This in-vitro study sought to characterize a concept for humeral component positioning during Total Elbow Arthroplasty (TEA) with bone defects. One-hundred specimens were analysed focusing a potential side-specific consensus; anatomical and Computed Tomography (CT) agreements; age-, sex- and humeral length-dependent associations. The angle of rotational alignment was defined by measuring the relationship between the flexion-extension axis (FEA) of the elbow joint and the flat posterior surface of the distal humerus (PDH).
View Article and Find Full Text PDFObjective: Pancreaticoduodenectomy (PD) is one of the most complex procedures in abdominal surgery. Nowadays, it is very difficult for novice surgeons to learn the procedure of PD on living patients. New concepts are needed to improve the surgical training of PD, comparable to education in the operating room.
View Article and Find Full Text PDFContext: Gynecological oncology requires a high level of surgical expertise. Therefore, new options for realistic surgical training for complex surgical procedures are required. This study aimed to determine how the trainees and experts perceive the use of soft-embalmed cadavers and how realistic it is compared to training on living patients.
View Article and Find Full Text PDFRev Esp Anestesiol Reanim (Engl Ed)
October 2023
Introduction: A proximal obturator nerve block has a similar block efficacy as the distal obturator nerve block. Previous cadaveric investigation injecting methylene blue dye solution and an immediate dissection proved the solution engulfing the anterior and posterior divisions of the obturator nerve as they emerge from the obturator canal. Uptake of methylene blue dye by the fascia and muscles obscures the exact delineation of the stained nerves.
View Article and Find Full Text PDFBackground: The lumbar plexus (LP) is a group of nerves located at the fourth lumbar vertebra level, between the anterior two-thirds and posterior one-thirds of the psoas muscle. In this study, the researchers aimed to investigate the spread of latex in injections of LP, suprainguinal fascia iliaca, and circum-psoas planes to assess the different regional techniques for blocking LP nerves (LPNs).
Methods: The study involved performing ultrasound-guided injections of three different colored latexes in six cadavers.
Objectives: To develop the use of Thiel soft embalmed human cadavers (TeC) in open radical cystectomy (ORC) training for the first time, to investigate the effect of cadaveric training on surgical trainees' technical skills/performance and to determine how trainees perceive the use of cadaveric workshops.
Methods: A 3-day hands-on workshop was organised. Ten trainees performed ORC on five TeC, supervised by five experts.
Anat Cell Biol
September 2024
The 7th cervical vertebra (C7) is described as having the most prominent spinous process (SP) and is characterized as the "vertebra prominens" (VP) of the cervical spine in anatomy textbooks. The VP is an important anatomical landmark of the neck for clinical examination and therapeutic intervention. The present study identifies the level of the most prominent SP of the cervical and uppermost thoracic vertebrae in a cadaveric cohort.
View Article and Find Full Text PDFIntroduction: Ganglionic local opioid analgesia (GLOA) at the superior cervical ganglion (SCG) is performed for pain control and is known to be an effective procedure. In this study, we evaluated the spread of the injectate in the area of the SCG. Our expectation was that there would be a correlation between the area and volume of the injectate spread and post-procedural outcome measures.
View Article and Find Full Text PDFMedicina (Kaunas)
January 2024
Brachial plexus blocks at the interscalene level are frequently chosen by physicians and recommended by textbooks for providing regional anesthesia and analgesia to patients scheduled for shoulder surgery. Published data concerning interscalene single-injection or continuous brachial plexus blocks report good analgesic effects. The principle of interscalene catheters is to extend analgesia beyond the duration of the local anesthetic's effect through continuous infusion, as opposed to a single injection.
View Article and Find Full Text PDFBackground: Paraneural sheath engulfing the sciatic nerve (SN) between the ischial tuberosity and the greater trochanter is well known.
Methods: In order to explore the anatomical planes separating the paraneurium from the epineurium in SN, we conducted a cadaveric study (two patients and four specimens), followed by a clinical study in 10 patients.
Results: We demonstrated an elevation of 5-7 layers of paraneural tissues after an in-plane injection in the longitudinal axis of the proximal SN, which was possibly the last of the paraneural sheath.
Dorsal penile nerve block stands out as one of the commonly employed regional anesthetic techniques in children. Despite the large body of experience, failure rates are still significant. We included 20 children (median (SD) age of 73 (31) months) scheduled for circumcision without general anesthesia and secondary airway manipulation in a consecutive case series.
View Article and Find Full Text PDFAnaesthesiologie
September 2023
In addition to the treatment for complex regional pain syndrome (CRPS), the stellate ganglion block is a treatment option for refractory intermittent ventricular tachycardia (VT). Despite the use of imaging techniques, such as fluoroscopy and ultrasound, numerous side effects and complications have been reported. These are a result of the complex anatomical site and the volume of injected local anesthetics.
View Article and Find Full Text PDFWorld J Emerg Med
January 2023
J Anaesthesiol Clin Pharmacol
June 2022
Background And Aims: The parasagittal ultrasound-guided infraclavicular block (ICB) aims to cover all the elements of brachial plexus for the surgeries at and below the elbow. Our aim was to demonstrate the spread of 20 ml latex in vicinity of brachial plexus cords after injecting posterior to the axillary artery in Thiel embalmed cadavers.
Material And Methods: A blunt insulated needle was inserted posterior to the axillary artery in a traditional parasagittal infraclavicular in 2 Thiel embalmed cadavers, on both the sides (four specimens).
Anaesthesiologie
March 2023
Placement of a peripheral indwelling venous catheter is a routinely performed invasive procedure, in which complications are often underestimated. In difficult venous conditions multiple puncture attempts are often required, which are time consuming, unnecessarily painful for the patients and nevertheless not always successful. Due to the close anatomical relationship between superficial veins and peripheral nerves in the arm, puncture-related nerve injury is not uncommon.
View Article and Find Full Text PDFPosteromedial knee pain is a common clinical problem. It is often accompanied by degenerative changes or tears in the posterior horn of the medial meniscus and/or pain during deep flexion of the knee. In more advanced cases, it is accompanied by the osteophytic formation of a cam lesion that develops gradually in the posterior of the medial condyle of the femur and, with it (or less frequently without it), an osteophytic lesion at the posterior of the tibia (i.
View Article and Find Full Text PDFBackground: Innervation of the thumb and radial part of the dorsum of the hand is achieved primarily by the radial nerve, which is usually blocked for hand surgery. Inefficient blocks occur because the lateral antebrachial cutaneous nerve also extends into this area. The question then arises, whether skin innervation and peripheral blocking techniques should be directed at from the innervation by these nerves or more by the dermatome and its spinal segments.
View Article and Find Full Text PDFBackground: We recently showed that a combined solution containing alpha-ketoglutarate (aKG) and 5-hydroxymethyl-furfural (5-HMF) has a solid antitumoral effect on the Jurkat cell line due to the fact of its antioxidative, caspase-3 and apoptosis activities, but no negative effect on human fibroblasts was obtained. The question arises how the single compounds, aKG and 5-HMF, affect peroxynitrite (ONOO) and nitration of tyrosine residues, Jurkat cell proliferation and caspase-activated apoptosis.
Methods: The ONOO luminol-induced chemiluminescence reaction was used to measure the ONOO scavenging function of aKG or 5-HMF, and their protection against nitration of tyrosine residues on bovine serum albumin was estimated with the ELISA technique.
Pain Ther
December 2022
Introduction: Computed tomography (CT)-guided coeliac plexus neurolysis (CPN) is considered effective at controlling pain in patients with intra-abdominal malignancies. The primary objective was to correlate pain outcomes with the spread of neurolytic solution in the coeliac area and to evaluate the predictive value for the spread of injectate for pain outcomes and side effects.
Methods: Blinded CT scans were reviewed.
Surg Radiol Anat
August 2022
Purpose: There are few studies searching for possible perforator flap donor sites on the arm. This study aimed to identify the locations of cutaneous perforators of the arm according to anatomical landmarks.
Methods: Thirteen Thiel-fixed and latex-filled upper extremities of bodies donated to science were used.
Introduction: The zygapophyseal joints represent one possible cause for back pain. Therefore, many interventions are targeting the denervation of the facet joints. The aim of this study is to describe the course of the medial branch of the dorsal branch of the spinal nerve and its articular branches to the zygapophyseal joints in the segments T10-T12.
View Article and Find Full Text PDFIntroduction: Percutaneous radiofrequency facet denervation (PRFD) by thermocoagulation is a useful treatment for nonspecific thoracic pain syndrome. To guarantee that maximal thermal lesion is applied to the nerve, it is essential to have precise knowledge of the topography of the thoracic dorsal branches of the spinal nerves. This special anatomy was investigated, and the results were compared with the existing technique for PRFD, where the active needle tip is placed in the junction of the superior articular process and the transverse process.
View Article and Find Full Text PDFJ Anaesthesiol Clin Pharmacol
January 2022
Background And Aims: Clinical case reports mention 3-5 ml of local anesthetic (LA) at the cervical root 5 (C5) for surgical anesthesia essential for clavicle surgeries with reasonable success. A volume of 5 ml LA has been shown to cause hemidiaphragmatic paresis.
Material And Methods: We implement the 3-5 ml LA for awake clavicle surgeries along with a supraclavicular nerve (SCN) block with another 2 ml.