Articles: lower-extremity-innervation.
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Journal of anesthesia · Feb 2012
Case ReportsSubclinical neuropathy in diabetic patients: a risk factor for bilateral lower limb neurological deficit following spinal anesthesia?
Total knee arthroplasty performed under spinal or general anesthesia is a common successful orthopedic procedure. Nonetheless, in patients with diabetes mellitus this procedure can present unique challenges to orthopedic surgeon and anesthesiologist alike. We describe a case of an elderly male diabetic patient who developed bilaterally symmetrical lower limb neurological deficit following an uneventful total knee arthroplasty performed under spinal anesthesia. ⋯ These findings were consistent with a preexisting neuropathy, thereby suggesting a subclinical neuropathy as a potential risk factor for this neurological complication. Our case highlights the fact that patients with longstanding comorbidities, namely peripheral vascular disease and diabetes mellitus, may be at an increased risk of neurological injury following regional anesthesia. Hence, we believe that preoperative evaluation of diabetic patients should include neurophysiological studies to identify subclinical neuropathy and minimize the risk of neurological injury.
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Reg Anesth Pain Med · Jan 2012
Three partial-task simulators for teaching ultrasound-guided regional anesthesia.
Simulation-based training is becoming an accepted tool for educating physicians before direct patient care. As ultrasound-guided regional anesthesia (UGRA) becomes a popular method for performing regional blocks, there is a need for learning the technical skills associated with the technique. Although simulator models do exist for learning UGRA, they either contain food and are therefore perishable or are not anatomically based. We developed 3 sonoanatomically based partial-task simulators for learning UGRA: an upper body torso for learning UGRA interscalene and infraclavicular nerve blocks, a femoral manikin for learning UGRA femoral nerve blocks, and a leg model for learning UGRA sciatic nerve blocks in the subgluteal and popliteal areas.
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Anesthesia and analgesia · Jan 2012
Brief reports: ultrasound-guided obturator nerve block: a proximal interfascial technique.
In this report, I describe and evaluate a proximal ultrasound (US)-guided obturator nerve block technique using an interfascial local anesthetic (LA) injection deep to the pectineus muscle. ⋯ The US-guided obturator nerve block using interfascial LA injection inferior to the superior pubic ramus, between the pectineus and obturator externus muscles, was shown to be a simple and successful technique.
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Foot and ankle clinics · Jun 2011
ReviewElectrodiagnostic evaluation of lower extremity neurogenic problems.
Electrodiagnosis is a powerful tool for evaluating lower extremity disorders that stem from the peripheral nervous system. Electrodiagnostic testing can help differentiate neurogenic versus non-neurogenic causes of complaints such as pain, weakness, and paresthesias. It can help practitioners pinpoint the anatomic location and reveal the underlying pathology in peripheral nerve lesions. This article focuses on the electrodiagnostic evaluation of neurogenic processes that present as foot and ankle symptoms.