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At least 487 records · Page 27Linked to original sources
PubMed1981

Intercostal nerve block: spread of india ink injected to the rib's costal groove.

Three and five millilitre of india ink were injected bilaterally into the costal groove of the 9th or 10th ribs of 14 cadavers. The spread was observed and the costal groove of the rib injected was dissected, with the one above and one below. Nunn and Slavin's study (1980) of similar injections in two cadavers indicated that an injection of one costal groove blocked not only the intercostal nerve of that groove, but at least the one above and below it. The present study verified the author's previous report that only the intercostal nerve in the costal groove of the rib injected is anaesthetized.

Humans↗
PubMed1984

Continuous intercostal nerve blockade. An anatomical study to elucidate its mode of action.

India ink was injected through extradural catheters placed in the posterior intercostal space in 12 cadavers undergoing autopsy and the subsequent spread of the India ink was assessed under direct vision. The ink spread subpleurally to reach a number of intercostal spaces and medially to reach the paravertebral space. It is concluded that analgesia extending over a number of dermatomes is achieved by subpleural tracking of local anaesthetic to reach intercostal nerves above and below the one injected.

Anesthetics, Local↗
PubMed1990

Plasma concentrations of bupivacaine after intercostal nerve block in patients after orthotopic liver transplantation.

Bilateral intercostal nerve blocks were performed on 12 occasions in 11 patients after liver transplantation. Group 1 (six patients) received bupivacaine 2 mg kg-1 on one occasion; in group 2 (five patients) bupivacaine 2 mg kg-1 with adrenaline 1:200,000 was injected on two occasions separated by 6 h. Arterial blood was sampled repeatedly and analysed for total bupivacaine concentrations by high performance liquid chromatography (HPLC). Six patients had bupivacaine concentrations within the putative toxic threshold of 2-4 micrograms ml-1. The use of adrenaline-containing solutions neither slowed absorption reliably nor decreased peak concentrations of bupivacaine. Cumulation of bupivacaine occurred in group 2. No patient had adverse effects attributable to the bupivacaine.

Adolescent↗
PubMed1989

Pharmacokinetics of bupivacaine following intraoperative intercostal nerve block in neonates and in infants aged less than 6 months.

Pharmacokinetics and blood concentrations of bupivacaine were studied after intercostal nerve blocks were performed intraoperatively using 1.5 mg.kg-1 in 11 neonates (age 0-28 days) and 11 infants between age 1 and 6 months. The study aimed to provide pharmacokinetic data that are limited in these age groups, and to identify any adverse effects of intercostal nerve block in infancy. Arterial blood samples were taken at 0, 5, 10, 15, 20, 30, 60, 120, 240, and 360 min. Whole blood bupivacaine was assayed by high-performance liquid chromatography. Peak blood concentrations were attained within 10 min in 18 of 22 subjects, and were 087 micrograms.ml-1 [corrected] +/- 0.56 micrograms.ml-1 (mean and SD) and 0.91 +/- 0.27 micrograms.ml-1 in neonates and infants, respectively. Pharmacokinetic variables in the two groups included elimination half-life (t1/2 beta): 132 +/- 59 min and 102 +/- 39 min; steady-state volume of distribution (Vdss): 2.56 +/- 0.76 l.kg-1 and 2.17 +/- 0.17 l.kg-1; and total body clearance (Clt): 16.93 +/- 9.32 ml.min-1.kg-1 and 15.71 +/- 6.99 ml.min-1.kg-1. There was no statistically significant difference between neonates and infants with regard to any of these parameters. Patients were further divided into those with acyanotic and cyanotic disease. Cyanotic infants were significantly heavier than acyanotic infants (P less than 0.05), but no other differences were demonstrated. No adverse effects resulting from the technique were identified.(ABSTRACT TRUNCATED AT 250 WORDS)

Bupivacaine↗
PubMed2004

Treatment of a proximal accessory nerve injury with nerve transfer.

OBJECTIVE AND HYPOTHESIS: This study presents a case report of a patient who sustained an iatrogenic proximal accessory nerve injury that was treated with a medial pectoral to accessory nerve transfer. STUDY DESIGN: Case study. MATERIALS AND METHODS: Chart of one patient who was treated with a medial pectoral to accessory nerve transfer was reviewed. RESULTS: Five months after excision of a branchial cyst that resulted in a very proximal injury to the accessory nerve, this patient underwent a medial pectoral to accessory nerve transfer. At final follow-up, 3 years after surgery, the patient had full abduction overhead with some residual shoulder/scapular discomfort and mild scapular winging. CONCLUSION: The medial pectoral to accessory nerve transfer provides a viable surgical option with good reinnervation of the trapezius muscle in patients with a proximal accessory nerve injury where standard nerve repair or graft techniques are not feasible.

Accessory Nerve↗
PubMed2001

Surgical relationship of the medial pectoral nerve to the musculocutaneous nerve: a cadaveric study.

OBJECTIVE: For purposes of neurotization of the musculocutaneous nerve (MCN) with the medial pectoral nerve (MPN) after upper trunk brachial plexus injuries, the anatomic relationship between these two nerves was defined in a cadaveric model. METHODS: Thirty-five brachial plexuses in 18 adult cadavers were dissected. The distance between the origin of the MPN from the medial cord to the origin of the MCN from the lateral cord was measured. The length, diameter, branching, and location of the MPN were recorded. The diameter of the proximal MCN was recorded. RESULTS: Thirty-seven percent of the MPNs, when detached from the pectoralis muscles, were too short to reach the proximal MCN by a mean distance of 15 mm. The MPN pierced the pectoralis minor muscle in 80% of the dissections. The cross sectional area of the MCN was always larger than the cross sectional area of the MPN by an average factor of 2.5. CONCLUSION: When planning to use the MPN for neurotization of the MCN, one should be prepared to harvest an interposition graft, because over one-third of MPNs may not have enough length to reach the MCN in a tension-free manner. Diameter mismatch occurs predictably between the distal MPN and the proximal MCN.

Adult↗
PubMedDate not supplied

Intercostal nerve transfer to lumbar nerve roots. Part II: Neuropathologic findings in the animal model.

These are the neuropathologic findings in dogs 8-11 months after a unilateral intercostal nerve transfer and anastomosis to a lumbar nerve root were performed. This is a follow-up study of a procedure that was initially carried out in the adult and infant human cadaver and subsequently in an animal model by Malik and Buhr, as reported in this issue of Spine. At the time of sacrifice, the animals in this study had lost the limp that they had postoperatively. The results demonstrate the viability of the intercostal nerve transfer and its anastomosis to the lumbar motor root. There was supplied by a lumbar nerve root that had been operated upon, but the basis of this was not definitely established.

Animals↗
PubMed2005

Radiotherapy and radiosurgery for benign neurofibromas.

The purpose of this study was to evaluate the efficacy of radiotherapy (RT) and stereotactic radiosurgery (SRS) for neurofibromas. We studied 4 patients treated with RT (3 patients) or SRS (1 patient) and followed from 1.7 to 14.8 years. The tumor remained locally controlled in all patients. No significant complications related to treatment were observed. RT and SRS are likely to locally control neurofibromas in patients who require treatment and are not good candidates for complete resection.

Adult↗
PubMed1993

Reactivation in vivo and in vitro of herpes simplex virus from mouse dorsal root ganglia which contain different levels of latency-associated transcripts.

In the dorsal root ganglia (DRG) of mice latently infected with the herpes simplex virus type 1 mutant in1814, there are more neurons that contain latency-associated transcripts (LATs) than in DRG of mice infected with a dose of equal infectivity of either a revertant or a wild-type virus. We investigated whether higher levels of LAT+ neurons resulted in more extensive reactivation either in vivo following neurectomy of the sciatic nerve or in vitro after explantation into culture. Neurectomy appeared to induce expression of immediate early 1 mRNA (IE1mRNA) in neurons of mice latently infected with each of three viruses. However IE1mRNA was detected in no more than 0.25% of the neurons of DRG from animals 2 to 4 days after neurectomy, irrespective of the percentage of LAT+ neurons present. Of the 22 neurons shown to express IE1mRNA, none expressed LATs also. However the lack of expression of viral antigen and the absence of a reduced potential for reactivation on explanation suggested that neurectomy had not induced full reactivation involving lytic replication leading to the death of the latently infected neurons. When DRG were explanted into culture, the distribution of the frequency of reactivation was similar to the distribution of DRG that contained LAT+ neurons. The presence of a high proportion of LAT+ neurons was not directly associated with earlier detection of reactivation but such experiments cannot be regarded as quantitative. We therefore concluded that neurectomy did not result in a reduced reactivation potential as described by others and that the frequency of expression of IE1mRNA following neurectomy did not correlate with the number of LAT+ neurons present.

Animals↗
PubMed1987

Intercostal catheterisation. An alternative approach to the paravertebral space.

Twenty-one patients scheduled to undergo thoracotomy or median sternotomy had intercostal catheters inserted pre-operatively. During thoracotomy, under direct vision, the spread of 20 ml of a solution containing bupivacaine and methylene blue was followed. In most cases the spread involved one or two intercostal spaces. However, in all but one patient, dye spread medially to the paravertebral space where it then spread in both caudad and cephalad directions to reach between two and five vertebrae. In three cases, dye was seen crossing the anterior surface of the vertebrae to reach the contralateral aspect. It is concluded that a major component of dermatomal block during intercostal catheterisations may be secondary to paravertebral spread.

Adolescent↗