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Mead SA, Allen MJ, Elsayed SAH, Gittel CS. Evaluating the Efficacy of a Peripheral Nerve Simulator-Guided Brachial Plexus Block in Rabbits Undergoing Orthopaedic Surgery Compared to Systemic Analgesia. Vet Sci 2024; 11:213. [PMID: 38787185 PMCID: PMC11125770 DOI: 10.3390/vetsci11050213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Revised: 03/24/2024] [Accepted: 05/12/2024] [Indexed: 05/25/2024] Open
Abstract
Locoregional anaesthetic techniques are invaluable for providing multimodal analgesia for painful surgical procedures. This prospective, randomised study describes a nerve stimulator-guided brachial plexus blockade (BPB) in rabbits undergoing orthopaedic surgery in comparison to systemic lidocaine. Premedication was provided with intramuscular (IM) medetomidine, fentanyl, and midazolam. Anaesthesia was induced (propofol IV) and maintained with isoflurane. Nine rabbits received a lidocaine BPB (2%; 0.3 mL kg-1), and eight received a lidocaine constant rate infusion (CRI) (2 mg kg-1 IV, followed by 100 µg kg-1 min-1). Rescue analgesia was provided with fentanyl IV. Carprofen was administered at the end of the surgery. Postoperative pain was determined using the Rabbit Grimace Scale (RGS) and a composite pain scale. Buprenorphine was administered according to the pain score for two hours after extubation. Rabbits were filmed during the first two hours to measure distance travelled and behaviours. Food intake and faeces output were compared. Every rabbit in CRI required intraoperative rescue analgesia compared to none in BPB. However, rabbits in both groups had similar pain scores, and there was no difference in the administration of postoperative analgesia. There were no significant differences in food intake or faeces production over 18 h, and no significant differences in distance travelled or behaviours examined during the first two hours. BPB seems superior for intraoperative analgesia. Postoperatively, both groups were comparable.
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Affiliation(s)
- Sophie A. Mead
- Queen’s Veterinary School Hospital, University of Cambridge, Cambridge CB3 0ES, UK;
- Southfields Veterinary Specialists, Basildon SS14 3AP, UK
| | - Matthew J. Allen
- Surgical Discovery Centre, University of Cambridge, Cambridge CB3 0ES, UK
| | - Sara Ahmed Hassouna Elsayed
- Faculty of Veterinary Medicine, Alexandria University, Alexandria 5424041, Egypt
- Department of Veterinary Medicine, University of Cambridge, Cambridge CB3 0ES, UK
| | - Claudia S. Gittel
- Queen’s Veterinary School Hospital, University of Cambridge, Cambridge CB3 0ES, UK;
- Rossdales Equine Hospital, Cotton End Rd, Newmarket CB8 7NN, UK
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Xu XD, Lin L, Qiu YB, Zeng BW, Chen Y, Liu JL, Ye CH, Wang JL, Liu PC, Zhang LC. Ultrasonic visualization technique for anatomical and functional analyses of the sciatic nerve in rats. Front Neurosci 2023; 17:1187669. [PMID: 37456994 PMCID: PMC10339105 DOI: 10.3389/fnins.2023.1187669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 06/01/2023] [Indexed: 07/18/2023] Open
Abstract
Background and objective Ultrasound has been widely used in the diagnosis and minimally invasive treatment of peripheral nerve diseases in the clinic, but there is still a lack of feasibility analysis in rodent models of neurological disease. The purpose of this study was to investigate the changes in the cross-sectional area of the sciatic nerve of different genders and body weights and to explore the effectiveness and reliability of an ultrasound-guided block around the sciatic nerve in living rats. Methods Using ultrasound imaging anatomy of the sciatic nerve of rats, the cross-sectional area of the sciatic nerve in rats of different genders from 6 to 10 weeks old was calculated, and then analyzed its correlation with body weight. Further analyses were conducted through behavioral and cadaveric studies to evaluate the feasibility of ultrasound-guided perineural injection of the sciatic nerve in rats. Results We first reported that the sciatic nerve cross-sectional area of rats was increased with age (F = 89.169, P < 0.001), males had a higher sciatic nerve cross-sectional area than females (F = 60.770, P < 0.001), and there was a positive correlation with body weight (rMale = 0.8976, P < 0.001; rFemale = 0.7733, P < 0.001). Behavioral observation of rats showed that the lower extremity complete block rate was 80% following the administration of drugs around the sciatic nerve under ultrasound guidance and staining with methylene blue occurred in all sciatic nerves and surrounding muscles and fascia using 20 ultrasound-guided injections. Conclusions Ultrasound visualization technology can be used as a new auxiliary evaluation and intervention therapy for animal models of peripheral nerve injury, and will provide overwhelming new references for the basic research of neurological diseases.
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Affiliation(s)
- Xiao-Dong Xu
- Department of Anesthesiology, Fujian Medical University Union Hospital, Fuzhou, China
- The Graduate School of Fujian Medical University, Fuzhou, China
| | - Lei Lin
- Department of Anesthesiology, Fujian Medical University Union Hospital, Fuzhou, China
| | - Yu-Bei Qiu
- School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China
| | - Bang-Wei Zeng
- Administration Department of Nosocomial Infection, Fujian Medical University Union Hospital, Fuzhou, China
| | - Ye Chen
- Department of Anesthesiology, Fujian Medical University Union Hospital, Fuzhou, China
- The Graduate School of Fujian Medical University, Fuzhou, China
| | - Jun-Le Liu
- Department of Anesthesiology, Xiamen Third Hospital, Xiamen, China
| | - Cai-Hong Ye
- The Graduate School of Fujian Medical University, Fuzhou, China
| | - Jia-Li Wang
- The Graduate School of Fujian Medical University, Fuzhou, China
| | - Pei-Chang Liu
- Department of Anesthesiology, Fujian Medical University Union Hospital, Fuzhou, China
| | - Liang-Cheng Zhang
- Department of Anesthesiology, Fujian Medical University Union Hospital, Fuzhou, China
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Ruíz‐López P, Felisberto R, Haardt H, Martens A, Schauvliege S. Ultrasound‐guided sciatic nerve block in two alpacas (
Vicugna pacos
) as part of an anaesthesia plan for hindlimb fractures. VETERINARY RECORD CASE REPORTS 2022. [DOI: 10.1002/vrc2.545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Patricia Ruíz‐López
- Department of Large Animal Surgery, Anaesthesia and Orthopaedics, Faculty of Veterinary Medicine University of Ghent Merelbeke Belgium
| | | | - Hanna Haardt
- Department of Large Animal Surgery, Anaesthesia and Orthopaedics, Faculty of Veterinary Medicine University of Ghent Merelbeke Belgium
| | - Ann Martens
- Department of Large Animal Surgery, Anaesthesia and Orthopaedics, Faculty of Veterinary Medicine University of Ghent Merelbeke Belgium
| | - Stijn Schauvliege
- Department of Large Animal Surgery, Anaesthesia and Orthopaedics, Faculty of Veterinary Medicine University of Ghent Merelbeke Belgium
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Effect of Ultrasound Image-Guided Nerve Block on the Postoperative Recovery Quality of Patients with Tibial Fractures Using the Concept of Enhanced Recovery after Surgery. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:4428883. [PMID: 36045945 PMCID: PMC9424038 DOI: 10.1155/2022/4428883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 07/28/2022] [Accepted: 08/03/2022] [Indexed: 11/24/2022]
Abstract
This study was aimed at investigating the clinical effect of ultrasound-guided nerve block based on the concept of enhanced recovery after surgery (ERAS) for postoperative anesthesia in patients with tibial fractures. The noise-reduction processing was introduced in ultrasound images to adjust the ultrasound clarity of the patient. A total of 177 patients with tibial fractures in our hospital were retrospectively analyzed and divided into OG group (general anesthesia combined with nerve block, 78 cases), C1 group (simple general anesthesia, 27 cases), C2 group (ultrasound-guided nerve block combined with general anesthesia, 10 cases), and C3 group (62 cases of spinal-epidural anesthesia). The effect of anesthesia and postoperative recovery time of patients in each group were analyzed. The wake-up time of the OG group was significantly shorter than that of the other three groups (P < 0.05). The doses of propofol and remifentanil in the OG group were much lower than those in the other groups (P < 0.05). After the ultrasound image was processed with noise reduction, the image showed the lesion more clearly. The excellent and good rates of OG group, C1 group, C2 group, and C3 group were 89.86%, 62.73%, 75.37%, and 61.07%, respectively. The Ramsay sedation score and anesthesia satisfaction in the OG group were obviously higher than those in the other groups, but there was no significant difference (P > 0.05). The visual analogue scale (VAS) scores of the OG group at 12 h, 24 h, and 36 h after the surgery were 4.52 ± 0.41, 4.72 ± 0.24, and 4.81 ± 0.74, respectively, which were significantly higher than those of the other three groups (P < 0.05). On the basis of ERAS, ultrasound-guided nerve block combined with general anesthesia can improve the perioperative pain in patients with tibial fractures and significantly shorten the time for the wake-up time. In addition, it was safe and reliable, so it was worthy of clinical promotion.
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Marchese GA, Calvo Carrasco D, Pascal M. Multimodal analgesic technique in a peacock (
Pavo cristatus
) anaesthetised for orthopaedic surgery. VETERINARY RECORD CASE REPORTS 2022. [DOI: 10.1002/vrc2.469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Intelligent Three-Dimensional Reconstruction Algorithm-Based Ultrasound-Guided Nerve Block in Intraoperative Anesthesia and Postoperative Analgesia of Orthopedic Surgery. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:9447649. [PMID: 35912159 PMCID: PMC9337952 DOI: 10.1155/2022/9447649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Revised: 06/24/2022] [Accepted: 07/04/2022] [Indexed: 11/17/2022]
Abstract
This research was aimed at analyzing the role of ultrasound-guided nerve block based on intelligent three-dimensional (3D) reconstruction algorithm in intraoperative anesthesia and postoperative analgesia of orthopedic surgery. 68 elderly patients were undergoing orthopedic surgery on the lower extremities, and they were randomly rolled into two groups with 34 patients in each group. The patients in control group received sciatic nerve block anesthesia (SNBA), and the patients in the experimental group received ultrasound-guided SNBA (UG-SNBA) under 3D reconstruction algorithm to analyze and compare the anesthesia effect and the postoperative analgesia effect. The results showed that compared with other algorithms, the evaluation index of ultrasound images processed by the 3D reconstruction algorithm was better. In terms of anesthesia effect, there was no significant difference in systolic blood pressure, diastolic blood pressure, and heart rate between the two groups before surgery (
). Intraoperative and postoperative indicators of the experimental group were significantly better than those of the control group; the drug dosage (61 mg) was less than that of the control group (78 mg). In addition, the onset time of anesthesia, the time of pain blockade, and the postoperative awake time (5 minutes, 8 minutes, and 8 minutes, respectively) were shorter than those in the control group (13 minutes, 15 minutes, and 15 minutes, respectively). The visual analogue scale (VAS) scores of the experimental group were better than those of the control group on the day after surgery, one day after surgery, two days after surgery, and three days after surgery, with significant differences (
). In summary, 3D reconstruction algorithm-based ultrasound image effect was clearer, the effect of UG-SNBA was more stable, and the postoperative analgesic effect was better. This work provided a higher reference for the selection of safe and effective anesthesia options in orthopedic surgery.
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Intelligent Algorithm-Based Ultrasound for Evaluating the Anesthesia and Nursing Intervention for Elderly Patients with Femoral Intertrochanteric Fractures. COMPUTATIONAL INTELLIGENCE AND NEUROSCIENCE 2022; 2022:3557994. [PMID: 35720883 PMCID: PMC9201732 DOI: 10.1155/2022/3557994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 04/25/2022] [Accepted: 05/05/2022] [Indexed: 11/26/2022]
Abstract
This study was aimed to explore the anesthesia, analgesia, and nursing intervention scheme for elderly patients undergoing the operation of intertrochanteric fracture of femur under the guidance of ultrasound optimized by blind deblurring algorithm. Fifty elderly patients undergoing intertrochanteric femoral surgery were randomly enrolled into control group (tracheal intubation intravenous anesthesia + routine nursing) and experimental group (ultrasound-guided nerve block anesthesia + comprehensive nursing based on blind deblurring algorithm), with 25 patients in each group. The effects of anesthesia and recovery were evaluated in the two groups. The results showed that the image evaluation index of blind deblurring algorithm was superior to other algorithms (BM3D, DnCNN, and Red-Net), which improved the quality of ultrasound imaging and was more conducive to intraoperative anesthesia guidance. At the beginning and end of intubation and operation, the fluctuation range of mean arterial pressure (MAP) and heart rate (HR) in the experimental group was lower than that in the control group. The maintenance time of sensory and motor anesthesia block (7.53 ± 1.47 h, 5.45 ± 1.36 h) was longer than that of control group (3.38 ± 1.26 h, 3.02 ± 1.31 h). Visual Analogue Scale/Score (VAS) scores at 6 h, 12 h, and 24 h after surgery were lower than those in the control group. The effective rate of nursing and the incidence of complications (92% and 8%) were better than the control group (80% and 16%), and the difference was statistically significant (P < 0.05). In summary, the optimization effect of blind deblurring algorithm was good, which can improve the quality of ultrasound-guided surgery and help in the smooth implementation of surgery. Moreover, nerve block anesthesia and comprehensive nursing were of great value in postoperative analgesia and recovery of patients.
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Reduced Concentrations of NSE, S100β, Aβ, and Proinflammatory Cytokines in Elderly Patients Receiving Ultrasound-Guided Combined Lumbar Plexus-Sciatic Nerve Block during Hip Replacement. Genet Res (Camb) 2022; 2022:1384609. [PMID: 35356751 PMCID: PMC8933066 DOI: 10.1155/2022/1384609] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 02/16/2022] [Indexed: 11/25/2022] Open
Abstract
Objective The increase of hip fractures is related to the aging of the population, which has caused a huge medical burden in many countries. Hip replacement has been approved as a highly successful surgical intervention for the patients with hip fractures. Different anesthesia choices in the surgical intervention are associated with the prognosis of patients. This study focused on investigating the application of ultrasound-guided combined lumbar plexus-sciatic nerve block in elderly patients with hip fractures. Methods In this retrospective study, 62 elderly patients received combined spinal-epidural anesthesia and 58 elderly patients underwent ultrasound-guided combined lumbar plexus-sciatic nerve block during the surgery. Hemodynamic monitoring including pulse oxygen saturation (SpO2), heart rate and blood pressure, the assessment of pain intensity using Visual Analogue Scale (VAS), cognitive function assessment through Montreal Cognitive Assessment (MoCA) and biomarkers consisting of serum levels of neuron specific-enolase (NSE), S100 beta protein (S100-β), and amyloid beta protein (Aβ), as well as immune function by interleukin-6 (IL-6), interleukin-1β (IL-1β), tumor necrosis factor-α (TNF-α), and high sensitivity C-reactive protein (hs-CRP) were detected in this study. Furthermore, length of hospital stay (LOS) and adverse reactions including hematoma, hypotension, nausea, and vomit were analyzed. Results The findings indicated that comparing with the patients receiving combined spinal-epidural anesthesia, those undergoing ultrasound-guided combined lumbar plexus-sciatic nerve block showed significantly lower level of heart rate, higher level of SpO2, and lower level of diastolic pressure and systolic pressure at 5 minutes and 30 minutes after anesthesia and after surgery (P < 0.05), indicated obviously lower VAS score at 12, 24, and 48 hours after surgery (P < 0.05), and revealed higher MoCA score at 12 days after surgery (P < 0.05). A significantly higher level of NSE, S100β, Aβ, IL-6, IL-1β, TNF-α, and hs-CRP was revealed in the two groups receiving different anesthesia methods at 10 days after surgery compared with that before surgery (P < 0.05). However, the patients receiving ultrasound-guided combined lumbar plexus-sciatic nerve block had obviously lower expression of NSE, S100β, Aβ, IL-6, IL-1β, TNF-α, and hs-CRP compared with the group accepting combined spinal-epidural anesthesia (P < 0.05). The two groups indicated no significant difference in incidence of hypotension and vomit, etc. (P < 0.05), but showed remarkable difference referring to total incidence of adverse reactions and LOS (P < 0.05). Conclusion The application of ultrasound-guided combined lumbar plexus-sciatic nerve block in hip replacement contributes to the stability of hemodynamics and alleviation of postoperative pain intensity. It can reduce cognitive and immune impairment of the elderly patients with hip fractures.
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Proximal Perineural Femoral Nerve Injection in Pigs Using an Ultrasound-Guided Lateral Subiliac Approach-A Cadaveric Study. Animals (Basel) 2021; 11:ani11061759. [PMID: 34204599 PMCID: PMC8231242 DOI: 10.3390/ani11061759] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 05/28/2021] [Accepted: 06/08/2021] [Indexed: 12/18/2022] Open
Abstract
Simple Summary Desensitizing the femoral nerve improves pain control in several species undergoing pelvic limb surgeries. Despite possible advantages, this method has not yet been described in pigs, although they make an accepted surgical animal model. We developed an approach for femoral nerve blockade using ultrasound guidance in pigs which could be useful for pain control in pigs undergoing pelvic limb surgery. Abstract Desensitizing the femoral nerve (FN) improves pain control in several species undergoing pelvic limb surgeries. Despite its advantages, this method has not yet been described in pigs, although they make an accepted surgical animal model. Based on anatomical dissections, first performed in two pig cadavers, an ultrasound-guided access for localization and perineural infiltration of the FN trunk at the iliopsoas compartment level was specified. The FN was found running between the psoas major and medial portion of iliac muscle. Ultrasonographically, the FN appeared as a hypoechogenic round–oval structure surrounded by a hyperechogenic rim. Technical feasibility and accuracy were assessed in six additional pig cadavers by injecting 0.15 mL kg−1 methylene blue dye bilaterally in direct proximity to the nerve. The needle was inserted caudoventral to the coxal tuber, traversing the ultrasound plane as it progressed towards the FN in dorsomedial direction. Staining of the nerve was evaluated by dissection. The injection was considered effective if the nerve was stained in its entire circumference over a length of 2 cm. FNs of all investigated individuals could be successfully stained. This ultrasound-guided subiliac approach allows feasible and accurate access to the FN and may be useful in producing a successful blockade in vivo.
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Lee MG, Choi SU, Lim JK, Lee MJ, Hong JS, Baek MO, Yoon SZ, Park HY, Shin HJ. Ultrasound-guided sciatic nerve block at the midthigh level in a porcine model: A descriptive study. Vet Med Sci 2020; 6:543-549. [PMID: 32281259 PMCID: PMC7397899 DOI: 10.1002/vms3.265] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Revised: 01/21/2020] [Accepted: 03/08/2020] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND AND OBJECTIVE There are a growing number of porcine models being used for orthopaedic experiments for human beings. Therefore, pain management of those research pigs using ultrasound (US)-guided nerve block can be usefully performed. The aim of this study is to determine optimal US approaches for accessing and localizing the sciatic nerve at the midthigh level, a relevant block site for hindlimb surgery in female Yorkshire pigs. METHODS As a first step, we dissected the intubated, blood-washed out pigs (n = 3) and confirmed the anatomical position of the sciatic nerve at midthigh level. After dissection, we found the sciatic nerve, connected with nerve stimulator, and checked the dorsiflexion or plantar flexion of the hindlimb. We matched the sciatic nerve location with the US image. After the pigs were euthanized, the neural structures of the sciatic nerve were confirmed by histological examination with H&E staining. In second step, a main US-guided sciatic nerve block study was done in the intubated, live pigs (n = 8) based on the above study. RESULTS In lateral position, the effective US-guided nerve block site was about 6 cm from the patella crease level; immediately proximal to the bifurcation of the sciatic nerve into the tibial nerve and common peroneal nerve. The distal femur was selected as the landmark. There were no vessels or other nerves surrounding the sciatic nerve. The needle-tip was positioned less than 1 cm lateral from the distal femur and about 2 cm deep to skin. 'Donut sign' in US images was confirmed in all 16 nerves. CONCLUSIONS Midthigh level sciatic nerve is located superficially, which enables nerve block to be easily performed using US. This is the first study to describe midthigh sciatic nerve block in the lateral position under US guidance in a porcine model from a clinical perspective.
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Affiliation(s)
- Mi Geum Lee
- Department of Anesthesiology and Pain medicine, Gachon University College of Medicine, Incheon, South Korea
| | - Sung Uk Choi
- Department of Anesthesiology and Pain medicine, Korea University College of Medicine, Seoul, South Korea
| | - Jae Kwan Lim
- Korea Artificial Organ Center, Korea University College of Medicine, Seoul, South Korea
| | - Mee Ju Lee
- Department of Anesthesiology and Pain medicine, Korea University College of Medicine, Seoul, South Korea
| | - Ji Su Hong
- Department of Anesthesiology and Pain medicine, Korea University College of Medicine, Seoul, South Korea
| | - Mi Ok Baek
- Korea Artificial Organ Center, Korea University College of Medicine, Seoul, South Korea
| | - Seung Zhoo Yoon
- Department of Anesthesiology and Pain medicine, Korea University College of Medicine, Seoul, South Korea
| | - Hee Yeon Park
- Department of Anesthesiology and Pain medicine, Gachon University College of Medicine, Incheon, South Korea
| | - Hyeon Ju Shin
- Department of Anesthesiology and Pain medicine, Korea University College of Medicine, Seoul, South Korea
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