scholarly journals Ultrasound Guided Popliteal Nerve Block For Various Ankle & Foot Surgeries

2021 ◽  
Vol 23 (2) ◽  
pp. 39-57
Author(s):  
Dipti Anandani ◽  
Manisha Kapdi ◽  
Bhakti Rajani
Keyword(s):  
General Anaesthesia ◽  
Nerve Block ◽  
Age Groups ◽  
Neurological Complications ◽  
Ultrasound Guided ◽  
Nerve Blocks ◽  
The Mean ◽  
Ultrasonographic Guidance ◽  
Time Required ◽  
Mean Time

Background: Ankle& foot surgeries are very common surgeries in various age groups like young & geriatric as well as in patients with comorbidities. Popliteal nerve block is one of multimodal Anaesthesia & analgesia for same. we have used ultrasound guided block to prevent complications &precise volume at a site for improving Characteristics of block. Aims of study: To study the technique of giving popliteal nerve blocks with ultrasonographic guidance and evaluate it in terms of: No of attempts, Time required for sensory and motor blockade, Quality of Intra operative analgesia, Duration for post-operative analgesia, Supplementation required in form of sedo analgesia/general anaesthesia & Complications encountered. Methods: We performed ultrasonography guided popliteal nerve block in 60 adult patients of ASA grade I/II/III undergoing foot and ankle surgeries. The volume of drug used was 20ml consisting of Lignocaine (1.5%) 10ml and Bupivacaine (0.5%) 10ml; Results: The mean time taken to conduct the block was 4.3±1.4 mins. The mean time taken for sensory onset was 3.8±1.1 mins. The mean time taken for motor onset was 7.0± 1.4 mins. The mean time taken for completing the surgery was 39.2±5.0 mins. The mean time taken for complete motor regression was 143.8±13.5 mins. The mean time taken for complete sensory regression was 184.8± 16.8 mins. The patients first complained of pain at the mean time of 239±22.4 mins. The patients have stable haemodynamic parameters: pulse rate, SBP, DBP throughout the operation. Failure of block was seen in 4 patients where supplementation in the form of Injection Midazolam 1mg IV and Injection Fentanyl 50microgm IV was given in 2 patients and general anaesthesia was given in 2 patients. No other neurological complications were noticed in our study. Conclusion: ultrasound guided Popliteal nerve block is safe& effective block for various ankle &foot surgeries.

scholarly journals Comparison of ultrasound-guided abdominal nerve blocks and subarachnoid block as an anaesthetic technique for appendectomy: a retrospective study

2017 ◽  
Vol 4 (1) ◽  
pp. 16-22 ◽  
Author(s):  
Prajjwal Raj Bhattarai ◽  
Anuj Jung Rayamajhi ◽  
Rupesh Kumar Yadav ◽  
Subash Chandra Paudel ◽  
Anang Pangeni ◽  
...  
Keyword(s):  
General Anaesthesia ◽  
Opioid Consumption ◽  
Block Group ◽  
Ultrasound Guided ◽  
Nerve Blocks ◽  
Hospital Records ◽  
Subarachnoid Block ◽  
Duration Of Hospital Stay ◽  
Group A ◽  
The Mean

Background: Ultrasound guided abdominal nerve blocks are increasingly being used for anaesthesia and analgesia for surgeries like appendectomy, hernia repair in our centre. The aim of the study was to compare abdominal nerve blocks and subarachnoid block for appendectomy.Method: Retrospective data of patients that underwent appendectomy either under subarachnoid block (Group-S) or abdominal nerve blocks (Group-A) for three months were collected from hospital records. The groups were compared for conversion to general anaesthesia as a primary end point of study and also for the time taken for the procedure, the first requirement of opioids, total opioid consumption and length of hospital stay.Result: Out of 116 patients studied, 75 surgeries were performed under subarachnoid block and 41 under abdominal plane blocks. Two patients in Group-S and 1 patient in Group-A were converted to general anaesthesia due to inadequate blockade. The time taken to perform the block was around four minutes in Group-S and 12 minutes in Group-A. The mean pethidine consumption in 24 hours was 62.33+16.63 mg and 23.17+15.19 mg in Group-S and Group-A respectively. The time to the first dose of pethidine in Group-S groups was 224.66+43.56 minutes and 813.17+361.80 minutes in Group-A. The mean duration of hospital stay in Group-S was 5.14+0.72 days and Group-A was 2.24+0.58 days.Conclusion: Appendectomy can be safely performed under subarachnoid block as well as the abdominal nerve blocks. The abdominal nerve block technique is found to be advantageous in terms of better postoperative analgesia, less opioid consumption and early hospital discharge.

scholarly journals Clinical analyses of ultrasound-guided nerve block in lower-extremity surgery: A retrospective study

2021 ◽  
Vol 29 (1) ◽  
pp. 230949902198910
Author(s):  
Chan Kang ◽  
Deuk-Soo Hwang ◽  
Jae-Hwang Song ◽  
Gi-Soo Lee ◽  
Jeong-Kil Lee ◽  
...  
Keyword(s):  
Lower Extremity ◽  
Nerve Block ◽  
Onset Time ◽  
Satisfaction Score ◽  
Ultrasound Guided ◽  
Time Duration ◽  
Tourniquet Time ◽  
Femoral Cutaneous Nerve ◽  
The Mean ◽  
Time Required

Purpose: The purpose of this study is to examine the clinical effects and results of lower-extremity surgery under ultrasound-guided nerve block; time required for nerve block, anesthesia onset time, duration of anesthesia, duration of analgesia, tolerable tourniquet time, visual analog scale (VAS) satisfaction score, and anesthetic-related complications. Methods: A total of 3312 cases (2597 patients) from January 2010 to April 2015 were analyzed retrospectively. A senior author performed ultrasound-guided nerve block of the lateral femoral cutaneous nerve (LFCN, 630 cases), femoral nerve (FN, 2503 cases), obturator nerve (ON, 366 cases), sciatic nerve (SN, 3271 cases), or posterior femoral cutaneous nerve (PFCN, 222 cases) depending on the type of surgery. Time required for nerve block, anesthesia onset time, duration of anesthesia, duration of analgesia, tolerable tourniquet time, VAS satisfaction score, and anesthetic-related complications were analyzed. Results: The mean times required were 1.1 min for SN block, 2.5 min for FN/SN block (1762 cases), and 4.8 min for FN/SN/LFCN/ON block. The mean anesthesia onset time was 48 min. The mean durations of anesthesia were 4.5 h for FN dermatome and 5.6 h for SN dermatome. The mean duration of analgesia was 11.5 h. The mean tolerable tourniquet times after were 35, 51, and 84 min after SN block, FN/SN block, and FN/SN/LFCN/ON block, respectively. The mean VAS satisfaction score was 9.3. There were no anesthetic-related complications, such as infection, hematoma, paralysis, or nerve irritation. Conclusion: Selective block of the LFCN, FN, ON, SN, and PFCN based on the locations of lesions and type of surgery showed favorable clinical results with high efficacy. Ultrasound-guided nerve block may be a good option for anesthesia and analgesia in lower-extremity surgery.

scholarly journals Acute coronary syndrome: which age group tends to delay call for help?

2021 ◽  
Vol 73 (1) ◽  
Author(s):  
Ahmed Ayuna ◽  
Ayyaz Sultan
Keyword(s):  
Acute Coronary Syndrome ◽  
Time Delay ◽  
Local Population ◽  
Age Groups ◽  
Age Group ◽  
Teaching Programme ◽  
The Road ◽  
Coronary Syndrome ◽  
The Mean ◽  
Mean Time

Abstract Background Early diagnosis and treatment of ACS can reduce the risk of complications and death. Delay calling for help can increase morbidity and mortality. It is unclear which age group among patients with acute coronary syndrome tend to delay their call for help. Results Our observational retrospective study showed that men and women in their 50s and 40s respectively tend to delay their call for help from symptoms onset. For the former, the mean time delays (590 ± 71.1 min), whereas for the latter it was (1084 ± 120.1 min). Moreover, these groups tend to have a longer time delay between symptoms onset and arrival at the hospital. Among deaths, we observed that the death rate was proportional to the time delay, which is not unexpected. Next step, we plan to perform a qualitative study in the form of questionnaires to target the individuals with a high risk of CVD within these age groups. Conclusion Middle age group of both genders tend to delay their call for help when they experience symptoms of ACS; moreover, regardless of the age, the longer the delay, the higher the mortality rate. The results of this study gave us a better understanding of our local population and will pave the road for a well-structured teaching programme for them to minimise the time delay for calling for help.

scholarly journals Time required to move cash through slot machines

2018 ◽  
Vol 21 (3) ◽  
pp. 376-384 ◽  
Author(s):  
Karen Kelly ◽  
Carl James Schwarz ◽  
Ricardo Gomez ◽  
Kim Marsh
Keyword(s):  
British Columbia ◽  
Slot Machines ◽  
Content Type ◽  
The Public ◽  
Average Value ◽  
The Mean ◽  
Time Required ◽  
Rest Breaks ◽  
Mean Time ◽  
Practical Implications

Purpose The purpose of this paper is to present an empirical study on the time needed to load and disburse cash using bill validators on slot machines and stand-alone cash dispensers in casinos in British Columbia under a Ticket In Ticket Out (TITO) system. Design/methodology/approach Testing took place over two days, using 18 machines. The results were extrapolated to estimate the approximate time required to process $1,000,000 with different average bill amounts in the cash mix and three different bill validator machines in common use. The average value per bill using the cash mix used by the public in the casino was $33.11 [standard error (SE) $2.11]. Findings The mean time/accepted note ranged from 4.12 to 9.65 s, depending on bill validator type. This implies that the time needed to load $1,000,000 onto credit slips using bill validators on slot machines ranges from 35 to 81 h, excluding rest breaks and other breaks. The time needed to redeem $1,000,000 is estimated to be 3 h. Practical/implications The implications of these finding for illicit actors to successfully launder large amounts of cash are discussed. Given the time needed to physically handle the cash, and other control systems currently in use in casinos in British Columbia, processing large amounts of cash using bill validators on slot machines would require a highly organized team that would find it difficult to elude detection. Originality/value The trial results provide a baseline estimate to be used going forward when investigating or proposing money laundering methodologies that include slot machines.

Treatment of hyperthyroidism with a small single daily dose of methimazole

1988 ◽  
Vol 119 (1) ◽  
pp. 139-144 ◽  
Author(s):  
Yasuo Mashio ◽  
Mutsuo Beniko ◽  
Akemi Ikota ◽  
Hiroaki Mizumoto ◽  
Haruhiko Kunita
Keyword(s):  
Divided Dose ◽  
Dose Regimen ◽  
Single Daily Dose ◽  
Once Daily ◽  
Daily Dose ◽  
The Mean ◽  
Time Required ◽  
Daily Dose Regimen ◽  
Mean Time ◽  
Immunoglobulin Levels

Abstract. A prospective randomized trial with the conventional divided doses (10 mg 3 times daily, N = 29) and a small single daily dose (15 mg once daily, N = 25) of methimazole for the treatment of Graves' hyperthyroidism was performed. Within 8 weeks, almost 80% of the patients in both groups became euthyroid. The mean time required to achieve the euthyroid state was 6.0 ± 2.8 and 6.0 ± 3.8 weeks, respectively. TSH binding inhibitor immunoglobulin was found in about 90% of the patients in both groups before methimazole treatment. However, a gradual fall of its levels was observed in nearly all patients after treatment. There was no difference in the mean levels of TSH binding inhibitor immunoglobulin between the two groups during therapy. We conclude that the single daily dose regimen of 15 mg of methimazole will control Graves' hyperthyroidism in most patients, and TSH binding inhibitor immunoglobulin levels decrease in this regimen in the same way as with the conventional divided dose regimen (10 mg 3 times daily).

scholarly journals A Rapid and Effective Method to Prolong Pain Relief in Sheep Using Bupivacaine and Intralipid ® Combination

2019 ◽  
Vol 4 (3) ◽  
pp. 1-6
Author(s):  
Farzin Sahebjam
Keyword(s):  
Nerve Block ◽  
Final Concentration ◽  
Noxious Stimulus ◽  
Control Group ◽  
Multiple Time ◽  
Treatment Results ◽  
Time Intervals ◽  
Nerve Blocks ◽  
Duration Of Action ◽  
The Mean

Background : To compare the duration of action of a local anesthetic block using a lipid formulation of bupivacaine to the commercially available aqueous formulation. Bupivacaine 0.5% was mixed with an equal volume of either lipid emulsion (Intralipid, Fresenius Kabi) or normal saline resulting in a final concentration of 0.25% bupivacaine. Eighteen sheep were administered a n erve block of either control or treatment at the metacarpal region of each forelimb to compare the efficacy of the injected formulations. The nociceptive test was determined by applying a blunt noxious stimulus to the foot below the nerve block at multiple time intervals until the sheep responded by withdrawing its foot. The person assessing the response to the noxious stimulus was blinded to the treatment. Results: The Intralipid formulation significantly extended the duration of the nerve block compared to the control group. The mean analgesic period (mean±SD) in the control legs was 4.23±1.8 hr. compared to 5.81±1.78 hr. in the Intralipid injected legs (p=0.013). Conclusions : In conclusion, an Intralipid® - based formulation provided a more prolonged dura tion of local anesthesia after nerve blocks in the sheep metacarpal region compared to aqueous bupivacaine.

scholarly journals A single blind controlled study comparing bipolar elecrocautery tonsillectomy to cold dissection method in pediatric age groups

2014 ◽  
Vol 11 (3) ◽  
pp. 270-272 ◽  
Author(s):  
ST Chettri ◽  
S Bhandary ◽  
A Nepal ◽  
RR Joshi ◽  
V Natesh ◽  
...  
Keyword(s):  
Age Groups ◽  
Controlled Study ◽  
Pediatric Age ◽  
The Mean ◽  
Patients Experience ◽  
Time Of Operation ◽  
Mean Time ◽  
Single Blind ◽  
Cold Dissection ◽  
Dissection Method

Background: Tonsillectomy is one of the most commonly performed operations in otolaryngology. There are many proven methods of tonsillectomy, including cold dissection and bipolar electrocautery. Objective: To compare bipolar elecrocautery tonsillectomy with cold dissection method in pediatric age groups. Methods: Single blind controlled study to compare bipolar technique against the conventional dissection/snare technique. Results: The average amount of bleeding on electrocautery side was 4.07ml and on the cold dissection side was 14.58 ml. The mean time of operation for electrocautery and cold dissection was 12.04 and 16.57 minutes respectively. On the second post operative day, 35% of the patients complained of pain on the cauterized side, 30% complained of more pain on the dissection side while 35 % experienced equal pain on both sides. Post-operative complication such as hemorrhage was not seen in both the techniques employed. Conclusion: In the present study, bipolar diathermy tonsillectomy had advantages in having less post-operative time and blood loss intraoperatively but patients experience slightly more pain than cold dissection. DOI: http://dx.doi.org/10.3126/hren.v11i3.9651 Health Renaissance 2013;11(3):270-272

scholarly journals Antithrombotic properties of hemofilter coated with polymer having a hydrophilic blood-contacting layer

2018 ◽  
Vol 42 (2) ◽  
pp. 88-94 ◽  
Author(s):  
Masashi Tagaya ◽  
Kazunobu Hara ◽  
Shunsuke Takahashi ◽  
Saki Nagoshi ◽  
Hiroki Handa ◽  
...  
Keyword(s):  
Extracorporeal Circulation ◽  
Polymer Coating ◽  
Coating Agent ◽  
Biocompatible Polymer ◽  
Time Points ◽  
Antithrombin Activity ◽  
Antithrombotic Effects ◽  
The Mean ◽  
Time Required ◽  
Mean Time

Objective: Extracorporeal circulation devices are coated with a biocompatible polymer coating agent (BPCA) that has a hydrophilic blood-contacting layer, but hemofilters are not. We aimed to investigate the antithrombotic properties of a BPCA-coated hemofilter. Methods: Four experiments using BPCA-coated circuits and non-coated hemofilters and four experiments using BPCA-coated circuits and BPCA-coated hemofilters were performed with whole human blood and compared by measuring the circuit pressure every 5 min, antithrombin activity every 40 min, and thrombin–antithrombin complex every 40 min, for a total of 240 min of recirculation. Results: The mean time required for the pressure at the inlet of the hemofilter to increase sharply was longer in BPCA-coated than in non-coated hemofilters (66 ± 11 min vs 25 ± 9 min, p < 0.01). The mean antithrombin activity value at 200 and 240 min of recirculation was significantly higher in the experiments with BPCA-coated versus non-coated hemofilters (43.3 ± 2.87 vs 33.3 ± 5.74, p = 0.04; 42.8 ± 3.59 vs 31.0 ± 5.35, p = 0.01, respectively); the antithrombin activity values at the other time points were not significantly different. Furthermore, all thrombin–antithrombin complex values in experiments with the BPCA-coated hemofilters achieved overrange at 80 min of recirculation, whereas those with the non-coated hemofilter achieved overrange at 40 min. Conclusion: This study suggests that BPCA-coated hemofilters can inhibit antithrombin consumption, contributing to antithrombotic effects in extracorporeal circulation circuits.

scholarly journals Ultrasonography-Guided Percutaneous Nephrolithotomy for the Treatment of Urolithiasis in Patients with Scoliosis

2012 ◽  
Vol 97 (2) ◽  
pp. 182-188 ◽  
Author(s):  
Hongyan Li ◽  
Zhuo Zhang ◽  
Hai Li ◽  
Yuanyuan Xing ◽  
Gang Zhang ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Percutaneous Nephrolithotomy ◽  
Operative Time ◽  
Single Session ◽  
Minimally Invasive Percutaneous Nephrolithotomy ◽  
The Mean ◽  
Ultrasonographic Guidance ◽  
Mean Time ◽  
Treatment Of Urolithiasis

Abstract We examined the surgical outcomes of minimally invasive percutaneous nephrolithotomy (MPCNL) in scoliotic patients with complicating urolithiasis. Two patients with scoliosis were hospitalized for MPNCL due to upper tract urolithiasis. Calyx puncture was performed in the prone position under ultrasonographic guidance. The renal access route was established using a set of 8F to 16F dilators, and a transpyelic ballistic lithotriptor was used to fragment the calculi. The stone burdens in the 2 patients were 410 mm2 and 500 mm2. The entire operative time was 40 to 70 minutes, and the mean time of establishing percutaneous access was 20 minutes. The calculi were completely removed by single-session pneumatic lithotripsy. The 2 patients recovered from MPCNL uneventfully, and the follow-up radiologic examinations identified no stone residual or recurrence. MPCNL is a minimally invasive modality that is effective and safe for the treatment of urolithiasis in patients with scoliosis.

Timing should no Longer be an Obstacle to Oocyte Cryopreservation in Patients with Cancer

2016 ◽  
Vol 103 (2) ◽  
pp. 182-186 ◽  
Author(s):  
Giorgia Mangili ◽  
Enrico Papaleo ◽  
Cristina Sigismondi ◽  
Rossella Masciangelo ◽  
Veronica Sarais ◽  
...  
Keyword(s):  
Malignant Tumors ◽  
Oocyte Cryopreservation ◽  
Relevant Issue ◽  
Patients With Cancer ◽  
Number Of Patients ◽  
Anticancer Treatment ◽  
The Mean ◽  
Time Required ◽  
Second Period ◽  
Mean Time

Purpose Anticancer treatment-related infertility is preventable with oocyte cryopreservation, but this is often not considered a relevant issue, due to lack of knowledge and time. The aim of this study is to prove that adequate organization of an Oncofertility Unit and the use of new protocols for controlled ovarian stimulation (COS) can reduce the time required by the procedure, encouraging consultants and patients to preserve fertility before gonadotoxic treatments. Methods A total of 125 patients diagnosed with malignant tumors were referred to the Oncofertility Unit of San Raffaele Hospital: 52 patients between April 2011 and October 2013 and 73 patients between October 2013 and November 2015. The 2 periods differ in office organization and type of COS protocol used. Results Between the 2 periods, a reduction in the mean number of days required from first counseling to the initiation (6.45 ± 1.058 vs 1.61 ± 0.228) and the end of the COS (17.83 ± 1.227 vs 13.70 ± 0.393) was observed (p<0.0001). No differences exist in the groups between the mean time required to complete COS (11.38 ± 0.360 vs 12.17 ± 0.309; p = 0.11) and mean number of frozen oocytes (8.458 ± 1.060 vs 10.30 ± 0.919; p = 0.22). Furthermore, in the second period, the number of patients who accepted fertility preservation increased (46.15% vs 64.38%; p<0.05). Conclusions Renewed organization of the Oncofertility Unit and the newest random-start COS protocol allowed us to shorten the time for oocyte cryopreservation and start anticancer treatment on time.

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