Guang Ying Zhang, Yi Feng Chen, Wei Xin Dai, Dan Zhang, Yi Huang, Wen Zheng He, Cheng Xin Lin
Purpose: To investigate the impact of diabetic peripheral neuropathy and its severity on the threshold of sciatic nerve electrical stimulation in diabetic patients. Patients and Methods: The case-control study included 60 patients that were divided into non-diabetic patients (control group, n = 26) and diabetic patients (diabetes group, n = 34). All the patients who were scheduled for lower leg, foot, and ankle surgery received a popliteal sciatic nerve block. We recorded the minimum current required to produce motor activity of the sciatic nerve during ultrasound-guided popliteal sciatic nerve block...
2020: Diabetes, Metabolic Syndrome and Obesity
Yuqing Niu, Massimiliano Galluzzi
Reconstruction of peripheral nerve defects with tissue engineered nerve scaffolds is an exciting field of biomedical research and holds potential for clinical application. However, due to poor neovascularization after the implantation, nerve regeneration is still not satisfactory, especially for large nerve defects. These obstacles hinder the investigation of basic neurobiological principles and development of a wide range of treatments for peripheral nerve diseases. Herein, we designed an amphiphilic alternating block polyurethane (abbreviated as PU) copolymer-based nerve guidance scaffold, which has good Schwann cell compatibility, and more importantly, a rapid vascularization of the scaffold in vivo...
November 17, 2020: Journal of Materials Chemistry. B, Materials for Biology and Medicine
Arianna L Gianakos, Filippo Romanelli, Naina Rao, Malaka Badri, Bart Lubberts, Daniel Guss, Christopher W DiGiovanni
The purpose of this study was to perform a systematic review of the literature examining postoperative outcomes following single site and combined peripheral nerve blocks (PNBs), including (1) sciatic and femoral nerve, (2) popliteal and saphenous nerve, and (3) popliteal and ankle nerve, during elective foot and ankle surgery. We hypothesized that combination blocks would decrease postoperative narcotic consumption and afford more effective postoperative pain control as compared to general anesthesia, spinal anesthesia, or single site PNBs...
September 3, 2020: Journal of Foot and Ankle Surgery
Kevin C Hoy, Misty M Strain, Joel D Turtle, Kuan H Lee, J Russell Huie, John J Hartman, Megan M Tarbet, Mark L Harlow, David S K Magnuson, James W Grau
Neurons within the spinal cord are sensitive to environmental relations and can bring about a behavioral modification without input from the brain. For example, rats that have undergone a thoracic (T2) transection can learn to maintain a hind leg in a flexed position to minimize exposure to a noxious electrical stimulation (shock). Inactivating neurons within the spinal cord with lidocaine, or cutting communication between the spinal cord and the periphery (sciatic transection), eliminates the capacity to learn, which implies that it depends upon spinal neurons...
October 22, 2020: Journal of Neuroscience
Clement Chassery, Philippe Marty, Olivier Rontes, Martine Chaubard, Corine Vuillaume, Bertrand Basset, Mehdi Merouani, Constance Marquis, Anne De Lussy, Marie-Claude Delbos, Julie Casalprim, Benoit Bataille, Cecile Naudin, Fabrice Ferre, Alain Delbos
BACKGROUND AND OBJECTIVES: Peripheral nerve blocks reduce postoperative pain and enhance recovery after total knee arthroplasty (TKA). This study aims to assess the benefits of addition of intravenous dexmedetomidine (DexM) to intravenous dexamethasone on the analgesic duration of quadruple nerve blocks. METHODS: This double-blind, randomized, controlled trial prospectively enrolled 90 patients scheduled for TKA under quadruple nerve blocks (sciatic, femoral, obturator, and lateral femoral cutaneous nerves blocks) with 70 mL, 0...
October 21, 2020: Regional Anesthesia and Pain Medicine
Manoj Kumar Karmakar, Miguel A Reina, Ranjith Kumar Sivakumar, Pornpatra Areeruk, Jatuporn Pakpirom, Xavier Sala-Blanch
The popliteal sciatic nerve block is routinely used for anesthesia and analgesia during foot and ankle surgery. This article reviews our current understanding of the anatomy of the sciatic nerve and discusses how fascial tissue layers associated with the nerve may affect block outcomes . The anatomy of the sciatic nerve is more complex than previously described. The tibial and common peroneal nerves within the sciatic nerve trunk appear to be centrally separated by the Compton-Cruveilhier septum and encompassed by their own paraneural sheaths...
October 19, 2020: Regional Anesthesia and Pain Medicine
Ismail Aissa, Loukman El Wartiti, Najib Bouhaba, Said Khallikane, Mohamed Moutaoukil, Noureddine Kartite, Abdelghafour Elkoundi, Aziz Benakrout, Abdellatif Chlouchi, Anas Elbouti, Hamza Najout, Ali Grine, Reda Touab, Abderrahim Zaizi, Jalal Youssef, Hicham Bakkali, Hicham Balkhi, Mustapha Bensghir
Introduction: emergency surgery for pertrochanteric femoral fractures (PFF) in patients at high risk of anaesthetic complications is a real challenge for surgeons due to the increased intraoperative risk. We report our experience with combined lumbar plexus-sciatic nerve block as an alternative anesthetic technique for these fractures. Methods: we conducted a three-year descriptive, single-center, cross-sectional study including patients with a history of recent pertrochanteric femoral fractures (PFF) at high risk anaesthetic complications...
2020: Pan African Medical Journal
Priscila Medeiros, Mariana Oliveira-Silva, Sylmara Esther Negrini-Ferrari, Ana Carolina Medeiros, Daoud Hibraim Elias-Filho, Norberto Cysne Coimbra, Renato Leonardo de Freitas
Neuropathic pain (NP) is a challenge due to our limited understanding of the mechanisms that initiate and maintain chronic pain. The prelimbic division (PrL) of the medial prefrontal cortex (mPFC) is an important area of the emotional and cognitive components of pain and pharmacological systems can interact into the neocortex to elaborate the chronic pain. This work aimed to investigate the pharmacological cross-talk between synaptic neurotransmission, neuroanatomical approaches and NP conditions. A bidirectional neuron tracer, the 3000-molecular-weight biodextran (BDA) was microinjected into the PrL cortex...
October 7, 2020: Brain Research Bulletin
Jian-Jun Zhang, Yun-Hua Feng, Jun-Feng He, Xiao-Ying Lu, Zhi-Gong Wang
Different neural signal blocking technologies provide potential therapy for various diseases caused by pathological or involuntary neural activities. In this paper, a novel neural signal blocking concept based on spike-trapping principle is introduced. The blocking system was designed and implemented. In the system, a compound action potential was induced by a proximal stimulus, and a blocking signal was generated after a neural signal was detected, which was applied to the distal end of the nerve to block the nerve conduction...
July 2020: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
Xing Xue, Jun Fan, Xiaoli Ma, Yongqiang Liu, Xuena Han, Yufang Leng, Jinjia Yu
Dexmedetomidine, used as an adjuvant to local anesthetics (LAs), may prolong the duration of peripheral nerve block. However, the effect of dexmedetomidine on the neurotoxicity of LAs is not completely understood. The present study was designed to investigate the efficacy of two doses of dexmedetomidine as an adjuvant to ropivacaine and its protective effect against the neurotoxicity of LAs. Paw withdrawal thermal latency testing was used to detect the sensory blockade. Extensor postural thrust testing was used to detect the motor blockade...
November 2020: Molecular Medicine Reports
M Galli, A Vergari, R Vitiello, R Nestorini, M Peruzzi, A Chierichini, G Spinazzola, M Rossi
Introduction: The aim of this study was the evaluation of two different techniques on post-operative analgesia and motor recovery after hallux valgus correction in one-day surgery patients. Material and Methods: We enrolled 26 patients scheduled for hallux valgus surgery and treated with the same surgical technique (SCARF osteotomy). After subgluteal sciatic nerve block with a short acting local anaesthetic (Mepivacaine 1.5%, 15ml), each patient received an ultrasound-guided Posterior Tibialis Nerve Block (PTNB) with Levobupivacaine 0...
July 2020: Malaysian Orthopaedic Journal
Jolanta Fertala, Michael Rivlin, Mark L Wang, Pedro K Beredjiklian, Andrzej Steplewski, Andrzej Fertala
INTRODUCTION: Posttraumatic scarring of peripheral nerves produces unwanted adhesions that block axonal growth. In the context of surgical nerve repair, the organization of the scar tissue adjacent to conduits used to span the gap between the stumps of transected nerves is poorly understood. The goal of this study was to elucidate the patterns of distribution of collagen-rich scar tissue and analyze the spatial organization of cells that produce fibrotic deposits around and within the conduit's lumen...
August 15, 2020: Brain and Behavior
Anna Piotrowska, Joanna Starnowska-Sokół, Wioletta Makuch, Joanna Mika, Ewa Witkowska, Dagmara Tymecka, Angelika Ignaczak, Beata Wilenska, Aleksandra Misicka, Barbara Przewłocka
The purpose of our work was to determine the role of non-opioid peptides derived from opioid prohormones in sensory hypersensitivity characteristics of neuropathic pain and to propose a pharmacological approach to restore the balance of these endogenous opioid systems. Non-opioid peptides may have a pronociceptive effect and therefore contribute to less effective opioid analgesia in neuropathic pain. In our study, we used unilateral chronic constriction injury (CCI) of the sciatic nerve as a neuropathic pain model in rats...
August 20, 2020: Pain
Andrew Foster, Alex McSloy, Paolo Monticelli
Background: Loco-regional anesthetic techniques are considered important in the multimodal approach to analgesia in both human and veterinary medicine. No such techniques are described in the alpaca, bar the use of epidural. This is in part due to the lack of anatomical description for this species. While this limitation exists, the use of ultrasound guidance makes peripheral nerve blocks a viable possibility in the alpaca. Case description: A 12-month-old alpaca was referred for the treatment of a septic left tarso-crural joint...
August 2020: Open Veterinary Journal
M McKendrick, A Sadler, A Taylor, J Seeley, T Filipescu, A Mustafa, G McKendrick, J Halcrow, P Raju, G A McLeod
In this study, we measured the performance of medical students and anaesthetists using a new tracker needle during simulated sciatic nerve block on soft embalmed cadavers. The tracker needle incorporates a piezo element near its tip that generates an electrical signal in response to insonation. A circle, superimposed on the ultrasound image surrounding the needle tip, changes size and colour according to the position of the piezo element within the ultrasound beam. Our primary objective was to compare sciatic block performance with the tracker switched on and off...
August 14, 2020: Anaesthesia
Onur Balaban, Merve Yaman, Tayfun Aydın, Ahmet Musmul
OBJECTIVES: It is possible to observe the in-vivo movements of nerves using real-time ultrasound. In this study, we aimed to visualize the movements of the sciatic nerve as a guide to identify the sciatic nerve to distinguish from surrounding tissue. METHODS: This trial was a prospective, cross-over comparative study. We included 25 healthy volunteers in this study. The movements of the sciatic nerve were visualized in the transverse view at popliteal and midthigh levels using ultrasonography...
August 2020: Journal of the Turkish Society of Algology
Patrick Discepola, Mohamed Bouhara, Minho Kwon, Bilal A Siddiqui, Trevor A Whitwell, Swetha Y Sanghvi, Keith D Cook, Ross E Moore, Anna Korban, Jean D Eloy
EXPAREL® has been used successfully to prolong postoperative pain control when applied as a wound infiltrate. EXPAREL® has not yet been approved for use in regional anesthesia to prolong postoperative pain control. We conducted a clinical case series of 4 patients using EXPAREL® for sciatic blocks via the popliteal fossa approach. Our results suggested that there is a large degree of variability in response to the medication. These inconsistent results and the possibility of bimodal kinetics creating analgesic gaps as seen in two of our patients indicate that more studies with larger sample size are needed to better characterize these phenomena and determine if more consistent results can be obtained in a future clinical trial...
2020: Pain Research & Management
Martin Charvin, François Longeras, Philippe Jouve, Anne-Laure Cherprenet, Emmanuel Futier, Bruno Pereira, Christian Dualé
BACKGROUND: Adding a regional block to general anaesthesia can prevent postoperative pain and improve peripheral circulation. OBJECTIVE: To seek improved postoperative analgesia and care due to a long-acting combined femoral and sciatic nerve block in patients undergoing femoropopliteal bypass surgery. DESIGN: A randomised, double-blind, controlled trial. SETTING: Vascular surgery unit of a French university hospital...
September 2020: European Journal of Anaesthesiology
Brett Davis, Sierra Erickson, Susan Wojtalewicz, Andrew Simpson, Cameron Metcalf, Himanshu Sant, Jill Shea, Bruce Gale, Jayant Agarwal
The purpose of this research was to evaluate a novel long-acting bupivacaine delivery system for control of postoperative pain. Bupivacaine-loaded lipid emulsion (BLE) droplets were created by high-speed homogenization. The BLE droplets were then entrapped into a crosslinked-hyaluronic acid hydrogel system to create an injectable composite gel formulation (HA-BLE). Dynamic light scattering, rheological, and drug release techniques were used to characterize the formulations. A rat sciatic nerve block with a thermal nociceptive assay was used to evaluate the anesthetic effect in comparison to controls, bupivacaine HCl and liposomal bupivacaine...
July 30, 2020: International Journal of Pharmaceutics
Andrew J Goldsmith, Andrew Liteplo, Bryan D Hayes, Nicole Duggan, Calvin Huang, Hamid Shokoohi
Sciatic radicular back pain is a painful condition resulting in approximately 2% of emergency department (ED) visits a year. Typically, the ED treatment has been limited to various analgesic regimens with limited success sometimes resulting in hospital admissions for pain control. Regional anesthesia has become increasing popular for lower-limb analgesia, but has not universally permeated the ED setting. The transgluteal sciatic nerve block (TGSNB) is a procedure that can provide effective analgesia for lower extremity pain...
June 6, 2020: American Journal of Emergency Medicine
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