scholarly journals REGIONAL ANESTHESIA FOR CHILDREN WITH THE DISEASES OF LOWER LIMBS

2017 ◽  
Vol 11 (3) ◽  
pp. 157-163
Author(s):  
Yuliya A. Manokhina ◽  
G. E Ulrikh
Keyword(s):  
Regional Anesthesia ◽  
Surgical Procedures ◽  
Postoperative Analgesia ◽  
Lower Limbs ◽  
Anesthesia Safety

The article presents an analysis of the publications devoted to the problems of anesthesia to surgical procedures at the diseases of the lower limbs in children. The article reviews the questions of anesthesia safety and the role of regional blockades in the structure of intra- and postoperative analgesia.

The regional anesthesia for surgical correction of the malformation of upper extremities in pediatric

2017 ◽  
Vol 8 (5) ◽  
pp. 83-90
Author(s):  
Julia A. Manokhina
Keyword(s):  
Young Children ◽  
Upper Extremity ◽  
Regional Anesthesia ◽  
Surgical Procedures ◽  
Postoperative Analgesia ◽  
Postoperative Period ◽  
Negative Impact ◽  
Early Postoperative Period ◽  
Surgical Correction ◽  
Nerve Blocks

The article presents an analysis of the publications devoted to the problems of anesthesia to surgical procedures at the malformations of the upper extremity in children. The article reviews the questions of epidemiology, classification of upper extremity malformation, safety of anesthesia and the role of regional blockades in the structure of intraoperative and postoperative analgesia to surgical procedures at the malformations of the upper extremity in children. Children are more likely than adults to experience stress in the operating room and early postoperative period. Children are almost impossible to prepare psychologically for the upcoming anesthesia, surgical intervention, a sense of pain after it. Surgical correction of malformations of the upper limbs in children is characterized by multistage and high traumatism, which requires the search for adequate methods of anesthesia, capable of ensuring not only the absence of pain, but also the negative impact on the nervous system of little patients. The key to the application of regional anesthesia in young children is the need for sedation or general anesthesia. The use of ultrasound navigation and electrostimulation of peripheral nerves significantly increases the level of safety and success of their realization. At present, the questions about the duration of postoperative analgesia with the use of peripheral nerve blocks and the need for additional anesthesia in the early postoperative period have been little studied. The influence of the applied anesthesia technique on the state of young children in the postoperative period are requires further investigation.

scholarly journals What Is Currently the Role of TcPO2 in the Choice of the Amputation Level of Lower Limbs? A Comprehensive Review

2021 ◽  
Vol 10 (7) ◽  
pp. 1413
Author(s):  
Judith Catella ◽  
Anne Long ◽  
Lucia Mazzolai
Keyword(s):  
Arterial Disease ◽  
Major Amputation ◽  
Lower Limbs ◽  
Limb Amputation ◽  
Quality Of Data ◽  
Amputation Level ◽  
Increased Risk ◽  
Transcutaneous Oximetry ◽  
Peripheral Arterial

Some patients still require major amputation for lower extremity peripheral arterial disease treatment. The purpose of pre-operative amputation level selection is to determine the most distal amputation site with the highest healing probability without re-amputation. Transcutaneous oximetry (TcPO2) can detect viable tissue with the highest probability of healing. Several factors affect the accuracy of TcPO2; nevertheless, surgeons rely on TcPO2 values to determine the optimal amputation level. Background about the development of TcPO2, methods of measurement, consequences of lower limb amputation level, and the place of TcPO2 in the choice of the amputation level are reviewed herein. Most of the retrospective studies indicated that calf TcPO2 values greater than 40 mmHg were associated with a high percentage of successful wound healing after below-knee-amputation, whereas values lower than 20 mmHg indicated an increased risk of unsuccessful healing. However, a consensus on the precise cut-off value of TcPO2 necessary to assure healing is missing. Ways of improvement for TcPO2 performance applied to the optimization of the amputation-level are reported herein. Further prospective data are needed to better approach a TcPO2 value that will promise an acceptable risk of re-amputation. Standardized TcPO2 measurement is crucial to ensure quality of data.

scholarly journals Protease nexin-1 deficiency increases mouse hindlimb neovascularisation following ischemia and accelerates femoral artery perfusion

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Sonia Selbonne ◽  
Celina Madjene ◽  
Benjamin Salmon ◽  
Yacine Boulaftali ◽  
Marie-Christine Bouton ◽  
...  
Keyword(s):  
Femoral Artery ◽  
Capillary Density ◽  
Leukocyte Recruitment ◽  
Lower Limbs ◽  
Artery Ligation ◽  
Angiogenic Balance ◽  
Important Player ◽  
Protease Nexin ◽  
Artery Perfusion

AbstractWe previously identified the inhibitory serpin protease nexin-1 (PN-1) as an important player of the angiogenic balance with anti-angiogenic activity in physiological conditions. In the present study, we aimed to determine the role of PN-1 on pathological angiogenesis and particularly in response to ischemia, in the mouse model induced by femoral artery ligation. In wild-type (WT) muscle, we observed an upregulation of PN-1 mRNA and protein after ischemia. Angiography analysis showed that femoral artery perfusion was more rapidly restored in PN-1−/− mice than in WT mice. Moreover, immunohistochemistry showed that capillary density increased following ischemia to a greater extent in PN-1−/− than in WT muscles. Moreover, leukocyte recruitment and IL-6 and MCP-1 levels were also increased in PN-1−/− mice compared to WT after ischemia. This increase was accompanied by a higher overexpression of the growth factor midkine, known to promote leukocyte trafficking and to modulate expression of proinflammatory cytokines. Our results thus suggest that the higher expression of midkine observed in PN-1- deficient mice can increase leukocyte recruitment in response to higher levels of MCP-1, finally driving neoangiogenesis. Thus, PN-1 can limit neovascularisation in pathological conditions, including post-ischemic reperfusion of the lower limbs.

scholarly journals Robotic Technologies and Rehabilitation: New Tools for Stroke Patients’ Therapy

2013 ◽  
Vol 2013 ◽  
pp. 1-8 ◽  
Author(s):  
Patrizia Poli ◽  
Giovanni Morone ◽  
Giulio Rosati ◽  
Stefano Masiero
Keyword(s):  
Gait Training ◽  
Lower Limbs ◽  
Robotic Rehabilitation ◽  
Stroke Patients ◽  
Home Based ◽  
Comprehensive Search ◽  
Improve Muscle Strength ◽  
Training Protocol ◽  
Robotic Technologies

Introduction. The role of robotics in poststroke patients’ rehabilitation has been investigated intensively. This paper presents the state-of-the-art and the possible future role of robotics in poststroke rehabilitation, for both upper and lower limbs.Materials and Methods. We performed a comprehensive search of PubMed, Cochrane, and PeDRO databases using as keywords “robot AND stroke AND rehabilitation.”Results and Discussion. In upper limb robotic rehabilitation, training seems to improve arm function in activities of daily living. In addition, electromechanical gait training after stroke seems to be effective. It is still unclear whether robot-assisted arm training may improve muscle strength, and which electromechanical gait-training device may be the most effective for walking training implementation.Conclusions. In the field of robotic technologies for stroke patients’ rehabilitation we identified currently relevant growing points and areas timely for developing research. Among the growing points there is the development of new easily transportable, wearable devices that could improve rehabilitation also after discharge, in an outpatient or home-based setting. For developing research, efforts are being made to establish the ideal type of treatment, the length and amount of training protocol, and the patient’s characteristics to be successfully enrolled to this treatment.

Role of Regional Anesthesia in Foot and Ankle Surgery

2015 ◽  
Vol 8 (3) ◽  
pp. 212-219 ◽  
Author(s):  
Nalini Vadivelu ◽  
Alice M. Kai ◽  
Benjamin Maslin ◽  
Vijay Kodumudi ◽  
Sible Antony ◽  
...  
Keyword(s):  
Regional Anesthesia ◽  
Foot And Ankle ◽  
Ankle Surgery

Pain—A Subject Ignored

PEDIATRICS ◽  
1987 ◽  
Vol 79 (2) ◽  
pp. 309-309
Author(s):  
SOHAIL R. RANA
Keyword(s):  
Surgical Procedures ◽  
Postoperative Analgesia ◽  
Personal Experience ◽  
Severe Pain ◽  
Hospitalized Children

To the Editor.— The majority of hospitalized children with severe pain do not receive optimal analgesia for its relief. Our opinion is based upon personal experience, communication with colleagues, and published surveys.1,2 Misuse of analgesics includes subtherapeutic doses, "prn" orders, inappropriately long intervals between doses, and use of placebos to prove that pain is not organic. This maltreatment reaches cruel proportions in infants and neonates when surgical procedures are sometimes performed without anesthesia and postoperative analgesia.

Opioid-Free Tonsillectomy With and Without Adenoidectomy: The Role of Regional Anesthesia in the “New Era”

2021 ◽  
Vol 133 (1) ◽  
pp. e7-e9
Author(s):  
Ban C. H. Tsui ◽  
Stephanie Pan ◽  
Lauren Smith ◽  
Carole Lin ◽  
Karthik Balakrishnan
Keyword(s):  
Regional Anesthesia ◽  
New Era

The role of rehabilitation exercises on weight, functional strength and exercise adherence in knee osteoarthritis patients

2021 ◽  
Vol 17 ◽  
Author(s):  
Muhammad Tariq Rafiq ◽  
Mohamad Shariff Abdul Hamid ◽  
Eliza Hafiz ◽  
Khalid Rashid ◽  
Farid Ahmad Chaudhary
Keyword(s):  
Knee Osteoarthritis ◽  
Weight Bearing ◽  
Exercise Adherence ◽  
Lower Limbs ◽  
Joint Disease ◽  
Control Group ◽  
Post Test ◽  
Rehabilitation Exercises ◽  
Normally Distributed

Introduction: Knee osteoarthritis (OA) is a weight-bearing joint disease and is more common in overweight and obese persons. The objective of this study was to determine the role of rehabilitation exercises (REs) of lower limbs on weight, functional strength, and exercise adherence in overweight and obese knee OA patients. Materials And Method: The patients were recruited from the Urban community of Lahore, Pakistan. The patients were divided into the rehabilitation group (RG) and control group (CG). The patients in the RG performed the REs of lower limbs and followed the instructions of daily care (IDC), while the patients in the CG only followed the IDC for 12 weeks. Outcome measures were assessed at pre-test before grouping and post-test after 12-weeks of interventions. The measures included: weight, functional strength, and exercise adherence. The Paired Samples t-test (for the normally distributed data) and the Wilcoxon Signed Ranked Test (for the data that was not normally distributed) were used to analyze the differences within groups from pre to post-test measurements. The analysis of variance 2 × 2 factors and the Mann-Whitney U-test were used to analyze the difference of weight and functional strength respectively between the groups. Results: The patients in the RG reported a statistically significant weight reduction (p < 0.001) and improvement in the functional strength (p < 0.001) within the group. Similarly, the patients in the CG also reported a significant improvement in the scores of functional strength (p = 0.004) within the group. The improvement in the scores of functional strength was greater in the patients of RG than the CG (p < 0.001. Similarly, the patients in the RG reported a statistically significant reduction in weight than the CG (p < 0.001). Conclusion: The REs could improve weight, functional strength and exercise adherence.

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