scholarly journals Physiotherapy. L. Blum. Treatment of sciatic nerve inflammation with epidural injections. Uber die Behandlung der Ischias mit epiduralen Injectionen.—Münch. med. Wochensch. 1910

2021 ◽  
Vol XVIII (2) ◽  
pp. 507-508
Author(s):  
V. N. Likhnitsky

The epidural injection technique was proposed almost simultaneously by Sicard and Chatelin. The author used epidural injections in the treatment of chronic ischias using first 1% cocaine solution or 4% stovaina, and subsequently with physiological sodium chloride solution.


2019 ◽  
Vol 8 (3) ◽  
pp. 288-294
Author(s):  
R. E. Lakhin ◽  
I. A. Gemua ◽  
V. V. Shustrov

When penetrating into the cell, local anesthetics affect some structures and processes, in addition to blocking sodium channels, leading to the development of cell damage. The aim of the article was to study the damaging effect of bupivacaine on the sciatic nerve and biceps femoris in rats. The study is double-blind and placebo-controlled. We used 0.9% sodium chloride as the placebo. The studied concentrations of bupivacaine were 0.2%, 0.5%, 0.75%, and 1%. We performed perineural introduction of 0.2 ml into the sciatic nerve and administered 0.2 ml into the biceps femoris muscle under the ultrasound guidance. The samples were taken twice: 1 hour after administration, and over 14 days. Cell necrosis or apoptosis were not found in the muscle and nerve after the 0.9% sodium chloride administration; occasional inflammatory cells were detected. Introduction of all concentrations of bupivacaine induced damage and inflammatory infiltration of muscle tissue and neural structures compared with 0.9% sodium chloride solution. Dystrophic changes and neutrophilic infiltration were detected in nerve fibers. Perimuscular edema, apoptosis, polychromasia, necrosis, disappearance of cross-striation of muscles, clusters of inflammatory cells were found in the biceps femoris. Signs of damage and inflammatory infiltration decreased, but continued to persist over 14 days. The study showed the presence of neurotoxicity and myotoxicity of all concentrations of bupivacaine compared to a 0.9% sodium chloride solution. It was revealed that signs of damage and inflammatory infiltration persisted 14 days after the administration of bupivacaine.



2009 ◽  
Vol 6;12 (6;12) ◽  
pp. E341-E354
Author(s):  
Laxmaiah Manchikanti

Background: Lumbar surgery and epidural injections for spinal stenosis are the most commonly performed interventions in the United States. However, there is only moderate evidence to the effectiveness of surgery and caudal epidural injections. The next sequential step is adhesiolysis and hypertonic neurolysis with targeted delivery. There have not been any randomized trials evaluating the effectiveness of percutaneous adhesiolysis and targeted delivery of local anesthetic, steroid and hypertonic sodium chloride solution in lumbar spinal stenosis. Study Design: A randomized, equivalence, controlled trial. Setting: An interventional pain management practice, a specialty referral center, a private practice setting in the United States. Objectives: To evaluate the effectiveness of percutaneous epidural adhesiolysis in patients with chronic low back and lower extremity pain with lumbar central spinal stenosis and compare with fluoroscopically directed caudal epidural injections. Methods: Patients were randomly assigned to one of 2 groups with 25 patients in each group. Group I patients received caudal epidural injections with catheterization up to S3 with local anesthetic, 0.9% sodium chloride solution, non-particulate betamethasone and served as the control group. Group II patients received percutaneous adhesiolysis with targeted delivery and injection of lidocaine, 10% hypertonic sodium chloride solution, and non-particulate Betamethasone and formed the intervention group. Randomization was performed by computer-generated random allocation sequence by simple randomization. Outcomes Assessment: Multiple outcome measures were utilized including the Numeric Rating Scale (NRS), the Oswestry Disability Index 2.0 (ODI), employment status, and opioid intake with assessment at 3, 6, and 12 months post treatment. Significant pain relief was described as 50% or more, whereas significant improvement in the disability score was defined as a reduction of 40% or more. Results: This evaluation showed significant pain relief (> 50%) in 76% of the patients at one year follow-up in the adhesiolysis group compared to 4% of the patients in the control group. Limitations: The results of this study are limited by the lack of a placebo group, the fact that it is a preliminary report, and there are only 25 patients in each group. Conclusions: With significant pain relief in 76% of patients, percutaneous adhesiolysis utilizing local anesthetic, steroids and hypertonic sodium chloride solution may be effective in patients with chronic function-limiting low back and lower extremity pain with spinal stenosis. Key words: Spinal stenosis, percutaneous adhesiolysis, steroids, local anesthetics, hypertonic sodium chloride solution, randomized equivalence controlled trial, pragmatic trial





2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Vahid Pourzarghan ◽  
Bahman Fazeli-Nasab

AbstractThe most important inhibitors used in bronze disease are BTA and AMT. While these inhibitors control corrosion, they are toxic and cancerous. In this study, the acacia fruit extract (200 ppm to 1800 ppm) was used to the prevention of corrosion inhibition of bronze alloy in corrosive sodium chloride solution 0.5 M, for 4 weeks consecutively. The Bronze alloy used in this research, was made based on the same percentage as the ancient alloys (Cu-10Sn). IE% was used to obtain the inhibitory efficiency percentage and Rp can be calculated from the resistance of polarization. SEM–EDX was used to evaluate the surfaces of alloy as well as inhibitory. The experiment was conducted in split plot design in time based on the RCD in four replications. ANOVA was performed and comparison of means square using Duncan's multiple range test at one percent probability level. The highest rate of corrosion inhibition (93.5%) was obtained at a concentration of 1800 ppm with an increase in the concentration of the extract, corrosion inhibition also increased, i.e., more bronze was prevented from burning. Also, the highest corrosion inhibitory activity of Acacia extract (79.66) was in the second week and with increasing duration, this effect has decreased. EDX analysis of the control sample matrix showed that the amount of chlorine was 8.47%wt, while in the presence of corrosive sodium chloride solution, after 4 weeks, the amount of chlorine detected was 3.20%wt. According to the morphology (needle and rhombus) of these corrosion products based on the SEM images, it can be said, they are the type of atacamite and paratacamite. They have caused bronze disease in historical bronze works. The green inhibitor of Acacia fruit aqueous extract can play an effective role in inhibiting corrosion of bronze, but at higher concentrations, it became fungal, which can reduce the role of Acacia fruit aqueous extract and even ineffective. To get better performance of green inhibitors, more tests need to be done to improve and optimize.





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