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[PMID]:29236823
[Au] Autor:Foroni L; Siqueira MG; Martins RS; Heise CO; Sterman H; Imamura AY
[Ad] Endereço:Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Divisão de Neurocirurgia Funcional, Grupo de Cirurgia de Nervos Periféricos. São Paulo SP, Brasil.
[Ti] Título:Good sensory recovery of the hand in brachial plexus surgery using the intercostobrachial nerve as the donor.
[So] Source:Arq Neuropsiquiatr;75(11):796-800, 2017 Nov.
[Is] ISSN:1678-4227
[Cp] País de publicação:Brazil
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: Restoration of the sensitivity to sensory stimuli in complete brachial plexus injury is very important. The objective of our study was to evaluate sensory recovery in brachial plexus surgery using the intercostobrachial nerve (ICBN) as the donor. METHODS: Eleven patients underwent sensory reconstruction using the ICBN as a donor to the lateral cord contribution to the median nerve, with a mean follow-up period of 41 months. A protocol evaluation was performed. RESULTS: Four patients perceived the 1-green filament. The 2-blue, 3-purple and 4-red filaments were perceptible in one, two and three patients, respectively. According to Highet's scale, sensation recovered to S3 in two patients, to S2+ in two patients, to S2 in six patients, and S0 in one patient. CONCLUSION: The procedure using the ICBN as a sensory donor restores good intensity of sensation and shows good results in location of perception in patients with complete brachial plexus avulsion.
[Mh] Termos MeSH primário: Plexo Braquial/lesões
Plexo Braquial/cirurgia
Mãos/cirurgia
Nervos Intercostais/transplante
Transferência de Nervo/métodos
[Mh] Termos MeSH secundário: Adulto
Feminino
Seguimentos
Mãos/fisiologia
Seres Humanos
Masculino
Regeneração Nervosa
Estudos Prospectivos
Recuperação de Função Fisiológica
Resultado do Tratamento
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180129
[Lr] Data última revisão:
180129
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171214
[St] Status:MEDLINE


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[PMID]:28591552
[Au] Autor:Deshmukh VR; Bhardwaj H; Khan F; Jacob TG
[Ad] Endereço:Department of Anatomy, All India Institute of Medical Sciences, New Delhi, India.
[Ti] Título:Aberrant Cutaneous Nerve Loops in the Axilla.
[So] Source:Acta Medica (Hradec Kralove);60(1):51-54, 2017.
[Is] ISSN:1211-4286
[Cp] País de publicação:Czech Republic
[La] Idioma:eng
[Ab] Resumo:During routine dissection classes, conducted for first year undergraduate medical students, we encountered a rare anatomical variation in relation to the intercostobrachial nerve (ICBN). The ICBN represents the lateral undivided cutaneous branch of second intercostal nerve. In this case, the ICBN formed nerve loops with branches of the lateral cutaneous branch of the third intercostal nerve. These loops eventually gave branches that probably supplied the floor of the axilla and proximal arm. Nowadays, this ICBN is gaining clinical importance during the axillary lymph node dissections and mammary gland surgeries. Damage to the ICBN, may results in the sensory deficits in patients undergoing surgery. In our case report, ICBN was making aberrant nerve loop along with the branches from the third intercostal nerve. Knowledge regarding the origin, formation and route of ICBN is of clinical significance to axillary surgeons, radiologist and anesthesiologists.
[Mh] Termos MeSH primário: Axila/patologia
Plexo Braquial/patologia
Nervos Intercostais/patologia
[Mh] Termos MeSH secundário: Axila/anatomia & histologia
Axila/inervação
Cadáver
Seres Humanos
Excisão de Linfonodo
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170817
[Lr] Data última revisão:
170817
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170608
[St] Status:MEDLINE
[do] DOI:10.14712/18059694.2017.50


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[PMID]:28532913
[Au] Autor:Alonso F; Graham R; Rustagi T; Drazin D; Loukas M; Oskouian RJ; Chapman JR; Tubbs RS
[Ad] Endereço:Swedish Neuroscience Institute, Seattle, Washington, USA; Seattle Science Foundation, Seattle, Washington, USA. Electronic address: Fea4@case.edu.
[Ti] Título:The Subcostal Nerve During Lateral Approaches to the Lumbar Spine: An Anatomical Study with Relevance for Injury Avoidance and Postoperative Complications Such as Abdominal Wall Hernia.
[So] Source:World Neurosurg;104:669-673, 2017 Aug.
[Is] ISSN:1878-8769
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Lateral approaches to the spine are increasing in popularity. However, details of the innervation pattern of the abdominal oblique muscles with the initial dissection have not been well studied. METHODS: Ten adult fresh-frozen cadavers (20 sides) were placed in the lateral position. On each side, the region in which transpsoas approaches are performed, between the iliac crest and the 12th rib, was dissected. The nerves, their course, and their muscular supply were studied. RESULTS: The subcostal nerve is the predominant nerve supply for the anterolateral abdominal muscle innervation. It is larger and has a wider field of distribution and more branches (8 on average) compared with the L1 (4 on average) and 11th intercostal nerves (2 on average 2). The proximal 6-10 cm of each nerve has few if any branches. The subcostal nerve is often (75%) located up to 5 cm inferior to the 12th rib in its initial course. The area of least concentration ("safe zone") is located at an approximate midpoint between the lower edge of the 12th rib and the superior-most aspect of the iliac crest. A previously undescribed branch of the subcostal nerve was found traveling posterior to the quadratus lumborum and joining the remaining subcostal nerve in an anastomosis at or near the lateral position. CONCLUSIONS: Knowledge of the innervation and nerve dominance patterns might help decrease postoperative complications such as sensory deficits or abdominal wall hernias. The subcostal nerve is the dominant nerve in both size and innervation of the oblique muscles in the lateral position, transpsoas approach.
[Mh] Termos MeSH primário: Músculos Abdominais Oblíquos/inervação
Hérnia Abdominal/prevenção & controle
Nervos Intercostais/lesões
Nervos Intercostais/patologia
Complicações Intraoperatórias/prevenção & controle
Vértebras Lombares/inervação
Vértebras Lombares/patologia
Vértebras Lombares/cirurgia
Traumatismos dos Nervos Periféricos/patologia
Traumatismos dos Nervos Periféricos/prevenção & controle
Complicações Pós-Operatórias/patologia
Complicações Pós-Operatórias/prevenção & controle
[Mh] Termos MeSH secundário: Músculos Abdominais Oblíquos/patologia
Idoso
Idoso de 80 Anos ou mais
Feminino
Hérnia Abdominal/patologia
Seres Humanos
Complicações Intraoperatórias/patologia
Masculino
Fatores de Risco
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170929
[Lr] Data última revisão:
170929
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170524
[St] Status:MEDLINE


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[PMID]:28339447
[Au] Autor:Boelens OB; Maatman RC; Scheltinga MR; van Laarhoven K; Roumen RM
[Ad] Endereço:Dept of Surgery, Maasziekenhuis Pantein, Boxmeer, The Netherlands.
[Ti] Título:Chronic Localized Back Pain Due to Posterior Cutaneous Nerve Entrapment Syndrome (POCNES): A New Diagnosis.
[So] Source:Pain Physician;20(3):E455-E458, 2017 Mar.
[Is] ISSN:2150-1149
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Most patients with chronic back pain suffer from degenerative thoracolumbovertebral disease. However, the following case illustrates that a localized peripheral nerve entrapment must be considered in the differential diagnosis of chronic back pain. We report the case of a 26-year-old woman with continuous excruciating pain in the lower back area. Previous treatment for nephroptosis was to no avail. On physical examination the pain was present in a 2 x 2 cm area overlying the twelfth rib some 4 cm lateral to the spinal process. Somatosensory testing using swab and alcohol gauze demonstrated the presence of skin hypo- and dysesthesia over the painful area. Local pressure on this painful spot elicited an extreme pain response that did not irradiate towards the periphery. These findings were highly suggestive of a posterior version of the anterior cutaneous nerve entrapment syndrome (ACNES), a condition leading to a severe localized neuropathic pain in anterior portions of the abdominal wall. She demonstrated a beneficial albeit temporary response after lidocaine infiltration as dictated by an established diagnostic and treatment protocol for ACNES. She subsequently underwent a local neurectomy of the involved superficial branch of the intercostal nerve. This limited operation had a favorable outcome resulting in a pain-free return to normal activities up to this very day (follow-up of 24 months).We propose to name this novel syndrome "posterior cutaneous nerve entrapment syndrome" (POCNES). Each patient with chronic localized back pain should undergo simple somatosensory testing to detect the presence of overlying skin hypo- and dysesthesia possibly reflecting an entrapped posterior cutaneous nerve.Key words: Chronic pain, back pain, posterior cutaneous nerve entrapment, peripheral nerve entrapment, surgical treatment for pain, anterior cutaneous nerve entrapment.
[Mh] Termos MeSH primário: Dor nas Costas/etiologia
Dor Crônica/etiologia
Síndromes de Compressão Nervosa/diagnóstico
[Mh] Termos MeSH secundário: Adulto
Dor nas Costas/cirurgia
Dor Crônica/cirurgia
Feminino
Seres Humanos
Nervos Intercostais/cirurgia
Lidocaína/uso terapêutico
Síndromes de Compressão Nervosa/complicações
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
98PI200987 (Lidocaine)
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170713
[Lr] Data última revisão:
170713
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170325
[St] Status:MEDLINE


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[PMID]:28301867
[Au] Autor:LaBan MM
[Ad] Endereço:From the Department of Physical Medicine and Rehabilitation, Oakland University William Beaumont School of Medicine, Rochester, Michigan.
[Ti] Título:An Intercostal Muscular Hernia as a Consequence of Intercostal Nerve Root Compromise After Trauma to the Thoracic Spine.
[So] Source:Am J Phys Med Rehabil;96(4):e68-e69, 2017 Apr.
[Is] ISSN:1537-7385
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:'True' intercostal hernias, that is, those containing both pleura and lung components, occur infrequently. Only 300 cases have been reported since Rolland's initial description in 1499. Rarer still are intercostal muscle hernias, which occur without containing pulmonary components. In both instances, males predominate, usually a consequence of direct blunt chest trauma. In many instances, recognition of the intercostal muscle hernia may be delayed from weeks to months, its diagnosis masked by more obvious evidence of physical trauma.
[Mh] Termos MeSH primário: Hérnia Diafragmática Traumática/etiologia
Vértebras Torácicas/lesões
[Mh] Termos MeSH secundário: Acidentes por Quedas
Acidentes de Trabalho
Hérnia Diafragmática Traumática/diagnóstico
Seres Humanos
Nervos Intercostais/lesões
Masculino
Meia-Idade
Vértebras Torácicas/cirurgia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170807
[Lr] Data última revisão:
170807
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170317
[St] Status:MEDLINE
[do] DOI:10.1097/PHM.0000000000000589


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[PMID]:28203022
[Au] Autor:Xu T; Li M; Tian Y; Song JT; Ni C; Guo XY
[Ad] Endereço:Department of Anesthesiology, Peking University Third Hospital, Beijing 100191, China.
[Ti] Título:[Clinical evaluation of in-plane ultrasound-guided thoracic paravertebral block using laterally intercostal approach].
[So] Source:Beijing Da Xue Xue Bao Yi Xue Ban;49(1):148-52, 2017 02 18.
[Is] ISSN:1671-167X
[Cp] País de publicação:China
[La] Idioma:chi
[Ab] Resumo:OBJECTIVE: To evaluate the feasibility and success rate of in-plane ultrasound-guided paravertebral block using laterally intercostal approach. METHODS: In the study, 27 patients undergoing elective thoracic surgery were selected to do paravertebral block preoperatively. The fifth intercostal space was scanned by ultrasound probe which was placed along the long axis of the rib and 8 cm lateral to the midline of the spine. The needle was advanced in increments aiming at the space between the internal and innermost intercostal muscles. Once the space between the muscles was achieved, 20 mL of 0.5% (mass fraction) ropivacaine was injected and a catheter was inserted. Whether the tip of catheter was in right place was evaluated by ultrasound image. The block dermatomes of cold sensation were recorded 10, 20 and 30 min after the bolus drug was given. Then 0.2% ropivacaine was infused with 6 mL/h via the catheter by an analgesia pump postoperatively. The block dermatomes of cold sensation and pain score were recorded 1, 6, 24 and 48 h postoperatively. RESULTS: The first attempt success rate of catheteration was 81.48% (22/27); the tips of catheter were proved in right places after the second or third attempt in 5 patients. The median numbers of the block dermatomes 10, 20 and 30 min after the bolus drug was given were 2, 3, 4; the median numbers of block dermatomes were 5, 5, 5, 4, and of pain score were 1, 1, 2, 2 at 1, 6, 24, 48 h postoperatively; no case of bilateral block, pneumothorax or vessel puncture occurred. CONCLUSION: Thoracic paravertebral block using laterally intercostal approach is feasible, which has high success rate of block and low rate of complications.
[Mh] Termos MeSH primário: Amidas/administração & dosagem
Anestesia Local/instrumentação
Anestesia Local/métodos
Bloqueio Nervoso/instrumentação
Bloqueio Nervoso/métodos
[Mh] Termos MeSH secundário: Amidas/uso terapêutico
Procedimentos Cirúrgicos Eletivos
Seres Humanos
Músculos Intercostais/diagnóstico por imagem
Nervos Intercostais/diagnóstico por imagem
Nervos Intercostais/efeitos dos fármacos
Agulhas
Bloqueio Nervoso/efeitos adversos
Dor Pós-Operatória/tratamento farmacológico
Cuidados Pós-Operatórios/métodos
Procedimentos Cirúrgicos Torácicos
Resultado do Tratamento
Ultrassonografia
Ultrassonografia de Intervenção/métodos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Amides); 7IO5LYA57N (ropivacaine)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:171116
[Lr] Data última revisão:
171116
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170217
[St] Status:MEDLINE


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[PMID]:27995373
[Au] Autor:Maldonado-Avila M; Del Rosario-Santiago M; Rosas-Nava JE; Manzanilla-Garcia HA; Rios-Davila VM; Rodriguez-Nava P; Vela-Mollinedo RA; Garduño-Arteaga ML
[Ad] Endereço:Mexican General Hospital, Mexico City, Mexico. mimalavi@yahoo.com.
[Ti] Título:Treatment of reno-ureteral colic by twelfth intercostal nerve block with lidocaine versus intramuscular diclofenac.
[So] Source:Int Urol Nephrol;49(3):413-417, 2017 Mar.
[Is] ISSN:1573-2584
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION AND OBJECTIVE: Renal colic is one of the most intense pains known to humans. Standard treatment usually consists of nonsteroidal anti-inflammatory drugs and opiates, but they do not always provide optimum efficacy and speed in relieving the pain. For more than 25 years, our hospital has been employing twelfth subcostal nerve block. The objective of the present study was to compare the efficacy of subcostal nerve block with lidocaine versus intramuscular diclofenac in renal colic management. METHODS: Sixty patients of both sexes, above the age of 18 years, and presenting with renal colic were randomly selected for the study. The visual analog scale was applied prior to the treatment and at minutes 1, 3, 5, 30, and 45 after the application of the twelfth nerve block or the intramuscular administration of diclofenac. RESULTS: A total of 60 patients, 35 women and 25 men, were included in the study. There were statistically significant differences in the mean scores for pain from minute 1 to minute 45. There were no adverse effects. CONCLUSIONS: Twelfth Subcostal nerve block with lidocaine is an efficacious, safe, inexpensive, and very fast-acting medication for pain control related to renal colic. These characteristics make it superior to diclofenac.
[Mh] Termos MeSH primário: Anestésicos Locais
Inibidores de Ciclo-Oxigenase
Diclofenaco
Nervos Intercostais
Lidocaína
Bloqueio Nervoso/métodos
Cólica Renal/terapia
[Mh] Termos MeSH secundário: Adulto
Feminino
Seres Humanos
Injeções Intramusculares
Masculino
Meia-Idade
Medição da Dor
Adulto Jovem
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Anesthetics, Local); 0 (Cyclooxygenase Inhibitors); 144O8QL0L1 (Diclofenac); 98PI200987 (Lidocaine)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171102
[Lr] Data última revisão:
171102
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161221
[St] Status:MEDLINE
[do] DOI:10.1007/s11255-016-1479-5


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[PMID]:27810148
[Au] Autor:Bryskin RB; Robie DK; Mansfield FM; Freid EB; Sukumvanich S
[Ad] Endereço:Department of Anesthesiology, Nemours Children's Clinic, Jacksonville, FL, USA,. Electronic address: RBryskin@Nemours.org.
[Ti] Título:Introduction of a novel ultrasound-guided extrathoracic sub-paraspinal block for control of perioperative pain in Nuss procedure patients.
[So] Source:J Pediatr Surg;52(3):484-491, 2017 Mar.
[Is] ISSN:1531-5037
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: A safe and effective method of multilevel thoracic pain control remains an elusive goal in patients undergoing the Nuss procedure. The aim of our study was to develop a nonopioid centered approach using a novel regional technique as part of a quality improvement initiative. METHODS: The proposed ultrasound-guided technique positions multi-perforated soaker catheter deep to the paraspinal muscles from T2 to T11. The project was conducted in two phases. First, a cadaveric dissection was performed to establish the pathway of spread of local anesthetic in vivo. Second, a pilot double blind randomized control project was conducted to evaluate effectiveness of the technique in ten patients and to derive parameters necessary for the definitive future study. Outcomes were evaluated based on the narcotic requirement, pain scores and functional measures. RESULTS: Placement of the catheters in two cadavers demonstrated reliable positioning in the subparaspinal tissue plane, and multilevel dye spread along the intercostal nerve path. In addition, a potential route of spread toward the paravertebral space along the canal accommodating dorsal ramus of the thoracic nerve was demonstrated. The pilot trial demonstrated a trend in decreased cumulative hydromorphone requirement in comparison to the control group at both 24h (0.19±0.09mg/kg vs. 0.13±0.08mg/kg p=0.72) and 48h (0.37±0.2mg/kg vs. 0.3±0.12mg/kg p=0.37). Functional performance ability was higher in the treatment group on both POD#1 (6.7±1.8 vs. 4.8±1 p=0.0495) and POD#2 (8.9±0.8 vs. 6.5±1.2 p=0.04). Pain scores were similar among the two groups (p=0.96). CONCLUSIONS: We describe a new technique to treat multilevel thoracic pain following the Nuss procedure that is reproducible, safe, allows diminished opioid use and enhances functional recovery.
[Mh] Termos MeSH primário: Tórax em Funil/cirurgia
Bloqueio Nervoso/métodos
Manejo da Dor/métodos
Medição da Dor/métodos
Dor Pós-Operatória/prevenção & controle
Ultrassonografia de Intervenção/métodos
[Mh] Termos MeSH secundário: Adolescente
Analgésicos Opioides/administração & dosagem
Cadáver
Cateteres
Método Duplo-Cego
Feminino
Seres Humanos
Hidromorfona/administração & dosagem
Músculos Intercostais/anatomia & histologia
Músculos Intercostais/diagnóstico por imagem
Nervos Intercostais
Masculino
Projetos Piloto
Tórax/anatomia & histologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Analgesics, Opioid); Q812464R06 (Hydromorphone)
[Em] Mês de entrada:1704
[Cu] Atualização por classe:170426
[Lr] Data última revisão:
170426
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161105
[St] Status:MEDLINE


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[PMID]:27043787
[Au] Autor:Lenz N; Hirschburger M; Roehrig R; Menges T; Mueller M; Padberg W; Mann V
[Ad] Endereço:Department of Anesthesiology, University Giessen, Giessen, Germany.
[Ti] Título:Application of Continuous Wound-Infusion Catheters in Lung Transplantation: A Retrospective Data Analysis.
[So] Source:Thorac Cardiovasc Surg;65(5):403-409, 2017 Aug.
[Is] ISSN:1439-1902
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:Lung transplantation is the only treatment option for many patients with end-stage pulmonary disease. Therefore, postthoracotomy pain therapy is of vital interest. Thoracic epidural analgesia (EPI) is the "gold standard" for postthoracotomy pain, but especially in lung transplantation contraindications, and potential infectious complications limit its advantages. Under these circumstances surgically placed postthoracotomy catheter-assisted continuous paravertebral intercostal nerve block (PVB) could be of advantage. We performed a retrospective cohort study of patients who underwent lung transplantation between 2005 and 2012. Groups were defined according to the type of postoperative pain therapy: PVB, EPI, and SYS (systemic analgesia). Total 44 patients were eligible. Postoperative opioid requirement of the PVB and EPI group was comparable and less than that of the SYS group. Patients of the PVB group were weaned earlier from mechanical ventilation after lung transplantation. The potency of postoperative pain therapy of EPI and PVB seemed to be comparable and superior to SYS. Considering the risks and benefits, PVB could be a better choice than EPI for postthoracotomy pain therapy, especially in lung transplantation.
[Mh] Termos MeSH primário: Analgesia Epidural
Anestésicos Locais/administração & dosagem
Cateteres de Demora
Nervos Intercostais
Transplante de Pulmão/efeitos adversos
Bloqueio Nervoso/instrumentação
Dor Pós-Operatória/prevenção & controle
Toracotomia/efeitos adversos
[Mh] Termos MeSH secundário: Analgesia Epidural/efeitos adversos
Analgésicos Opioides/administração & dosagem
Anestésicos Locais/efeitos adversos
Seres Humanos
Transplante de Pulmão/métodos
Bloqueio Nervoso/efeitos adversos
Bloqueio Nervoso/métodos
Medição da Dor
Dor Pós-Operatória/diagnóstico
Dor Pós-Operatória/etiologia
Seleção de Pacientes
Estudos Retrospectivos
Fatores de Risco
Fatores de Tempo
Resultado do Tratamento
Desmame do Respirador
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Analgesics, Opioid); 0 (Anesthetics, Local)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170918
[Lr] Data última revisão:
170918
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160405
[St] Status:MEDLINE
[do] DOI:10.1055/s-0036-1580621


  10 / 1073 MEDLINE  
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[PMID]:26656033
[Au] Autor:Ahmed A; Bhatnagar S; Khurana D; Joshi S; Thulkar S
[Ad] Endereço:1 Department of Anesthesia, Pain and palliative care, Dr BRA Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India.
[Ti] Título:Ultrasound-Guided Radiofrequency Treatment of Intercostal Nerves for the Prevention of Incidental Pain Arising Due to Rib Metastasis.
[So] Source:Am J Hosp Palliat Care;34(2):115-124, 2017 Mar.
[Is] ISSN:1938-2715
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Breakthrough pain (BTP) arising due to rib metastasis is very distressing and often very difficult to manage by titration of traditional analgesics. This study is undertaken to determine the efficacy of radiofrequency (RF) treatment of intercostal nerves for the prevention of BTP. METHODS: The RF treatment of the intercostal nerves was carried out in 25 patients with uncontrolled BTP arising out of the rib metastasis. The intensity and episode of BTP, background pain, opioid dose, functional status (Karnofky score), and quality of life (Short-Form Health Survey [SF-36]) were noted at baseline visit and subsequently after the RF treatment. RESULTS: After the RF treatment, there was more than 50% decrease in both intensity and frequency of BTP in more than 50% of patients for 3 months, and there was more than 50% decrease in BTP opioid dose in more than 50% of patients throughout the study period. There was also significant improvement in background pain, functional status, and the quality of life after the RF. Interestingly, pain relief, lowering of opioid dose, and functional status improvement were found mostly in patients with mixed and neuropathic type of pain and in patients in whom the metastasis were confined to the ribs only. CONCLUSION: RF of the intercostal nerves is effective in preventing and deceasing the severity of BTP arising due to rib metastasis in selected group of patients with mixed and neuropathic type of pain and with the metastasis involving the ribs only.
[Mh] Termos MeSH primário: Neoplasias Ósseas/secundário
Dor Irruptiva/prevenção & controle
Ablação por Cateter/métodos
Nervos Intercostais
Manejo da Dor/métodos
Costelas
[Mh] Termos MeSH secundário: Neoplasias Ósseas/complicações
Dor Irruptiva/etiologia
Dor Irruptiva/cirurgia
Feminino
Seres Humanos
Masculino
Meia-Idade
Medição da Dor
Estudos Prospectivos
Resultado do Tratamento
Ultrassonografia de Intervenção
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170714
[Lr] Data última revisão:
170714
[Sb] Subgrupo de revista:IM; N
[Da] Data de entrada para processamento:151215
[St] Status:MEDLINE
[do] DOI:10.1177/1049909115617933



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