients undergoing surgery for fractured radius. © 2017 The Association of Anaesthetists of Great Britain and Ireland.

Adding Sufentanil to TAP Block Hyperbaric Bupivacaine Decreases Post-Cesarean Delivery Morphine Consumption

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Laleh Eslamian

2016-04-01

Full Text Available Pain management is crucially important in the postoperative period as it increases patient comfort and satisfaction. The primary outcome of present study was to evaluate the effect of sufentanil added to hyperbaric bupivacaine solution 0.25% in transversus abdominis plane (TAP block, on postoperative analgesic consumption. Fifty ASA physical status I–II term primiparous single-tone pregnant women aged 20–40 years scheduled for elective cesarean delivery with Pfannenstiel incision under general anaesthesia were enrolled in this randomized, double-blind, placebo-controlled trial. Ultrasound guided TAP block was performed at the end of surgery. Patients were randomly enrolled into two groups. Patients in the study group received 20 ml of hyperbaric bupivacaine 0.25% plus 1mL of sufentanil on either side while patients in the placebo group were administered 20 ml of hyperbaric bupivacaine 0.25% along with 1mL of placebo. Post-cesarean delivery visual analogue scale (VAS for pain and morphine usage were measured and recorded. The morphine consumption was significantly less in the study group (37.2 ± 16.1 mg than the control group (52.8 ± 16.7 mg, P =0.002.The VAS for pain both in rest and coughing were same in groups. Sufentanil added to 0.25% hyperbaric bupivacaine in TAP block decreases post cesarean delivery morphine consumption.

Femoral nerve block in a representative sample of elderly people with hip fracture: A randomised controlled trial.

Science.gov (United States)

Unneby, Anna; Svensson, Olle; Gustafson, Yngve; Olofsson, Birgitta

2017-07-01

The number of elderly people with hip fracture and dementia is increasing, and many of these patients suffer from pain. Opioids are difficult to adjust and side effects are common, especially with increased age and among patients with dementia. Preoperative femoral nerve block is an alternative pain treatment. To investigate whether preoperative femoral nerve block reduced acute pain and opioid use after hip fracture among elderly patients, including those with dementia. In this randomised controlled trial involving patients aged ≥70years with hip fracture (trochanteric and cervical), including those with dementia, we compared femoral nerve block with conventional pain management, with opioid use if required. The primary outcome was preoperative pain, measured at five timepoints using a visual analogue scale (VAS). Preoperative opioid consumption was also registered. The study sample comprised 266 patients admitted consecutively to the Orthopaedic Ward. The mean age was 84.1 (±6.9)years, 64% of participants were women, 44% lived in residential care facilities, and 120 (45.1%) had dementia diagnoses. Patients receiving femoral nerve block had significantly lower self-rated pain scores from baseline to 12h after admission than did controls. Self-rated and proxy VAS pain scores decreased significantly in these patients from baseline to 12h compared with controls (pblock required less opioids than did controls, overall (2.3±4.0 vs. 5.7±5.2mg, pblock had lower pain scores and required less opioids before surgery compared with those receiving conventional pain management. Femoral nerve block seems to be a feasible pain treatment for elderly people, including those with dementia. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

49 CFR 236.401 - Automatic block signal system and interlocking standards applicable to traffic control systems.

Science.gov (United States)

2010-10-01

... TRAIN CONTROL SYSTEMS, DEVICES, AND APPLIANCES Traffic Control Systems Standards § 236.401 Automatic... 49 Transportation 4 2010-10-01 2010-10-01 false Automatic block signal system and interlocking standards applicable to traffic control systems. 236.401 Section 236.401 Transportation Other Regulations...

Adductor canal block for post-operative analgesia after simultaneous bilateral total knee replacement: A randomised controlled trial to study the effect of addition of dexmedetomidine to ropivacaine

Directory of Open Access Journals (Sweden)

Rakhee Goyal

2017-01-01

Full Text Available Background and Aims: Knee replacement surgery causes tremendous post-operative pain and adductor canal block (ACB is used for post-operative analgesia. This is a randomised, controlled, three-arm parallel group study using different doses of dexmedetomidine added to ropiavcaine for ACB. Methods: A total of 150 patients aged 18–75 years, scheduled for simultaneous bilateral total knee replacement, received ultrasound-guided ACB. They were randomised into three groups -Group A received ACB with plain ropivacaine; Groups B and C received ACB with ropivacaine and addition of dexmedetomidine 0.25 μg/kg and 0.50 μg/kg, respectively, on each side of ACB. The primary outcome was the duration of analgesia. Total opioid consumption, success of early ambulation, and level of patient satisfaction were also assessed. Results: The patient characteristics and block success rates were comparable in all groups. Group C patients had longer duration of analgesia (Group C 18.4 h ± 7.4; Group B 14.6 ± 7.1; Group A 10.8 ± 7; P < 0.001; lesser tramadol consumption (Group C 43.8 mg ± 53.2; Group B 76.4 ± 49.6; Group A 93.9 mg ± 58.3; P < 0.001 and lesser pain on movement (P < 0.001. The patients in Group B and C walked more steps than in Group A (P < 0.002. The level of patient satisfaction was highest in Group C (P < 0.001. Conclusions: The addition of dexmedetomidine to ropivacaine resulted in longer duration of analgesia after adductor canal block for simultaneous bilateral total knee replacement surgery.

Blending of styrene-block-butadiene-block-styrene copolymer with sulfonated vinyl aromatic polymers

NARCIS (Netherlands)

Ruggeri, Giacomo; Passaglia, Elisa; Giorgi, Ivan; Picchioni, Francesco; Aglietto, Mauro

2001-01-01

Different polymers containing sulfonic groups attached to the phenyl rings were prepared by sulfonation of polystyrene (PS) and styrene-block-(ethylene-co-1-butene)-block-styrene (SEBS). The sulfonation degree (SD) was varied between 1 and 20 mol% of the styrene units. Polyphase materials containing

Suprascapular block associated with supraclavicular block: An alternative to isolated interscalene block for analgesia in shoulder instability surgery?

Science.gov (United States)

Trabelsi, W; Ben Gabsia, A; Lebbi, A; Sammoud, W; Labbène, I; Ferjani, M

2017-02-01

Interscalene brachial plexus block (ISB) is the gold standard for postoperative pain management in shoulder surgery. However, this technique has side effects and potentially serious complications. The aim of this study was to compare the combinations of ultrasound-guided suprascapular (SSB) associated with supraclavicular nerve block (SCB) and ultrasound-guided ISB for postoperative analgesia after shoulder instability surgery. Sixty ASA physical status I-II patients scheduled to undergo shoulder instability surgery were included. Two groups: (i) the SSB+SCB group (n=30) in which the patients received a combination of US-guided SSB (15mL of bupivacaine 0.25%) and US-guided SCB (15mL of bupivacaine 0.25%) and (ii) the ISB group (n=30) in which the patients received US-guided ISB with 30mL of bupivacaine 0.25%. General anesthesia was administered to all patients. During the first 24h, the variables assessed were time to administer the anesthesia, duration of the analgesia, onset and duration of motor and sensory blockade, opioid consumption, cardiovascular stability, complications, and patient satisfaction. Anesthesia induction took more time for the SSB+SCB group than for the ISB group. However, the onset time of motor and sensory blockade was similar in the two groups. Statistical analysis of the visual analog postoperative pain scoring at H0, H6, H12, and H24 showed nonsignificant differences between the groups. Analgesia, the first request for morphine, and total morphine consumption during the first 24h was similar in both groups. No complication was recorded in the SSB+SCB group. However, phrenic nerve block occurred in all patients in the ISB group. US-guided SCB combined with US-guided SSB was as effective as ISB for postoperative analgesia after shoulder instability surgery without decreasing potential side effects. NCT identifier: NCT02397330. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Extrapunitive and intropunitive individuals activate different parts of the prefrontal cortex under an ego-blocking frustration.

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Takehiro Minamoto

Full Text Available Different people make different responses when they face a frustrating situation: some punish others (extrapunitive, while others punish themselves (intropunitive. Few studies have investigated the neural structures that differentiate extrapunitive and intropunitive individuals. The present fMRI study explored these neural structures using two different frustrating situations: an ego-blocking situation which blocks a desire or goal, and a superego-blocking situation which blocks self-esteem. In the ego-blocking condition, the extrapunitive group (n = 9 showed greater activation in the bilateral ventrolateral prefrontal cortex, indicating that these individuals prefer emotional processing. On the other hand, the intropunitive group (n = 9 showed greater activation in the left dorsolateral prefrontal cortex, possibly reflecting an effortful control for anger reduction. Such patterns were not observed in the superego-blocking condition. These results indicate that the prefrontal cortex is the source of individual differences in aggression direction in the ego-blocking situation.

Blocks and families for cyclotomic Hecke algebras

CERN Document Server

Chlouveraki, Maria

2009-01-01

The definition of Rouquier for the families of characters introduced by Lusztig for Weyl groups in terms of blocks of the Hecke algebras has made possible the generalization of this notion to the case of complex reflection groups. The aim of this book is to study the blocks and to determine the families of characters for all cyclotomic Hecke algebras associated to complex reflection groups. This volume offers a thorough study of symmetric algebras, covering topics such as block theory, representation theory and Clifford theory, and can also serve as an introduction to the Hecke algebras of complex reflection groups.

Intrathecal tramadol as and adjuvant in subrachnoid block to prolong the duration of analgesia

International Nuclear Information System (INIS)

Zahid, F.; Tarar, H. M.; Tariq, M.; Nazir, H.; Zafar, I.; Munir, S.

2017-01-01

Objective: To assess the effect of intrathecal tramadol added to bupivacaine to prolong the duration of analgesia in subarachnoid block for lower limb orthopedic surgeries. Study Design: Randomized controlled trial. Place and Duration of Study: Anesthesia department of Combined Military Hospital Sialkot, from Nov 2015 to Apr 2016. Material and Methods: Patients were selected by non-probability consecutive sampling. One hundred and fifty patients from American Society of Anesthesiologists (ASA) I, II and III category fulfilling inclusion criteria undergoing various lower limb orthopedic surgeries were divided into two groups by lottery system. Group tramadol bupivacaine (TB) received 25mg (1 ml) of tramadol plus 2ml (10mg) of 0.5 percent bupivacaine while group bupivacaine alone (SB) received 1 ml normal saline plus 2ml (10mg) of 0.5 percent bupivacaine. Time to first analgesia request was noted as a measure of duration of analgesia. Time of onset of sensory block level and peak sensory block level and time to reach the peak sensory block level were also noted. Quality of anesthesia was compared among two groups. Data were analyzed by using SPSS version 22. Results: Four patients were excluded from the study. The duration of anesthesia was effectively prolonged in group TB 181.56 ± 12.42 mins as compared to group SB 120.93 ± 15.54 mins. VAS score was significantly lower in group TB. Higher peak sensory block levels (T6) were achieved in group TB as compared to group SB. However time to reach the peak sensory block levels were significantly longer in group TB. (4.5 ± 0.47mins vs 3.09 ± 0.54 mins). Conclusion: This study showed that intrathecal tramadol (25mg) can safely be used along with bupivacaine in subarachnoid blockade to prolong the duration of analgesia and improve the quality of anesthesia as well. (author)

The Efficacy of Ilioinguinal and Iliohypogastric Nerve Block for Postoperative Pain After Caesarean Section

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Melike Sakallı

2010-01-01

Full Text Available Background:: The effect of ilioinguinal and iliohypogastric (II-IH nerve block on postoperative pain is well documented when applied before Caesarean section but the efficacy remains unclear when applied after the surgical procedure. Therefore we investigated the effect of II-IH nerve block on postoperative pain and analgesic consumption in patients when applied after Caesarean Section. Methods: Sixty ASA I-II patients, scheduled for elective C/S were included in the study. After general anaesthesia was performed, the patients were allocated into 2 groups randomly. In Group I (n=30, bilateral II-IH block had been applied after the skin closure, with 10 ml of 0.5% ropivacaine on each side. In Group II (n=30 sham block had been applied. For postoperative analgesia all patients received tramadol via i.v patient controlled analgesia. VAS scores, tramadol consumption and side effects at 0th, 2nd, 4th, 6th, 8th, 12th, 16th, 20th, 24th hours were noted. Results: There was no difference between groups regarding demographical data. The mean VAS scores in Group I were significantly lower than in Group II at 6th (p=0.003, 8th (p=0.019, 12th (p=0.024, 24th hours (p=0.004 at rest and at 6th (p=0.022, 8th hours (p=0.047 with movement. Tramadol usage in Group I was significantly less than in Group II at all estimated time intervals (P=0.001. Total tramadol consumption was 331 ± 82 mg in Group I and 622±107 mg in group II (P=0.001. Conclusions: We observed that II-IH nerve block when applied after the surgery may reduce analgesic consumption after C/S. Key Words: Caesarean section, postoperative analgesia, Ilioinguinal and Iliohypogastric (II-IH nerve block.

Biological effects of blocking blue and other visible light on the mouse retina.

Science.gov (United States)

Narimatsu, Toshio; Ozawa, Yoko; Miyake, Seiji; Kubota, Shunsuke; Yuki, Kenya; Nagai, Norihiro; Tsubota, Kazuo

2014-08-01

To elucidate the biological effects of blocking fluorescent light on the retina using specific blocking materials. Seven- to 8-week-old BALB/c mice were divided into three groups and placed in one of the three boxes: one blocked ultraviolet and violet wavelengths of light (violet blockade), one blocked ultraviolet, violet, blue and some other visible wavelengths (blue-plus blockade), and one allowed most visible light to pass through (control). They were then exposed to a white fluorescent lamp for 1 h at 5.65E-05 mW/cm(2) /s. After treatment, the electroretinogram, retinal outer nuclear layer thickness and retinal outer segment length were measured. In addition, retinal apoptotic cells were quantified by TdT-mediated dUTP nick-end labelling assay and c-Fos messenger RNA, and protein levels were measured by real-time reverse-transcription polymerase chain reaction and immunoblot analyses, respectively. The blue-plus blockade group retained a significantly better electroretinogram response following light exposure than the control or violet blockade groups. The blue-plus blockade group also exhibited greater outer nuclear layer thickness and greater outer-segment length, and fewer apoptotic cells after light exposure than the other groups. The c-Fos messenger RNA and protein levels were substantially reduced in the blue-plus blockade group and reduced to a lesser extent in the violet blockade group. The blockade of blue plus additional visible wavelengths of light was most effective in protecting the retina from light-induced damage. The blockade of violet light alone was also effective in reducing intracellular molecular responses, but these effects were not sufficient for attenuating retinal degeneration. © 2013 Royal Australian and New Zealand College of Ophthalmologists.

Detection of combustion start in the controlled auto ignition engine by wavelet transform of the engine block vibration signal

International Nuclear Information System (INIS)

Kim, Seonguk; Min, Kyoungdoug

2008-01-01

The CAI (controlled auto ignition) engine ignites fuel and air mixture by trapping high temperature burnt gas using a negative valve overlap. Due to auto ignition in CAI combustion, efficiency improvements and low level NO x emission can be obtained. Meanwhile, the CAI combustion regime is restricted and control parameters are limited. The start of combustion data in the compressed ignition engine are most critical for controlling the overall combustion. In this research, the engine block vibration signal is transformed by the Meyer wavelet to analyze CAI combustion more easily and accurately. Signal acquisition of the engine block vibration is a more suitable method for practical use than measurement of in-cylinder pressure. A new method for detecting combustion start in CAI engines through wavelet transformation of the engine block vibration signal was developed and results indicate that it is accurate enough to analyze the start of combustion. Experimental results show that wavelet transformation of engine block vibration can track the start of combustion in each cycle. From this newly developed method, the start of combustion data in CAI engines can be detected more easily and used as input data for controlling CAI combustion

Detection of combustion start in the controlled auto ignition engine by wavelet transform of the engine block vibration signal

Science.gov (United States)

Kim, Seonguk; Min, Kyoungdoug

2008-08-01

The CAI (controlled auto ignition) engine ignites fuel and air mixture by trapping high temperature burnt gas using a negative valve overlap. Due to auto ignition in CAI combustion, efficiency improvements and low level NOx emission can be obtained. Meanwhile, the CAI combustion regime is restricted and control parameters are limited. The start of combustion data in the compressed ignition engine are most critical for controlling the overall combustion. In this research, the engine block vibration signal is transformed by the Meyer wavelet to analyze CAI combustion more easily and accurately. Signal acquisition of the engine block vibration is a more suitable method for practical use than measurement of in-cylinder pressure. A new method for detecting combustion start in CAI engines through wavelet transformation of the engine block vibration signal was developed and results indicate that it is accurate enough to analyze the start of combustion. Experimental results show that wavelet transformation of engine block vibration can track the start of combustion in each cycle. From this newly developed method, the start of combustion data in CAI engines can be detected more easily and used as input data for controlling CAI combustion.

The Effect of Unilateral Spinal Anaesthesia and Psoas Compartment with Sciatic Block on the Postoperative Pain Management in Total Knee Artroplastic Surgery

Directory of Open Access Journals (Sweden)

Ebru Canakci

2017-01-01

Full Text Available Purpose. This study was designed to investigate the effects of peripheral nerve block methods, applied through unilateral spinal anaesthesia on elderly patients to undergo total knee arthroplasty, on perioperative hemodynamic parameters and postoperative analgesia period. Materials and Method. 60 patients were randomly divided into two groups in the study. In group USA spinal anaesthesia was performed. In group PCS it was applied on psoas compartment block and sciatic nerve block. Results. Significantly higher intraoperative 60th and 90th minute mean arterial pressure values were ascertained in the PCS group compared to the USA group. The decrease observed in the 5th, 10th, and 20th minute MAP values in the USA group was statistically significant according to the control MAP value. Concerning within group comparisons, the decrease in 5th, 10th, and 20th minute heart rate values in the USA group was statistically significant compared with the control measurement value. The mean beginning time of sensory and motor blocks in the PCS group was found to be at a significantly advanced level compared with that in the USA group. Conclusions. The PCS block technique using bupivacaine hydrochloride ensured a higher haemodynamic efficiency in the perioperative period in high-risk elderly patients undergoing total knee arthroplasty. This trial is registered with ClinicalTrials.gov Identifier: NCT03021421.

Efficacy of pudendal nerve block for alleviation of catheter-related bladder discomfort in male patients undergoing lower urinary tract surgeries: A randomized, controlled, double-blind trial.

Science.gov (United States)

Xiaoqiang, Li; Xuerong, Zhang; Juan, Liu; Mathew, Bechu Shelley; Xiaorong, Yin; Qin, Wan; Lili, Luo; Yingying, Zhu; Jun, Luo

2017-12-01

Catheter-related bladder discomfort (CRBD) to an indwelling urinary catheter is defined as a painful urethral discomfort, resistant to conventional opioid therapy, decreasing the quality of postoperative recovery. According to anatomy, the branches of sacral somatic nerves form the afferent nerves of the urethra and bladder triangle, which deriving from the ventral rami of the second to fourth sacral spinal nerves, innervating the urethral muscles and sphincter of the perineum and pelvic floor; as well as providing sensation to the penis and clitoris in males and females, which including the urethra and bladder triangle. Based on this theoretical knowledge, we formed a hypothesis that CRBD could be prevented by pudendal nerve block. To evaluate if bilateral nerve stimulator-guided pudendal nerve block could relieve CRBD through urethra discomfort alleviation. Single-center randomized parallel controlled, double blind trial conducted at West China Hospital, Sichuan University, China. One hundred and eighty 2 male adult patients under general anesthesia undergoing elective trans-urethral resection of prostate (TURP) or trans-urethral resection of bladder tumor (TURBT). Around 4 out of 182 were excluded, 178 patients were randomly allocated into pudendal and control groups, using computer-generated randomized numbers in a sealed envelope method. A total of 175 patients completed the study. Pudendal group received general anesthesia along with nerve-stimulator-guided bilateral pudendal nerve block and control group received general anesthesia only. Incidence and severity of CRBD; and postoperative VAS score of pain. CRBD incidences were significantly lower in pudendal group at 30 minutes (63% vs 82%, P = .004), 2 hours (64% vs 90%, P < .000), 8 hours (58% vs 79%, P = .003) and 12 hours (52% vs 69%, P = .028) also significantly lower incidence of moderate to severe CRBD in pudendal group at 30 minutes (29% vs 57%, P < .001), 2 hours (22

Ultrasound-guided peripheral and truncal blocks in pediatric patients

Directory of Open Access Journals (Sweden)

Mohamed Bilal Delvi

2011-01-01

Full Text Available Ultrasound has added a feather in the cap of the anesthesiologists as real-time nerve localization and drug deposition around the nerve structure under real-time guidance is now a reality, as the saying "seeing is believing" has been proven true with the advent of ultrasound in anesthesia. Pediatric patients are a unique group regarding their anatomical and physiological features in comparison with adults; regional blocks in adults with the anatomical landmark and surface marking are almost uniform across the adult population. The landmark technique in pediatric patients is not reliable in all patients due to the variability in the age and size; the advent of ultrasound in assisting nerve localization has changed the way regional blocks are achieved in children and the range of blocks performed on adults can now be performed on pediatric patients; with advances in the technology and dexterity of ultrasound equipment, the chances of success of blocks has increased with a smaller dose of the local anesthetic in comparison to the traditional methods. Anesthesiologists are now able to perform blocks with more accuracy and avoid complications like intravascular injection and injury to the pleura and peritoneum during routine practice with the assistance of high-frequency transducers and top of the range portable ultrasound machines; catheters can be inserted to provide a continuous analgesia in the postoperative period. This review article describes the common peripheral blocks in pediatric patients; the readers are encouraged to gain experience by attending workshops, hands-on practice under supervision, and conduct random controlled trials pertaining to ultrasound-guided blocks in the pediatric age group. The recent literature is encouraging and further research is promising; a wide range of blocks being described in detail by many prominent experts from all over the world.

An Angular Method with Position Control for Block Mesh Squareness Improvement

Energy Technology Data Exchange (ETDEWEB)

Yao, J. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Stillman, D. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States)

2017-09-19

We optimize a target function de ned by angular properties with a position control term for a basic stencil with a block-structured mesh, to improve element squareness in 2D and 3D. Comparison with the condition number method shows that besides a similar mesh quality regarding orthogonality can be achieved as the former does, the new method converges faster and provides a more uniform global mesh spacing in our numerical tests.

Readiness for surgery after axillary block

DEFF Research Database (Denmark)

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

1997-01-01

required less time for block performance (mean 5.5 min) than multiple injections (mean 9.5 min), P requirement for supplemental nerve blocks was greater, after single injections (33 min and 57%) than after multiple injections (15.5 min and 7......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......%, respectively), P effectiveness was 100% in group 1 and 98% in group 2 (NS). The frequency of adverse effects (vessel puncture or paraesthesia) was similar...

Rapid self-assembly of block copolymers to photonic crystals

Science.gov (United States)

Xia, Yan; Sveinbjornsson, Benjamin R; Grubbs, Robert H; Weitekamp, Raymond; Miyake, Garret M; Atwater, Harry A; Piunova, Victoria; Daeffler, Christopher Scot; Hong, Sung Woo; Gu, Weiyin; Russell, Thomas P.

2016-07-05

The invention provides a class of copolymers having useful properties, including brush block copolymers, wedge-type block copolymers and hybrid wedge and polymer block copolymers. In an embodiment, for example, block copolymers of the invention incorporate chemically different blocks comprising polymer size chain groups and/or wedge groups that significantly inhibit chain entanglement, thereby enhancing molecular self-assembly processes for generating a range of supramolecular structures, such as periodic nanostructures and microstructures. The present invention also provides useful methods of making and using copolymers, including block copolymers.

49 CFR 236.708 - Block.

Science.gov (United States)

2010-10-01

... 49 Transportation 4 2010-10-01 2010-10-01 false Block. 236.708 Section 236.708 Transportation... OF SIGNAL AND TRAIN CONTROL SYSTEMS, DEVICES, AND APPLIANCES Definitions § 236.708 Block. A length of track of defined limits, the use of which by trains is governed by block signals, cab signals, or both. ...

Feasibility and analgesic efficacy of the transversus abdominis plane block after single-port laparoscopy in patients having bariatric surgery

Directory of Open Access Journals (Sweden)

Wassef M

2013-11-01

Full Text Available Michael Wassef, David Y Lee, Jun L Levine, Ronald E Ross, Hamza Guend, Catherine Vandepitte, Admir Hadzic, Julio TeixeiraDepartment of Anesthesiology, St Luke's-Roosevelt Hospital Center, New York, NY, USAPurpose: The transversus abdominis plane (TAP block is a technique increasingly used for analgesia after surgery on the anterior abdominal wall. We undertook this study to determine the feasibility and analgesic efficacy of ultrasound-guided TAP blocks in morbidly obese patients. We describe the dermatomal spread of local anesthetic in TAP blocks administered, and test the hypothesis that TAP blocks decrease visual analog scale (VAS scores.Patients and methods: After ethics committee approval and informed consent, 35 patients with body mass index >35 undergoing single-port sleeve gastrectomy (SPSG were enrolled. All patients received balanced general anesthesia, followed by intravenous patient-controlled analgesia (IV-PCA; hydromorphone postoperatively; all reported VAS >3 upon arrival to the recovery room. From the cohort of 35 patients having single-port laparoscopy (SPL, a sealed envelope method was used to randomly select ten patients to the TAP group and 25 patients to the control group. The ten patients in the TAP group received ultrasound-guided TAP blocks with 30 mL of 0.2% Ropivacaine injected bilaterally. The dermatomal distribution of the sensory block (by pinprick test was recorded. VAS scores for the first 24 hours after surgery and opioid use were compared between the IV-PCA+TAP block and IV-PCA only groups.Results: Sensory block ranged from T5–L1. Mean VAS pain scores decreased from 8 ± 2 to 4 ± 3 (P=0.04 within 30 minutes of TAP block administration. Compared with patients given IV-PCA only, significantly fewer patients who received TAP block had moderate or severe pain (VAS 4–10 after block administration at 6 hours and 12 hours post-surgery. However, cumulative consumption of hydromorphone at 24 hours after SPSG surgery

Adductor canal block with local infiltrative analgesia compared with local infiltrate analgesia for pain control after total knee arthroplasty

OpenAIRE

Xing, Qiujuan; Dai, Weiwei; Zhao, Dongfeng; Wu, Ji; Huang, Chunshui; Zhao, Yun

2017-01-01

Abstract Background: This meta-analysis aimed to evaluate the efficiency and safety of the combined adductor canal block with peri-articular infiltration versus periarticular infiltration alone for pain control after total knee arthroplasty (TKA). Methods: PubMed, Medline, Embase, Web of Science, and the Cochrane Library were searched to identify articles comparing the combined adductor canal block with peri-articular infiltration and periarticular infiltration alone for pain control after TK...

Paravertebral Block: An Improved Method of Pain Control in Percutaneous Transhepatic Biliary Drainage

International Nuclear Information System (INIS)

Culp, William C.; McCowan, Timothy C.; DeValdenebro, Miguel; Wright, Lonnie B.; Workman, James L.; Culp, William C.

2006-01-01

Background and Purpose. Percutaneous transhepatic biliary drainage remains a painful procedure in many cases despite the routine use of large amounts of intravenous sedation. We present a feasibility study of thoracic paravertebral blocks in an effort to reduce pain during and following the procedure and reduce requirements for intravenous sedation. Methods. Ten consecutive patients undergoing biliary drainage procedures received fluoroscopically guided paravertebral blocks and then had supplemental intravenous sedation as required to maintain patient comfort. Levels T8-T9 and T9-T10 on the right were targeted with 10-20 ml of 0.5% bupivacaine. Sedation requirements and pain levels were recorded. Results. Ten biliary drainage procedures in 8 patients were performed for malignancy in 8 cases and for stones in 2. The mean midazolam use was 1.13 mg IV, and the mean fentanyl requirement was 60.0 μg IV in the block patients. Two episodes of hypotension, which responded promptly to volume replacement, may have been related to the block. No serious complications were encountered. The mean pain score when traversing the chest wall, liver capsule, and upon entering the bile ducts was 0.1 on a scale of 0 to 10, with 1 patient reporting a pain level of 1 and 9 reporting 0. The mean peak pain score, encountered when manipulating at the common bile duct level or when addressing stones there, was 5.4 and ranged from 0 to 10. Conclusions. Thoracic paravertebral block with intravenous sedation supplementation appears to be a feasible method of pain control during biliary interventions

Optimal dose of perineural dexmedetomidine for interscalene brachial plexus block to control postoperative pain in patients undergoing arthroscopic shoulder surgery: A prospective, double-blind, randomized controlled study.

Science.gov (United States)

Jung, Hong Soo; Seo, Kwon Hui; Kang, Jae Hyuk; Jeong, Jin-Young; Kim, Yong-Shin; Han, Na-Re

2018-04-01

Adjuvant perineural dexmedetomidine can be used to prolong the analgesic effect of interscalene brachial plexus block (ISB). We investigated the optimal dose of dexmedetomidine in ISB for postoperative analgesia in patients undergoing arthroscopic shoulder surgery. One hundred patients scheduled for elective shoulder arthroscopic surgery were enrolled in this randomized, double-blind study. Ultrasound-guided ISB was performed before general anesthesia using 22 mL of ropivacaine 0.5% combined with 1, 1.5, or 2 μg/kg of dexmedetomidine (group D1, D2, and D3, respectively) or with normal saline as a control (group R, n = 25 per group). The primary outcome was the duration of analgesia (DOA), numeric pain rating scale (NRS), and consumption of additional analgesics during 36 h after ISB. Secondary outcome included durations of motor and sensory block (DOM and DOS), hemodynamic variables and sedation and dyspnea scores. Ninety-seven patients completed the study. The DOS, DOM, and DOA were significantly longer in the dexmedetomidine groups than in group R. The DOA was significantly longer in group D3 than in groups D1 (P = .026) and D2 (P = .039). The DOA was 808.13 ± 179.97, 1032.60 ± 288.14, 1042.04 ± 188.13, and 1223.96 ± 238.06 min in groups R, D1, D2, and D3, respectively. The NRS score was significantly higher in group R than in the dexmedetomidine groups 12 h after ISB (P surgery (P = .008 and P = .011, respectively). There were no significant differences in consumption of rescue analgesics, sedation, and dyspnea scores between the study groups. Perineural dexmedetomidine 2 μg/kg could be the optimal dose in ISB for arthroscopic shoulder surgery in that it provides an adequate DOA. However, this dose was associated with increased risk of hypotension.

Fibrin network pattern changes of platelet-rich fibrin in young versus old age group of individuals: A cell block cytology study

OpenAIRE

Shravanthi Raghav Yajamanya; Anirban Chatterjee; Chaitanya Nischay Babu; Deepika Karunanithi

2016-01-01

Background: To evaluate variations in fibrin network patterns of the platelet-rich fibrin (PRF) in different age groups. Materials and Methods: Ninety-five patients were divided into three age groups: Group 1: (20?39 years); Group 2: (40?59 years); and Group 3: (60 years and above). PRF was prepared from blood samples of all patients and were subjected to cell block cytology method of histological analysis and slides were prepared to histologically assess the age-related changes in (i) fibrin...

Comparison of extended-release epidural morphine with femoral nerve block to patient-controlled epidural analgesia for postoperative pain control of total knee arthroplasty: a case-controlled study.

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Sugar, Scott L; Hutson, Larry R; Shannon, Patrick; Thomas, Leslie C; Nossaman, Bobby D

2011-01-01

Because newer anticoagulation strategies for total knee replacement present potentially increased risk of neuraxial analgesia, there is movement away from using patient-controlled epidural analgesia (PCEA) for pain control. This concern opens the door for other regional modalities in postoperative analgesia, including the use of extended-release epidural morphine (EREM) combined with a femoral nerve block (FNB). This study was a prospective observational chart review with the use of recent historical controls in patients undergoing unilateral total knee replacement. Outcomes of interest were 0-, 24-, and 48-hour postoperative pain scores using the visual analog scale (VAS); incidence of side effects; and time spent in the postanesthesia care unit (PACU). Postoperative pain scores at 24 and 48 hours in the EREM and FNB group (n  =  14; 2.6 ± 0.6 and 5.0 ± 0.9, respectively) were comparable to the PCEA group (n  =  14; 3.8 ± 0.6 and 4.2 ± 0.9). The PACU time was shorter in the EREM and FNB group (2.4 ± 0.3 hours) compared with PCEA (3.6 ± 0.3 hours, P  =  .02). No statistically significant difference was found in the incidence of side effects between the 2 groups. The VAS scores at 24 and 48 hours indicate that EREM and FNB provide comparable analgesia to PCEA. The trend toward shorter PACU times represents an opportunity for cost-identification analysis. The study data are limited by their observational nature and the small number of patients involved; nevertheless, this study demonstrates a therapeutic equivalence to PCEA that may be more cost effective.

The effects of dexketoprofen on duration of analgesia to a thermal stimulus when compared with a systemic control in a rat sciatic nerve block with levobupivacaine.

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Kara, Inci; Apiliogullari, Seza; Bagcı Taylan, Sengal; Bariskaner, Hulagu; Celik, Jale Bengi

2014-04-01

This study was designed to investigate whether dexketoprofen added to perineuraly or subcutaneously alters the effects of levobupivacaine in a rat model of sciatic nerve blockade. Thirty-six rats received unilateral sciatic nerve blocks along with a subcutaneous injection by a blinded investigator assigned at random. Combinations were as follows: Group 1 (sham) perineural and subcutaneous saline; Group 2, perineural levobupivacaine alone and subcutaneous saline; Group 3, perineural levobupivacaine plus dexketoprofen and subcutaneous saline; Group 4, perineural levobupivacaine and subcutaneous dexketoprofen; Group 5, perineural dexketoprofen and subcutaneous saline; and Group 6, perineural saline and subcutaneous dexketoprofen. The levobupivacaine concentration was fixed at 0.05%, and the dose of dexketoprofen was 1 mg kg(-1) . Sensory analgesia was assessed by paw withdrawal latency to a thermal stimulus every 30 min. The unblocked paw served as the control for the assessment of systemic, centrally mediated analgesia. Perineural and subcutaneous dexketoprofen coadministered with perineural levobupivacaine did not enhance the duration of sensory blockade when compared with levobupivacaine alone. There were significant differences between the operative and control paws for time points 30-90 min in the perineural levobupivacaine alone, levobupivacaine + dexketoprofen and subcutaneous dexketoprofen added levobupivacaine group. Significant differences were not determined between the levobupivacaine alone group and dexketoprofen added groups in operative paw. The effects of dexketoprofen are unknown for perineural administration. There is no significant difference between the analgesic effects of peripheral nerve blocks using levobupivacaine alone and plus subcutaneous or perineural dexketoprofen. © 2012 The Authors Fundamental and Clinical Pharmacology © 2012 Société Française de Pharmacologie et de Thérapeutique.

Bier′s block using lignocaine and butorphanol

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Abhishek Bansal

2011-01-01

Full Text Available Background : Opioids are most commonly used as adjuncts in intravenous regional anesthesia (IVRA to improve the quality of intraoperative and postoperative analgesia. There is paucity of literature on the use of butorphanol in IVRA. Aims : The aim of this study was to evaluate the likely benefits of addition of butorphanol to lignocaine in Bier′s block in terms of onset and duration of sensory block and also for analgesic requirement in postoperative period. Settings and Design : A randomized double blind study was conducted at Tertiary Care Educational Institute. Patients and Methods : A total of 40 adult ASA I or II patients scheduled to undergo upper limb surgery were randomized in two groups (n=20. Group I received 3 mg/kg of lignocaine alone and group II received 1 mg butorphanol in addition to 3 mg/kg lignocaine. Sensory block onset time and time to recovery from sensory block after tourniquet deflation were noted using the pin prick method. Duration of postoperative analgesia was noted using a visual analogue scale. All the patients were compared for the time to first rescue analgesic consumption and total analgesic consumption in first 24 hours postoperatively. Statistical Analysis Used : The statistical analysis was done using unpaired Student′s t-test. Results : Our study showed significant prolongation of postoperative analgesia in group II as noted by the time to first analgesic requirement. Total analgesic consumption in first 24 hours postoperatively was less in group II. Sensory block onset time and time to recovery from sensory block after tourniquet deflation, did not show any significant difference between the two groups. Conclusions : Addition of butorphanol to lignocaine in IVRA significantly prolongs the duration of postoperative analgesia and 24 hours analgesic consumption is less in patients receiving butorphanol along with lignocaine in IVRA. However, there is no effect on sensory block onset time and time to recovery

Post-operative analgesia following total knee arthroplasty: comparison of low-dose intrathecal morphine and single-shot ultrasound-guided femoral nerve block: a randomized, single blinded, controlled study.

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Frassanito, L; Vergari, A; Zanghi, F; Messina, A; Bitondo, M; Antonelli, M

2010-07-01

Total knee arthroplasty often results in marked postoperative pain. A recent meta-analysis supports the use of femoral nerve block or alternatively spinal injection of morphine plus local anaesthetic for post-operative analgesia. On the other hand, the use of intrathecal morphine may be associated with a large number of distressing side effects (itching, urinary retention, nausea and vomiting, delayed respiratory depression). The aim of this study was to compare the effectiveness of femoral nerve block and low dose intrathecal morphine in post-operative analgesia after primary unilateral total knee arthroplasty. Fifty-two consecutive patients scheduled for primary unilateral total knee arthroplasty were allocated to the intrathecal morphine group (ITM group) or to the femoral nerve block group (FNB group). In ITM group a subarachnoid puncture was performed at the L3-L4 inter-vertebral space with hyperbaric bupivacaine 15 mg plus 100 mcg of preservative-free morphine. Patients allocated to the FNB group received a single-injection ultrasound-assisted femoral nerve block with ropivacaine 0.75% 25 ml before the spinal injection of hyperbaric bupivacaine 15 mg. All patients received postoperative patient-controlled-analgesia (PCA) morphine, using a 1-mg bolus and a 5-minute lockout period. Data were analyzed using Student t test or two-way analysis of variance (ANOVA) for repeated measures with time and treatment as the 2 factors. Post hoc comparisons were performed by Bonferroni test. Statistical significance for all test was a p value < 0.05. Patient characteristics were similar between the 2 groups. We found a statistically significant differences in postoperative pain between the two groups: ITM group had the lower visual analogic pain score (VAS) values. Morphine consumption was lower in the ITM group: average consumption within the first 6 hours was 0.9 mg in IT group compared to 3.1 mg in FNB group; at 12 h 4.2 mg vs 6.3 mg; at 24 h 6.9 mg vs 10.3 mg; at 48 h 9

Pituitary block with gonadotrophin-releasing hormone antagonist during intrauterine insemination cycles: a systematic review and meta-analysis of randomised controlled trials.

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Vitagliano, A; Saccone, G; Noventa, M; Borini, A; Coccia, M E; Nardelli, G B; Saccardi, C; Bifulco, G; Litta, P S; Andrisani, A

2018-06-03

Several randomised controlled trials (RCTs) have investigated the usefulness of pituitary block with gonadotrophin-releasing hormone (GnRH) antagonists during intrauterine insemination (IUI) cycles, with conflicting results. The aim of the present systematic review and meta-analysis of RCTs was to evaluate the effectiveness of GnRH antagonist administration as an intervention to improve the success of IUI cycles. Electronic databases (MEDLINE, Scopus, EMBASE, Sciencedirect) and clinical registers were searched from their inception until October 2017. Randomised controlled trials of infertile women undergoing one or more IUI stimulated cycles with GnRH antagonists compared with a control group. The primary outcomes were ongoing pregnancy/live birth rate (OPR/LBR) and clinical pregnancy rate (CPR). Pooled results were expressed as odds ratio (OR) or mean differences with 95% confidence interval (95% CI). Sources of heterogeneity were investigated through sensitivity and subgroups analysis. The body of evidence was rated using GRADE methodology. Publication bias was assessed with funnel plot, Begg's and Egger's tests. Fifteen RCTs were included (3253 IUI cycles, 2345 participants). No differences in OPR/LBR (OR 1.14, 95% CI 0.82-1.57, P = 0.44) and CPR (OR 1.28, 95% CI 0.97-1.69, P = 0.08) were found. Sensitivity and subgroup analyses did not provide statistical changes in pooled results. The body of evidence was rated as low (GRADE 2/4). No publication bias was detected. Pituitary block with GnRH antagonists does not improve OPR/LBR and CPR in women undergoing IUI cycles. Pituitary block with GnRH antagonists does not improve the success of IUI cycles. © 2018 Royal College of Obstetricians and Gynaecologists.

Asymmetric PS-block-(PS-co-PB)-block-PS block copolymers: morphology formation and deformation behaviour

International Nuclear Information System (INIS)

Adhikari, Rameshwar; Huy, Trinh An; Buschnakowski, Matthias; Michler, Goerg H; Knoll, Konrad

2004-01-01

Morphology formation and deformation behaviour of asymmetric styrene/butadiene triblock copolymers (total polystyrene (PS) content ∼70%) consisting of PS outer blocks held apart by a styrene-co-butadiene random copolymer block (PS-co-PB) each were investigated. The techniques used were differential scanning calorimetry, transmission electron microscopy, uniaxial tensile testing and Fourier-transform infrared spectroscopy. A significant shift of the phase behaviour relative to that of a neat symmetric triblock copolymer was observed, which can be attributed to the asymmetric architecture and the presence of PS-co-PB as a soft block. The mechanical properties and the microdeformation phenomena were mainly controlled by the nature of their solid-state morphology. Independent of morphology type, the soft phase was found to deform to a significantly higher degree of orientation when compared with the hard phase

Effect of Transversus Abdominis Plane Block on Postoperative Pain after Colorectal Surgery: A Meta-Analysis of Randomized Controlled Trials.

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Liu, Lin; Xie, Yan-Hu; Zhang, Wei; Chai, Xiao-Qing

2018-01-01

To assess the analgesic efficacy of transversus abdominis plane (TAP) block in patients undergoing colorectal surgery (CRS). The databases of PubMed, ISI Web of Science, and Embase were searched, and randomized controlled studies (RCTs) that compared TAP block to control for relief of postoperative pain in patients who underwent CRS were included. Outcomes, including postoperative pain at rest and with movement, morphine use, postoperative nausea and vomiting, and the length of hospital stay, were analyzed using STATA software. The weighted mean differences (WMDs) with 95% confidence intervals (95% CIs) or relative risk with 95% CI were used to present the strength of associations. A total of 7 RCTs with 511 patients were included. The results of this study suggested that TAP block significantly relieved postoperative pain during postanesthetic recovery after CRS at rest and during movement (WMDs were -0.98 [95% CI -1.57 to -0.38] and -0.68 [-1.07 to -0.30], respectively), and also decreased pain intensity during movement 24 h after CRS (WMD: -0.57 [95% CI -1.06 to -0.08]). TAP block significantly reduced opioid consumption within 24 h when compared to controls, with a WMD of 15.66 (95% CI -23.93 to -7.39). However, TAP block did not shorten the length of hospital stay. TAP block was an effective approach for relief of postoperative pain and reduced postoperative consumption of morphine. More RCTs with large sample sizes are required to confirm these findings. © 2018 The Author(s) Published by S. Karger AG, Basel.

Dental and skeletal changes in mild to moderate Class II malocclusions treated by either a Twin-block or Xbow appliance followed by full fixed orthodontic treatment.

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Ehsani, Sayeh; Nebbe, Brian; Normando, David; Lagravere, Manuel O; Flores-Mir, Carlos

2015-11-01

To compare the short-term skeletal and dental effects of two-phase orthodontic treatment including either a Twin-block or an XBow appliance. This was a retrospective clinical trial of 50 consecutive Class II cases treated in a private practice with either a Twin-block (25) or XBow (25) appliance followed by full fixed orthodontic treatment. To factor out growth, an untreated Class II control group (25) was considered. A MANOVA of treatment/observation changes followed by univariate pairwise comparisons showed that the maxilla moved forward less in the treatment groups than in the control group. As for mandibular changes, the corpus length increase was larger in the Twin-block group by 3.9 mm. Dentally, mesial movement of mandibular molars was greater in both treatment groups. Although no distalization of maxillary molars was found in either treatment group, restriction of mesial movement of these teeth was seen in both treatment groups. Both treatment groups demonstrated increased mandibular incisor proclination with larger increases for the XBow group by 3.3°. The Wits value was decreased by 1.6 mm more in the Twin-block group. No sex-related differences were observed. Class II correction using an XBow or Twin-block followed by fixed appliances occurs through a relatively similar combination of dental and skeletal effects. An increase in mandibular incisor inclination for the XBow group and an increased corpus length for the Twin-block group were notable exceptions. No overall treatment length differences were seen.

An efficient, block-by-block algorithm for inverting a block tridiagonal, nearly block Toeplitz matrix

International Nuclear Information System (INIS)

Reuter, Matthew G; Hill, Judith C

2012-01-01

We present an algorithm for computing any block of the inverse of a block tridiagonal, nearly block Toeplitz matrix (defined as a block tridiagonal matrix with a small number of deviations from the purely block Toeplitz structure). By exploiting both the block tridiagonal and the nearly block Toeplitz structures, this method scales independently of the total number of blocks in the matrix and linearly with the number of deviations. Numerical studies demonstrate this scaling and the advantages of our method over alternatives.

Randomized controlled trial to study the effect of dexamethasone as additive to ropivacaine on duration of ultrasound-guided transversus abdominis plane block in cesarean section

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Jasleen Sachdeva

2016-01-01

Full Text Available Background: Transversus abdominis plane (TAP block is a regional anesthesia technique whose efficacy has been proven for postoperative pain relief after cesarean section (CS. Dexamethasone, a glucocorticoid, is now emerging as a new adjunct to local anesthetics for prolonging the duration of action and has been studied in different brachial plexus blocks. The primary outcome was to study the effect of dexamethasone as additive to ropivacaine on the duration of TAP block as assessed by time to first analgesic (TFA . The secondary outcome was total postoperative analgesic consumption, postoperative nausea and vomiting, and patient satisfaction. Method: This RCT was conducted on seventy American Society of Anesthesiology Grade I and II patients undergoing CS under subarachnoid block. Patients were randomly allocated to two groups comprising 35 patients each. Patients in Group I received ultrasound-guided bilateral TAP block at the end of surgery using 40 ml ropivacaine 0.2% and 2 ml saline, and patients in Group II received the block using 40 ml ropivacaine 0.2% and 2 ml (8 mg dexamethasone. Result: TFA was significantly longer in Group II (5.92 ± 1.02 vs. 3.11 ± 0.82 h, P = 0. Group II also had decreased tramadol requirement postoperatively (100.00 ± 0.00 vs. 140.00 ± 50.26 mg, P = 0.046. The incidence of nausea and vomiting was also lower (82.86% vs. 97.14%, P = 0.02318. The patient satisfaction with regard to pain relief was more (57.14% vs. 25.71%, P = 0.038. Conclusion: Addition of dexamethasone to ropivacaine in TAP block prolonged the duration of the block. There was no complication seen with TAP block in any of the patients.

Lumbar Sympathetic Plexus Block as a Treatment for Postamputation Pain: Methodology for a Randomized Controlled Trial.

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McCormick, Zachary L; Hendrix, Andrew; Dayanim, David; Clay, Bryan; Kirsling, Amy; Harden, Norman

2018-03-08

We present a technical protocol for rigorous assessment of patient-reported outcomes and psychophysical testing relevant to lumbar sympathetic blocks for the treatment of postamputation pain (PAP). This description is intended to inform future prospective investigation. Series of four participants from a blinded randomized sham-controlled trial. Tertiary, urban, academic pain medicine center. Four participants with a single lower limb amputation and associated chronic PAP. Participants were randomized to receive a lumbar sympathetic block with 0.25% bupivacaine or sham needle placement. Patient-rated outcome measures included the numerical rating scale (NRS) for pain, the McGill Pain Questionnaire-Short Form, Center for Epidemiological Studies Depression Scale, Pain and Anxiety Symptoms Scale-short version, and Pain Disability Index (PDI). Psychophysical and biometric testing was also performed, which included vibration sensation testing, pinprick sensation testing, brush sensation testing, Von Frey repeated weighted pinprick sensation, and thermal quantitative sensory testing. In the four described cases, treatment of PAP with a single lumbar sympathetic block but not sham intervention resulted in reduction of both residual limb pain and phantom limb pain as well as perceived disability on the PDI at three-month follow-up. An appropriately powered randomized controlled study using this methodology may not only aid in determining the possible clinical efficacy of lumbar sympathetic block in PAP, but could also improve our understanding of underlying pathophysiologic mechanisms of PAP.

Enhancing the early differential diagnosis of plateau iris and pupillary block using a-scan ultrasonography.

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Yu-Yen Chen

Full Text Available To distinguish the frequently misdiagnosed plateau iris eyes from pupillary block group and normal group, we compared the ocular biometrical parameters of them by A-scan ultrasongraphy.In total, we retrospectively reviewed general characteristics and ocular findings including ocular biometric measurements of 71 normal, 39 plateau iris, and 83 pupillary block eyes.The normal controls, plateau iris group and pupillary block group were significantly different in age, but not in gender. The anterior chamber depth tended to decrease and the lens thickness tended to increase from normal to plateau iris to pupillary block eyes. Compared to those of plateau iris group, the pupillary block group had significantly shallower anterior chamber depth (2.90mm vs. 2.33mm; p<0.001, thicker lens (4.77mm vs. 5.11mm; p<0.001, shorter axial length (23.16mm vs. 22.63mm; p<0.001, smaller relative lens position (2.28 vs. 2.16; p<0.001 and larger lens/axial length factor (2.06 vs. 2.26; p<0.001. However, when comparing plateau iris and normal eyes, only axial length and lens/axial length factor were significantly different (23.16 vs. 23.54; p<0.05 and 2.06 vs. 1.96; p<0.05.Measured by A-scan ultrasonography, the ocular biometrics of plateau iris were significantly different from those of pupillary block eyes. However, our A-scan ultrasongraphy generally found no significant biometric differences between plateau iris and normal eyes. These findings suggest that while A-scan ultrasonography might be used as a practical tool for differentiating plateau iris and papillary block eyes, a more meticulous gonioscopy and other assessments may be necessary to distinguish plateau iris from normal eyes.

The analgesic efficacy of continuous transversus abdominis plane block in renal transplant recipients

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Beena Kandarp Parikh

2015-01-01

Full Text Available Background and Aims: Transversus abdominis plane (TAP block is suitable for operations where parietal pain is a major cause of pain. Renal transplant recipients are ideally suited to gain maximum benefit from TAP block as the incision classically involves the lower abdomen. This study was conducted to evaluate the analgesic efficacy of continuous TAP block in transplant recipients. Material and Methods: In a prospective double-blind study, 40 chronic renal failure patients undergoing open renal transplant were randomly divided into two groups. At the end of surgery during closure, a multiorifice epidural catheter was placed in TAP plane. Study group (Group S received Inj bupivacaine bolus 1 mg/kg (0.25% followed by infusion 0.25 mg/kg (0.125% through the catheter, whereas control group (Group C received normal saline through the catheter. Inj pentazocine (0.3 mg/kg was given as rescue analgesic at visual analogue score (VAS > 3 in any group at rest or on movement. The analgesic efficacy was judged by VAS, time of first rescue analgesic, and total analgesic consumption in 24 h. Results: Patients in Group S had significant lower VAS scores, longer time to first rescue analgesic (270 ± 347.96 vs. 42.85 ± 32.27 min and lower pentazocine consumption (9.75 ± 13.95 vs. 56.42 ± 12.46 mg in 24 h. There was significant sedation in Group C. Conclusion: The TAP catheter technique for postoperative pain control after renal transplant has proved to be effective in relieving the postoperative pain after renal transplant with less pentazocine requirement and less sedation.

Phenotypic characterization of mononuclear inflammatory cells following equine hydroxyapatite/collagen block grafting in rats

International Nuclear Information System (INIS)

Alsuwaiyan, Asim; Wang, Bing-Yan; Cohen, Robert E

2012-01-01

To measure the inflammatory changes associated with the implantation of an equine hydroxyapatite and collagen-containing block graft (eHAC block) in a rodent model system, an eHAC block graft was implanted subcutaneously in rats. Control groups included saline, turpentine oil, and human mineralized particulate allograft (hMPA). Animals were sacrificed and tissue samples obtained after three days, as well as after 1, 2, 4 and 8 weeks. A panel of immunologic probes was used to identify circulatory monocytic cells (ED1), resident mononuclear phagocytes (ED2), mononuclear phagocytes of lymphoid origin (ED3), expression of Ia antigen (OX6), T-cells (OX19), and B-cells (OX33). Immunocytochemical localization was performed and mononuclear cells localized with each immunologic probe counted. Rat sera obtained after eight weeks were used for nitrocellulose dot-blotting to assess circulating anti-equine immunoglobulins. Statistical analysis was performed using two-way analysis of variance, in conjunction with the Bonferroni correction to account for multiple comparisons. A transient increase in monocytes at 3 days and 1 week was observed in all groups, but was significantly higher in the turpentine control (P < 0.0001). A significant increase in the numbers of mononuclear cells detected with clones ED2 and ED3 was observed in specimens from the turpentine group, in contrast to the other groups in the 3 day to 4 week interval (P < 0.0001), as well as within all time periods (P < 0.0001). A statistically significant difference in numbers of ED3-positive cells was observed in the hMPA group compared to the saline and the eHAC block groups after one week (P < 0.0001). Significantly more OX6-positive cells were observed in the turpentine group, compared to other groups (3 days to 1 week; P < 0.0001). T-lymphocytes were essentially absent except for rats given turpentine (after 1 week). No B-lymphocyte response was found and none of the rats developed systemic anti

Striving for Group Agency: Threat to Personal Control Increases the Attractiveness of Agentic Groups

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Janine eStollberg

2015-05-01

Full Text Available When their sense of personal control is threatened people try to restore perceived control through the social self. We propose that it is the perceived agency of ingroups that provides the self with a sense of control. In three experiments, we for the first time tested the hypothesis that threat to personal control increases the attractiveness of being part or joining those groups that are perceived as coherent entities engaging in coordinated group goal pursuit (agentic groups but not of those groups whose agency is perceived to be low. Consistent with this hypothesis we found in Study 1 (N = 93 that threat to personal control increased ingroup identification only with task groups, but not with less agentic types of ingroups that were made salient simultaneously. Furthermore, personal control threat increased a sense of collective control and support within the task group, mediated through task-group identification (indirect effects. Turning to groups people are not (yet part of, Study 2 (N = 47 showed that personal control threat increased relative attractiveness ratings of small groups as possible future ingroups only when the relative agency of small groups was perceived to be high. Perceived group homogeneity or social power did not moderate the effect. Study 3 (N = 78 replicated the moderating role of perceived group agency for attractiveness ratings of entitative groups, whereas perceived group status did not moderate the effect. These findings extend previous research on group-based control, showing that perceived agency accounts for group-based responses to threatened control.

The effects of transversus abdominis plane block on analgesic and anesthetic consumption during total abdominal hysterectomy: a randomized controlled study

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Tugba Karaman

2018-05-01

Full Text Available Background and objectives: A transversus abdominis plane block is a peripheral block method that has been used successfully for pain relief after total abdominal hysterectomy. However, the effects of the combination of the transversus abdominis plane block and general anesthesia on analgesic and anesthetic requirements remain unclear. This randomized placebo-controlled study is aimed to evaluate the effects of transversus abdominis plane block on analgesic and anesthetic consumption during total abdominal hysterectomy under general anesthesia. Methods: Sixty-six women undergoing total abdominal hysterectomy were randomized into two groups to receive general anesthesia alone (control group or with transversus abdominis plane block using 20 mL of 0.25% bupivacaine (transversus abdominis plane group. Intraoperative remifentanil and sevoflurane consumption were recorded. We also evaluated the postoperative pain, nausea, quality of recovery scores and rescue analgesic requirement during postoperative 24 hours. Results: The total remifentanil and sevoflurane consumption is significantly lower in transversus abdominis plane group; respectively mean (SD 0.130 (0.25 vs. 0.094 (0.02 mcg.kg−1.min−1; p < 0.01 and 0.295 (0.05 vs. 0.243 (0.06 mL.min−1; p < 0.01. In the postoperative period, pain scores were significantly reduced in transversus abdominis plane group soon after surgery; median (range 6 (2–10 vs. 3 (0–5; p < 0.001, at 2 h (5 [3–9] vs. 2.5 [0–6]; p < 0.001, at 6 h (4 [2–7] vs. 3[0–6], p < 0.001, at 12 h (3.5 [1–6] vs. 2 [1–5]; p = 0.003. The patients in the transversus abdominis plane group had significantly higher QoR-40 scores 190.5 (175–197 vs. 176.5 (141–187; p < 0.001. Conclusion: Combining transversus abdominis plane block with general anesthesia can provide reduced opioid and anesthetic consumption and can improve postoperative pain and quality of recovery scores in patients undergoing total

Effects of Interscalene Nerve Block for Postoperative Pain Management in Patients after Shoulder Surgery.

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Chen, Hsiu-Pin; Shen, Shih-Jyun; Tsai, Hsin-I; Kao, Sheng-Chin; Yu, Huang-Ping

2015-01-01

Shoulder surgery can produce severe postoperative pain and movement limitations. Evidence has shown that regional nerve block is an effective management for postoperative shoulder pain. The purpose of this study was to investigate the postoperative analgesic effect of intravenous patient-controlled analgesia (PCA) combined with interscalene nerve block in comparison to PCA alone after shoulder surgery. In this study, 103 patients receiving PCA combined with interscalene nerve block (PCAIB) and 48 patients receiving PCA alone after shoulder surgery were included. Patients' characteristics, preoperative shoulder score and range of motion, surgical and anesthetic condition in addition to visual analog scale (VAS) pain score, postoperative PCA consumption, and adverse outcomes were evaluated. The results showed that PCA combined with interscalene nerve block (PCAIB) group required less volume of analgesics than PCA alone group in 24 hours (57.76 ± 23.29 mL versus 87.29 ± 33.73 mL, p shoulder surgery.

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

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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.

A rapid method of detecting motor blocks in patients with Parkinson's disease during volitional hand movements

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Popović Mirjana B.

2002-01-01

number (N of MB episodes, allow identification and quantification of motor blocks. Duration of motor blocks (MVT is defined as the time sequence when (x,y coordinates do not change their values and is expressed in percentage from the whole movement duration MBT% = MBT/T (%. If during some movements more than one motor block occurs (N > 1 then this movement is decomposed. The whole movement motor block (mbt is the sum of all motor blocks MVT,; during the same movement and expressed in percentage from the whole movement duration mbt%= tYJa (%. The onset of motor block (t is determined with the beginning of motor block and expressed in percentage from the whole move- ment duration: t% = t/T (%. After the determination of kinematic indicators of motor blocks (MVT, N, t for healthy controls, their mean values are calculated. Statistical package ANOVA is applied to determine statistical significance of the difference between PD patients and mean values from age matched control healthy group. PD patients are then classified into two groups: one group consisting of PD patients with motor blocks and the other without motor blocks, similar to healthy controls. RESULTS Acquired movements are processed and analyzed. Fig. 2 is an example of hand trajectories. Time course of (x, y coordinates indicates motor block appearance, Fig.3. Detailed presentation of kinematic indicators of motor block (MVT, N, t is in Fig. 4. Intra-subject variability of these parameters is presented in Figs 5, 6 and 7 for patient #3. The results for N show that 45% of all patients #3 movements had none motor blocks (N = 0; 20% had N = 1; 15% had N = 2; 11.5% had N = 3; 5.7% had N = 4; 0.3 % had N = 5; 0.7% had N = 6; 0.3 % had N = 7 and 1% had N = 8 motor blocks. The results for t% show that 3% of all patients' #3 blocks started at first quarter, 17% started in the second, 36% in the third, and 44% in the last quarter of movement. The results for MBT% show that 14.5% of all movements had MBT% in the range 0

Integral-fuel blocks

International Nuclear Information System (INIS)

Cunningham, C.; Simpkin, S.D.

1975-01-01

A prismatic moderator block is described which has fuel-containing channels and coolant channels disposed parallel to each other and to edge faces of the block. The coolant channels are arranged in rows on an equilateral triangular lattice pattern and the fuel-containing channels are disposed in a regular lattice pattern with one fuel-containing channel between and equidistant from each of the coolant channels in each group of three mutually adjacent coolant channels. The edge faces of the block are parallel to the rows of coolant channels and the channels nearest to each edge face are disposed in two rows parallel thereto, with one of the rows containing only coolant channels and the other row containing only fuel-containing channels. (Official Gazette)

Controlled release of cortisone drugs from block copolymers synthetized by ATRP

Science.gov (United States)

Valenti, G.; La Carta, S.; Mazzotti, G.; Rapisarda, M.; Perna, S.; Di Gesù, R.; Giorgini, L.; Carbone, D.; Recca, G.; Rizzarelli, P.

2016-05-01

Diseases affecting posterior eye segment, like macular edema, infection and neovascularization, may cause visual impairment. Traditional treatments, such as steroidal-drugs intravitreal injections, involve chronic course of therapy usually over a period of years. Moreover, they can require frequent administrations of drug in order to have an adequately disease control. This dramatically reduce patient's compliance. Efforts have been made to develop implantable devices that offer an alternative therapeutic approach to bypass many challenges of conventional type of therapy. Implantable drug delivery systems (DDS) have been developed to optimize therapeutic properties of drugs and ensure their slow release in the specific site. Polymeric materials can play an essential role in modulating drug delivery and their use in such field has become indispensable. During last decades, acrylic polymers have obtained growing interest. Biocompatibility and chemical properties make them extremely versatile, allowing their use in many field such as biomedical. In particular, block methacrylate copolymer with a balance of hydrophilic and hydrophobic properties can be suitable for prolonged DDS in biomedical devices. In this work, we focused on the realization of a system for controlled and long term release of betamethasone 17,21-dipropionate (BDP), a cortisone drug, from methacrylic block copolymers, to be tested in the treatment of the posterior eye's diseases. Different series of methyl methacrylate/hydroxyethyl methacrylate (MMA/HEMA) block and random copolymers, with different monomer compositions (10-60% HEMA), were synthetized by Atom Transfer Radical Polymerization (ATRP) to find the best hydrophilic/hydrophobic ratio, able to ensure optimal kinetic release. Copolymer samples were characterized by NMR spectroscopy (1H-NMR, 13C-NMR, CosY), SEC, TGA and DSC. Monitoring of drug release from films loaded with BDP was carried out by HPLC analysis. Evaluation of different kinetic

Controlled release of cortisone drugs from block copolymers synthetized by ATRP

Energy Technology Data Exchange (ETDEWEB)

Valenti, G.; La Carta, S.; Rapisarda, M.; Carbone, D.; Recca, G.; Rizzarelli, P., E-mail: paola.rizzarelli@cnr.it [Istituto per i Polimeri, Compositi e Biomateriali, Consiglio Nazionale delle Ricerche Via P. Gaifami 18, 95129 Catania (Italy); Mazzotti, G.; Giorgini, L. [Dipartimento di Chimica Industriale «Toso Montanari», Università di Bologna Via Risorgimento 4, 40136 Bologna (Italy); Perna, S. [ST Microelectronics Srl, Stradale Primosole, 50–95121 Catania (Italy); Di Gesù, R. [Merck Serono S.p.A., Via L. Einaudi, 11–00012 Guidonia Montecelio, Rome (Italy)

2016-05-18

Diseases affecting posterior eye segment, like macular edema, infection and neovascularization, may cause visual impairment. Traditional treatments, such as steroidal-drugs intravitreal injections, involve chronic course of therapy usually over a period of years. Moreover, they can require frequent administrations of drug in order to have an adequately disease control. This dramatically reduce patient’s compliance. Efforts have been made to develop implantable devices that offer an alternative therapeutic approach to bypass many challenges of conventional type of therapy. Implantable drug delivery systems (DDS) have been developed to optimize therapeutic properties of drugs and ensure their slow release in the specific site. Polymeric materials can play an essential role in modulating drug delivery and their use in such field has become indispensable. During last decades, acrylic polymers have obtained growing interest. Biocompatibility and chemical properties make them extremely versatile, allowing their use in many field such as biomedical. In particular, block methacrylate copolymer with a balance of hydrophilic and hydrophobic properties can be suitable for prolonged DDS in biomedical devices. In this work, we focused on the realization of a system for controlled and long term release of betamethasone 17,21-dipropionate (BDP), a cortisone drug, from methacrylic block copolymers, to be tested in the treatment of the posterior eye’s diseases. Different series of methyl methacrylate/hydroxyethyl methacrylate (MMA/HEMA) block and random copolymers, with different monomer compositions (10–60% HEMA), were synthetized by Atom Transfer Radical Polymerization (ATRP) to find the best hydrophilic/hydrophobic ratio, able to ensure optimal kinetic release. Copolymer samples were characterized by NMR spectroscopy ({sup 1}H-NMR, {sup 13}C-NMR, CosY), SEC, TGA and DSC. Monitoring of drug release from films loaded with BDP was carried out by HPLC analysis. Evaluation of

Controlled release of cortisone drugs from block copolymers synthetized by ATRP

International Nuclear Information System (INIS)

Valenti, G.; La Carta, S.; Rapisarda, M.; Carbone, D.; Recca, G.; Rizzarelli, P.; Mazzotti, G.; Giorgini, L.; Perna, S.; Di Gesù, R.

2016-01-01

Diseases affecting posterior eye segment, like macular edema, infection and neovascularization, may cause visual impairment. Traditional treatments, such as steroidal-drugs intravitreal injections, involve chronic course of therapy usually over a period of years. Moreover, they can require frequent administrations of drug in order to have an adequately disease control. This dramatically reduce patient’s compliance. Efforts have been made to develop implantable devices that offer an alternative therapeutic approach to bypass many challenges of conventional type of therapy. Implantable drug delivery systems (DDS) have been developed to optimize therapeutic properties of drugs and ensure their slow release in the specific site. Polymeric materials can play an essential role in modulating drug delivery and their use in such field has become indispensable. During last decades, acrylic polymers have obtained growing interest. Biocompatibility and chemical properties make them extremely versatile, allowing their use in many field such as biomedical. In particular, block methacrylate copolymer with a balance of hydrophilic and hydrophobic properties can be suitable for prolonged DDS in biomedical devices. In this work, we focused on the realization of a system for controlled and long term release of betamethasone 17,21-dipropionate (BDP), a cortisone drug, from methacrylic block copolymers, to be tested in the treatment of the posterior eye’s diseases. Different series of methyl methacrylate/hydroxyethyl methacrylate (MMA/HEMA) block and random copolymers, with different monomer compositions (10–60% HEMA), were synthetized by Atom Transfer Radical Polymerization (ATRP) to find the best hydrophilic/hydrophobic ratio, able to ensure optimal kinetic release. Copolymer samples were characterized by NMR spectroscopy ("1H-NMR, "1"3C-NMR, CosY), SEC, TGA and DSC. Monitoring of drug release from films loaded with BDP was carried out by HPLC analysis. Evaluation of different

A randomized trial comparing surgeon-administered intraoperative transversus abdominis plane block with anesthesiologist-administered transcutaneous block.

Science.gov (United States)

Narasimhulu, D M; Scharfman, L; Minkoff, H; George, B; Homel, P; Tyagaraj, K

2018-04-27

Injection of local anesthetic into the transversus abdominis plane (TAP block) decreases systemic morphine requirements after abdominal surgery. We compared intraoperative surgeon-administered TAP block (surgical TAP) to anesthesiologist-administered transcutaneous ultrasound-guided TAP block (conventional TAP) for post-cesarean analgesia. We hypothesized that surgical TAP blocks would take less time to perform than conventional TAP blocks. We performed a randomized trial, recruiting 41 women undergoing cesarean delivery under neuraxial anesthesia, assigning them to either surgical TAP block (n=20) or conventional TAP block (n=21). Time taken to perform the block was the primary outcome, while postoperative pain scores and 24-hour opioid requirements were secondary outcomes. Student's t-test was used to compare block time and Kruskal-Wallis test opioid consumption and pain-scores. Time taken to perform the block (2.4 vs 12.1 min, P consumption (P=0.17) and postoperative pain scores at 4, 8, 24 and 48 h were not significantly different between the groups. Surgical TAP blocks are feasible and less time consuming than conventional TAP blocks, while providing comparable analgesia after cesarean delivery. Copyright © 2018 Elsevier Ltd. All rights reserved.

The Challenge of Recruiting Control Groups

DEFF Research Database (Denmark)

O'Connor, Maja

2011-01-01

. This study was a direct reaction to the first recruitment attempt that had a 10% response rate. This study consisted of four groups of randomly selected elderly married people (65-81 years) receiving a postal questionnaire measuring depression, social support, coping style, adult attachment, life......  Recruitment of a large and reliable control group is a challenge in psychological survey based research. The effect of recruitment styles and age on response-rate, data quality, and individual differences were investigated in a control group for a postal survey of elderly bereaved people...... incentive had the highest response-rate (51%), good data quality, and no sampling bias in individual differences. This method can be highly recommended in future control group recruitment....

Effect of QTc interval on prediction of hypotension following subarachnoid block in patients undergoing cesarean section: A comparative study

Directory of Open Access Journals (Sweden)

Sampa Dutta Gupta

2012-01-01

Full Text Available Background: Previous studies have revealed that QTc interval is prolonged in pre-eclamptic parturients. Another study reflected the relationship between the sympathetic block and QTc interval. Subarachnoid block was safely administered in patients with severe pre-eclampsia. It has also been noticed that hypotension in response to spinal anesthesia is relatively less in pre-eclamptic patients than normal parturients. Aim: To compare the QTc values in normal and pre-eclamptic term parturients and to establish whether any correlation exists between the QTc interval and the systemic hypotension following subarachnoid block. Materials and Methods: Twenty-five pre-eclamptic patients (Group A and 25 normotensive patients (Group B were included in this study. QTc interval was recorded for each patient before subarachnoid block for cesarean section. Changes in arterial blood pressure and heart rate were measured in both the groups and compared. Results: Baseline QTc was significantly higher in the pre-eclamptic group (Group A: 0.47 ± 0.11 with that of control (Group B: 0.36. ± 0.02. Significant fall in blood pressure was seen only in one group with QTc between 0.38 and 0.39 in Group A. Hypotension was significantly more in normotensive mothers (Group B. However, no statistical correlation could be drawn from this study between QTc interval and hypotension, although a trend toward increasing hypotension with decreasing QTc was present. Discussion : The prolonged QTc intervals seen in pre-eclamptic patients may be due to the contributory effects of sympathetic hyperactivity, hypertension, and hypocalcemia secondary to underlying vasoconstriction. Decreased vagal control of heart in pre-eclampsia may have produced the difference in change in hemodynamic status between pre-eclamptic and normotensive parturient. Conclusion: Any consistent correlation between QTc and hypotension following subarachnoid block could not be derived from this study. To achieve a

Influence of preoperative oral rehydration on arterial plasma rocuronium concentrations and neuromuscular blocking effects: A randomised controlled trial.

Science.gov (United States)

Ishigaki, Sayaka; Ogura, Takahiro; Kanaya, Ayana; Miyake, Yu; Masui, Kenichi; Kazama, Tomiei

2017-01-01

The influence of preoperative rehydration on the action of rocuronium has not yet been investigated. The objective is to evaluate the hypothesis that preoperative rehydration lowers arterial rocuronium plasma concentrations and changes its associated neuromuscular blocking effects during induction of anaesthesia. Randomised, single-blinded study. A secondary hospital from October 2013 to July 2014. In total, 46 men undergoing elective surgery were eligible to participate and were randomly allocated into two groups. Exclusion criteria were severe hepatic, renal or cardiovascular disorder; neuromuscular disease; history of allergy to rocuronium; BMI more than 30 kg m; receiving medication known to influence neuromuscular function. Participants received 1500 ml of oral rehydration solution (rehydration group) or none (control group) until 2 hours before anaesthesia. Arterial blood samples were obtained 60, 90 and 120 s and 30 min after rocuronium (0.6 mg kg) administration during total intravenous anaesthesia. Responses to 0.1-Hz twitch stimuli were measured at the adductor pollicis muscle using acceleromyography. Arterial plasma rocuronium concentrations. Arterial plasma rocuronium concentrations at 60, 90 and 120 s in the rehydration and control groups were 9.9 and 13.7, 6.8 and 9.5 and 6.2 and 8.1 μg ml, respectively (P = 0.02, 0.003 and 0.02, respectively); the onset times in the rehydration and control groups were 92.0 and 69.5 s (P = 0.01), and the times to twitch re-appearance were 25.3 and 30.4 min (P = 0.004), respectively. Preoperative rehydration significantly reduces arterial plasma rocuronium concentrations in the first 2 minutes after administration, prolonging the onset time and shortening the duration of effect. A higher dose or earlier administration should be considered for patients who receive preoperative rehydration. Umin identifier: UMIN000011981.

The efficacy of adding dexamethasone, midazolam, or epinephrine to 0.5% bupivacaine in supraclavicular brachial plexus block.

Science.gov (United States)

El-Baradey, Ghada F; Elshmaa, Nagat S

2014-11-01

The aim was to assess the effectiveness of adding either dexamethasone or midazolam in comparison with epinephrine addition to 0.5% bupivacaine in supraclavicular brachial plexus block. This is a prospective randomized controlled observer-blinded study. This study was carried out in Tanta University Hospital on 60 patients of both sexes; American Society of Anesthesiologists physical Status I and II, age range from 18 to 45 years undergo elective surgery to upper limb. All patients were anesthetized with ultrasound guided supraclavicular brachial plexus block and randomly divided into three groups (each group 20 patients) Group E (epinephrine): 30 mL bupivacaine 0.5%with 1:200,000 epinephrine (5 μg/mL). Group D (dexamethasone): 30 mL bupivacaine 0.5% and dexamethasone 8 mg. Group M (midazolam): 30 ml bupivacaine 0.5% and midazolam 50 μg/kg. The primary outcome measures were onset and duration of sensory and motor block and time to first analgesic request. The windows version of SPSS 11.0.1 (SPSS Inc., Chicago, IL, USA) was used for statistical analysis. Data were presented in form of mean ± standard deviation multiple analysis of variance (ANOVA) was used to compare the three groups and Scheffe test was used after ANOVA. Power of significance P < 0.05 was considered to be statistically significant. Onset of sensory and motor block was significantly rapid (P < 0.05) in Groups D and M in comparison with Group E. Time of administration of rescue analgesic, duration of sensory and motor block showed significant increase (P < 0.05) in Group D in comparison with Group M which showed significant increase (P < 0.05) in comparison with Group E. In comparison with epinephrine and midazolam addition of dexamethasone to bupivacaine had rapid onset of block and longer time to first analgesic request with fewer side-effects.

[Improved detection of the pulse oximeter signal with a digital nerve block in patients in poor health status].

Science.gov (United States)

Cordoví de Armas, L; Espinaco Valdés, J; Jiménez Paneque, R E; Costa Hidalgo, T; Vallongo Menéndez, M B

2008-10-01

To demonstrate the efficacy of a digital nerve block for improving pulse oximetry in conditions of low tissue perfusion. A randomized single-blind study of adult patients undergoing surgery under general anesthesia for conditions characterized by hypoperfusion. Patients were assigned to a control group or an experimental group. The experimental group received a digital nerve block in the middle finger of the left hand; a sensor was then placed on the finger for between 120 and 300 minutes. Age, sex, diagnosis, total observation time (TOT), percentage of time with no pulse oximeter signal (NoPO), and percentage of time with an unstable pulse oximeter signal (UnstPO) were recorded. Each patient was questioned between 16 and 24 hours after surgery and was examined for flushing, paresthesia, hypoesthesia, pain, and ecchymosis. The chi2 test was used to compare dichotomized or nominal variables and the t test was used to compare age, TOT, NoPO, and UnstPO. Values of P<.05 were considered statistically significant in both cases. Fifty patients were randomized to each group. A total of 82 patients remained in the study (control group=42, experimental group=40). There were no significant between-group differences in diagnoses or TOT. The mean values for NoPO and UnstPO were higher in the control group than in the experimental group (11.1% vs 4.4% and 35.9% vs 15.7%, respectively; P<.001). A digital nerve block can be used to prevent pulse oximetry failures in conditions of low peripheral perfusion.

Regional Growth and income convergence in the western black belt counties of Alabama: evidence from census block group data

Science.gov (United States)

Buddhi Gyawali; Rory Fraser; James Bukenya; John Schelhas

2010-01-01

This paper examines the effects of growth in African Ameriocan population, employment, and human capital on growth in per capita income at the census block group (CBG) level using ordinary least square and spatial reqression models. The results indicate the presence of conditional incaom conbergence between 1980 and 2000 with poorer CBGs growing faster than the...

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.

Coordinated Control of Vehicle Groups

National Research Council Canada - National Science Library

Kumar, Vijay

2004-01-01

.... There are three main objectives: (1) to develop a theoretical paradigm for formalizing the concepts of a group, a team, and control of groups, with specified tasks such as exploring, mapping, searching, and transporting objects; (2...

78 FR 46851 - Controlled Group Regulation Examples

Science.gov (United States)

2013-08-02

...) to require the presence of two levels of controlled entities for a controlled group to exist, and... changes would add a new example to illustrate both the mechanics of the controlled group rules as applied...

Multi-block methods in multivariate process control

DEFF Research Database (Denmark)

Kohonen, J.; Reinikainen, S.P.; Aaljoki, K.

2008-01-01

methods the effect of a sub-process can be seen and an example with two blocks, near infra-red, NIR, and process data, is shown. The results show improvements in modelling task, when a MB-based approach is used. This way of working with data gives more information on the process than if all data...... are in one X-matrix. The procedure is demonstrated by an industrial continuous process, where knowledge about the sub-processes is available and X-matrix can be divided into blocks between process variables and NIR spectra.......In chemometric studies all predictor variables are usually collected in one data matrix X. This matrix is then analyzed by PLS regression or other methods. When data from several different sub-processes are collected in one matrix, there is a possibility that the effects of some sub-processes may...

A comparative study to evaluate ultrasound-guided transversus abdominis plane block versus ilioinguinal iliohypogastric nerve block for post-operative analgesia in adult patients undergoing inguinal hernia repair.

Science.gov (United States)

Kamal, Kirti; Jain, Parul; Bansal, Teena; Ahlawat, Geeta

2018-04-01

Both transversus abdominis plane (TAP) block and combined ilioinguinal-iliohypogastric (IIN/IHN) blocks are used routinely under ultrasound (USG) guidance for postoperative pain relief in patients undergoing inguinal hernia surgery. This study compares USG guided TAP Vs IIN/IHN block for post-operative analgesic efficacy in adults undergoing inguinal hernia surgery. Sixty adults aged 18 to 60 with American Society of Anesthesiologsts' grade I or II were included. After general anaesthesia, patients in Group I received USG guided unilateral TAP block using 0.75% ropivacaine 3 mg/kg (maximum 25 mL) and those in Group II received IIN/IHN block using 10 mL 0.75% ropivacaine. Postoperative rescue analgesia was with tramadol (intravenous) IV ± diclofenac IV in the first 4 h followed by oral diclofenac subsequently. Total analgesic consumption in the first 24 h was the primary objective, intraoperative haemodynamics, number of attempts and time required for performing the block as well as the postoperative pain scores were also evaluated. Time to first analgesic request was 319.8 ± 115.2 min in Group I and 408 ± 116.4 min in Group II ( P = 0.005). Seven patients (23.33%) in Group I and two (6.67%) in Group II required tramadol in first four hours. No patient in either groups received diclofenac IV. The average dose of tablet diclofenac was 200 ± 35.96 mg in Group I and 172.5 ± 34.96 mg in Group II ( P = 0. 004). USG guided IIN/IHN block reduces the postoperative analgesic requirement compared to USG guided TAP block.

Improving of the Drones Group Control System

Directory of Open Access Journals (Sweden)

Tatiana Yurievna Morozova

2015-05-01

Full Text Available The article deals with the problem of drone group control, in particular, the problem of formation damage drone ensure safe movement of the group. To solve this problem is proposed to use multi-agent approach to the implementation of the overall strategy of management and metric routing algorithm for communication and the formation of the group. In general, the action of the control algorithms are shown and controlled drones in the formation of groups and roles. The conditions for the safe distance of the drone relative to each other in the group. It is shown that the combined use of these mechanisms can improve the efficiency of group management drone resistance groups to failures and failures, resulting in an increased probability of the assignment.

How to block and tackle the face.

Science.gov (United States)

Zide, B M; Swift, R

1998-03-01

Regional blocking techniques as noted in dentistry, anesthesia, and anatomy texts may result in inconsistent and imperfect analgesia when needed for facial aesthetic surgery. The advent of laser facial surgery and more complicated aesthetic facial procedures has thus increased the demand for anesthesia support. Surgeons should know a fail-safe method of nerve blocks. Fresh cadaver dissections are used to demonstrate a series of eight regional nerve-blocking routes. This sequence of bilateral blocks will routinely provide profound full facial anesthesia. Certain groupings of blocks are effective for perioral or periorbital laser surgery.

Patchy micelles based on coassembly of block copolymer chains and block copolymer brushes on silica particles.

Science.gov (United States)

Zhu, Shuzhe; Li, Zhan-Wei; Zhao, Hanying

2015-04-14

Patchy particles are a type of colloidal particles with one or more well-defined patches on the surfaces. The patchy particles with multiple compositions and functionalities have found wide applications from the fundamental studies to practical uses. In this research patchy micelles with thiol groups in the patches were prepared based on coassembly of free block copolymer chains and block copolymer brushes on silica particles. Thiol-terminated and cyanoisopropyl-capped polystyrene-block-poly(N-isopropylacrylamide) block copolymers (PS-b-PNIPAM-SH and PS-b-PNIPAM-CIP) were synthesized by reversible addition-fragmentation chain transfer polymerization and chemical modifications. Pyridyl disulfide-functionalized silica particles (SiO2-SS-Py) were prepared by four-step surface chemical reactions. PS-b-PNIPAM brushes on silica particles were prepared by thiol-disulfide exchange reaction between PS-b-PNIPAM-SH and SiO2-SS-Py. Surface micelles on silica particles were prepared by coassembly of PS-b-PNIPAM-CIP and block copolymer brushes. Upon cleavage of the surface micelles from silica particles, patchy micelles with thiol groups in the patches were obtained. Dynamic light scattering, transmission electron microscopy, and zeta-potential measurements demonstrate the preparation of patchy micelles. Gold nanoparticles can be anchored onto the patchy micelles through S-Au bonds, and asymmetric hybrid structures are formed. The thiol groups can be oxidized to disulfides, which results in directional assembly of the patchy micelles. The self-assembly behavior of the patchy micelles was studied experimentally and by computer simulation.

Harmony of spinning conformal blocks

Energy Technology Data Exchange (ETDEWEB)

Schomerus, Volker [Deutsches Elektronen-Synchrotron (DESY), Hamburg (Germany). Theory Group; Sobko, Evgeny [Stockholm Univ. (Sweden); Nordita, Stockholm (Sweden); Isachenkov, Mikhail [Weizmann Institute of Science, Rehovoth (Israel). Dept. of Particle Physics and Astrophysics

2016-12-07

Conformal blocks for correlation functions of tensor operators play an increasingly important role for the conformal bootstrap programme. We develop a universal approach to such spinning blocks through the harmonic analysis of certain bundles over a coset of the conformal group. The resulting Casimir equations are given by a matrix version of the Calogero-Sutherland Hamiltonian that describes the scattering of interacting spinning particles in a 1-dimensional external potential. The approach is illustrated in several examples including fermionic seed blocks in 3D CFT where they take a very simple form.

Harmony of spinning conformal blocks

Energy Technology Data Exchange (ETDEWEB)

Schomerus, Volker [DESY Hamburg, Theory Group,Notkestraße 85, 22607 Hamburg (Germany); Sobko, Evgeny [Nordita and Stockholm University,Roslagstullsbacken 23, SE-106 91 Stockholm (Sweden); Isachenkov, Mikhail [Department of Particle Physics and Astrophysics, Weizmann Institute of Science,Rehovot 7610001 (Israel)

2017-03-15

Conformal blocks for correlation functions of tensor operators play an increasingly important role for the conformal bootstrap programme. We develop a universal approach to such spinning blocks through the harmonic analysis of certain bundles over a coset of the conformal group. The resulting Casimir equations are given by a matrix version of the Calogero-Sutherland Hamiltonian that describes the scattering of interacting spinning particles in a 1-dimensional external potential. The approach is illustrated in several examples including fermionic seed blocks in 3D CFT where they take a very simple form.

Controlling the morphology of side chain liquid crystalline block copolymer thin films through variations in liquid crystalline content.

Science.gov (United States)

Verploegen, Eric; Zhang, Tejia; Jung, Yeon Sik; Ross, Caroline; Hammond, Paula T

2008-10-01

In this paper, we describe methods for manipulating the morphology of side-chain liquid crystalline block copolymers through variations in the liquid crystalline content. By systematically controlling the covalent attachment of side chain liquid crystals to a block copolymer (BCP) backbone, the morphology of both the liquid crystalline (LC) mesophase and the phase-segregated BCP microstructures can be precisely manipulated. Increases in LC functionalization lead to stronger preferences for the anchoring of the LC mesophase relative to the substrate and the intermaterial dividing surface. By manipulating the strength of these interactions, the arrangement and ordering of the ultrathin film block copolymer nanostructures can be controlled, yielding a range of morphologies that includes perpendicular and parallel cylinders, as well as both perpendicular and parallel lamellae. Additionally, we demonstrate the utilization of selective etching to create a nanoporous liquid crystalline polymer thin film. The unique control over the orientation and order of the self-assembled morphologies with respect to the substrate will allow for the custom design of thin films for specific nanopatterning applications without manipulation of the surface chemistry or the application of external fields.

Effect of paracetamol, dexketoprofen trometamol, lidocaine spray, and paracervical block application for pain relief during suction termination of first-trimester pregnancy.

Science.gov (United States)

Açmaz, Gökhan; Aksoy, Hüseyin; Özoğlu, Nil; Aksoy, Ülkü; Albayrak, Evrim

2013-01-01

The aim of the study was to investigate the analgesic efficacy of preoperative oral dexketoprofen trometamol, intravenous paracetamol, lidocaine spray, and paracervical block with ultracaine on curettage procedure. A total of 111 subjects with the request of pregnancy termination between 5 and 7 weeks of gestation were included in the study. The first group (control group) consisted of 20 participants without medication. The second group consisted of 25 participants receiving 2 puffs of lidocaine sprays on cervical mucosa. The third group consisted of 20 participants receiving oral 25 mg dexketoprofen trometamol. The fourth group consisted of 23 participants receiving 1000 mg intravenous paracetamol and the fifth group consisted of 23 participants receiving paracervical block with ultracaine. Paracervical block reduced pain score significantly in both intraoperative and postoperative periods. All analgesic procedures were significantly effective for reducing pain in postoperative period. Paracervical block may be the best method for reducing pain scores in intraoperative and postoperative periods during curettage procedure. All analgesic procedures such as lidocaine, paracetamol, ultracaine, and paracervical block with ultracaine can be used for reducing pain score in postoperative period. This trial is registered with NCT01947205.

Effect of Paracetamol, Dexketoprofen Trometamol, Lidocaine Spray, and Paracervical Block Application for Pain Relief during Suction Termination of First-Trimester Pregnancy

Directory of Open Access Journals (Sweden)

Gökhan Açmaz

2013-01-01

Full Text Available The aim of the study was to investigate the analgesic efficacy of preoperative oral dexketoprofen trometamol, intravenous paracetamol, lidocaine spray, and paracervical block with ultracaine on curettage procedure. A total of 111 subjects with the request of pregnancy termination between 5 and 7 weeks of gestation were included in the study. The first group (control group consisted of 20 participants without medication. The second group consisted of 25 participants receiving 2 puffs of lidocaine sprays on cervical mucosa. The third group consisted of 20 participants receiving oral 25 mg dexketoprofen trometamol. The fourth group consisted of 23 participants receiving 1000 mg intravenous paracetamol and the fifth group consisted of 23 participants receiving paracervical block with ultracaine. Paracervical block reduced pain score significantly in both intraoperative and postoperative periods. All analgesic procedures were significantly effective for reducing pain in postoperative period. Paracervical block may be the best method for reducing pain scores in intraoperative and postoperative periods during curettage procedure. All analgesic procedures such as lidocaine, paracetamol, ultracaine, and paracervical block with ultracaine can be used for reducing pain score in postoperative period. This trial is registered with NCT01947205.

Synthesis and self-assembly of well-defined block copolypeptides via controlled NCA polymerization

OpenAIRE

Deming, TJ

2013-01-01

This article summarizes advances in the synthesis of well-defined polypeptides and block copolypeptides. Traditional methods used to polymerize α-amino acid-N-carboxyanhydrides (NCAs) are described, and limitations in the utility of these systems for the preparation of polypeptides are discussed. Improved initiators and methods that allow polypeptide synthesis with good control over chain length, chain length distribution, and chain-end functionality are also discussed. Using these methods, b...

Addition of dexmedetomidine to bupivacaine in supraclavicular brachial plexus block.

Science.gov (United States)

Aksu, Recep; Bicer, Cihangir