Safe zone for the superior gluteal nerve in the transgluteal approach to the dysplastic hip: Intraoperative evaluation using a nerve stimulator

Introduction: Vagus nerve stimulation is a palliative treatment for patients with refractory epilepsy to reduce the frequency and intensity of seizures. A bipolar helical electrode is placed around the left vagus nerve at the cervical level and is connected to the pulse generator placed in a subcutaneous pocket, most commonly in the subclavian region. Methods: Between March 1998 and October 2019, we performed 196 procedures related to the vagal nerve stimulation at the Neurosurgery Department in Motol University Hospital. Of these, 126 patients were vagal nerve stimulator implantation surgeries for intractable epilepsy. The cases included 69 female and 57 male patients with mean age at the time of the implantation surgery 22±12.4 years (range 2.1−58.4 years). Results: Nine patients (7.1%) were afflicted by complications related to implantation. Surgical complications included postoperative infection in 1.6%, VNS-associated arrhythmias in 1.6%, jugular vein bleeding in 0.8% and vocal cord paresis in 2.4%. One patient with vocal cord palsy also suffered from severe dysphagia. One patient (0.8%) did not tolerate extra stimulation with magnet due to a prolonged spasm in his throat. The extra added benefit of vagus stimulation in one patient was a significant reduction of previously regular severe headaches. Conclusion: Vagus nerve stimulation is an appropriate treatment for patients with drug-resistant epilepsy who are not candidates for focal resective surgery. Implantation of the vagus nerve stimulator is a relatively safe operative procedure.

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Surgical treatment of dysplastic hip instability in children

Practical medicine ◽

10.32000/2072-1757-2019-6-39-42 ◽

2019 ◽

Vol 17 (6 (part 2)) ◽

pp. 39-42

Author(s):

P. S. Andreev ◽

◽

I. F. Akhtyamov ◽

A. P. Skvortsov ◽

◽

...

Keyword(s):

Surgical Treatment ◽

Hip Instability ◽

Dysplastic Hip

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INTERSCALENE BRACHIAL PLEXUS BLOCK WITH A NERVE STIMULATOR FOR CLAVICULAR FRACTURE SURGERY

Journal of Medicine and Pharmacy ◽

10.34071/jmp.2013.6.3 ◽

2014 ◽

pp. 20-24

Author(s):

Van Minh Nguyen

Keyword(s):

Side Effects ◽

Brachial Plexus ◽

Brachial Plexus Block ◽

Clavicle Fracture ◽

Onset Time ◽

Clavicular Fracture ◽

Nerve Stimulator ◽

Interscalene Brachial Plexus Block ◽

Plexus Block ◽

Fracture Surgery

Objective:To evaluate the effectiveness and side effects, complications of interscalene brachial plexus block with a nerve stimulator for clavicular fracture surgery. Materials and Methods:In a prospective descriptive study, fifty patients received interscalene brachial plexus block for fixation of clavicle fracture. The dose was 7 mg/kg of 1% lidocaine mixed with 1 : 200000 adrenaline. Results:The success rate was 94%, including 4% of patients needed sedation and small amount of narcotic, failure rate was 6%. The minimal stimulating current of the nerve location was 0.46 ±0.08 mA, the onset time of sensory block was 8.86 ±2.65min. There were 3 complications with one Horner’s syndrome and two hoarsenesses. Conclusion:We found that in patients undergoing fixation of clavicle fracture the interscalene block with a nerve stimulator was an effective anesthetic with a low rate of side effects and complications. Key words:Interscalene block, nerve stimulator, clavicular fracture surgery.

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