scholarly journals A Rapid and Effective Method to Prolong Pain Relief in Sheep Using Bupivacaine and Intralipid ® Combination

2019 ◽  
Vol 4 (3) ◽  
pp. 1-6
Author(s):  
Farzin Sahebjam
Keyword(s):  
Nerve Block ◽  
Final Concentration ◽  
Noxious Stimulus ◽  
Control Group ◽  
Multiple Time ◽  
Treatment Results ◽  
Time Intervals ◽  
Nerve Blocks ◽  
Duration Of Action ◽  
The Mean

Background : To compare the duration of action of a local anesthetic block using a lipid formulation of bupivacaine to the commercially available aqueous formulation. Bupivacaine 0.5% was mixed with an equal volume of either lipid emulsion (Intralipid, Fresenius Kabi) or normal saline resulting in a final concentration of 0.25% bupivacaine. Eighteen sheep were administered a n erve block of either control or treatment at the metacarpal region of each forelimb to compare the efficacy of the injected formulations. The nociceptive test was determined by applying a blunt noxious stimulus to the foot below the nerve block at multiple time intervals until the sheep responded by withdrawing its foot. The person assessing the response to the noxious stimulus was blinded to the treatment. Results: The Intralipid formulation significantly extended the duration of the nerve block compared to the control group. The mean analgesic period (mean±SD) in the control legs was 4.23±1.8 hr. compared to 5.81±1.78 hr. in the Intralipid injected legs (p=0.013). Conclusions : In conclusion, an Intralipid® - based formulation provided a more prolonged dura tion of local anesthesia after nerve blocks in the sheep metacarpal region compared to aqueous bupivacaine.

scholarly journals Adding low concentrations of clonidine to ropivacaine for transversus abdominis plane blocks does not reduce plasma ropivacaine levels, suggesting a lack of vasoconstrictor effect

2019 ◽  
Vol 47 (2) ◽  
pp. 134-140
Author(s):  
Jennifer M Crawford ◽  
John A Loadsman ◽  
Kenny XF Yang ◽  
Peter CA Kam
Keyword(s):  
Local Anaesthetics ◽  
Transversus Abdominis ◽  
Control Group ◽  
Transversus Abdominis Plane ◽  
Nerve Blocks ◽  
Duration Of Action ◽  
Low Concentrations ◽  
Vasoconstrictor Effect ◽  
Surrogate Measure ◽  
To Receive

Clonidine has been used successfully to prolong the duration of action of local anaesthetics in peripheral nerve blocks, but its mechanism of action in this setting remains unclear. Some studies suggest that clonidine exerts a vasoconstrictor effect, limiting the washout of local anaesthetic from its site of deposition. We investigated this potential vasoconstrictor effect, using plasma ropivacaine concentrations as a surrogate measure of vasoconstriction, in patients who received transversus abdominis plane (TAP) blocks with and without clonidine. Eighty women undergoing laparoscopic gynaecological surgery were randomly assigned to receive one of four TAP block solutions: 0.2% ropivacaine (control), ropivacaine with clonidine 2 μg/kg (clonidine), ropivacaine with 1:400,000 adrenaline (adrenaline) or ropivacaine and a subcutaneous injection of clonidine 2 μg/kg (SC clonidine). The primary outcome was total venous plasma ropivacaine concentrations up to 6 h after the block. There were no significant differences in plasma ropivacaine concentrations between the control group and the clonidine group at any timepoint in the study, nor were there differences in either the mean maximum ropivacaine concentration ( Cmax) (1.99 μg/mL versus 2.05 μg/mL, P = 0.712) or the time to maximum concentration ( Tmax) (51.0 min versus 56.0 min, P = 0.537). The SC clonidine group also did not differ significantly from the controls ( Cmax 2.13 μg/mL versus 1.99 μg/mL, P = 0.424; Tmax 43.5 min versus 51.0 min, P = 0.201). Plasma ropivacaine concentrations in the adrenaline group were significantly lower than the controls from 10 to 90 min ( P < 0.003 for each comparison), and the Cmax was less than that of the control group (1.36 μg/mL versus 1.99 μg/mL, P < 0.001) with a longer Tmax (103.5 min versus 51.0 min, P = 0.001). These findings indicate that clonidine at a concentration of 1.35 μg/mL added to ropivacaine for TAP blocks did not produce a reduction in plasma ropivacaine concentrations. This suggests a lack of vasoconstrictor effect during TAP blocks. Further studies should evaluate whether vasoconstriction occurs when clonidine is used at higher concentrations or for other blocks.

scholarly journals Association Between Osteoarticular Scores and Acute Phase Reactant Levels in Rheumatoid Arthritis

2009 ◽  
Vol 28 (2) ◽  
pp. 116-121 ◽  
Author(s):  
Irena Kafeđiska ◽  
Dejan Spasovski ◽  
Todor Gruev ◽  
Mane Grličkov ◽  
Kočo Cakalaroski ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Acute Phase ◽  
Acute Phase Reactant ◽  
Control Group ◽  
Time Intervals ◽  
Acute Phase Reactants ◽  
Mean Values ◽  
Cell Counts ◽  
Phase Reactant ◽  
The Mean

Association Between Osteoarticular Scores and Acute Phase Reactant Levels in Rheumatoid Arthritis The aim of this prospective control study was a quantitative evaluation of the activity of rheumatoid arthritis (RA) in certain time intervals, using articular indexes (set of 28 sensitive and 28 swollen joints), laboratory parameters (Hb, Hct, Er, Le and Plt) and acute phase reactants (ESR, RF, CRP); to determine which of the acute phase reactants is the most useful biochemical marker for the evaluation of disease activity in RA; to quantify the therapeutical and laboratory differences in certain time intervals in the group with and without immunomodulatory therapy with Methotrexate. Sixty patients with RA were included, 27 of who were treated with non-steroid antiinflammatory drugs (NSAIDs) and Methotrexate (MTX). The control group consisted of 33 patients treated only with NSAIDs because of irregular controls. In the first group of patients the disease activity was estimated at four time intervals, and in the control group of patients at three time intervals following the scores of the articular indexes, blood cell counts, ESR and CRP in every patient. In the first group of patients decreased activity of RA was found upon every following control with a consecutive decrease in mean values of the scores of articular indexes with statistically significant differences at the four time intervals. Considering laboratory parameters, there were statistically significant differences in the mean values of Hb, Er, Plt, ESR, (p=0.0462, p=0.0076, p= 0.0058, p= 0.0003). Mean values of CRP did not show statistically significant differences, but the number of patients who were CRP negative increased (there were great standard deviations). In the group of patients treated only with NSAIDs, there were statistically significant differences in the mean values of the scores of articular indexes with an increse at every following control (in favour of progression of the disease). There were no statistically significant differences considering blood cell counts, ESR and CRP (in favour of permanently active disease). In conclusion, CRP is the most useful marker for the prospective follow-up of patients with RA.

scholarly journals Postoperative analgesia with the use of peripheral nerve block of the foot and ankle

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0046
Author(s):  
Kelly Stéfani ◽  
Gabriel Ferraz
Keyword(s):  
Peripheral Nerve ◽  
Pain Intensity ◽  
Nerve Block ◽  
Postoperative Analgesia ◽  
Postoperative Period ◽  
Peripheral Nerve Block ◽  
Control Group ◽  
Study Group ◽  
Foot And Ankle ◽  
The Mean

Category: Basic Sciences/Biologics Introduction/Purpose: Peripheral nerve block in the foot and ankle is usually used for anesthesia in forefoot and midfoot surgeries. However, since the postoperative analgesia obtained is prolonged, we can expand its use, as an adjuvant after the end of the spinal or general anesthesia. The aim of this study was to evaluate the use of peripheral nerve block of the foot and ankle as a method of postoperative analgesia. Methods: A prospective, randomized, blinding study was performed. The study group included 30 patients (32 feet) submitted to peripheral anesthetic block after surgery with spinal anesthesia and the control group (30 patients, 31 feet) were patients not submitted to nerve block. The inclusion criterion was: patients submitted to foot and ankle surgery at our institution. Patients answered the questionnaire postoperatively, with the measurement of pain intensity by the Visual Analog Scale (VAS) and the time of onset of pain. All local peripheral block was performed by the same orthopedic team with 20 mL of Ropivacaine at a concentration of 7.5 mg / mL (0.75%). Results: The mean patient age was 52,5 years, and the majority of patients were women (66%). The results showed a statistically significant difference between the control group and the study group, with a longer time of postoperative analgesia (p <0.001) and lower pain intensity in the immediate postoperative period (p <0.001) in patients submitted to blockade anesthetic. There was no statistical difference between the two groups regarding pain intensity on the first and second postoperative day. Conclusion: In the study group, the mean postoperative pain (six hours after surgery) was lower when compared to the control group, with statistical significance. This result showed that the ankle block helped to control pain, in a safe and effective mode. The use of ropivacaine presents a sensitive block similar to bupivacaine, but with shorter motor block, allowing early initiation of rehabilitation. The study demonstrated that peripheral nerve block in the foot and ankle region can be used effectively in postoperative analgesia, reducing pain intensity in the immediate postoperative period and also prolonging analgesia and thus maximizing physiotherapy postoperative period.

Wrist extension strength required for power grip: a study using a radial nerve block model

2011 ◽  
Vol 37 (5) ◽  
pp. 432-435 ◽  
Author(s):  
T. Suzuki ◽  
T. Kunishi ◽  
J. Kakizaki ◽  
N. Iwakura ◽  
J. Takahashi ◽  
...  
Keyword(s):  
Nerve Block ◽  
Strong Correlation ◽  
Radial Nerve ◽  
Recovery Process ◽  
Wrist Flexion ◽  
Nerve Blocks ◽  
Wrist Extension ◽  
Power Grip ◽  
The Mean ◽  
Healthy Males

The aim of this study was to investigate the correlation of wrist extension strength (WES) and grip strength (GS) using a radial nerve block, and to determine the WES required to prevent the “wrist flexion phenomenon” (antagonistic WES) when making a fist. We tested 14 arms in seven healthy males. WES and GS were measured before blocking as standard WES and standard GS. All participants then had radial nerve blocks with mepivacaine hydrochloride. During the recovery process from radial nerve blockade, WES and GS were recorded every 5 minutes. There was a very strong correlation between WES and GS ( p < 0.0001). The mean antagonistic WES was 51% of standard WES, and the mean GS, recorded at the same time, was 66% of standard GS.

scholarly journals Eutectic mixture of Local Anaesthetic (EMLA) an alternative for painful palatal nerve blocks: Randomised controlled trial

2020 ◽  
Vol 11 (4) ◽  
pp. 6440-6445
Author(s):  
Jones Jayabalan ◽  
Muthusekhar M R ◽  
Senthil Murugan P
Keyword(s):  
Nerve Block ◽  
Soft Tissues ◽  
Controlled Trial ◽  
Eutectic Mixture ◽  
T Test ◽  
Nerve Blocks ◽  
Greater Palatine Foramen ◽  
The Mean ◽  
Group B ◽  
Randomised Controlled

The purpose of this study is to compare the efficacy of EMLA to Palatal nerve blocks in providing anaesthesia to the palatal soft tissues during extraction. Seventy patients who reported for extraction of maxillary premolar and maxillary molar tooth were included in this study. These patients were divided into two groups randomly. One group consisted of patients receiving EMLA (Eutectic mixture of Lidocaine and Prilocaine) over the palatal soft tissues adjacent to the tooth with a cotton swab, and the other group consisted of patients receiving 0.4 – 0.6 ml of 2% lignocaine with 1;2,00,000 dilution adrenaline slightly anterior to the greater palatine foramen with a syringe. The mean score VAS while applying EMLA cream in group A was 0.00. In contrast, while giving palatal nerve block in group B, it was 4.09 that was statistically significant using the independent sample t-test. Likewise, the mean VAS score while extraction in the EMLA group was 0.11, whereas in palatal nerve block group was 0.00 that was not statistically significant using independent sample t-test. EMLA may be advantageous in providing palatal soft tissue anaesthesia during prophylactic extraction, thereby avoiding painful palatal nerve blocks.

scholarly journals Dexamethasone with Local Anesthetics Versus Local Anesthetics Alone in Supraclavicular Brachial Plexus Block in Upper Limb Surgeries

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
A N Elshaer ◽  
S G A Said ◽  
D S Alawady ◽  
A M Reyad
Keyword(s):  
Brachial Plexus ◽  
Nerve Block ◽  
Local Anesthetics ◽  
Brachial Plexus Block ◽  
Sensory Block ◽  
Control Group ◽  
Nerve Blocks ◽  
Supraclavicular Brachial Plexus Block ◽  
Prolonged Hospital ◽  
Plexus Block

Abstract Background Poorly controlled acute pain after surgery is associated with a variety of unwanted postoperative consequences, including patient suffering, distress, myocardial ischemia, prolonged hospital stays and an increased likelihood of chronic pain. Systemic analgesics (opioids and non-opioids) have long been used for postoperative pain, then neuroaxial or peripheral nerve blocks were employed. Local anesthetics alone were used, then various adjuvants were added to achieve quick, dense and prolonged block. Objective The aim of this study was to study the effect of dexamethasone as an adjuvant to bupivacaine in supraclavicular brachial plexus block. The comparison included the onset and the duration of the sensory and motor blocks, the duration of analgesia of the block as well as their effects on the postoperative analgesic requirements. The effect of the drugs on hemodynamics and monitoring the occurrence of any complication were also done. Patients and Methods In our study, 60 patients were randomly divided into 2 equal groups. Control group received bupivacaine only (0.5%) and dexa group in which 8 mg of dexamethasone were added to bupivacaine. All patients received equal volumes of 20 milliliters. Results Our study showed that addition of 8 milligrams of dexamethasone to bupivacaine in ultrasound-guided supraclavicular nerve block shortened the onset times of motor blocks and significantly prolonged motor and sensory block durations. In addition, dexamethasone prolonged the duration of analgesia of the plexus block significantly, as proved by the time of request of analgesia. Moreover, in dexa group, postoperative analgesic requirements were greatly lesser than that of bupivacaine groups. Addition of dexamethasone also did not affect the hemodynamics to a significant level. This makes dexamethasone with bupivacaine more superior than the use of bupivacaine alone. Conclusion Addition of dexamethasone to bupivacaine in supraclavicular nerve block shortened the onset motor blocks. Addition of dexamethasone to bupivacaine significantly prolongs of both sensory and motor block durations.

scholarly journals Role of Various Estrus Induction and Synchronization Protocols in Influencing Plasma Progesterone, Metabolic Profile and Fertility in Acyclic Buffaloes

2018 ◽  
Vol 14 (1) ◽  
Author(s):  
J. P. Prajapati ◽  
D. M. Patel ◽  
A. J. Dhami ◽  
J. A. Patel ◽  
K. K. Hadiya ◽  
...  
Keyword(s):  
Plasma Protein ◽  
Field Conditions ◽  
Control Group ◽  
Untreated Control Group ◽  
Time Intervals ◽  
Plasma Progesterone ◽  
Conception Rates ◽  
The Mean ◽  
Maximal Benefit

A study was carried out under field conditions on 50 acyclic/ anestrus buffaloes to evaluate the efficacy of four standard estrus synchronization protocols, viz., Doublesynch, Estradoublesynch, Ovsynch, and Ovsynch Plus (10 buffaloes in each protocol, and in untreated control group) in terms of estrus induction response, conception rates at induced estrus with FTAI and monitoring plasma progesterone, protein and cholesterol profile at different time intervals during treatment and day 12 post-AI. All the animals received pre-synchronization treatment, i.e., Inj. 100 mg ivermectin s/c, Inj. tono-vita 20 ml, and multi-minerals 1 bolus daily for 7 days. The conception rates obtained at induced estrus (FTAI) were 50.0, 40.0, 30.0 and 50.0 % with Doublesynch, Estradoublesynch, Ovsynch and Ovsynch Plus protocol, respectively. The rests were taken as non-conceived ones. The plasma progesterone concentrations monitored on day 0 (start of treatment), 7/9 (PGF2 α injection), 10/12 (FTAI) and on day 12 post-AI revealed significant (p Lass Than 0.01) effect of sampling days in all four protocols with higher values on day of PGF2 α injection and on day 12 post-AI compared to other days. Moreover, the plasma progesterone concentrations were significantly (p Lass Than 0.05) higher in conceiving than the non-conceiving buffaloes on day 12 post-AI in all 4 protocols. The mean plasma protein and cholesterol profile did not differ significantly between days in any of the protocols. The animals under Doublesynch protocol however had significantly higher protein values as compared to Ovsynch and Ovsynch Plus protocols. Moreover, the non-conceiving buffaloes under Ovsynch Plus protocol had significantly (p Lass Than 0.05) lower mean plasma protein (5.73±0.15 vs. 6.49±0.13 g/dl) and cholesterol (57.42±1.19 vs. 76.68±1.85 mg/dl) concentrations compared to their counterparts. It was concluded that all four hormonal protocols improved plasma progesterone profile and conception rates in acyclic buffaloes without altering plasma protein and cholesterol profile. The maximal benefit was with Doublesynch and Ovsynch plus protocols, hence these can be practiced under field conditions to manage acyclic buffaloes.

scholarly journals A Cadaveric Study of Radial Nerve Course and its Clinical Implications on Radial Nerve Block at Elbow

2021 ◽  
Author(s):  
Srimathi Ramasamy ◽  
Muthu Kumar Thyagarajan ◽  
Chandrasekar Raju
Keyword(s):  
Peripheral Nerve ◽  
Nerve Block ◽  
Radial Nerve ◽  
Biceps Tendon ◽  
Cross Sectional Study ◽  
Upper Limbs ◽  
Nerve Blocks ◽  
Cross Sectional ◽  
Lateral Epicondyle ◽  
The Mean

Introduction: Upper limb nerve blocks are done commonly by brachial plexus (C5-T1) blocks via supraclavicular, infraclavicular approaches. Sometimes a single peripheral nerve needs additional block with local anaesthetic to achieve adequate block. Peripheral nerve blocks are useful for minor surgical procedures in a single nerve distribution. Aim: To study the course and clinical significance of the radial nerve in 50 cadaveric upper limbs. Materials and Methods: A cross-sectional study was conducted on 50 intact dissected upper limbs. The upper limbs were obtained from the Department of Anatomy, Sri Ramachandra Medical College from August 2020 to December 2020. Radial nerve was exposed by routine dissection in all the upper limbs and its entire course was studied and observed for any variation. The distance from the biceps tendon to the radial nerve at the elbow, distance of the radial nerve in the Lateral Intermuscular Septum (LIS) from the epicondyles at the elbow were measured. The results obtained were statistically analysed using Statistical Package for the Social Sciences (SPSS) version 16.0. Results: In present study, the mean distance of the radial nerve in the LIS to the medial epicondyle was 12.4±0.31 cm and to the lateral epicondyle was 12.1±0.28 cm. The mean distance from the biceps tendon to the radial nerve at the elbow was 1.75±0.22 cm. Conclusion: From the present study, it can be inferred that effective peripheral radial nerve block can be achieved by blocking the nerve 1.75 cm lateral to the biceps tendon at the elbow 3 cm above the elbow crease. This can be made comfortable to the patient and more precise by ultrasound localisation of the radial nerve.

Synchronization of Estrus by ‘Buck Effect’ and PGF2α Treatment in Surti Does

2018 ◽  
Vol 13 (03) ◽  
Author(s):  
M. M. Chaudhary ◽  
C. T. Khasatiya ◽  
N. F. Chaudhari ◽  
K. K. Tyagi ◽  
V. B. Kharadi ◽  
...  
Keyword(s):  
Control Group ◽  
Sexually Active ◽  
Estrus Synchronization ◽  
Time Intervals ◽  
Treatment Groups ◽  
Double Injection ◽  
Significant Difference ◽  
The Mean ◽  
Mean Time ◽  
Apparently Healthy

This investigation was aimed to study the influence of buck and PGF2α treatment on estrus synchronization in Surti does. Apparently healthy non-pregnant Surti does (n=18) were identified from the flock by Ultrasonography. They were evenly divided into 3 groups, 6 does in each group. The does of Treatment T1 group were teased with a sexually-active-apronized buck; the does of Treatment T2 group were treated with PGF2α, i.e., Inj. Lutalyse® @ 7.5 mg/doe IM twice, i.e. on day 0th and 11th, while the does of Control group T3 were kept without any treatment. The behavioural estrus was successfully synchronized by double injection of PGF2α at 11 days apart, as well as by buck effect in T2 and T1 groups, respectively. The induction of estrus was observed cent per cent in all the groups within one month. The mean time intervals between start of treatment and onset of estrus differed significantly between T1 (5.83±2.20 d) and T3 (14.67±2.76 d) groups. However, the mean duration of estrus was 29.83±0.91, 27.50±1.23 and 28.67±1.28 hrs and the mean number of services per conception was found 1.33±0.33, 1.50±0.50 and 1.33±0.33 for T1, T2 and T3 groups of Surti does, respectively, none differ significantly (p>0.05) between the groups. There was no significant difference in conception rates at first service amongst the groups (83.33%). The 17 does among 18 does (94.44 %) from all the three groups conceived within three services, irrespective of treatment groups. It was found that the buck effect appeared to be as effective as conventional PGF2α treatment in Surti does for synchronization of estrus

Nerve Blocks Prior to Microfocused Ultrasound Treatment are Safe and Reduce Patient Discomfort

2020 ◽  
Vol 40 (8) ◽  
pp. 887-891
Author(s):  
Marc A Polacco ◽  
Daniel R Butz ◽  
Rachel Bass ◽  
Teresa Luu ◽  
Esra Kurum ◽  
...  
Keyword(s):  
Adverse Events ◽  
Pain Score ◽  
Ultrasound Treatment ◽  
Patient Comfort ◽  
Control Group ◽  
Level Of Evidence ◽  
Nerve Blocks ◽  
Patient Discomfort ◽  
The Mean ◽  
Split Face

Abstract Background Microfocused ultrasound with visualization has become one of the more popular nonsurgical facial rejuvenation therapies available. Although the treatment has gained wide acceptance, providing adequate pain relief during the procedure can be challenging. Objectives The aim of this study was to test our hypothesis that nerve blocks prior to treatment would be well tolerated and significantly reduce patient discomfort. Methods Subjects undergoing microfocused ultrasound were offered the choice of participating in a split face nerve block, bilateral block, or a control group. Nerves targeted included infraorbital, supratrochlear, supraorbital, zygomaticofrontal, mental, great auricular, and cervical plexus. Pain assessment was based on a 10-point Wong-Backer FACES Pain score. Results A total of 65 patients were included in the study: 28 in the split face group, 19 in the bilateral block group, and 18 without a block. The mean [standard deviation] pain score of the bilateral block cohort was 3.9 [1.2], and that of the control group was 5.1 [1.7] (P = 0.001). Patients in the split face cohort reported a higher pain score on the unblocked side of the face (7.5 [1.3]) than on the blocked side (2.9 [1.0]) (P &lt; 0.001). The mean pain score for local anesthetic injection was 2.7 and 1.4 for the split face and the bilateral groups, respectively. There were no adverse events. Conclusions Nerve blocks are well tolerated and significantly improve patient comfort during microfocused ultrasound treatment without compromising outcomes or increasing adverse events. Level of Evidence: 2

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