Faculty Opinions recommendation of Continuous femoral nerve blocks: the impact of catheter tip location relative to the femoral nerve (anterior versus posterior) on quadriceps weakness and cutaneous sensory block.

2013 ◽  
Author(s):  
Peter Gerner ◽  
Thomas Danninger
Keyword(s):  
Femoral Nerve ◽  
Sensory Block ◽  
Nerve Blocks ◽  
Quadriceps Weakness ◽  
Catheter Tip ◽  
The Impact

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

2019 ◽  
Author(s):  
Valery Piacherski ◽  
Aliaksei Marachkou
Keyword(s):  
Nerve Block ◽  
Femoral Nerve Block ◽  
Femoral Nerve ◽  
Sensory Block ◽  
Cross Sectional Area ◽  
Sectional Area ◽  
Effective Volume ◽  
Nerve Blocks ◽  
Cross Sectional ◽  
The Cross

Abstract Background. 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.Methods. The chosen starting concentration of lidocaine was 1%, as the most widely applied solution for the peripheral blocks. Subsequently , depending upon the acquired results, we applied 0.75%, 1.5%, 2%, 3%, and 4% solutions in volumes that were defined in accordance with the results of the research. 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.Results. While measuring the cross-sectional area of the femoral nerve, no valid intergroup differences were observed (p = 0.98). The cross-sectional area of the femoral nerve within the region of the performed block was 0.27 cm2 (range: 0.24–0.3 cm2). Our research indicated that the minimal efficient volume of lidocaine that was necessary for the development of a complete block of the femoral nerve was 5 ml, and the amount of 75 mg. Conclusion. For 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 Impact of COVID-19 on Hip Fracture Management in a Tertiary Referral Hospital; Pearls and Pitfalls.

2020 ◽  
Author(s):  
Curran MG ◽  
Hickey P ◽  
Reddin C ◽  
Murphy R ◽  
Mohd Asri NA ◽  
...  
Keyword(s):  
Hip Fracture ◽  
Patient Outcomes ◽  
Femoral Nerve ◽  
Inpatient Mortality ◽  
Tertiary Referral Hospital ◽  
Nerve Blocks ◽  
Fracture Care ◽  
Fracture Management ◽  
The Impact ◽  
Patient Administration System

Abstract Background COVID-19 has caused significant challenges in the provision of safe and effective healthcare globally. Safeguarding the management of frail older adults is imperative in hip fracture care moving forward. Aims This study aimed to compare clinical outcomes of hip fracture care during the COVID-19 pandemic with the same timeframe in 2019, following significant reconfigurations in hip fracture management pathways during the pandemic. Methods We conducted a retrospective study comparing all patients treated for a hip fracture between two timeframes; March 1st2020 - May 1st 2020 and March 1st 2019 – May 1st 2019. Data was collected using the Irish Hip Fracture Database and the UHL electronic patient administration system. Results 118 patients were included in the study; 60 patients in the COVID-19 cohort and 58 patients in the control cohort. Demographic characteristics were comparable between groups. Improvements in adherence to Irish Hip Fracture Standards were noted during the COVID-19 cohort, however they were not significant. Three patients tested positive for COVID-19 during the timeframe of interest. Their length of stay (LOS) was noticeably longer than the median LOS of both groups. A significant decrease in femoral nerve blocks was noted during the COVID-19 cohort (p = < 0.001). There was a trend towards higher inpatient mortality, 30 day mortality rates and 30 day readmission in the COVID-19 cohort which was not statistically significant. ConclusionsOur study demonstrates continued adherence to the Irish Hip Fracture Standards at our institution and suggests the necessary alterations in hip fracture management did not negatively impact patient outcomes during the COVID-19 pandemic.

Ultrasound-guided approach for axillary brachial plexus, femoral nerve, and sciatic nerve blocks in dogs

2010 ◽  
Vol 37 (2) ◽  
pp. 144-153 ◽  
Author(s):  
Luis Campoy ◽  
Abraham J Bezuidenhout ◽  
Robin D Gleed ◽  
Manuel Martin-Flores ◽  
Robert M Raw ◽  
...  
Keyword(s):  
Sciatic Nerve ◽  
Brachial Plexus ◽  
Femoral Nerve ◽  
Ultrasound Guided ◽  
Nerve Blocks

scholarly journals In vitro Remote Aspiration Embolectomy for the Treatment of Acute Ischemic Stroke

2018 ◽  
Vol 8 (1) ◽  
pp. 20-26
Author(s):  
Asim Rizvi ◽  
Sean T. Fitzgerald ◽  
Kent D. Carlson ◽  
Dan Dragomir Daescu ◽  
Waleed Brinjikji ◽  
...  
Keyword(s):  
Case Series ◽  
In Vitro Study ◽  
Side Branch ◽  
Collateral Branch ◽  
Proximal Internal Carotid Artery ◽  
Glass Model ◽  
Catheter Tip ◽  
Inner Diameter ◽  
The Impact

Background: “Remote aspiration,” using suction from the proximal internal carotid artery (ICA) to open terminus occlusions, has been reported in small case series. However, it remains unclear whether remote aspiration is feasible for middle cerebral artery occlusions in the setting of potential inflow from communicating arteries. We performed an in vitro study to assess whether suction applied at various locations proximal to an occlusion could successfully aspirate the clot. Methods: A glass model of 4 mm inner diameter (ID) with 1 mm distal narrowing and 2 mm side branch to simulate a communicating artery was constructed. A proximal side branch was placed to simulate inflow from the proximal ICA. The impact of three different-sized catheters (ID 0.088, 0.070, and 0.056 in) on histologically different (red blood cell-cell rich, fibrin-rich, and mixed) clot analogues was tested with the catheter tip placed remotely either distal or proximal to the collateral branch. Aspiration was attempted with (1) open system (flow in both the ICA and the collateral branch, (2) flow arrest with open collateral (no flow in the ICA, but flow in the collateral branch), and (3) closed system (no flow in either the ICA or the collateral branch). The outcome was success or failure of remote aspiration. Results: For the 0.088-in catheter, remote aspiration was successful in all conditions. For the 0.070-in catheter, remote aspiration was unsuccessful without proximal flow arrest, but was successful in all other scenarios. For the 0.056-in catheter, remote aspiration was successful only with complete flow arrest. Conclusions: In a noncollapsible system, remote aspiration can be successfully achieved even in the setting of prominent branch arteries by using relatively large aspiration catheters. Proximal flow arrest may facilitate successful remote aspiration for some catheter sizes.

Ultrasound‐guided femoral nerve blocks are not superior to ultrasound‐guided fascia iliaca blocks for fractured neck of femur

2018 ◽  
Vol 31 (3) ◽  
pp. 393-398 ◽  
Author(s):  
Alannah L Cooper ◽  
Yusuf Nagree ◽  
Adrian Goudie ◽  
Peter R Watson ◽  
Glenn Arendts
Keyword(s):  
Femoral Nerve ◽  
Ultrasound Guided ◽  
Fractured Neck Of Femur ◽  
Nerve Blocks ◽  
Neck Of Femur

Analgesia and anaesthesia

2020 ◽  
pp. 281-327
Author(s):  
Jonathan P. Wyatt ◽  
Robert G. Taylor ◽  
Kerstin de Wit ◽  
Emily J. Hotton ◽  
Robin J. Illingworth ◽  
...  
Keyword(s):  
Emergency Department ◽  
Nerve Block ◽  
Local Anaesthetic ◽  
Local Anaesthesia ◽  
Femoral Nerve Block ◽  
Rapid Sequence Induction ◽  
Femoral Nerve ◽  
General Anaesthetic ◽  
Intravenous Sedation ◽  
Nerve Blocks

This chapter in the Oxford Handbook of Emergency Medicine investigates analgesia and anaesthesia in the emergency department (ED). It looks at options for relieving pain, such as the analgesics aspirin, paracetamol, non-steroidal anti-inflammatory drugs (NSAIDs), morphine and other opioids, Entonox®, and ketamine, and explores analgesia for trauma and other specific situations. It discusses local anaesthesia (LA) and local anaesthetic toxicity, including use of adrenaline (epinephrine) and general principles of local anaesthesia. It explores blocks such as Bier’s block, local anaesthetic nerve blocks, intercostal nerve block, digital nerve block, median and ulnar nerve blocks, radial nerve block at the wrist, dental anaesthesia, nerve blocks of the forehead and ear, fascia iliaca compartment block, femoral nerve block, and nerve blocks at the ankle. It examines sedation, including drugs for intravenous sedation and sedation in children, and discusses general anaesthesia in the emergency department, emergency anaesthesia and rapid sequence induction, difficult intubation, and general anaesthetic drugs.

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