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Aug 2020 DOI 10.14302/issn.2641-7669.ject-20-3529
Wen XianjieCorresponding author
Department of Anesthesiology, the Second People`s Hospital of Foshan City, Foshan, Guangdong Province, China.
Background Local anesthetic neurotoxicity is a common complication in clinical anesthesia, which can cause permanent nerve damage in severe cases. The T-type calcium channel is an important channel for regulating the excitability of neurons. Normally, extracellular calcium ions enter the cell through the T-type calcium channel to change the excitability of neurons. When the intracellular calcium is overloaded, it can cause cell damage. Aims To investigated the roles of T-type calcium channel in the SH-SY5Y cells injury induced by the bupivacaine. Methods The SH-SY5Y cell culture model was used to observe the effect of T-type calcium channel blocker NNC55-0396 on the neurotoxicity of bupivacaine hydrochloride by MTT methold,flow cytometry, Western blotting and other methods. Results The results show that NNC55-0396 can block the T-type calcium channel of SH-SY5Y cells, improve the decrease of cell viability caused by bupivacaine hydrochloride, reduce the level of intracellular calcium ion, reduce the expression of Cleavedcaspase-3, and reduce cell apoptosis. Conclusion The above results indicate that the T-type calcium channel is involved in the SH-SY5Y cell damage caused by bupivacaine hydrochloride, and blocking the T-type calcium channel can reduce the neurotoxicity of bupivacaine hydrochloride.
Aug 2026 DOI 10.14302/issn.2641-5518.jcci-26-6134
Khafaga DPM MBBCh MS AshrafCorresponding author
Background Sural neuritis is a recognized and common complication resulting from iatrogenic injury, postsurgical or posttraumatic fibrosis, traction injury, or chronic nerve compression. Previously in a case series by Stockton and Brodsky, sural neuritis was reported as a complication in 16.6% of the patients who underwent peroneal tendon repair. Patients with sural neuritis often report pain and tingling in the distribution of the sural nerve along the lateral posterior leg, lateral foot, and the fifth digit. Symptoms of sural neuritis could be intense and debilitating, necessitating prompt recognition and treatment. Method Patients who underwent peroneal tendon repair between January 2022 to January 2024 by a single surgeon were included in this retrospective case series. Medical charts of the patients included in the study were reviewed. Demographics for all patients included in the study were recorded. Time to onset of sural neuritis, time to resolution, and management of the condition were recorded for patients who developed sural neuritis. Results A total of 39 patients were retrospectively reviewed, of which three patients (7.69%) developed symptoms attributed to sural neuritis post-peroneal tendon repair. Diagnosis of sural neuritis in the three patients ranged from 130 to 191 days post-peroneal tendon repair. Time to resolution of neuritis symptoms in the three patients who developed sural neuritis were 113 to 574 days after the onset. Successful management of sural neuritis were observation, serial injection of a mixture of 1 ml 1% lidocaine, 1 ml 0.5% bupivacaine, and 1 ml dexamethasone (4 mg/mL), and sural neurectomy. Conclusion While conservative treatments may be effective to manage sural neuritis, surgical options may be necessary for patients who fail to respond adequately. Patients suffering from sural neuritis often experience intense and debilitating symptoms that significantly impact their quality of life, highlighting the critical importance of early identification and appropriate management to mitigate long-term disability and ensure optimal outcomes.
Feb 2018 DOI 10.14302/issn.2640-690X.jfm-17-1900
Ali M. Elzohry AlaaCorresponding author
Department of Anesthesia, ICU and Pain Relief, South Egypt Cancer Institute, Assiut University.
Background PMPS nowadays is common due to advances in both; diagnosis and treatment of cancer breast. Choosing proper treatments can improve the patients’ quality of life. Cancer breast is common and quite important disease and female in our family must be aware of it. Improvement of the diagnosis and treatment PMPS lead to increased patient’s satisfaction and decrease fear of cancer breast. Objective Discuss different methods for management of PMPS with less side effects, adequate analgesia, improvement of quality of life, and better patient satisfaction in the future. Methods Treatment approaches include both pharmacological interventions and non-pharmacological strategies. However, current treatments of the PMPS are near-optimal and prevention much better than treatment. Conclusion Continuous perioperative thoracic epidural Fentanyl–bupivacaine infusion was much better in pain relief, less sedating effect and shorter duration of hospital and ICU stay than continuous perioperative entanyl intravenous infusion in patients undergoing major upper gastrointestinal cancer surgery.
Dec 2016 DOI 10.14302/issn.2379-8572.joa-16-1369
Klessinger StephanCorresponding author
Department of Neurosurgery, nova clinic Biberach, Eichendorffweg 5, 88400 Biberach, Germany.
The purpose was to discover if medial branch blocks (MBBs) of the cervical spine can be used as a diagnostic tool to identify patients with somatosensory tinnitus. MBBs are a diagnostic tool to confirm the diagnosis facet joint pain in patients with neck pain. It is not known, if MBBs are also suitable for testing other symptoms than pain. However, the existence of neural connections between the auditory system and the cervical region can be assumed. Included were 22 consecutive patients presenting with tinnitus, who had received MBBs in a ten years’ period. Patients were tested with a MBB with bupivacaine and triamcinolone. Injections were performed with fluoroscopic visualization using established techniques. The mean follow-up time was 6.2 weeks. Tinnitus was analyzed through the global clinical impression of the patient. Seven patients (31.8 %) experienced a significant improvement of the tinnitus. In one patient a thermal radiofrequency neurotomy was done after positive response to two MBBs. The pain relief and a significant reduction of the tinnitus sustained at the follow-up examination 20 weeks after the denervation. No statistically significant difference was found in age, gender, duration of symptoms, additional neck pain or vertigo, or side or level of the intervention. This pilot study shows the feasibility to identify patients with somatosensory tinnitus with MBBs. Further studies with the primary intention on tinnitus are necessary to prove the significance of MBBs. After a positive response to MBBs, treatment with radiofrequency neurotomy is the rational consequence.