Articles: nerve-block.
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To test the hypothesis that poststimulation block of nerve conduction can be achieved by low-frequency (≤1 kHz) biphasic stimulation (LFBS). ⋯ This study discovered that LFBS (≤1 kHz), like high-frequency (≥5 kHz) biphasic stimulation (HFBS), can induce poststimulation block. The result provides support for the theory that biphasic stimulation waveforms block axonal conduction by changing intracellular and extracellular ion concentrations. The post-LFBS block provides the opportunity to develop new neuromodulation devices for clinical applications where initial nerve firing is acceptable.
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Reg Anesth Pain Med · Aug 2021
MRI and muscle enzymes do not support the diagnosis of local anesthetic myotoxicity: a descriptive case series.
The presence of thigh muscle edema as characterized by increased signal intensity on MRI has been used to support the diagnosis of presumed local anesthetic-induced myotoxicity reported after total knee arthroplasty (TKA) with continuous adductor canal block (CACB). However, neither postoperative baseline imaging appearance nor muscle enzyme values have been described in conjunction with this clinical scenario. Thus, the usefulness of MRI or enzymatic biomarkers of muscle injury for supporting the diagnosis of local anesthetic myotoxicity is unknown. ⋯ The non-specificity of these findings suggests that MRI and near normal muscle enzyme levels are of limited diagnostic value when there is clinical suspicion of local anesthetic myotoxicity in the setting of TKA with CACB.
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J Coll Physicians Surg Pak · Aug 2021
Treatment of Renal Colic by Nerve Blockade with Lidocaine Versus Intravenous Dexketoprofen.
To compare non-steroidal anti-inflammatory drugs (NSAIDs) with spinal nerve blockade of related dermatomes using lidocaine for pain palliation of patients admitted to the Emergency Department (ED) with an episode of renal colic. ⋯ Spinal nerve blocks with 2% lidocaine resulted in greater short-term pain relief than intravenous dexketoprofen in ED patients with renal colic. Key Words: Renal colic, NSAID, lidocaine, Nerve blockade.
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Reg Anesth Pain Med · Aug 2021
Anatomy of the thoracic paravertebral space: 3D micro-CT findings and their clinical implications for nerve blockade.
A precise anatomical understanding of the thoracic paravertebral space (TPVS) is essential to understanding how an injection outside this space can result in paravertebral spread. Therefore, we aimed to clarify the three-dimensional (3D) structures of the TPVS and adjacent tissues using micro-CT, and investigate the potential routes for nerve blockade in this area. ⋯ A non-destructive, multi-sectional approach using 3D micro-CT more comprehensively demonstrated the real topography of the intricate TPVS than previous cadaver studies. The posterior boundary and connectivity of the TPVS provides an anatomical rationale for the notion that paravertebral spread can be achieved with an injection outside this space.