scholarly journals Combined Ultrasound and Nerve Stimulator-Guided deep nerve block may decrease the rate of local anesthetics systemic toxicity especially in HBV carriers: A Randomized clinical trial

2019 ◽  
Author(s):  
Xu-hao Zhang ◽  
Yu-jie Li ◽  
Wenquan He ◽  
Chunyong Yang ◽  
Jianteng Gu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Clinical Trial ◽  
Nerve Block ◽  
Local Anesthetics ◽  
Ultrasound Guidance ◽  
Female Gender ◽  
Hbv Infection ◽  
Nerve Stimulator ◽  
Nerve Blocks ◽  
Associated Risk Factors

Abstract Background: Ultrasound-guidance might decrease the incidence of local anesthetics systemic toxicity(LAST) for many peripheral nerve blocks compared with nerve stimulator-guidance. However, it remained uncertain whether ultrasound-guidance would be superior to the nerve stimulator-guidance for deep nerve block in the lower extremity. This study was designed to investigate that whether ultrasound-guided deep nerve block would decrease the incidence of LAST comparing with those with nerve stimulator-guidance, and to find out associated risk factors for LAST. Methods: Three hundred patients for elective lower limb surgery and desiring lumbar plexus blocks(LPBs) and sciatic nerve blocks(SNBs) were enrolled in this study. Patients were randomly assigned to receive LPBs and SNBs with ultrasound-guidance (Group U), nerve stimulator-guidance (Group N) or dual-guidance (Group M). The primary outcome was the incidence of the LAST. The secondary outcomes were the number of needle redirection, motor and sensory block onset and restoration time in the nerve distributions, and associated risk factors. Results: There were 18 patients occurring with LAST, including 12 in group U, 4 in group N and 2 in group M. For multiple comparisons among the three groups, we found that the incidence of LAST in group U(12%) was significantly higher than that in group N(4%)(P=0.037) and group M(2%)(P=0.006). The OR of LAST with hepatitis B （HBV） infection and female gender were 3.352(95% CI,1.233-9.108, P=0.013 ) and 9.488(95% CI,2.142-42.093, P=0.0004), respectively. Conclusions: Ultrasound-guidance, HBV infection and female gender were risk factors for LAST in LPBs and SNBs. For patients with HBV infection or female gender undergoing LPBs and SNBs, we recommended that combined ultrasound and nerve stimulator-guidance should be used to improve the safety. Trial registration: This study was approved by the Ethical Committee from the first affiliated hospital of Army Medical University. The protocol was registered prospectively with Chinese Clinical Trial Registry (ChiCTR-IOR-16008099) on March 15th，2016. Key words: ultrasound; nerve stimulation; nerve block; female; HBV; LAST

scholarly journals Ultrasound-guided deep nerve block may increase the rate of local anesthetics toxicity in HBV carriers: A Randomized clinical trial

2019 ◽  
Author(s):  
Xu-hao Zhang ◽  
Yu-jie Li ◽  
Wenquan He ◽  
Chunyong Yang ◽  
Jianteng Gu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Clinical Trial ◽  
Nerve Block ◽  
Nerve Stimulation ◽  
Local Anesthetics ◽  
Ultrasound Guidance ◽  
Female Gender ◽  
Hbv Infection ◽  
Nerve Stimulator ◽  
Nerve Blocks

Abstract Background: Ultrasound-guidance might decrease the incidence of local anesthetics systemic toxicity(LAST) for many peripheral nerve blocks compared to nerve stimulation. However, it remained uncertain whether ultrasound-guidance would be superior to the nerve stimulation for deep nerve block in the lower extremity. This study was designed to investigate that deep nerve block with ultrasound-guidance would result in a lower rate of LAST comparing to that with nerve stimulator-guidance. Methods: Three hundred patients who were for elective lower limb surgery and desiring lumbar plexus blocks(LPBs) and sciatic nerve blocks(SNBs) were enrolled in this study. Patients were randomly assigned to receive LPB and SNB with ultrasound-guidance (Group U), nerve stimulator-guidance (Group N) and dual-guidance (Group M). The primary outcome was the incidence of the LAST. The secondary outcomes were number of needle redirections, motor and sensory block onset and restoration times in the nerve distributions, and associated risk factors. Results: There were 18 patients with the LAST, including 12 in group U, 4 in group N and 2 in group M. For multiple comparisons among the tree groups, we found that the incidence of LAST in group U(12%) was significantly higher than that in group N(4%)(P=0.037) and group M(2%)(P=0.006). The OR of LAST with HBV infection and female gender was 3.352(95% CI,1.233-9.108, P=0.013 ) and 9.488(95% CI,2.142-42.093, P=0.0004), respectively. Conclusions: For patients undergoing LPBs and SNBs, use of ultrasound may increase the incidence of the LAST. HBV infection and female gender were risk factors for deep nerve block. Trial registration: This study was approved by the human research review committee at the southwest hospital of third military medical university. The protocol was registered prospectively with Chinese Clinical Trial Registry (ChiCTR-IOR-16008099) on March 15th，2016. Keywords: Ultrasound; nerve stimulation; nerve block; female; HBV; LAST

scholarly journals Combined Ultrasound and Nerve Stimulator-Guided deep nerve block may decrease the rate of local anesthetics systemic toxicity: A Randomized clinical trial

2019 ◽  
Author(s):  
Xu-hao Zhang ◽  
Yu-jie Li ◽  
Wenquan He ◽  
Chunyong Yang ◽  
Jianteng Gu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Clinical Trial ◽  
Nerve Block ◽  
Local Anesthetics ◽  
Ultrasound Guidance ◽  
Systemic Toxicity ◽  
Hbv Infection ◽  
Nerve Stimulator ◽  
Nerve Blocks ◽  
Associated Risk Factors

Abstract Background: Ultrasound guidance might decrease the incidence of local anesthetics systemic toxicity (LAST) for many peripheral nerve blocks compared with nerve stimulator guidance. However, it remains uncertain whether ultrasound guidance is superior to nerve stimulator guidance for deep nerve block of the lower extremity. This study was designed to investigate whether deep nerve block with ultrasound guidance would decrease the incidence of LAST compared with that with nerve stimulator guidance and to identify associated risk factors of LAST. Methods: Three hundred patients undergoing elective lower limb surgery and desiring lumbar plexus blocks (LPBs) and sciatic nerve blocks (SNBs) were enrolled in this study. The patients were randomly assigned to receive LPBs and SNBs with ultrasound guidance (group U), nerve stimulator guidance (group N) or dual guidance (group M). The primary outcome was the incidence of LAST. The secondary outcomes were the number of needle redirections, motor and sensory block onset and nerve distribution restoration time, as well as associated risk factors. Results: There were 18 patients with LAST, including 12 in group U, 4 in group N and 2 in group M. By multiple comparisons among the three groups, we found that the incidence of LAST in group U (12%) was significantly higher than that in group N (4%) (P=0.037) and group M (2%) (P=0.006). The OR of LAST with hepatitis B (HBV) infection and the female sex was 3.352 (95% CI, 1.233-9.108, P=0.013) and 9.488 (95% CI, 2.142-42.093, P=0.0004), respectively. Conclusions: Ultrasound guidance, HBV infection and the female sex were risk factors of LAST with LPBs and SNBs. For patients infected with HBV or female patients receiving LPBs and SNBs, we recommended that combined ultrasound and nerve stimulator guidance should be used to improve the safety. Trial registration: This study was approved by the Ethical Committee of the First Affiliated Hospital of Army Medical University. The protocol was registered prospectively with the Chinese Clinical Trial Registry (ChiCTR-IOR-16008099) on March 15, 2016.

scholarly journals Combined Ultrasound and Nerve Stimulator-Guided Deep Nerve Block May Decrease the Rate of Local Anesthetics Systemic Toxicity: A Randomized Clinical Trial

2019 ◽  
Author(s):  
Xu-hao Zhang ◽  
Yu-jie Li ◽  
Wenquan He ◽  
Chunyong Yang ◽  
Jianteng Gu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Clinical Trial ◽  
Nerve Block ◽  
Local Anesthetics ◽  
Ultrasound Guidance ◽  
Systemic Toxicity ◽  
Hbv Infection ◽  
Nerve Stimulator ◽  
Nerve Blocks ◽  
Associated Risk Factors

Abstract Background: Ultrasound guidance might decrease the incidence of local anesthetics systemic toxicity (LAST) for many peripheral nerve blocks compared with nerve stimulator guidance. However, it remains uncertain whether ultrasound guidance is superior to nerve stimulator guidance for deep nerve block of the lower extremity. This study was designed to investigate whether deep nerve block with ultrasound guidance would decrease the incidence of LAST compared with that with nerve stimulator guidance and to identify associated risk factors of LAST. Methods: Three hundred patients undergoing elective lower limb surgery and desiring lumbar plexus blocks (LPBs) and sciatic nerve blocks (SNBs) were enrolled in this study. The patients were randomly assigned to receive LPBs and SNBs with ultrasound guidance (group U), nerve stimulator guidance (group N) or dual guidance (group M). The primary outcome was the incidence of LAST. The secondary outcomes were the number of needle redirections, motor and sensory block onset and nerve distribution restoration time, as well as associated risk factors. Results: There were 18 patients with LAST, including 12 in group U, 4 in group N and 2 in group M. By multiple comparisons among the three groups, we found that the incidence of LAST in group U (12%) was significantly higher than that in group N (4%) (P=0.037) and group M (2%) (P=0.006). The OR of LAST with hepatitis B (HBV) infection and the female sex was 3.352 (95% CI, 1.233-9.108, P=0.013) and 9.488 (95% CI, 2.142-42.093, P=0.0004), respectively. Conclusions: Ultrasound guidance, HBV infection and the female sex were risk factors of LAST with LPBs and SNBs. For patients infected with HBV or female patients receiving LPBs and SNBs, we recommended that combined ultrasound and nerve stimulator guidance should be used to improve the safety. Trial registration: This study was approved by the Ethical Committee of the First Affiliated Hospital of Army Medical University. The protocol was registered prospectively with the Chinese Clinical Trial Registry (ChiCTR-IOR-16008099) on March 15, 2016.

Stress, anxiety, depression and burnout in frontline health care workers during COVID-19 pandemic: a brief systematic review and new data from Russia

2021 ◽  
Author(s):  
Ekaterina Mosolova ◽  
Dmitry Sosin ◽  
Sergey Mosolov
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Female Gender ◽  
Assessment Tools ◽  
Care Workers ◽  
Younger Age ◽  
Wide Range ◽  
Associated Risk Factors ◽  
Anxiety Depression ◽  
The Impact

During the COVID-19 pandemic, healthcare workers (HCWs) have been subject to increased workload while also exposed to many psychosocial stressors. In a systematic review we analyze the impact that the pandemic has had on HCWs mental state and associated risk factors. Most studies reported high levels of depression and anxiety among HCWs worldwide, however, due to a wide range of assessment tools, cut-off scores, and number of frontline participants in the studies, results were difficult to compare. Our study is based on two online surveys of 2195 HCWs from different regions of Russia during spring and autumn epidemic outbreaks revealed the rates of anxiety, stress, depression, emotional exhaustion and depersonalization and perceived stress as 32.3%, 31.1%, 45.5%, 74.2%, 37.7% ,67.8%, respectively. Moreover, 2.4% of HCWs reported suicidal thoughts. The most common risk factors include: female gender, nurse as an occupation, younger age, working for over 6 months, chronic diseases, smoking, high working demands, lack of personal protective equipment, low salary, lack of social support, isolation from families, the fear of relatives getting infected. These results demonstrate the need for urgent supportive programs for HCWs fighting COVID-19 that fall into higher risk factors groups.

scholarly journals Prevalence of Long COVID symptoms in Bangladesh: a prospective Inception Cohort Study of COVID-19 survivors

2021 ◽  
Vol 6 (12) ◽  
pp. e006838
Author(s):  
Mohammad Anwar Hossain ◽  
K M Amran Hossain ◽  
Karen Saunders ◽  
Zakir Uddin ◽  
Lori Maria Walton ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Structural Equation ◽  
Functional Limitation ◽  
Maximal Oxygen Consumption ◽  
Female Gender ◽  
Inception Cohort ◽  
Persistent Symptoms ◽  
Health Initiatives ◽  
Associated Risk Factors

BackgroundThe objective of this study was to identify the prevalence of long COVID symptoms in a large cohort of people living with and affected by long COVID and identify any potential associated risk factors.MethodsA prospective survey was undertaken of an inception cohort of confirmed people living with and affected by long COVID (aged 18–87 years). 14392 participants were recruited from 24 testing facilities across Bangladesh between June and November 2020. All participants had a previously confirmed positive COVID-19 diagnosis, and reported persistent symptoms and difficulties in performing daily activities. Participants who consented were contacted by face-to-face interview, and were interviewed regarding long COVID, and restriction of activities of daily living using post COVID-19 functional status scale. Cardiorespiratory parameters measured at rest (heart rate, systolic blood pressure, diastolic blood pressure, oxygen saturation levels, maximal oxygen consumption, inspiratory and expiratory lung volume) were also measured.ResultsAmong 2198 participants, the prevalence of long COVID symptoms at 12 weeks was 16.1%. Overall, eight long COVID symptoms were identified and in descending order of prominence are: fatigue, pain, dyspnoea, cough, anosmia, appetite loss, headache and chest pain. People living with and affected by long COVID experienced between 1 and 8 long COVID symptoms with an overall duration period of 21.8±5.2 weeks. Structural equation modelling predicted the length of long COVID to be related to younger age, female gender, rural residence, prior functional limitation and smoking.ConclusionIn this cohort, at 31 weeks post diagnosis, the prevalence of long COVID symptoms was 16.1%. The risk factors identified for presence and longer length of long COVID symptoms warrant further research and consideration to support public health initiatives.

scholarly journals Defining the minimal effective volume and amount of lidocaine to perform a femoral nerve block under ultrasound control

2020 ◽  
Author(s):  
Valery Piacherski ◽  
Aliaksei Marachkou
Keyword(s):  
Sciatic Nerve ◽  
Nerve Block ◽  
Local Anesthetics ◽  
Peripheral Nerves ◽  
Femoral Nerve Block ◽  
Femoral Nerve ◽  
The Body ◽  
Effective Volume ◽  
Nerve Blocks ◽  
Nerve Blockade

Abstract BackgroundThe application of the combination of local anesthetics (LA) in some parts of the body increases the amount of LA and plasma concentration. The aim of our research was to define the minimal effective volume and amount of lidocaine with added adrenaline (1:200,000) to perform a femoral nerve block under ultrasound control and with neurostimulation. MethodsFemoral nerve blockade was performed with the following lidocaine solutions: 0.75% -10 ml, 7.5 ml; 1% -20ml, 15ml, 10ml, 7.5ml, 5ml; 1.5% -5ml, 4ml; 2% -5 ml, 4 ml; 3% -5ml, 4ml, 3ml; 4% -5 ml, 4 ml, 3 ml, 2.5 ml. All blocks were performed with added adrenaline (1:200,000). In all, 181 blocks of the femoral nerve, in combination with sciatic nerve blocks, were carried out with the help of the electrostimulation of peripheral nerves, and under ultrasound. The quality of motor and sensory blocks was assessed after 45 min of administration of the femoral nerve block. ResultsA total of 181 femoral nerve blocks, in combination with sciatic nerve blocks, were used via the help of electrostimulation of the peripheral nerves (EPN), and under ultrasound (US) control. The femoral nerve blockade was effective with the following lidocaine solutions: 0.75% -10 ml (75mg); 1% -20ml, 15ml, 10ml, 7.5ml (75mg); 1.5% -5ml (75mg); 2% -5 ml (100 mg); 3% -5ml (150mg); 4% -5 ml (200mg). Femoral blockade was ineffective when using the following solutions of lidocaine: 0.75% - 7.5ml (56.25 mg); 1% - 5ml (50mg); 1.5% - 4ml (60mg, No spread along the entire circumference of the nerve - NSAECN); 2% - 4 ml (80mg, NSAECN); 3% - 4ml (120mg NSAECN), 3 ml; 4% - 4 ml (160 mg, NSAECN), 3 ml, 2.5 ml. ConclusionFor a complete motor and sensory block of the femoral nerve: the minimum effective volume of local anesthetics was 5 ml; and the minimum effective amount of lidocaine was 75 mg. А complete block of the femoral nerve was achieved only with the spreading of local anesthetic along the whole circumference of the femoral nerve.

scholarly journals The Prevalence and Risk Factors for Symptomatic Dry Eye in Adults in Riyadh, Saudi Arabia

2021 ◽  
Vol 15 (1) ◽  
pp. 277-282
Author(s):  
Anas Abdulaziz Almujalli ◽  
Abdulaziz Abdullah Almatrafi ◽  
Anas Abdullah Aldael ◽  
Talal Waleed Aljudi ◽  
Bahaa-Eldin Hasan Abdulhalim
Keyword(s):  
Risk Factors ◽  
Saudi Arabia ◽  
Dry Eye ◽  
Skin Diseases ◽  
Contact Lenses ◽  
Female Gender ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Associated Risk Factors ◽  
Structured Questionnaire

Objectives: The objective of this study is to estimate the prevalence of symptomatic suspected dry eye, diagnosed dry eye syndrome (DES), and associated risk factors; in Riyadh, Saudi Arabia. Methods: A cross-sectional study of 654 participants was employed using a self-administered semi-structured questionnaire that included demographic characteristics like age, gender, and risk factors (smoking, using contact lenses, chronic comorbidities, etc.). Results: There were 266 (40.7%) previously diagnosed DES participants and 388 (59.3%) non-diagnosed DES, of which 497 were female and 157 were male. Females had a significantly higher rate of diagnosed DES than males (p<0.001), with a significant increase in the rate of DES diagnosis with age (p<0.001). There was also a significant increase in DES in participants with diabetes mellitus, allergic eye, thyroid eye, and skin diseases, as well as having undergone laser surgery or using contact lenses. There was no significant increase in DES in cases of smoking, daily use of electronic devices, or duration of sleep. Conclusion: The prevalence of dry eye among adults in Riyadh was 46.6%, with the most important risk factors being female gender, increasing age, Lasik refractive surgery, skin disease around the eye, and thyroid eye disease.

scholarly journals Cross-Sectional Investigation of Stress Fractures in German Elite Triathletes

Sports ◽  
2019 ◽  
Vol 7 (4) ◽  
pp. 88 ◽  
Author(s):  
Neidel ◽  
Wolfram ◽  
Hotfiel ◽  
Engelhardt ◽  
Koch ◽  
...  
Keyword(s):  
Risk Factors ◽  
Professional Community ◽  
Female Gender ◽  
Cross Sectional Study ◽  
Stress Fractures ◽  
Cross Sectional ◽  
Web Based ◽  
Competitive Athletes ◽  
Associated Risk Factors ◽  
Retrospective Questionnaire

Triathlon is a popular sport for both recreational and competitive athletes. This study investigated the rates and patterns of stress fractures in the German national triathlon squad. We developed a web-based retrospective questionnaire containing questions about the frequency of stress fractures, anatomic localisation and associated risk factors. The survey was conducted as an explorative cross-sectional study. Eighty-six athletes completed the questionnaire. Twenty athletes (23%) sustained at least one stress fracture. All documented stress fractures were located in the lower extremities. Factors associated with a higher risk for stress fractures were female gender, competitive sport prior to triathlon career, Vitamin D or iron deficiency, menstrual disturbances and a high number of annual training hours. Disseminating knowledge among athletes and their professional community in order to raise awareness about early symptoms and relevant risk factors could help to improve prevention and reduce the incidence of stress fractures.

scholarly journals Double axillary vein variation diagnosed with ultrasound guidance during infraclavicular nerve block intervention

2019 ◽  
Vol 12 (1) ◽  
pp. bcr-2018-227495
Author(s):  
Başak Altıparmak ◽  
Melike Korkmaz Toker ◽  
Ali İhsan Uysal ◽  
Semra Gümüş Demirbilek
Keyword(s):  
Nerve Block ◽  
Ultrasound Guidance ◽  
Peripheral Nerve Block ◽  
Anaesthetic Management ◽  
Detailed Knowledge ◽  
Axillary Vein ◽  
Nerve Blocks ◽  
Different Types ◽  
Axillary Anatomy ◽  
Peripheral Block

The use of ultrasound guidance increases the safety of peripheral block interventions by allowing anaesthesiologists to simultaneously see the position of block needle, the targeted nerves and surrounding vessels. In this report, we represented three patients diagnosed with double axillary vein variation with ultrasound guidance during infraclavicular nerve block intervention. The patients were scheduled for different types of upper limb surgeries. All patients received infraclavicular nerve block for anaesthetic management. A double axillary vein variation was diagnosed with ultrasound during block interventions. Hydro-location technique was used in all cases and the procedures were completed uneventfully. In the current literature, there is limited number of reports concerning double axillary vein variation. Detailed knowledge of the axillary anatomy is important to avoid complications such as intravascular injection during peripheral nerve block interventions. The use of ultrasound guidance and hydro-location technique should be considered for nerve blocks, especially in the axillary area.

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