scholarly journals Evaluation of High-Volume Injections Using a Modified Dorsal Quadratus Lumborum Block Approach in Canine Cadavers

Animals ◽  
2021 ◽  
Vol 12 (1) ◽  
pp. 18
Author(s):  
André Marchina-Gonçalves ◽  
Francisco Gil ◽  
Francisco G. Laredo ◽  
Marta Soler ◽  
Amalia Agut ◽  
...  
Keyword(s):  
Methylene Blue ◽  
High Volume ◽  
Sympathetic Trunk ◽  
Abdominal Muscles ◽  
Analgesic Effects ◽  
Area Of Interest ◽  
Quadratus Lumborum ◽  
Block Approach ◽  
Minor Muscle ◽  
Ct Studies

The quadratus lumborum (QL) block targets the fascial plane surrounding the QL muscle providing abdominal somatic and visceral analgesia. The extension of its analgesic effects is a subject of research, as it could not cover areas of the cranial abdomen in dogs. This study assesses in eight thawed canine cadavers, the distribution of high-volume injections (0.6 mL kg−1 of a mixture of methylene blue and iopromide) injected between the psoas minor muscle and the vertebral body of L1. Anatomical features of the area of interest were studied in two cadavers. In another six dogs, QL blocks were performed bilaterally under ultrasound-guidance. The distribution of contrast was evaluated by computed tomography (CT). Hypaxial abdominal muscles were dissected to visualize the dye spread (spinal nerves and sympathetic trunk) in 5 cadavers. The remaining cadaver was refrozen and cross-sectioned. CT studies showed a maximum distribution of contrast from T10 to L7. The methylene blue stained T13 (10%), L1 (100%), L2 (100%), L3 (100%), L4 (60%) and the sympathetic trunk T10 (10%), T11 (20%), T12 (30%), T13 (70%), L1 (80%), L2 (80%), L3 (60%) and L4 (30%). These findings may suggest that despite the high volume of injectate administered, this modified QL block could not produce somatic analgesia of the cranial abdomen, although it could provide visceral analgesia in dogs.

Quantitative analysis of the distal, lateral, and posterior articular branches of the axillary nerve to the shoulder: implications for intervention

2019 ◽  
Vol 44 (9) ◽  
pp. 875-880
Author(s):  
Brittany Bickelhaupt ◽  
Maxim S Eckmann ◽  
Caroline Brennick ◽  
Omid B Rahimi
Keyword(s):  
Methylene Blue ◽  
Shoulder Pain ◽  
Nerve Block ◽  
Humeral Head ◽  
Shoulder Joint ◽  
Deltoid Muscle ◽  
Axillary Nerve ◽  
Blue Staining ◽  
Lateral Aspect ◽  
Minor Muscle

IntroductionThe terminal sensory branches innervating the shoulder joint are potential therapeutic targets for the treatment of shoulder pain. This cadaveric study investigated in detail the anatomic pathway of the posterior terminal sensory branch of the axillary nerve (AN) and its relationship to nearby anatomic structures for applications, such as nerve block or ablation of the shoulder joint.MethodsFor this study, nine shoulders were dissected. Following dissection, methylene blue was used to stain the pathway of the terminal sensory branches of the AN to provide a visual relationship to the nearby bony structures. A transparent grid was overlaid on the humeral head to provide further detailed information regarding the innervation to the shoulder joint.ResultsEight of the nine shoulders displayed terminal sensory branches of the AN. The terminal sensory branches of the AN innervated the posterolateral head of the humerus and shoulder capsule and were deep and distal to the motor branches innervating the deltoid muscle and teres minor muscle. All terminal branches dissected innervated the shoulder capsule at the posteroinferior-lateral aspect of the greater tuberosity of the humerus. All specimens displayed innervation to the shoulder joint in the lateral most 25% and inferior most 37.5% before methylene blue staining.ConclusionThe terminal sensory branches of the AN consistently innervate the inferior and lateral aspects of the posterior humeral head and shoulder capsule. These nerves are easily accessible and would provide a practical target for nerve block or ablation to relieve shoulder pain without compromising motor integrity.

scholarly journals Involvement of the L-arginine/Nitric Oxide/Cyclic GMP/KATP Channel Pathway and PPARγ Receptors in the Peripheral Antinociceptive Effect of Carbamazepine

Drug Research ◽  
2019 ◽  
Vol 69 (12) ◽  
pp. 650-657 ◽  
Author(s):  
Behnam Ghorbanzadeh ◽  
Vahid Kheirandish ◽  
Mohammad Taghi Mansouri
Keyword(s):  
Nitric Oxide ◽  
Methylene Blue ◽  
Katp Channel ◽  
Formalin Test ◽  
Antinociceptive Effect ◽  
Experimental Pain ◽  
Analgesic Effects ◽  
Pparγ Agonist ◽  
Nos Inhibitor ◽  
Pre Treatment

AbstractCarbamazepine has been shown to exert analgesic effects in clinical and experimental pain situation. This study was conducted to evaluate its potential peripheral antinociceptive effects and the possible involvement of L-arginine/NO/cGMP/KATP channel pathway and PPARγ receptors in an animal model of pain. The antinociceptive effect induced by intraplantar administration of carbamazepine (100–1 000 μg/paw) was assessed using the formalin test in rats. To evaluate the involvement of L-arginine/NO/cGMP/KATP channel pathway in the antinociceptive action of carbamazepine, rats were pre-treated intraplantarlly with L-arginine (a nitric oxide precursor, 100 and 200 μg/paw), L-NAME (NOS inhibitor, 50 and 100 μg/paw), methylene blue (guanylyl cyclase inhibitor, 100 and 200 μg/paw), glibenclamide (KATP channel blocker, 100 and 200 μg/paw), and diazoxide (400 μg/paw). Moreover, to investigate the possible involvement of PPARγ receptors, pioglitazone (10 μg/paw; a PPARγ agonist) alone or in combination with GW9662 (3 μg/paw; a PPARγ antagonist) were pre-treated with carbamazepine. The local ipsilateral, but not contralateral, administration of carbamazepine into the hind paw produced dose-related analgesia during both early and late phases of formalin test. Moreover, pre-treatment with L-NAME, methylene blue, and glibenclamide dose-dependently prevented carbamazepine (300 μg/paw)-induced antinociception in both phases of the test. In addition, administration of L-arginine and diazoxide before the sub-effective dose of carbamazepine (100 μg/paw) produced an antinociceptive effect. Also, antinociception induced by carbamazepine plus pioglitazone (10 μg/paw) was blocked by GW-9662 in both phases of the test. In conclusion, carbamazepine induced a peripheral antinociceptive effect through PPARγ receptors and L-arginine/NO/cGMP/KATP channel pathway, with potential for a new topical analgesic drug.

scholarly journals Ultrasound-Guided Quadratus Lumborum Block: An Updated Review of Anatomy and Techniques

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Hironobu Ueshima ◽  
Hiroshi Otake ◽  
Jui-An Lin
Keyword(s):  
Abdominal Surgery ◽  
Local Anesthetic ◽  
Future Research ◽  
Original Publication ◽  
Ultrasound Guided ◽  
Nerve Roots ◽  
Quadratus Lumborum ◽  
Lateral Posterior ◽  
Psoas Major ◽  
Block Approach

Purpose of Review. Since the original publication on the quadratus lumborum (QL) block, the technique has evolved significantly during the last decade. This review highlights recent advances in various approaches for administering the QL block and proposes directions for future research. Recent Findings. The QL block findings continue to become clearer. We now understand that the QL block has several approach methods (anterior, lateral, posterior, and intramuscular) and the spread of local anesthetic varies with each approach. In particular, dye injected using the anterior QL block approach spread to the L1, L2, and L3 nerve roots and within psoas major and QL muscles. Summary. The QL block is an effective analgesic tool for abdominal surgery. However, the best approach is yet to be determined. Therefore, the anesthetic spread of the several QL blocks must be made clear.

scholarly journals Analgesic effects and distribution of cutaneous sensory blockade of quadratus lumborum block type 2 and posterior transversus abdominis plane block: an observational comparative study

2020 ◽  
Vol 73 (4) ◽  
pp. 326-333 ◽  
Author(s):  
Yuki Aoyama ◽  
Shinichi Sakura ◽  
Shoko Abe ◽  
Minori Wada ◽  
Yoji Saito
Keyword(s):  
Comparative Study ◽  
Transversus Abdominis Plane Block ◽  
Transversus Abdominis ◽  
Gynecologic Surgery ◽  
Transversus Abdominis Plane ◽  
Sensory Blockade ◽  
Analgesic Effects ◽  
Quadratus Lumborum ◽  
Laparoscopic Gynecologic Surgery

Background: The posterior transversus abdominis plane block (TAPB) and quadratus lumborum block (QLB) were developed for postoperative pain control after lower abdominal surgery. However, there is little data regarding their effects. Their analgesic effects and the distribution of the cutaneous sensory blockade were observed in patients undergoing laparoscopic gynecologic surgery. Methods: After an induction of general anesthesia, patients alternately received bilateral ultrasound-guided QLB type 2 (QLB2) or posterior TAPB using 20 ml of 0.375% levobupivacaine on each side. The measurements included visual analogue pain scores (VAS), cutaneous sensory blockade in each dermatome, demands for postoperative analgesics, and complications for up to 48 h after the block. Our primary endpoint was VAS at 24 h after the block. Results: Forty patients completed the study. The VAS at rest was significantly lower after QLB2 than that after TAPB at 48 h, but not at 24 h. Neither group differed in VAS when coughing at any point in time. Postoperative demands for fentanyl and other analgesics also did not differ for either block. The majority of injections produced a cutaneous sensory blockade in the T11 and T12 dermatomes in both groups. The median number of dermatomes blocked was limited to three dermatomes after either block. No severe complication related to either block was observed. Conclusions: The analgesic effects of QLB2 and posterior TAPB did not differ in patients undergoing laparoscopic gynecologic surgery. The cutaneous sensory blockade produced was limited to three dermatomal levels in the majority of patients. However, these findings need to be confirmed through a larger comparative study.

scholarly journals A Modified Approach for the Ultrasound-Guided Quadratus Lumborum Block in Dogs: A Cadaveric Study

Animals ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. 2945
Author(s):  
Jaime Viscasillas ◽  
Jose Terrado ◽  
Reyes Marti-Scharfhausen ◽  
Diego Castiñeiras ◽  
Vicente Esteve ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Methylene Blue ◽  
Ct Images ◽  
Cadaveric Study ◽  
Abdominal Organ ◽  
Ultrasound Guided ◽  
Quadratus Lumborum Block ◽  
Quadratus Lumborum ◽  
Transverse Position ◽  
Lateral Recumbency

Ultrasound-guided quadratus lumborum block (QLB) is a locoregional technique described in canine cadavers. The aim of this study was to assess a modified approach to QLB to minimise potential complications such as abdominal organ puncture. Nine canine cadavers were included and were positioned in lateral recumbency. An ultrasound-guided QLB was performed on each side. The probe was placed in the transverse position over the lumbar muscles just caudal to the last rib, and a needle was advanced in-plane from a dorso-lateral to a ventro-medial. A volume of 0.2 mL kg−1 of a mixture of iomeprol and methylene blue was injected. Computed tomography (CT) and dissection were performed to evaluate the spreading. Success was defined as staining of the nerve with a length of more than 0.6 cm. Potential complications such as intra-abdominal, epidural, or intravascular spreading of the mixture were also assessed. The CT images showed a T13 to L7 vertebra distribution, with a median of 5 (3–6). Dissection showed staining of the nerves from T13 to L4, with a median of 3 (2–5). No complications were found. This modified approach to QLB is safe and shows similar results to the previous studies in canine carcass.

scholarly journals Methylene Blue Application to Lessen Pain: Its Analgesic Effect and Mechanism

2021 ◽  
Vol 15 ◽  
Author(s):  
Seung Won Lee ◽  
Hee Chul Han
Keyword(s):  
Methylene Blue ◽  
Pain Relief ◽  
Sodium Current ◽  
Public Attention ◽  
Analgesic Effects ◽  
Relieve Pain ◽  
Discogenic Low Back Pain ◽  
Current Reduction ◽  
Insight Into ◽  
Anti Inflammation

Methylene blue (MB) is a cationic thiazine dye, widely used as a biological stain and chemical indicator. Growing evidence have revealed that MB functions to restore abnormal vasodilation and notably it is implicated even in pain relief. Physicians began to inject MB into degenerated disks to relieve pain in patients with chronic discogenic low back pain (CDLBP), and some of them achieved remarkable outcomes. For osteoarthritis and colitis, MB abates inflammation by suppressing nitric oxide production, and ultimately relieves pain. However, despite this clinical efficacy, MB has not attracted much public attention in terms of pain relief. Accordingly, this review focuses on how MB lessens pain, noting three major actions of this dye: anti-inflammation, sodium current reduction, and denervation. Moreover, we showed controversies over the efficacy of MB on CDLBP and raised also toxicity issues to look into the limitation of MB application. This analysis is the first attempt to illustrate its analgesic effects, which may offer a novel insight into MB as a pain-relief dye.

Wafer Embedment to Facilitate Light Microscope Selection of Specimens for Ultrathin Sectioning

1976 ◽  
Vol 34 ◽  
pp. 348-349
Author(s):  
Dwight K. Romanovicz ◽  
Jacob S. Hanker
Keyword(s):  
Electron Microscopy ◽  
Methylene Blue ◽  
Light Microscopy ◽  
Light Microscope ◽  
Standard Procedure ◽  
High Magnification ◽  
Area Of Interest ◽  
Blue Stain ◽  
Special Embedding ◽  
Selection Of

An unfortunate consequence of the high magnification achieved in electron microscopy is the inability to scan large areas of tissue or locate structures which are small and of infrequent occurrence. The standard procedure is to section repeatedly, hoping that an area of interest will be encountered. However, this time-consuming practice can be avoided by the use of a special embedding platform which permits the embedment of tissue for examination by light microscopy prior to sectioning.Aldehyde-fixed tissues are cut into 10μm sections with a Vibratome or into 20-30μm sections with a Sorvall TC-2 tissue sectioner. At this point optimal sections may be selected on the basis of a particular morphological feature, for which a light methylene blue or Alcian blue stain may be employed; or selection may be based upon activity of a cytochemical enzyme stain, particularly one which involves 3,3'-diaminobenzidine (DAB).

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