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Xu X, Xie YX, Zhang M, Du JH, He JX, Hu LH. Comparison of Thoracoscopy-Guided Thoracic Paravertebral Block and Ultrasound-Guided Thoracic Paravertebral Block in Postoperative Analgesia of Thoracoscopic Lung Cancer Radical Surgery: A Randomized Controlled Trial. Pain Ther 2024:10.1007/s40122-024-00593-7. [PMID: 38592611 DOI: 10.1007/s40122-024-00593-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 03/11/2024] [Indexed: 04/10/2024] Open
Abstract
INTRODUCTION Ultrasound-guided thoracic paravertebral block (UTPB) is widely used for postoperative analgesia in thoracic surgery. However, it has many disadvantages. Thoracoscopy-guided thoracic paravertebral block (TTPB) is a new technique for thoracic paravertebral block (TPB). In this study, we compared the use of TTPB and UTPB for pain management after thoracoscopic radical surgery for lung cancer. METHODS In total, 80 patients were randomly divided 1:1 into the UTPB group and the TTPB group. The surgical time of TPB, the success rate of the first puncture, block segment range, visual analog scale (VAS) scores at 2, 6, 12, 24, and 48 h post operation, and the incidence of postoperative adverse reactions were compared between the two groups. RESULTS The surgical time of TPB was significantly shorter in the TTPB group than in the UTPB group (2.2 ± 0.3 vs. 5.7 ± 1.7 min, t = - 12.411, P < 0.001). The success rate of the first puncture and the sensory block segment were significantly higher in the TTPB group than in the UTPB group (100% vs. 76.9%, χ2 = 8.309, P < 0.001; 6.5 ± 1.2 vs. 5.1 ± 1.3 levels, t = - 5.306, P < 0.001, respectively). The VAS scores were significantly higher during rest and coughing at 48 h post operation than at 2, 6, 12, and 24 h post operation in the TTPB group. The VAS scores were significantly lower during rest and coughing at 12 and 24 h post operation in the TTPB group than in the UTPB group (rest: 2.5 ± 0.4 vs. 3.4 ± 0.6, t = 7.325, P < 0.001; 2.5 ± 0.5 vs. 3.5 ± 0.6, t = 7.885, P < 0.001; coughing: 3.4 ± 0.6 vs. 4.2 ± 0.7, t = 5.057, P < 0.001; 3.4 ± 0.6 vs. 4.2 ± 0.8, t = 4.625, P < 0.001, respectively). No significant difference was observed in terms of postoperative adverse reactions between the two groups. CONCLUSIONS Compared with UTPB, TTPB shows advantages, such as simpler and more convenient surgery, shorter surgical time, a higher success rate of the first puncture, wider block segments, and superior analgesic effect. TTPB can effectively reduce postoperative pain due to thoracoscopic lung cancer radical surgery. TRIAL REGISTRATION https://www.chictr.org.cn , identifier ChiCTR2300072005, prospectively registered on 31/05/2023.
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Affiliation(s)
- Xia Xu
- Department of Anesthesiology, The Affiliated Lihuili Hospital of Ningbo University, No. 57 Xingning Road, Ningbo, 315040, People's Republic of China
| | - Ying-Xin Xie
- Department of Anesthesiology, The Affiliated Lihuili Hospital of Ningbo University, No. 57 Xingning Road, Ningbo, 315040, People's Republic of China
| | - Meng Zhang
- Department of Anesthesiology, The Affiliated Lihuili Hospital of Ningbo University, No. 57 Xingning Road, Ningbo, 315040, People's Republic of China
| | - Jian-Hui Du
- Department of Anesthesiology, The Affiliated Lihuili Hospital of Ningbo University, No. 57 Xingning Road, Ningbo, 315040, People's Republic of China
| | - Jin-Xian He
- Department of Thoracic Surgery, The Affiliated Lihuili Hospital of Ningbo University, No. 57 Xingning road, Ningbo, 315040, People's Republic of China
| | - Li-Hong Hu
- Department of Anesthesiology, The Affiliated Lihuili Hospital of Ningbo University, No. 57 Xingning Road, Ningbo, 315040, People's Republic of China.
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Pan T, Zhou X, Pan J, Chen B, Xu C, Xu Z, Dong P, Yu T. Axillary vein as an alternative venous access site for VV-ECMO cannulation: a case report. J Cardiothorac Surg 2024; 19:122. [PMID: 38481279 PMCID: PMC10935936 DOI: 10.1186/s13019-024-02600-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 03/05/2024] [Indexed: 03/17/2024] Open
Abstract
BACKGROUND Ultrasound-guided percutaneous axillary vein cannulation can reduce cannulation failure and mechanical complications, is as safe and effective as internal jugular vein cannulation, and is superior to subclavian vein cannulation using landmark technique. As far, reports of venovenous extracorporeal membrane oxygenation (VV-ECMO) with percutaneous axillary vein cannulation are rare. CASE PRESENTATION A 64-year-old man presenting with dyspnea and chest tightness after aspirating sewage was admitted to the emergency department. Computed tomography (CT) showed diffuse exudation of both lungs and arterial blood gas analysis showed an oxygenation index of 86. He was diagnosed with aspiration pneumonia-induced acute respiratory distress syndrome (ARDS) and intubated for deteriorated oxygenation. Despite the combination therapy of protective mechanical ventilation and prone position, the patient's oxygenation deteriorated further, accompanied with multiple organ dysfunction syndrome, which indicated the requirement of support with VV-ECMO. However, vascular ultrasound detected multiple thrombus within bilateral internal jugular veins. As an alternative, right axillary vein was chosen as the access site of return cannula. Subsequently, femoral-axillary VV-ECMO was successfully implemented under the ultrasound guidance, and the patient's oxygenation was significantly improved. Unfortunately, the patient died of hyperkalemia-induced ventricular fibrillation after 36 h of VV-ECMO running. Despite the poor prognosis, the blood flow during ECMO run was stable, and we observed no bleeding complication, vascular injury, or venous return disorder. CONCLUSIONS Axillary vein is a feasible alternative access site of return cannula for VV-ECMO if internal jugular vein access were unavailable.
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Affiliation(s)
- Tao Pan
- Department of Intensive Care Medicine, Ningbo No.2 Hospital, Ningbo, 315000, Zhejiang, China
| | - Xiaoyang Zhou
- Department of Intensive Care Medicine, Ningbo No.2 Hospital, Ningbo, 315000, Zhejiang, China
| | - Jianneng Pan
- Department of Intensive Care Medicine, Ningbo No.2 Hospital, Ningbo, 315000, Zhejiang, China
| | - Bixin Chen
- Department of Intensive Care Medicine, Ningbo No.2 Hospital, Ningbo, 315000, Zhejiang, China
| | - Chang Xu
- Department of Intensive Care Medicine, Ningbo No.2 Hospital, Ningbo, 315000, Zhejiang, China
| | - Zhaojun Xu
- Department of Intensive Care Medicine, Ningbo No.2 Hospital, Ningbo, 315000, Zhejiang, China
| | - Pingping Dong
- Baihe Street Community Health Services of Yinzhou District, Ningbo, 315000, Zhejiang, China.
| | - Tingting Yu
- Department of Ophthalmology, Ningbo No.2 Hospital, Ningbo, 315000, Zhejiang, China.
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Ruiz Santiago F, Moraleda Cabrera B, Láinez Ramos-Bossini AJ. Ultrasound guided injections in ankle and foot. J Ultrasound 2024; 27:153-159. [PMID: 37518823 PMCID: PMC10908885 DOI: 10.1007/s40477-023-00808-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Accepted: 07/03/2023] [Indexed: 08/01/2023] Open
Abstract
Ultrasound guidance is particularly useful for percutaneous injections in the diagnosis and management of painful conditions of the ankle and foot. The injectates used include steroids and local anesthetics, such as lidocaine, mepivacaine, bupivacaine, ropivacaine, and platelet-rich plasma. Osteoarthritis is the main indication for joint injections. Joints amenable to being injected include the tibiotalar, subtalar, midtarsal, and metatarsophalangeal joints. Tendon injections mainly involve the Achilles, peroneus, extensors, and tibialis tendons, while plantar fascia injections are useful for treating plantar fasciitis and plantar fibromatosis. Forefoot injections include joint arthritis, intermetatarsal bursitis, and Morton neuroma. The standardized approaches and doses reviewed in this paper are based on the authors' experience and can lead to high success in symptomatic relief for various conditions. These injections can be curative or serve as a guide to identify the source of pain when surgery or other therapeutic options are planned.
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Affiliation(s)
- Fernando Ruiz Santiago
- Department of Radiology and Physical Medicine, Faculty of Medicine, University of Granada, 18071, Granada, Spain.
- Musculoskeletal Radiology Unit, Hospital Universitario Virgen de Las Nieves, 18014, Granada, Spain.
- Instituto de Investigación Biosanitaria ibs. Granada, 18012, Granada, Spain.
- , C-Julio Verne 8, 7 B, 18003, Granada, Spain.
| | - Beatriz Moraleda Cabrera
- Musculoskeletal Radiology Unit, Hospital Universitario Virgen de Las Nieves, 18014, Granada, Spain
- Instituto de Investigación Biosanitaria ibs. Granada, 18012, Granada, Spain
| | - Antonio Jesús Láinez Ramos-Bossini
- Musculoskeletal Radiology Unit, Hospital Universitario Virgen de Las Nieves, 18014, Granada, Spain
- Instituto de Investigación Biosanitaria ibs. Granada, 18012, Granada, Spain
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Thaitirarot C, Sze S, Armstrong S, Somani R. Ultrasound-guided explantation technique for implantable loop recorder in patients with high body mass index: a practical approach. Heart Rhythm O2 2024; 5:198-199. [PMID: 38560376 PMCID: PMC10980916 DOI: 10.1016/j.hroo.2024.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024] Open
Affiliation(s)
- Chokanan Thaitirarot
- Cardiology Department, Glenfield Hospital, University Hospitals of Leicester, Leicester, United Kingdom
| | - Shirley Sze
- Cardiology Department, Glenfield Hospital, University Hospitals of Leicester, Leicester, United Kingdom
- Department of Cardiovascular Sciences, University of Leicester, Leicester, United Kingdom
| | - Suzanne Armstrong
- Cardiology Department, Glenfield Hospital, University Hospitals of Leicester, Leicester, United Kingdom
| | - Riyaz Somani
- Cardiology Department, Glenfield Hospital, University Hospitals of Leicester, Leicester, United Kingdom
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Yan L, Wang X, Zhang Z, Li Z, Chi L, Wang L. Safety and efficacy of ultrasound-guided superior hypogastric plexus block combined with conscious sedation in ambulatory patients undergoing percutaneous microwave ablation of uterine myomas: Study protocol for a single-center, double-blinded, randomized controlled trial. Heliyon 2024; 10:e26421. [PMID: 38434068 PMCID: PMC10906327 DOI: 10.1016/j.heliyon.2024.e26421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2023] [Revised: 02/11/2024] [Accepted: 02/13/2024] [Indexed: 03/05/2024] Open
Abstract
Background Pain is a major challenge in performing ultrasound-guided percutaneous microwave ablation (PMWA) of uterine myomas. Inadequate analgesia by local anesthetics hinders the possibility of conducting PMWA of uterine myomas in the Ambulatory Surgery Center (ASC) of the Department of Ultrasound. Objective The superior hypogastric plexus (SHP) forms a suitable target for pain relief through the blockade, as it contains nociceptive afferent fibers from pelvic organs such as the uterus, rectum, and bladder. Superior hypogastric plexus block (SHPB) has demonstrated promise as an alternative treatment option for alleviating pelvic pain, reducing opioid consumption, and improving quality of life. This study aims to evaluate the efficacy of ultrasound-guided SHPB combined with conscious sedation as an alternative anesthesia option for ambulatory patients receiving ultrasound-guided PMWA of uterine myomas. Methods and analysis This randomized controlled trial (RCT) will be carried out at the Department of Ultrasound, The First Affiliated Hospital of Xiamen University. Women scheduled for ultrasound-guided PMWA of uterine myomas will be eligible. 86 patients will be recruited and randomly assigned to either the intervention or control groups in a 1:1 ratio. The intervention group will undergo ultrasound-guided superior hypogastric plexus block (SHPB) combined with conscious sedation, while the control group will receive local anesthesia combined with conscious sedation. The primary outcome is the success rate of anesthesia, secondary outcomes include vasoactive drug consumption, acetaminophen consumption, sleep quality, sonographer satisfaction score, patient satisfaction score, the detained time in hospital, and adverse events. Discussions This RCT represents the inaugural effort to specifically evaluate the safety and efficacy of ultrasound-guided SHPB combined with conscious sedation in patients undergoing ultrasound-guided PMWA of uterine myomas and will provide valuable evidence and insight into the analgesic management of this ambulatory surgery. Ethics and dissemination This study has been approved by the Ethics Committee of the First Affiliated Hospital of Xiamen University (Scientific Research Ethics Review 2023, No. 139). The results will be submitted for publication in peer-reviewed journals.
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Affiliation(s)
- Lijuan Yan
- Department of Anesthesiology, The First Affiliated Hospital of Xiamen University, Xiamen, Fujian, China
| | - Xiao Wang
- Department of Ultrasound, The First Affiliated Hospital of Xiamen University, Xiamen, Fujian, China
| | - Zuobing Zhang
- Department of Ultrasound, The First Affiliated Hospital of Xiamen University, Xiamen, Fujian, China
| | - Zhibin Li
- Epidemiology Research Unit, Translational Medicine Research Center, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
| | - Laiting Chi
- Department of Anesthesiology, Peking University Shenzhen Hospital, Shenzhen, Guangdong, China
| | - Lijuan Wang
- Department of Anesthesiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Dai J, Li S, Weng Q, Long J, Wu D. Opioid-free anesthesia with ultrasound-guided quadratus lumborum block in the supine position for lower abdominal or pelvic surgery: a randomized controlled trial. Sci Rep 2024; 14:4652. [PMID: 38409359 PMCID: PMC10897418 DOI: 10.1038/s41598-024-55370-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 02/22/2024] [Indexed: 02/28/2024] Open
Abstract
In the past, quadratus lumborum block (QLB) was mostly used for postoperative analgesia in patients, and few anesthesiologists applied it during surgery with opioid-free anesthesia (OFA). Consequently, it is still unclear whether QLB in the supine position can provide perfect analgesia and inhibit anesthetic stress during surgery under the OFA strategy. To observe the clinical efficacy of ultrasound-guided quadratus lumborum block (US-QLB) in the supine position with OFA for lower abdominal and pelvic surgery. A total of 122 patients who underwent lower abdominal or pelvic surgery in People's Hospital of Wanning between March 2021 and July 2022 were selected and divided into a quadratus lumborum block group (Q) (n = 62) and control group (C) (n = 60) according to the random number table method. Both groups underwent general anesthesia combined with QLB in the supine position. After sedation, unilateral or bilateral QLB was performed via the ultrasound guided anterior approach based on images resembling a "human eye" and "baby in a cradle" under local anesthesia according to the needs of the operative field. In group Q, 20 ml of 0.50% lidocaine and 0.20% ropivacaine diluted in normal saline (NS) were injected into each side. In group C, 20 ml of NS was injected into each side. The values of BP, HR, SPO2, SE, RE, SPI, NRS, Steward score, dosage of propofol, dexmedetomidine, and rocuronium, the number of patients who needed remifentanil, propofol, or diltiazem, puncture point, block plane, duration of anesthesia, catheter extraction, and wakefulness during the operation were monitored. There were no significant differences in the general data, number of cases requiring additional remifentanil, propofol, or diltiazem treatment, as well as puncture point and puncture plane between the two groups (P > 0.05). HR, SBP, and DBP values were higher in group Q than in group C at T1; HR, SPI, and SE, while RE values were lower in group Q than in group C at T3, SE, and RE; the Steward score was higher in group Q than in group C at T4 and T5, and the difference was statistically significant (P < 0.05). The extubation and awake times were lower in group Q than in group C, and the difference was statistically significant (P < 0.05). The SE, RE, and SPI values were lower at T1, T2, T3, and T4 than at T0. The Steward scores at T4 and T5 were higher in group Q than in group C, and were lower than at T0, with a statistically significant difference (P < 0.05). There were significant differences in the effectiveness of postoperative analgesia between the two groups at t1, t3 and t4 (P < 0.05). US-QLB in the supine position with OFA is effective in patients undergoing lower abdominal or pelvic surgery with stable intraoperative vital signs, complete recovery and better postoperative analgesia.
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Affiliation(s)
- Jingwei Dai
- Department of Anesthesiology, People's Hospital of Wanning, Wanning, 571500, Hainan, China
| | - Shanliang Li
- Department of Anesthesiology, People's Hospital of Wanning, Wanning, 571500, Hainan, China
| | - Qijun Weng
- Department of Anesthesiology, People's Hospital of Wanning, Wanning, 571500, Hainan, China
| | - Jinxiong Long
- Department of Anesthesiology, People's Hospital of Wanning, Wanning, 571500, Hainan, China
| | - Duozhi Wu
- Department of Anesthesiology, Hainan General Hospital, Haikou, 570311, Hainan, China.
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Yin G, Li Y, Wei P, Ma X, Li B, Gan G, Song X. Analgesic effect of the ultrasound-guided thoracolumbar paravertebral block in patients undergoing robot-assisted laparoscopic nephrectomy: a randomized controlled trial. BMC Anesthesiol 2024; 24:69. [PMID: 38388893 PMCID: PMC10882795 DOI: 10.1186/s12871-024-02460-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 02/17/2024] [Indexed: 02/24/2024] Open
Abstract
BACKGROUND Paravertebral block has similar effect as epidural anesthesia, and has good somatic and visceral analgesic effect. Paravertebral block is widely used in thoracic surgery, but rarely used in abdominal surgery. AIMS This study aimed to evaluate the analgesic effect of thoracolumbar paravertebral block in patients undergoing robot-assisted laparoscopic nephrectomy. METHODS One hundred patients undergoing elective robot-assisted laparoscopic nephrectomy were included in this study. Based on whether the thoracolumbar paravertebral block was performed, the patients were randomly divided into the thoracolumbar paravertebral block combined with general anesthesia group (TL-PVB group) and simple general anesthesia group (NO-PVB group). Oxycodone was administered for patient-controlled intravenous analgesia (PCIA). The primary outcomes included the amount of remifentanil used during surgery, the amount of oxycodone used in 24 and 48 h after surgery. Secondary outcomes included the changes of heart rate (HR) and mean arterial pressure (MAP), time for the first analgesia administration, visual analog score (VAS) of pain during rest and movement, and time of postoperative recovery. RESULTS Compared to the NO-PVB group, the amount of remifentanil used during surgery in patients with TL-PVB group was significantly reduced (1.78 ± 0.37 mg vs. 3.09 ± 0.48 mg, p < 0.001), the amount of oxycodone used 24 h after surgery was significantly reduced (8.70 ± 1.70 mg vs. 13.79 ± 2.74 mg, p < 0.001), and the amount of oxycodone used 48 h after surgery was remarkably reduced (21.83 ± 4.28 mg vs. 27.27 ± 4.76 mg, p < 0.001). There were significant differences in the changes of HR and MAP between the two groups (p < 0.001). The first analgesic requirement time of TL-PVB group was significantly longer than that of NO-PVB group (468.56 ± 169.60 min vs. 113.48 ± 37.26 min, p < 0.001). The postoperative VAS during rest and movement of TL-PVB group were significantly lower than that of NO-PVB group (p < 0.01). Compared with NO-PVB group, patients in TL-PVB group needed shorter time to awaken from anesthesia, leave the operating room, anal exhaust, get out of bed, and had shorter length of postoperative hospital stay (p < 0.001). The incidence of postoperative adverse reactions were lower in the TL-PVB group than that in the NO-PVB group (p < 0.05). CONCLUSIONS Ultrasound-guided thoracolumbar paravertebral block significantly reduces intraoperative and postoperative opioid consumption, and provides better analgesia in patients undergoing robot-assisted laparoscopic nephrectomy, which is a recommendable combined anesthesia technique. TRIAL REGISTRATION ChiCTR2200061326, 21/06/2022.
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Affiliation(s)
- Guojiang Yin
- Department of Anesthesiology, General Hospital of Central Theater Command of People's Liberation Army, Wuhan, 430070, China
| | - Yue Li
- The First School of Clinical Medicine, Southern Medical University, Guangzhou, 510515, China
| | - Pengxiao Wei
- General Hospital Base of Central Theater Command of People's Liberation Army, Hubei University of Medicine, Wuhan, 430070, China
| | - Xuyuan Ma
- General Hospital Base of Central Theater Command of People's Liberation Army, Hubei University of Medicine, Wuhan, 430070, China
| | - Bixi Li
- Department of Anesthesiology, General Hospital of Central Theater Command of People's Liberation Army, Wuhan, 430070, China.
| | - Guosheng Gan
- Department of Anesthesiology, General Hospital of Central Theater Command of People's Liberation Army, Wuhan, 430070, China.
| | - Xiaoyang Song
- Department of Anesthesiology, General Hospital of Central Theater Command of People's Liberation Army, Wuhan, 430070, China
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Men X, Wang Q, Chen P, Hu WS, Chai Y, Shou HY, Zhou ZF. Subcutaneous nitroglycerin increased the success rate of radial artery cannulation in women with gestational hypertension undergoing cesarean section : A randomized controlled trial. Anaesthesiologie 2023; 72:28-35. [PMID: 36884054 PMCID: PMC10692033 DOI: 10.1007/s00101-023-01264-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 10/06/2022] [Accepted: 11/20/2022] [Indexed: 06/18/2023]
Abstract
BACKGROUND Radial artery cannulation helps to maintain the stability of maternal hemodynamics and reduce complications; however, it is difficult for women with gestational hypertension. Subcutaneous nitroglycerin was found to improve the first attempt success rate of radial artery cannulation in pediatric patients. Therefore, this study evaluated the effect of subcutaneous nitroglycerin on the radial artery diameter and area, blood flow rate and the success rate of radial artery cannulation in women with pregnancy-induced hypertension. METHODS A total of 94 women with gestational hypertension and risk of intraoperative bleeding undergoing cesarean section were identified and randomized into the subcutaneous nitroglycerin group and control group. The primary outcome was the success rate of left radial artery cannulation within 3 min after subcutaneous injecting (T2). The puncture time, number of attempts, the overall complications, and ultrasonographic measurements including radial artery diameter, cross-sectional area and depth were also recorded before subcutaneous injection (T1), 3 min after subcutaneous injection (T2) and immediately after radial artery cannulation (T3). RESULTS The first attempt success rate of radial artery cannulation was significantly higher (97.9% vs. 76.6%, p = 0.004) and procedure time to success was significantly shorter (111 ± 18 s vs. 171 ± 70 s, p < 0.001) in the subcutaneous nitroglycerin group as compared to the control group. The subcutaneous nitroglycerin group also had a significantly less overall number of attempts as 1/2/3 attempts (n), 46/1/0 vs. 36/7/4 (p = 0.008). Compared with the control group, the diameter and cross-sectional area of radial artery increased significantly at the T2 and T3 points in the subcutaneous nitroglycerin group (p < 0.001), as well as percentage change of radial artery diameter and CSA. Vasospasm (6.4% vs. 31.9%; p = 0.003) was significantly lower in the subcutaneous nitroglycerin group; however, no difference was found in hematoma (2.1% vs. 12.8%; p = 0.111). CONCLUSION Subcutaneous nitroglycerin along with the routine local anesthetic preparation before radial artery cannulation increased the first attempt success rate of radial artery cannulation and decreased the overall number of cannulation attempts in women with gestational hypertension and risks of intraoperative bleeding undergoing cesarean section, it also decreased cannulation times and overall number of vasospasms.
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Affiliation(s)
- Xin Men
- Department of Anesthesiology, Hangzhou Women's Hospital (Hangzhou Maternity and Child Health Care Hospital, Hangzhou First People's Hospital Qianjiang New City Campus, The Affiliated Women's Hospital of Hangzhou Normal University), 315014, Hangzhou, China
| | - Qian Wang
- Department of Anesthesiology, The Affiliated ZheJiang Hospital, School of Medicine, Zhejiang University, 315014, Hangzhou, China
| | - Pei Chen
- Department of Anesthesiology, Hangzhou Women's Hospital (Hangzhou Maternity and Child Health Care Hospital, Hangzhou First People's Hospital Qianjiang New City Campus, The Affiliated Women's Hospital of Hangzhou Normal University), 315014, Hangzhou, China
| | - Wen-Sheng Hu
- Department of Anesthesiology, Hangzhou Women's Hospital (Hangzhou Maternity and Child Health Care Hospital, Hangzhou First People's Hospital Qianjiang New City Campus, The Affiliated Women's Hospital of Hangzhou Normal University), 315014, Hangzhou, China
| | - Yun Chai
- Department of Anesthesiology, Hangzhou Women's Hospital (Hangzhou Maternity and Child Health Care Hospital, Hangzhou First People's Hospital Qianjiang New City Campus, The Affiliated Women's Hospital of Hangzhou Normal University), 315014, Hangzhou, China
| | - Hong-Yan Shou
- Department of Anesthesiology, Hangzhou Women's Hospital (Hangzhou Maternity and Child Health Care Hospital, Hangzhou First People's Hospital Qianjiang New City Campus, The Affiliated Women's Hospital of Hangzhou Normal University), 315014, Hangzhou, China
| | - Zhen-Feng Zhou
- Department of Anesthesiology, Hangzhou Women's Hospital (Hangzhou Maternity and Child Health Care Hospital, Hangzhou First People's Hospital Qianjiang New City Campus, The Affiliated Women's Hospital of Hangzhou Normal University), 315014, Hangzhou, China.
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Lin J, Deng H, Yang Q, Zuo Y. Case report: Ultrasound-guided removal of foreign matter from the chest wall. Int J Surg Case Rep 2023; 113:109091. [PMID: 38006738 PMCID: PMC10724684 DOI: 10.1016/j.ijscr.2023.109091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 11/17/2023] [Accepted: 11/20/2023] [Indexed: 11/27/2023] Open
Abstract
INTRODUCTION AND IMPORTANCE Positioning nodule with a steel wire in pulmonary surgery is a common preoperative step. To date, no reports have been published on the retention of steel wires in the body post-surgery, nor have there been studies describing the ultrasound-guided removal of foreign objects from the chest wall. This report describes a case of a foreign matter was removed from the chest wall by ultrasound-guided. CASE PRESENTATION A 70-year-old woman underwent thoracoscope resection of a pulmonary nodule; however, a fragment of the positioning steel wire remained in the chest wall during the surgery. The anesthetist located the residual steel wire using ultrasound, and subsequently, the surgeon successfully removed it. CLINICAL DISCUSSION Detection of foreign matter in the body is rare and usually associated with trauma or accidental retention of materials such as absorbable gelatin sponges or sutures during surgery, which are often found using X-rays. This process is often time-consuming, and X-rays being radioactive are potentially harmful to patients and medical workers. Ultrasonic waves are safe and offer a convenient alternative for such procedures. We removed the residual steel wire through a 0.5 cm skin incision, this method neither caused trauma nor increased costs. CONCLUSION Ultrasonography-assisted positioning is a rapid, convenient, and safe technique, promising to enhance future surgical interventions.
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Affiliation(s)
- Jing Lin
- Department of Anesthesiology, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, China
| | - Huifei Deng
- Department of Anesthesiology, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, China
| | - Qiuyan Yang
- Department of Emergency, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, China
| | - Youbo Zuo
- Department of Anesthesiology, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, China.
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Li L, Cao Y, Zhang H, Zheng M, Xing J, Zheng C, Zhao Y, Yang X. Temperature sensitive nanogel-stabilized pickering emulsion of fluoroalkane for ultrasound guiding vascular embolization therapy. J Nanobiotechnology 2023; 21:413. [PMID: 37946199 PMCID: PMC10634024 DOI: 10.1186/s12951-023-02181-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 10/26/2023] [Indexed: 11/12/2023] Open
Abstract
Various X-ray imaging technologies like computed tomography (CT) and digital subtraction angiography (DSA) are widely used in transcatheter arterial embolization (TAE) therapy for treating hepatocellular cancer (HCC) patients. Although they display high-contrast imaging, they have a few disadvantages, such as complex operation and exposure to ionizing radiation. Thus, ultrasound (US) imaging plays an important role in medical diagnosis because of its advantages, like simple and fast operation, no ionizing radiation exposure, and accurate real-time imaging. Subsequently, Poly N-isopropylacrylamide-co-2,2,3,4,4,4-Hexafluorobutyl methacrylate (PNF) nanogels were synthesized for stabilizing TGFPE, the Pickering emulsions of 2H, 3H-decafluoropentane (HDFP). These emulsions displayed dual abilities of thermosensitive sol-gel transition and long-term US imaging in vitro. Thus, it was concluded that these emulsions could achieve vascular embolization and long-term US imaging in vivo as per the TAE animal model results. The emulsion droplets' flow and accumulation were visualized under the US imaging guidance. In summary, the Pickering emulsions have the potential to be used as US-guided embolization material for mediating TAE surgeries.
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Affiliation(s)
- Ling Li
- School of Biomedical Engineering and Imaging, Xianning Medical College, Hubei University of Science and Technolog, Xianning, 437100, People's Republic of China
| | - Yanyan Cao
- Department of Radiology, Hubei Province Key Laboratory of Molecular Imaging, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Haining Zhang
- Key Laboratory of Molecular Biophysics of Ministry of Education, College of Life Science and Technology, National Engineering Research Center for Nanomedicine, Huazhong University of Science and Technology, Wuhan City, 430074, People's Republic of China
| | - Min Zheng
- School of Biomedical Engineering and Imaging, Xianning Medical College, Hubei University of Science and Technolog, Xianning, 437100, People's Republic of China
| | - Jun Xing
- School of Biomedical Engineering and Imaging, Xianning Medical College, Hubei University of Science and Technolog, Xianning, 437100, People's Republic of China
| | - Chuansheng Zheng
- Department of Radiology, Hubei Province Key Laboratory of Molecular Imaging, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
| | - Yanbing Zhao
- Key Laboratory of Molecular Biophysics of Ministry of Education, College of Life Science and Technology, National Engineering Research Center for Nanomedicine, Huazhong University of Science and Technology, Wuhan City, 430074, People's Republic of China.
- Hubei Key Laboratory of Bioinorganic Chemistry and Materia Medical, Hubei Engineering Research Center for Biomaterials and Medical Protective Materials, Huazhong University of Science and Technology, Wuhan City, 430074, People's Republic of China.
| | - Xiangliang Yang
- Key Laboratory of Molecular Biophysics of Ministry of Education, College of Life Science and Technology, National Engineering Research Center for Nanomedicine, Huazhong University of Science and Technology, Wuhan City, 430074, People's Republic of China.
- Hubei Key Laboratory of Bioinorganic Chemistry and Materia Medical, Hubei Engineering Research Center for Biomaterials and Medical Protective Materials, Huazhong University of Science and Technology, Wuhan City, 430074, People's Republic of China.
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Finkelstein ER, Buitrago J, Jose J, Levi AD, Xu KY, Burks SS. Lower extremity peripheral nerve pathology: Utility of preoperative ultrasound-guided needle localization before operative intervention. Skeletal Radiol 2023; 52:1997-2002. [PMID: 37060462 DOI: 10.1007/s00256-023-04347-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 03/23/2023] [Accepted: 04/10/2023] [Indexed: 04/16/2023]
Abstract
Historically, the use of ultrasound (US) in the management of peripheral nervous system (PNS) pathology has been limited to diagnostic confirmation or guidance for interventional injections. This technical case series will demonstrate the utility and versatility of preoperative US-guided needle localization for the excision of lower extremity neuromas and other pathology of the PNS. Five patients with symptomatic lower extremity PNS tumors were retrospectively reviewed. This case series corroborates the technical nuances of localizing lower extremity neuromas by US-guided needle and wire placement prior to operative excision. This was achieved by a multidisciplinary team that included plastic surgery, neurosurgery, and radiology. Five patients had US-guided needle localization of a lower extremity PNS target prior to operative intervention. Three patients had lower extremity neuromas of varying origins, including the lateral femoral cutaneous nerve (LFCN), saphenous nerve, and sural nerve. The remaining two patients had a sciatic nerve sheath Schwannoma and a femoral nerve glomus tumor. Under sonographic visualization, a needle was advanced to the target perimeter and withdrawn, leaving behind a percutaneous guidewire. This technique simplified the marking of the nerve course prior to dissection and led to efficient intraoperative identification of all five PNS tumors without any complications. Preoperative US-guided needle localization led to safe, accurate, and efficient perioperative and intraoperative identification of neuromas and other PNS tumors of the lower extremity prior to excision. By reducing the challenges of nerve identification in a scarred tissue bed, this multidisciplinary approach may decrease postoperative patient morbidity.
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Affiliation(s)
- Emily R Finkelstein
- Department of Surgery, Division of Plastic and Reconstructive Surgery, University of Miami Miller School of Medicine, Miami, Florida, 33136, USA.
| | - Joanne Buitrago
- Department of Surgery, Division of Plastic and Reconstructive Surgery, University of Miami Miller School of Medicine, Miami, Florida, 33136, USA
| | - Jean Jose
- Department of Clinical Radiology, University of Miami Miller School of Medicine, Miami, Florida, 33136, USA
| | - Allan D Levi
- Department of Neurosurgery, University of Miami Miller School of Medicine, Miami, Florida, 33136, USA
| | - Kyle Y Xu
- Department of Surgery, Division of Plastic and Reconstructive Surgery, University of Miami Miller School of Medicine, Miami, Florida, 33136, USA
| | - S Shelby Burks
- Department of Neurosurgery, University of Miami Miller School of Medicine, Miami, Florida, 33136, USA
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Li L, Wang ZY, Liu B. Ultrasound-guided carotid angioplasty and stenting in a patient with iodinated contrast allergy: A case report. World J Clin Cases 2023; 11:5926-5933. [PMID: 37727497 PMCID: PMC10506023 DOI: 10.12998/wjcc.v11.i25.5926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 08/03/2023] [Accepted: 08/09/2023] [Indexed: 09/01/2023] Open
Abstract
BACKGROUND Ischemic stroke is an entity with high incidence, morbidity, and mortality rates. Carotid artery stenosis is an important and independent risk factor for ischemic stroke. The three current approaches for treating carotid artery stenosis are drug treatment, carotid endarterectomy (CEA), carotid angioplasty and stenting (CAS). The approach is chosen based on the degree of stenosis. CEA or CAS could have been chosen for the current patient, who had severe carotid stenosis and an iodinated contrast allergy. After thoroughly communicating with the patient, the patient chose CAS for treatment. Therefore, we performed ultrasound-guided CAS to avoid the use of iodinated contrast. CASE SUMMARY The main symptoms of the patient were numbness and weakness of the left limb. Computed tomography angiography of the head and neck at another hospital indicated multiple sites of stenosis in the arteries of the head and neck. The patient requested CAS for treatment but was allergic to iodinated contrast media. Thus, routine digital subtraction angiography (DSA) with iodinated contrast could not be used for the procedure. The diagnosis of this patient was as follows: (1) Right parietal lobe cerebral infarction; (2) multiple sites of stenosis in the arteries of the head and neck (severe stenosis of the right internal carotid artery, severe stenosis of the right subclavian artery); (3) right subclavian steal syndrome; and (4) hypertension (stage 3, high risk). The interventions included routine treatment for cerebral infarction, oral administration of clopidogrel (75 mg qd) and aspirin (100 mg qd), ultrasound-guided CAS, and postoperative follow-up. Postoperative color Doppler ultrasound and cerebrovascular magnetic resonance angiography of the carotid artery showed good vascular recovery, and the postoperative follow-up indicated a good prognosis. CONCLUSION This case study suggests that ultrasound-guided endovascular treatment is a potential option for patients with contraindications to the iodinated contrast agents used in DSA-guided surgery, although excellent surgical operating skills are needed.
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Affiliation(s)
- Le Li
- Department of Neurology, Shenzhen Longhua District Central Hospital, Shenzhen 518110, Guangdong Province, China
- Department of Neurology, The Third Hospital of Mianyang (Sichuan Mental Health Center), Mianyang 621000, Sichuan Province, China
| | - Zi-Yan Wang
- Department of Neurology, The Third Hospital of Mianyang (Sichuan Mental Health Center), Mianyang 621000, Sichuan Province, China
- Department of Clinical Medicine, North Sichuan Medical College, Nanchong 637000, Sichuan Province, China
| | - Bo Liu
- Department of Neurology, Shenzhen Longhua District Central Hospital, Shenzhen 518110, Guangdong Province, China
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Hamoudi C, Martins A, Debordes PA, Goetsch T, Liverneaux P, Facca S. A Cadaveric Study Examining the Accuracy of Wireless Hand-Held Guided Ultrasound Injections Versus Blind Injections in the Flexor Tendon Sheath. J Hand Surg Glob Online 2023; 5:650-654. [PMID: 37790827 PMCID: PMC10543784 DOI: 10.1016/j.jhsg.2023.04.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 04/22/2023] [Indexed: 10/05/2023] Open
Abstract
Purpose Hand-held ultrasound (HHUS) is gaining popularity among clinicians. Although its use for procedural guidance could have several advantages in hand surgery, other surgeons may wonder about its added benefits. This cadaveric study aimed to examine the hypothesis of increased accuracy of wireless HHUS-guided injections versus that of blind injections into the flexor sheath. Methods Our series included 20 fresh cadaveric hands with 80 fingers randomly assigned to 2 groups. In group A, 10 hands were randomly assigned to receive a landmark injection and then received a blinded injection to the flexor tendon sheath (FTS). In group B, 10 hands were blinded in the same manner and received an ultrasound-guided injection with HHUS. Methylene blue was injected, and anatomic dissection was performed to evaluate the injection accuracy based on the dye's filling pattern in the FTS as stage I (no filling), stage II (<50% filling), and stage III (>50% filling). Statistical analysis was performed, and P <.05 indicated a significant difference. Results One finger was excluded because of severe Dupuytren contracture. In group A, 39 blind injections of the FTS were performed, with 82% (32/39) fingers achieving stage III filling. In group B, 40 ultrasound-guided FTS injections were performed, with 90% (36/40) of fingers achieving stage III filing. Our study did not reveal any superiority in accuracy when ultrasound guidance was used (P = .35). Conclusions Hand-held ultrasound-guided FTS injections were not more accurate than blind injections performed by an experienced hand surgeon. These findings suggest that blind injections can be used as routine practice when performed by experienced operators to treat trigger finger. However, the use of HHUS may offer other advantages in hand surgery practice. Clinical relevance Ultimately, choosing to perform HHUS-guided injection versus blind injection to treat trigger finger depends on the surgeon's experience and preference for a particular technique.
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Affiliation(s)
- Ceyran Hamoudi
- Department of Hand Surgery, SOS main, University hospital of Strasbourg, Strasbourg, France
| | - Antoine Martins
- Department of Hand Surgery, SOS main, University hospital of Strasbourg, Strasbourg, France
| | | | - Thibaut Goetsch
- Department of Public Health, Strasbourg University Hospital, Strasbourg, France
| | - Philippe Liverneaux
- Department of Hand Surgery, SOS main, University hospital of Strasbourg, Strasbourg, France
- UMR7357, ICube CNRS, Strasbourg University, Strasbourg, France
| | - Sybille Facca
- Department of Hand Surgery, SOS main, University hospital of Strasbourg, Strasbourg, France
- UMR7357, ICube CNRS, Strasbourg University, Strasbourg, France
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Hoshino Y, Yokoi H. Ultrasound-guided stenting in the common femoral vein for accurate stent distal landing. J Vasc Surg Cases Innov Tech 2023; 9:101245. [PMID: 37799836 PMCID: PMC10547735 DOI: 10.1016/j.jvscit.2023.101245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 05/26/2023] [Indexed: 10/07/2023] Open
Abstract
Objective/Background Venous stenting has been reported with excellent clinical results; however, inadequate inflow can increase the risk of stent occlusion. When extending the stent into the common femoral vein (CFV), it is essential to ensure adequate inflow from the femoral vein, deep femoral vein (DFV), and great saphenous vein. Accurate identification of the distal landing zone (DLZ) of the stent is crucial to ensure adequate inflow. The DLZ is usually determined by venography or intravascular ultrasound (IVUS) with reference to bony landmarks. However, the uncertainty can lead to misidentification of the DLZ and inadequate stent placement, resulting in stent occlusion. Methods From December 2016 to December 2022, 42 venous stent placements were performed in 40 patients with post-thrombotic iliofemoral vein obstruction and/or stenosis. Three patients had developed early stent occlusion owing to a misidentified DLZ. To improve accuracy in identifying the DLZ during venous stenting, ultrasound-guided placement was performed in the CFV of five patients (four on the left and one on the right) with post-thrombotic changes in the CFV and occlusion of the common iliac vein and external iliac vein. The distal end of the stent was adjusted just above the saphenofemoral junction in two cases and just proximal to the DFV confluence in three cases. Stent placement was verified using both long-axis ultrasound and fluoroscopy. Results Ultrasound images of the CFV region provided clear visualization of the stent deployment site and accurate landmark locations, such as the saphenofemoral junction and DFV confluence, allowing for precise adjustments during stent deployment. This technique enabled easier and more definitive identification of other branches of the CFV than previously provided by IVUS and venography. No complications were observed in any of the 42 cases, and long-term patency was achieved at the final follow-up after stenting (average, 10 months; range, 3-14 months). Conclusions Ultrasound-guided stenting in the CFV allows for real-time and accurate stent deployment with precise adjustment to the optimal DLZ. Using this technique, combined with venography and IVUS, missed distal lesions and subsequent stent occlusion can be prevented, potentially contributing to better treatment outcomes.
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Affiliation(s)
- Yuji Hoshino
- Section of Vascular Surgery, Fukuoka Sanno Hospital, Fukuoka, Japan
| | - Hiroyoshi Yokoi
- Division of Cardiovascular Medicine, Fukuoka Sanno Hospital, Fukuoka, Japan
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Dakkak M, Patel V, King D, Genin J. Ultrasound-guided tenotomy for lateral epicondylitis with TenJet improves physical functional and decreased pain outcomes at 1 year: a case series review. JSES Int 2023; 7:872-876. [PMID: 37719823 PMCID: PMC10499850 DOI: 10.1016/j.jseint.2023.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/19/2023] Open
Abstract
Background Common extensor tendinopathy is a common cause of lateral elbow pain. Ultrasound-guided minimally invasive tenotomy (MIT) has been utilized successfully as a treatment for several years, but the use of TenJet device has not been well described. Purpose To evaluate the effectiveness and safety of MIT with TenJet who failed nonsurgical management of common extensor tendinopathy in an outpatient setting. Methods A total of 100 patients with common extensor tendinopathy who failed conservative treatment underwent ultrasound-guided MIT with TenJet device in the outpatient setting at a single institution. All 100 patients prior to MIT underwent diagnostic musculoskeletal ultrasound showing common extensor tendinosis. The findings were interpreted by a fellowship-trained and board-certified musculoskeletal radiologist. Patients were evaluated with the Oxford Elbow Score prior to the procedure and at 1-year follow-up. Exclusion criteria included prior corticosteroid injection within the past 6 weeks of the MIT intervention, active local or systemic infection, complete full thickness tear of the common extensor tendon, and pregnancy. Results Oxford Elbow Score had a statistically significant difference in baseline to 1 year (P < .001). No complications were reported and zero patients went on to require open surgical intervention. Conclusion MIT with TenJet is a safe, effective, and well-tolerated treatment for common extensor tendinopathy.
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Affiliation(s)
- Michael Dakkak
- Levitetz Department of Orthopaedic Surgery, Cleveland Clinic Florida, Weston, FL, USA
| | - Vikas Patel
- Cleveland Clinic Primary Sports Medicine, Department of Orthopaedics, Cleveland, OH, USA
| | - Dominic King
- Cleveland Clinic Primary Sports Medicine, Department of Orthopaedics, Cleveland, OH, USA
| | - Jason Genin
- Cleveland Clinic Primary Sports Medicine, Department of Orthopaedics, Cleveland, OH, USA
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Park S, Beom DG, Bae EH, Kim SW, Kim DJ, Kim CS. Model-Based Needle Identification Using Image Analysis and Needle Library Matching for Ultrasound-Guided Kidney Biopsy: A Feasibility Study. Ultrasound Med Biol 2023; 49:1699-1708. [PMID: 37137741 DOI: 10.1016/j.ultrasmedbio.2023.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 03/05/2023] [Accepted: 03/07/2023] [Indexed: 05/05/2023]
Abstract
OBJECTIVE The aim of the work described here was to determine the feasibility of using a novel biopsy needle detection technique that achieves high sensitivity and specificity in a trade-off of resolution, detectability and depth of imaging. METHODS The proposed needle detection method consists of a model-based image analysis, temporal needle projection and needle library matching: (i) Image analysis was formulated under the signal decomposition framework; (ii) temporal projection converted the time-resolved needle dynamics into a single image of the desired needle; and (iii) the enhanced needle structure was spatially refined by matching a long, straight linear object in the needle library. The efficacy was examined with respect to different needle visibility. RESULTS Our method effectively eliminated confounding effects of the background tissue artifacts more robustly than conventional methods, thus improving needle visibility even with the low contrast between the needle and tissue. The improvement in needle structure further resulted in an improvement in estimation performance for the trajectory angle and tip position. CONCLUSION Our three-step needle detection method can reliably detect needle position without the need for external devices, increasing the needle conspicuity and reducing motion sensitivity.
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Affiliation(s)
- Suhyung Park
- Department of Computer Engineering, Chonnam National University, Gwangju, Republic of Korea; Department of ICT Convergence System Engineering, Chonnam National University, Gwangju, Republic of Korea
| | - Dong Gyu Beom
- Department of Computer Engineering, Chonnam National University, Gwangju, Republic of Korea
| | - Eun Hui Bae
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea; Department of Internal Medicine, Chonnam National University Hospital, Gwangju, Republic of Korea
| | - Soo Wan Kim
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea; Department of Internal Medicine, Chonnam National University Hospital, Gwangju, Republic of Korea
| | - Dong Joon Kim
- Department of Anesthesiology and Pain Medicine, Chosun University Medical School, Gwangju, Republic of Korea; Department of Anesthesiology and Pain Medicine, Chosun University Hospital, Gwangju, Republic of Korea
| | - Chang Seong Kim
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea; Department of Internal Medicine, Chonnam National University Hospital, Gwangju, Republic of Korea.
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Colla S, Seabaugh KA, Zanotto GM, Selberg K. Blind Versus Ultrasound-Guided Low-Volume Perineural Injection of Tibial and Fibular Nerves in Equine Cadaver Limbs. J Equine Vet Sci 2023; 126:104299. [PMID: 36990251 DOI: 10.1016/j.jevs.2023.104299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 03/21/2023] [Accepted: 03/23/2023] [Indexed: 03/30/2023]
Abstract
Techniques for local anesthesia of the tibial (TN) and superficial and deep fibular nerves (FNs) in horses are well established. Ultrasound-guided perineural blocks can identify the nerve location, reduce the anesthetic volume needed and avoid needle misplacement. The aim of this research was to compare the success of blind perineural injection technique (BLIND) to ultrasound-guided technique (USG). Fifteen equine cadaver hindlimbs were divided into two groups. Perineural injection of the TN and FNs was performed using a mixed solution of radiopaque contrast, saline and food dye. BLIND (n = 8) used 15 mL for the TN and 10 mL for each fibular nerve. USG (n = 7) used 3 mL for the TN and 1.5 mL for each fibular nerve. The limbs were radiographed immediately after injections and sectioned transversally to evaluate the diffusion and presence of the injectate adjacent to the TN and FNs. The presence of dye immediately adjacent to the nerves was considered a successful perineural injection. No statistically significant difference was observed between groups for success. Distal diffusion of injectate following perineural injection of the TN was significantly less for USG compared to BLIND. Proximal, distal and medial diffusion of injectate following perineural injection of FNs was significantly less for USG compared to BLIND. Low-volume USG results in less diffusion but similar success compared to BLIND leaving it up to veterinarian preference when selecting a technique.
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Affiliation(s)
- Sandro Colla
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO.
| | - Kathryn A Seabaugh
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO
| | - Gustavo Miranda Zanotto
- Large Animal Clinical Science, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX
| | - Kurt Selberg
- Department of Environmental and Radiological Health Science, Colorado State University, Fort Collins, CO
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Gallo Pellitero AJ, Formigo Couceiro J, Otero Villaverde S. [ Ultrasound-guided radiofrequency ablation of the sural nerve for chronic ankle pain: A case report]. Rehabilitacion (Madr) 2023; 57:100806. [PMID: 37352600 DOI: 10.1016/j.rh.2023.100806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 01/13/2023] [Indexed: 06/25/2023]
Abstract
Chronic lateral ankle pain related to sural neuralgia is a rare pathology. The sural nerve innervates the sensitivity of the posterolateral border of the leg, as well as the dorsolateral border of the foot. On occasions, sural neuralgia is resistant to conservative treatment and can affect the patient's psycho-emotional and social sphere. We describe the case of a 54-year-old patient with neuropathic pain in the sural territory and a history of several ankle surgeries. After unsuccessful conservative treatment, ultrasound-guided ablative radiofrequency is performed in the sural nerve with subsequent complete cessation of pain without side effects. We propose to give importance to ecopalpation in the consultation of a rehabilitation physician, as well as to describe ultrasound-guided ablative radiofrequency as a safe and effective technique for sural neuralgia that does not respond to conservative treatment. However, more quality studies are needed to corroborate these results.
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Goldrath KE, Parvataneni R, Munro MG, Mehta SK. Transcervical Ultrasound-guided Radiofrequency Ablation of Adenomyosis: A Case Report. J Minim Invasive Gynecol 2023; 30:502-507. [PMID: 36878403 DOI: 10.1016/j.jmig.2023.02.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 02/23/2023] [Accepted: 02/27/2023] [Indexed: 03/07/2023]
Abstract
Transcervical, ultrasound-guided radiofrequency ablation with the Sonata System was performed on a patient with symptomatic localized adenomyosis. Six-month postoperative follow-up demonstrated subjective improvement of heavy and painful menstrual bleeding and objective decreases in the volume of the adenomyosis lesion (66.3%) and the uterine corpus (40.8%) as determined by magnetic resonance imaging. This is the first known case of successful use of the Sonata System for treating adenomyosis.
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Affiliation(s)
- Kathryn E Goldrath
- Department of Obstetrics and Gynecology, University of California, Los Angeles, California (all authors)..
| | - Ram Parvataneni
- Department of Obstetrics and Gynecology, University of California, Los Angeles, California (all authors)
| | - Malcolm G Munro
- Department of Obstetrics and Gynecology, University of California, Los Angeles, California (all authors)
| | - Sukrant K Mehta
- Department of Obstetrics and Gynecology, University of California, Los Angeles, California (all authors)
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Quan Y, Liu Y, Li G, Liu Z. Clinical application of ultrasound-guided thoracic nerve block in the operation of benign breast tumors. Am J Transl Res 2023; 15:3468-3475. [PMID: 37303624 PMCID: PMC10251030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 03/16/2023] [Indexed: 06/13/2023]
Abstract
OBJECTIVE To analyze the application of ultrasound-guided thoracic nerve block (TNB) in the operation of benign breast tumors. METHODS A retrospective analysis was conducted on 69 patients who underwent resection of benign breast tumors (fibroma, segment) in the Maternity and Child Care Center of Qinhuangdao from January 2021 to June 2022. Among them, 33 patients who received TNB were assigned to an observation group, and 36 patients who received local infiltration anesthesia were assigned to a control group. The heart rate (HR) and systolic blood pressure (SBP) and diastolic blood pressure (DBP) of patients were recorded before anesthesia (T0), at skin incision (T1), at 0.5 h after operation (T2) and before leaving the operating room (T3). We also recorded the operation indexes, comprising operation time, total propofol dosage administered during operation, anesthesia recovery time and extubation time. The visual analogue scale (VAS) score was evaluated at 0.5, 2, 4 and 6 h after the operation. The two groups were also compared in terms of the levels of immunoglobulin (Ig) A, IgG, interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α). The postoperative adverse reactions in the two groups were statistically analyzed. RESULTS Compared with the observation group, the control group experienced a longer operation time, anesthesia recovery time and extubation time and consumed more propofol (P < 0.001). At T0 and T1, the two groups were not notably different in SBP, DBP and HR (P > 0.05), but at T2 and T3, the control group showed higher SBP, DBP and HR than the observation group (P < 0.001). The control group exhibited notably higher VAS scores than the observation group (P < 0.001). Before operation, the differences in the levels of IgA, IgG, IL-6 and TNF-α were not significantly different between the two groups (P > 0.05), while after operation and at 24 h after operation, the control group showed higher levels of IgA, IgG, IL-6 and TNF-α in comparison to the observation group (P < 0.01). The incidences of adverse reactions were not significantly different between the two groups (P > 0.05). CONCLUSION Ultrasound-guided TNB can substantially reduce both the operation time and the postoperative pain in patients with benign breast tumors, without increasing the incidence of adverse reactions.
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Affiliation(s)
- Yan Quan
- Department of Anesthesiology, Maternity and Child Care Center of Qinhuangdao Qinhuangdao 066000, Hebei, China
| | - Yinhua Liu
- Department of Anesthesiology, Maternity and Child Care Center of Qinhuangdao Qinhuangdao 066000, Hebei, China
| | - Gang Li
- Department of Anesthesiology, Maternity and Child Care Center of Qinhuangdao Qinhuangdao 066000, Hebei, China
| | - Zhongyu Liu
- Department of Anesthesiology, Maternity and Child Care Center of Qinhuangdao Qinhuangdao 066000, Hebei, China
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Cai H, Zhu C, Fang J. Ultrasound-guided perineal laser ablation versus prostatic arterial embolization for benign prostatic hyperplasia: two similar short-term efficacies. Acta Radiol 2023; 64:2033-2039. [PMID: 36437581 DOI: 10.1177/02841851221140214] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND There are many ways to treat prostatic hyperplasia; these are currently more inclined to minimally invasive treatment. We mainly compared the differences between two treatment methods, ultrasound-guided transperineal laser ablation (US-TPLA) and prostatic artery embolization (PAE). PURPOSE To evaluate the efficacy and safety of US-TPLA and PAE in the treatment of benign prostatic hyperplasia (BPH). MATERIAL AND METHODS The clinical information for 40 patients with BPH admitted to our hospital between June 2018 and January 2021 were retrospectively analyzed. The changes in International Prostate Symptom Score (IPSS), quality of life (QoL), maximum urinary flow rate (Qmax), postvoid residual (PVR), prostate volume (PV), and the incidence of complications were compared between groups. RESULTS The IPSS (P < 0.001; P < 0.001), QoL (P < 0.001; P < 0.001), Qmax (P < 0.001; P < 0.001), PVR (P < 0.001; P < 0.001), and PV (P < 0.001; P < 0.001) at three and six months after US-TPLA and PAE improved with respect to those before surgery. There was no significant difference in IPSS (P = 0.235; P = 0.151), QoL (P = 0.527; P = 0.294), Qmax (P = 0.776; P = 0.420), PVR (P = 0.745; P = 0.607), and PV (P = 0.527; P = 0.573) between the groups at three and six months after surgery. No serious complications occurred in either group. CONCLUSION US-TPLA and PAE seem to have a similar short-term efficacy. The efficacy of the two procedures is comparable, and neither is associated with serious complications. US-TPLA and PAE are both effective complementary measures for the treatment of BPH.
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Affiliation(s)
- Huaijie Cai
- Department of Ultrasound, Quanzhou First Hospital Affiliated to Fujian Medical University, Quanzhou, PR China
| | - Conghui Zhu
- Department of Interventional Radiology, Quanzhou First Hospital Affiliated to Fujian Medical University, Quanzhou, PR China
| | - Jianhua Fang
- Department of Ultrasound, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, PR China
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Wang Z, Guo H, Shi S, Xu Y, Ye M, Bai L, Tan Y, Li Y, Liu L. Long-axis in-plane combined with short-axis out-of-plane technique in ultrasound-guided arterial catheterization in infants: A randomized controlled trial. J Clin Anesth 2023; 85:111038. [PMID: 36603327 DOI: 10.1016/j.jclinane.2022.111038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 12/04/2022] [Accepted: 12/07/2022] [Indexed: 01/05/2023]
Abstract
STUDY OBJECTIVE To determine whether the long-axis in-plane (LAX-IP) combined with short-axis out-of-plane (SAX-OOP) technique is more suitable than modified dynamic needle tip positioning (MDNTP) technique for ultrasound-guided radial artery catheterization in infants. DESIGN A randomized controlled trial. SETTING Department of Anesthesiology, Children's Hospital of Chongqing Medical University. PATIENTS Overall, 72 patients, aged 1-12 months old, who were primarily undergoing thoracic or cardiac surgery in the Children's Hospital of Chongqing Medical University between July 1, 2021, and March 31, 2022, were selected. These patients were randomly divided into two groups: i) the MDNTP group and ii) the LAX-IP combined with SAX-OOP group. INTERVENTIONS Radial artery cannulation in the two groups was performed using ultrasound-guided MDNTP or LAX-IP combined with SAX-OOP technique. MEASUREMENTS The primary outcome was first-time success rate, and the secondary outcomes included total success rate, cannulation time, and incidence of complications. MAIN RESULTS In the LAX-IP combined with SAX-OOP group, the first-time success rate was 75.0% (n = 27), total success rate was 97.2% (n = 35), cannulation time was 91.39 ± 102.60 s, puncture attempts was 1.5 ± 1.3 times, and local hematoma was formed on the first day in one (2.8%) infant. In the MDNTP group, the first-time success rate was 36.1% (n = 13) (P = 0.001; RR, 2.08; 95% confidence interval, 1.29-3.34), total success rate was 91.7% (n = 33) (P = 0.303; RR, 1.06; 95% confidence interval, 0.95-1.19), cannulation time was 181.00 ± 146.72 s(P = 0.047; Median difference,-89.61; 95% confidence interval, -149.12 to -30.10), puncture attempts was 2.3 ± 1.6 times (P = 0.133; Median difference,-0.81), and local hematoma was formed on the first day in nine (25%) infants (P = 0.006; RR, 0.11; 95% confidence interval, 0.01-0.83). No thrombosis occurred in any group. CONCLUSIONS The ultrasound-guided LAX-IP combined with SAX-OOP technique for radial arterial catheterization in infants, which was performed by anesthesia residents, exhibited an increased first-time success rate, reduced cannulation time, and lower incidence of complications than the MDNTP technique.
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Affiliation(s)
- Ziyi Wang
- Department of Anesthesiology, Children's Hospital of Chongqing Medical University, PR China
| | - Hongjie Guo
- Department of Anesthesiology, Children's Hospital of Chongqing Medical University, PR China
| | - Shujun Shi
- Department of Anesthesiology, Children's Hospital of Chongqing Medical University, PR China
| | - Ying Xu
- Department of Anesthesiology, Children's Hospital of Chongqing Medical University, PR China; National Clinical Research Center for Child Health and Disorders, PR China; Ministry of Education Key Laboratory of Child Development and Disorders, PR China; Chongqing Key Laboratory of Pediatrics, PR China
| | - Mao Ye
- Department of Anesthesiology, Children's Hospital of Chongqing Medical University, PR China; National Clinical Research Center for Child Health and Disorders, PR China; Ministry of Education Key Laboratory of Child Development and Disorders, PR China; Chongqing Key Laboratory of Pediatrics, PR China
| | - Lin Bai
- Department of Anesthesiology, Children's Hospital of Chongqing Medical University, PR China; National Clinical Research Center for Child Health and Disorders, PR China; Ministry of Education Key Laboratory of Child Development and Disorders, PR China; Chongqing Key Laboratory of Pediatrics, PR China
| | - Yanzhe Tan
- Department of Anesthesiology, Children's Hospital of Chongqing Medical University, PR China; National Clinical Research Center for Child Health and Disorders, PR China; Ministry of Education Key Laboratory of Child Development and Disorders, PR China; Chongqing Key Laboratory of Pediatrics, PR China
| | - Yihui Li
- Department of Anesthesiology, Children's Hospital of Chongqing Medical University, PR China; National Clinical Research Center for Child Health and Disorders, PR China; Ministry of Education Key Laboratory of Child Development and Disorders, PR China; Chongqing Key Laboratory of Pediatrics, PR China
| | - Lifei Liu
- Department of Anesthesiology, Children's Hospital of Chongqing Medical University, PR China; National Clinical Research Center for Child Health and Disorders, PR China; Ministry of Education Key Laboratory of Child Development and Disorders, PR China; Chongqing Key Laboratory of Pediatrics, PR China.
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Cao L, Tan YT, Wei T, Li H. Comparison between the long-axis in-plane and short-axis out-of-plane approaches for ultrasound-guided arterial cannulation: a meta-analysis and systematic review. BMC Anesthesiol 2023; 23:120. [PMID: 37055775 PMCID: PMC10100252 DOI: 10.1186/s12871-023-02076-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 04/03/2023] [Indexed: 04/15/2023] Open
Abstract
BACKGROUND The two most common methods for ultrasound-guided arterial cannulation are the long-axis in-plane (LA-IP) and short-axis out-of-plane (SA-OOP) approaches. However, it is uncertain which method is more advantageous. We conducted a meta-analysis of reported randomized clinical trials (RCTs) comparing the two techniques in terms of success rate, cannulation time, and complications. METHODS We systematically searched PubMed, Embase, and the Cochrane Library database for RCTs comparing the LA-IP and SA-OOP techniques for ultrasound-guided arterial cannulation published from inception through April 31, 2022. The Cochrane Collaboration's Risk of Bias Tool was used to evaluate the methodological quality of each RCT. Review Manager 5.4 and Stata/SE 17.0 were used to analyze the two primary outcome measures (first-attempt success rate and total success rate) and two secondary outcome measures (cannulation time and complications). RESULTS A total of 13 RCTs with 1,377 patients were included. There were no significant differences in first-attempt success rate (risk ratio [RR], 0.93; 95% confidence interval [CI], 0.78-1.12; P = 0.45; I2 = 84%) and overall success rate (RR, 0.99; 95% CI, 0.95-1.02; P = 0.48; I2 = 57%). When compared with the LA-IP technique, the SA-OOP technique was associated with an increased incidence of posterior wall puncture (RR, 3.01; 95% CI, 1.27-7.14; P = 0.01; I2 = 79%) and hematoma (RR, 2.15; 95% CI, 1.05-4.37; P = 0.04; I2 = 63%). There was no significant difference in the incidence of vasospasm between techniques (RR, 1.26; 95% CI, 0.37-4.23; P = 0.07; I2 = 53%). CONCLUSIONS The present results suggest that the SA-OOP technique is associated with a higher incidence of posterior wall puncture and hematoma than the LA-IP technique, whereas success rates are similar for the two ultrasound-guided arterial cannulation techniques. These findings should be experimentally evaluated in a more rigorous manner due to high inter-RCT heterogeneity.
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Affiliation(s)
- Lei Cao
- Department of Anesthesiology, Second Affiliated Hospital of Army Medical University, Chongqing, China
| | - Yu-Ting Tan
- Department of Anesthesiology, Second Affiliated Hospital of Army Medical University, Chongqing, China
| | - Ting Wei
- Department of Anesthesiology, Second Affiliated Hospital of Army Medical University, Chongqing, China
| | - Hong Li
- Department of Anesthesiology, Second Affiliated Hospital of Army Medical University, Chongqing, China.
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Yang F, Li S, Chen H, Jiang R, Wang X, Wang W, Shi Y, Liu L, Guo H, Ye M, Tu S, Wang Q, Wang H. Scale ultrasound-guided radial artery cannulation in infant: A randomized controlled trial. J Vasc Access 2023; 24:205-212. [PMID: 34148388 DOI: 10.1177/11297298211024053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Cannulation of the radial artery can be extremely challenging in infants. Scale ultrasound can provide accurate arterial location and guidance for operators. We hypothesized that scale ultrasound helps increase the initial success rate of radial artery cannulation in this population. METHOD Seventy-six infants aged 0-3 months who needed arterial puncture after general anesthesia were randomly divided into two groups (1:1 ratio): the scale ultrasound group and the traditional ultrasound group. The primary endpoints were the success rate of the first attempt and the total success rate of arterial cannulation. The secondary endpoints were the time during arterial puncture and the incidence of vascular complications. RESULTS The success rate of the first attempt and the total success rate of arterial cannulation were 92.1% (35/38) versus 50% (19/38) and 100% (38/38) versus 86.8% (33/38) in the scale ultrasound and traditional ultrasound group (p < 0.005), respectively. The median time to ultrasound location, needle entry into the radial artery, and successful cannulation in the scale ultrasound group were significantly shorter than those in the traditional ultrasound group: 10 (8.0, 17.2) s, 15 (11.7, 20) s, and 65 (53.8, 78.5) s vs 30 (26.5, 43.5) s, 35 (23, 51) s, and 224.5 (123.5, 356) s (p < 0.001), respectively. The incidence of hematoma was higher in the traditional group (p < 0.005). CONCLUSIONS Scale ultrasound-guided radial arterial cannulation can significantly improved initial success rate and overall success rate, shorten puncture time in infant, compared with that achieved with the use of traditional ultrasound guidance.
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Affiliation(s)
- Fei Yang
- Chongqing Key Laboratory of Pediatrics, Department of Anesthesiology, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Shangyingying Li
- Chongqing Key Laboratory of Pediatrics, Department of Anesthesiology, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Hang Chen
- Chongqing Key Laboratory of Pediatrics, Department of Anesthesiology, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Rui Jiang
- Chongqing Key Laboratory of Pediatrics, Department of Anesthesiology, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Xuanqin Wang
- Chongqing Key Laboratory of Pediatrics, Department of Anesthesiology, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Weiping Wang
- Chongqing Key Laboratory of Pediatrics, Department of Anesthesiology, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Yuan Shi
- Chongqing Key Laboratory of Pediatrics, Department of Anesthesiology, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Lifei Liu
- Chongqing Key Laboratory of Pediatrics, Department of Anesthesiology, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Hongjie Guo
- Chongqing Key Laboratory of Pediatrics, Department of Anesthesiology, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Mao Ye
- Chongqing Key Laboratory of Pediatrics, Department of Anesthesiology, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Shengfen Tu
- Chongqing Key Laboratory of Pediatrics, Department of Anesthesiology, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Qiang Wang
- Chongqing Key Laboratory of Pediatrics, Department of Anesthesiology, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Hong Wang
- Chongqing Key Laboratory of Pediatrics, Department of Anesthesiology, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China
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Ma J, Jin Y, Ni Y, Hu R, Han R, Huang D, Zhou H. Ultrasound-guided percutaneous laser cervical discectomy for intractable hiccups: A rare case report. Heliyon 2023; 9:e13830. [PMID: 36873525 PMCID: PMC9976316 DOI: 10.1016/j.heliyon.2023.e13830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 02/06/2023] [Accepted: 02/13/2023] [Indexed: 02/19/2023] Open
Abstract
Background Intractable hiccups serve no physiological purpose, but significantly reduce the quality of life. There are a variety of medications suggested for the treatment of persistent or intractable hiccups. However, it remains a great challenge for the management of intractable hiccups. In this case report, we describe the technique of percutaneous laser cervical discectomy under the sonographic guidance in treatment of intractable hiccups. Case description A 41-year-old male, who suffered intractable hiccups over 11 years, came to our pain department in December 2020. Neither oral medication nor phrenic nerve block achieved satisfactory relief of hiccups. Magnetic resonance imaging and computed tomography scan revealed cervical disc herniation of C4/5 and C5/6. Following selective cervical nerve root block, complete but short-term control of symptoms lasted less than 48 hours. Percutaneous laser cervical discectomy was then performed under ultrasound guidance and achieved complete and enduring symptomatic relief up to 14-month follow-up. Conclusion Cervical degenerative changes may be considered as potential cause for intractable hiccups, and ultrasound-guided percutaneous laser cervical discectomy may be used to treat hiccups caused by cervical discogenic etiology.
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Affiliation(s)
- Jiahui Ma
- Department of Pain, The Third Xiangya Hospital and Institute of Pain Medicine, Central South University, Changsha, China
| | - Yangqing Jin
- Department of Pain, The Third Xiangya Hospital and Institute of Pain Medicine, Central South University, Changsha, China
| | - Yuncheng Ni
- Department of Pain, The Third Xiangya Hospital and Institute of Pain Medicine, Central South University, Changsha, China
| | - Rong Hu
- Department of Pain, The Third Xiangya Hospital and Institute of Pain Medicine, Central South University, Changsha, China
| | - Rui Han
- Department of Pain, The Third Xiangya Hospital and Institute of Pain Medicine, Central South University, Changsha, China
| | - Dong Huang
- Department of Pain, The Third Xiangya Hospital and Institute of Pain Medicine, Central South University, Changsha, China.,Hunan Key Laboratory of Brain Homeostasis, Central South University, Changsha, China
| | - Haocheng Zhou
- Department of Pain, The Third Xiangya Hospital and Institute of Pain Medicine, Central South University, Changsha, China.,Hunan Key Laboratory of Brain Homeostasis, Central South University, Changsha, China
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Wu M, Han Y, An X, Yuan H. Thyroid abscess treated by ultrasound-guided puncture with pus aspiration: A case report. Asian J Surg 2023; 46:1477-1478. [PMID: 36175282 DOI: 10.1016/j.asjsur.2022.09.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 09/06/2022] [Indexed: 11/02/2022] Open
Affiliation(s)
- Mengmeng Wu
- Department of Thyroid Surgery, Binzhou Medical University Hospital, Binzhou, Shandong, 256603, PR China.
| | - Yong Han
- Department of Thyroid Surgery, Binzhou Medical University Hospital, Binzhou, Shandong, 256603, PR China.
| | - Xingguo An
- Department of Thyroid Surgery, Binzhou Medical University Hospital, Binzhou, Shandong, 256603, PR China.
| | - Haibin Yuan
- Department of Health Management, Binzhou Medical University Hospital, Binzhou, Shandong, 256603, PR China.
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Kim DY, Han HJ, Sohn BS, Shim HS. Lower eyelid blepharoplasty combined with ultrasound-guided percutaneous diode laser lipolysis: evaluating effectiveness with long-term outcome. Lasers Med Sci 2023; 38:78. [PMID: 36847890 DOI: 10.1007/s10103-023-03739-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 02/18/2023] [Indexed: 03/01/2023]
Abstract
Laser lipolysis may be considered for selective removal of excess orbital fat via minimally invasive lower blepharoplasty. To control the energy delivery to a precise anatomic location while avoiding complications, ultrasound guidance can be utilized. Under local anesthesia, a diode laser probe (Belody, Minslab, Korea) was introduced percutaneously to the lower eyelid. The tip of the laser device and changes in orbital fat volume were carefully controlled with ultrasound imaging. A 1470-nm wavelength was used for orbital fat reduction (maximal energy 300 J), and a 1064-nm wavelength was used to tighten the lower eyelid skin (maximal energy 200 J). From March 2015 to December 2019, a total of 261 patients underwent ultrasound-guided diode laser lower blepharoplasty. The procedure took 17 min on average. Total energy of 49 J-510 J (average = 228.31 J) was delivered in 1470-nm wavelengths or 45-297 J (average = 127.68 J) was delivered in 1064-nm wavelengths. Most patients were very satisfied with their results. Fourteen patients experienced complications, including nine cases of transient hypesthesia (3.45%), and three skin thermal burns (1.15%). However, these complications were not observed after strict control of the energy delivery below 500 J for each lower lid. Improvement in lower eyelid bags can be achieved using a minimally invasive approach in selected patients with ultrasound-guided laser lipolysis. It is a fast and safe procedure that can be performed in the outpatient setting.
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Affiliation(s)
- Dong Yeon Kim
- Department of Plastic and Reconstructive Surgery, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, 93, Jungbu-Daero, Paldal-Gu, Suwon-Si, Gyeonggi-Do, Republic of Korea
| | - Hye Ju Han
- Department of Plastic and Reconstructive Surgery, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, 93, Jungbu-Daero, Paldal-Gu, Suwon-Si, Gyeonggi-Do, Republic of Korea
| | | | - Hyung-Sup Shim
- Department of Plastic and Reconstructive Surgery, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, 93, Jungbu-Daero, Paldal-Gu, Suwon-Si, Gyeonggi-Do, Republic of Korea.
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Rahimzadeh P, Faiz SHR, Salehi S, Imani F, Mueller AL, Sabouri AS. Unilateral Right-Sided Ultrasound-Guided Erector Spinae Plane Block for Post-Laparoscopic Cholecystectomy Analgesia: A Randomized Control Trial. Anesth Pain Med 2022; 12:e132152. [PMID: 36938107 PMCID: PMC10016115 DOI: 10.5812/aapm-132152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Revised: 11/26/2022] [Accepted: 11/28/2022] [Indexed: 12/27/2022] Open
Abstract
Background Post-laparoscopic cholecystectomy (LC) pain control is still an issue postoperatively. Objectives We investigated the effectiveness of the unilateral right-side ultrasound-guided erector spinae plane block (ESPB) on post-LC pain intensity and opioid consumption. Methods This is a parallel-arm randomized control trial on 62 adult patients with an American Society of Anesthesiologists (ASA) physical status ≤ 2 who underwent LC. The patients were randomized into 2 groups (the block group [BG] and the control group [CG]; n = 31 per group). BG received a single-shot right-sided T7 ESPB with 20 mL of 0.2% ropivacaine at arrival time in the post-anesthesia care unit (PACU). CG) received no regional anesthesia. Both groups received patient-controlled intravenous fentanyl and rescue meperidine for analgesia. The primary outcome was the pain intensity determined using a Numerical Rating Scale (NRS) in the first 24 hours after surgery. Secondary outcomes included total fentanyl and meperidine consumption within 24 hours. Results Median pain scores were significantly higher in CG at rest and with coughing up to 12 hours after surgery compared with BG. Pain scores were higher in CG with a cough at 24 hours compared with BG (median 1 [interquartile range (IQR) 1, 2] vs. 1 [1, 0]; P = 0.0005). Total fentanyl consumption and meperidine consumption within 24 hours were significantly lower in BG compared with CG (median 60 µg [IQR 60, 90] vs 250 µg [90, 300]; P < 0.0001 and median 20 µg [IQR 10, 20] vs 25 [20, 25]; P = 0.002, respectively). Conclusions A single-shot, right-sided, unilateral ESPB decreases post-LC opioid consumption and pain.
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Affiliation(s)
- Poupak Rahimzadeh
- Pain Research Center, Department of Anesthesiology and Pain Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Seyed Hamid Reza Faiz
- Minimally Invasive Surgery Research Center, Department of Anesthesiology and Pain Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Sajede Salehi
- Pain Research Center, Department of Anesthesiology and Pain Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Farnad Imani
- Pain Research Center, Department of Anesthesiology and Pain Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Ariel L. Mueller
- Department of Anesthesia, Critical Care and Pain Medicine, Massachussetts General Hospital, Harvard Medical School, Boston, Massachussetts, USA
| | - A. Sassan Sabouri
- Department of Anesthesia, Critical Care and Pain Medicine, Massachussetts General Hospital, Harvard Medical School, Boston, Massachussetts, USA
- Corresponding Author: Department of Anesthesia, Critical Care and Pain Medicine, Massachussetts General Hospital, Harvard Medical School, Boston, Massachussetts, USA.
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Katiyar V, Sadhwani N, Sharma R, Tandon V, Raheja A, Goda R, Ganeshkumar A, Mishra S, Garg K, Prada F, Kale SS. A High-Fidelity Agar-Based Phantom for Ultrasonography-Guided Brain Biopsy Simulation: A Novel Training Prototype with Visual Feedback. World Neurosurg 2022; 167:e333-43. [PMID: 35961586 DOI: 10.1016/j.wneu.2022.08.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 08/02/2022] [Accepted: 08/03/2022] [Indexed: 11/20/2022]
Abstract
OBJECTIVE A novel agar-based phantom was developed and assessed for ultrasonography (USG)-guided brain biopsy training. The phantom provides visual cues combined with sonologic cues, allowing multimodal training. Impact of multimodal training is evaluated through pretraining and posttraining trials. METHODS Twenty-five participants were divided based on experience with USG-based procedures into familiar (≥3 procedures performed in the past) (n = 14) and unfamiliar (<3 procedures performed) (n = 11). Agar phantoms with an opaque top and transparent middle layer were constructed in transparent glass bowls, each having 12 embedded targets. Participants underwent 2 supervised trials of USG-guided biopsy with aluminum foil covering the glass bowls, eliminating visual cues. Between 2 trials, participants underwent unsupervised self-training on a phantom without foil cover, providing visual cues. Performance was measured through insonation efficiency (EfI), biopsy efficiency (EfB), efficiency score (Ef), error score (Er), and performance score (PS). Scores were compared between and within the 2 groups before and after training. Impact of the self-training session on subjective comfort levels with the procedure was assessed through feedback forms. RESULTS Familiars had better pretraining EfB, Ef, Er, and PS (P < 0.001) compared with unfamiliars. After training, both performed similarly on all metrics. After training, familiars improved only in EfI (P = 0.001), with the unfamiliars showing significance in all metrics except EfI. CONCLUSIONS Simulation and phantom-based models can never supplant training through supervised skill application in vivo but our model supplements training by enabling technical skill acquisition, especially for beginners in USG-guided brain biopsy.
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Xu H, Zhang Y, Wang C. Ultrasound-guided hydrodilatation of glenohumeral joint combined with acupotomy for treatment of frozen shoulder. J Back Musculoskelet Rehabil 2022; 35:1153-1160. [PMID: 35213351 DOI: 10.3233/bmr-210272] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Frozen shoulder (FS), also known as shoulder adhesive capsulitis, is a musculoskeletal disorder associated with pain and functional disability. There is a lack of evidence on the optimal treatment strategy for FS. OBJECTIVE The present study aimed to evaluate the effectiveness and safety of ultrasound-guided hydrodilatation of glenohumeral joint combined with acupotomy for treatment of FS. METHODS In this prospective randomized, double-blind, controlled study, 63 FS patients were recruited, and equally allocated to treatment group and control group. The treatment group was treated with ultrasound-guided hydrodilatation of glenohumeral joint combined with acupotomy, while the control group was only treated with ultrasound-guided hydrodilatation of glenohumeral joint. The pain and mobility of shoulder, overall efficacy and adverse reactions were evaluated 3 months after treatment. RESULTS At baseline, no significant difference in all characteristic value was found between the treatment group (n= 33) and control group (n= 30). Three months after operation, the joint's Active Range of Motion (AROM) and Constant-Murley Scale (CMS) scores in the experimental group were higher than those in the control group, and the coracohumeral ligament (CHL) thickness and the rate of hypoechoic thickening in rotator cuff space in the experimental group were lower than those in the control group (all P< 0.05). The amount of injection volume at the third hydrodilatation was significantly higher in the experimental group than that in the control group (15.8 ± 4.7 vs 12.2 ± 5.2, P= 0.03). After 2 times of treatment, the volume increment of glenohumeral joint Δ2 in the experimental group was greater than that in the control group (3.5 ± 1.8 vs 1.2 ± 1.6, P< 0.001). There were significant differences in the effective rate between the two groups (93.94% vs. 76.67%, P= 0.04). CONCLUSION The ultrasound-guided hydrodilatation of glenohumeral joint combined with acupotomy may benefit FS patients.
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Affiliation(s)
- Huajun Xu
- Department of Ultrasound, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China.,Department of Ultrasound, Huzhou Central Hospital, Suzhou, Jiangsu, China.,Department of Ultrasound, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Yingchun Zhang
- Department of Ultrasound, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China.,Department of Ultrasound, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Caishan Wang
- Department of Ultrasound, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
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Wu XZ, Xia HM, Zhang P, Li L, Hu QH, Guo SP, Li TY. Effects of ultrasound-guided alveolar recruitment manoeuvres compared with sustained inflation or no recruitment manoeuvres on atelectasis in laparoscopic gynaecological surgery as assessed by ultrasonography: a randomized clinical trial. BMC Anesthesiol 2022; 22:261. [PMID: 35974310 PMCID: PMC9380300 DOI: 10.1186/s12871-022-01798-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 08/03/2022] [Indexed: 12/16/2022] Open
Abstract
Background The majority of patients may experience atelectasis under general anesthesia, and the Trendelenburg position and pneumoperitoneum can aggravate atelectasis during laparoscopic surgery, which promotes postoperative pulmonary complications. Lung recruitment manoeuvres have been proven to reduce perioperative atelectasis, but it remains controversial which method is optimal. Ultrasonic imaging can be conducive to confirming the effect of lung recruitment manoeuvres. The purpose of our study was to assess the effects of ultrasound-guided alveolar recruitment manoeuvres by ultrasonography on reducing perioperative atelectasis and to check whether the effects of recruitment manoeuvres under ultrasound guidance (visual and semiquantitative) on atelectasis are superior to sustained inflation recruitment manoeuvres (classical and widely used) in laparoscopic gynaecological surgery. Methods In this randomized, controlled, double-blinded study, women undergoing laparoscopic gynecological surgery were enrolled. Patients were randomly assigned to receive either lung ultrasound-guided alveolar recruitment manoeuvres (UD group), sustained inflation alveolar recruitment manoeuvres (SI group), or no RMs (C group) using a computer-generated table of random numbers. Lung ultrasonography was performed at four predefined time points. The primary outcome was the difference in lung ultrasound score (LUS) among groups at the end of surgery. Results Lung ultrasound scores in the UD group were significantly lower than those in both the SI group and the C group immediately after the end of surgery (7.67 ± 1.15 versus 9.70 ± 102, difference, -2.03 [95% confidence interval, -2.77 to -1.29], P < 0.001; 7.67 ± 1.15 versus 11.73 ± 1.96, difference, -4.07 [95% confidence interval, -4.81 to -3.33], P < 0.001;, respectively). The intergroup differences were sustained until 30 min after tracheal extubation (9.33 ± 0.96 versus 11.13 ± 0.97, difference, -1.80 [95% confidence interval, -2.42 to -1.18], P < 0.001; 9.33 ± 0.96 versus 10.77 ± 1.57, difference, -1.43 [95% confidence interval, -2.05 to -0.82], P < 0.001;, respectively). The SI group had a significantly lower LUS than the C group at the end of surgery (9.70 ± 1.02 versus 11.73 ± 1.96, difference, -2.03 [95% confidence interval, -2.77 to -1.29] P < 0.001), but the benefit did not persist 30 min after tracheal extubation. Conclusions During general anesthesia, ultrasound-guided recruitment manoeuvres can reduce perioperative aeration loss and improve oxygenation. Furthermore, these effects of ultrasound-guided recruitment manoeuvres on atelectasis are superior to sustained inflation recruitment manoeuvres. Trial registration Chictr.org.cn, ChiCTR2100042731, Registered 27 January 2021, www.chictr.org.cn.
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Affiliation(s)
- Xiong-Zhi Wu
- Department of Anesthesiology, First Affiliated Hospital of Nanchang University, NO. 17, Yongwaizheng Street, Nanchang, Jiangxi, 330006, China.,Department of Anesthesiology, Shaoxing People's Hospital (Shaoxing Hospital, Zhejiang University School of Medicine), NO.568, North Zhongxing Road, Shaoxing, Zhejiang, China
| | - Hai-Mei Xia
- Department of Anesthesiology, First Affiliated Hospital of Nanchang University, NO. 17, Yongwaizheng Street, Nanchang, Jiangxi, 330006, China
| | - Ping Zhang
- Department of Anesthesiology, Jiangxi Provincial People's Hospital, NO.152 Aiguo Road, Nanchang, Jiangxi, 330006, China
| | - Lei Li
- Department of Anesthesiology, First Affiliated Hospital of Nanchang University, NO. 17, Yongwaizheng Street, Nanchang, Jiangxi, 330006, China
| | - Qiao-Hao Hu
- Department of Anesthesiology, First Affiliated Hospital of Nanchang University, NO. 17, Yongwaizheng Street, Nanchang, Jiangxi, 330006, China
| | - Su-Ping Guo
- Department of Ultrasound Medicine, First Affiliated Hospital of Nanchang University, NO. 17, Yongwaizheng Street, Nanchang, Jiangxi, 330006, China
| | - Tian-Yuan Li
- Department of Anesthesiology, First Affiliated Hospital of Nanchang University, NO. 17, Yongwaizheng Street, Nanchang, Jiangxi, 330006, China.
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Hu J, Chen Q, Xu Q, Song Y, Wei K, Lei XF. Analgesic effect of ultrasound-guided erector spinae plane block (espb) in general anesthesia for cesarean section: a randomized controlled trial. BMC Anesthesiol 2022; 22:244. [PMID: 35918638 PMCID: PMC9344714 DOI: 10.1186/s12871-022-01781-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 07/21/2022] [Indexed: 11/24/2022] Open
Abstract
Background The analgesic effects of erector spinae plane block in general anesthesia for cesarean section and recovery from puerperae remain unclear. Methods Sixty patients with contraindications for spinal anesthesia who required general anesthesia for cesarean section were enrolled and randomly divided into the erector spinal plane block (ESPB) combined with the general anesthesia group (group E) and general anesthesia group (group G). Group E received bilateral ESPB (20 ml of 0.25% ropivacaine on each side) under ultrasound guidance 30 min before general anesthesia. The primary outcomes were the number of patient-controlled intravenous analgesia (PCIA) boluses, and Bruggemann comfort scale (BCS) scores at 2 h, 6 h, 12 h, and 24 h after operation. The second outcome was intraoperative anesthesia dosage, fetal delivery time, puerperae emergence time, visual analog scale (VAS) at 2 h, 6 h, 12 h, and 24 h after operation, and incidence of nausea and vomiting. Heart rate (HR) and mean arterial pressure (MAP) were recorded 10 min before the start of anesthesia (T0), at the induction of anesthesia (T1), at skin incision (T2), and fetal delivery (T3), and immediately after surgery (T4). Results The number of PCIA boluses was lower in group E than in group G (P < 0.001). The BCS score increased at 2 h and 6 h after the operation in group E (P < 0.05), while the VAS score significantly decreased in group E at the same time (P < 0.05). Compared with group G, the doses of propofol and remifentanil were significantly decreased in group E (P < 0.001), the emergence time of puerperae was shortened (P = 0.003), and the incidence of nausea and vomiting was significantly decreased (P = 0.014). Conclusion Ultrasound-guided ESPB applied to general anesthesia for a cesarean section can significantly reduce the required dose of general anesthetic drugs, shorten the recovery time of the puerperae, and improve postoperative analgesia. Trial registration:www.clinicaltrials.gov under the number ChiCTR2200056337 (04–02-2022).
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Affiliation(s)
- Jia Hu
- Department of Anesthesiology, Woman and Children's Hospital of Chongqing Medical University, Chongqing, China.,Department of Anesthesiology, Chongqing Health Center for Woman and Children, 120# Longshan Road, Yubei District, Chongqing, China
| | - Qi Chen
- Department of Anesthesiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.,Department of Anesthesiology, Chongqing University Cancer Hospital, Chongqing, China
| | - Qian Xu
- Department of Anesthesiology, Woman and Children's Hospital of Chongqing Medical University, Chongqing, China.,Department of Anesthesiology, Chongqing Health Center for Woman and Children, 120# Longshan Road, Yubei District, Chongqing, China
| | - Yun Song
- Department of Anesthesiology, Woman and Children's Hospital of Chongqing Medical University, Chongqing, China.,Department of Anesthesiology, Chongqing Health Center for Woman and Children, 120# Longshan Road, Yubei District, Chongqing, China
| | - Ke Wei
- Department of Anesthesiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xiao-Feng Lei
- Department of Anesthesiology, Woman and Children's Hospital of Chongqing Medical University, Chongqing, China. .,Department of Anesthesiology, Chongqing Health Center for Woman and Children, 120# Longshan Road, Yubei District, Chongqing, China.
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Ho LM, Pendse AA, Ronald J, Desai H, Dai R, Ziegler C, Nelson RC, Wildman-Tobriner B. Comparison of clinical efficacy, subjective user experience, and safety for two different core biopsy needles, the Achieve® and Marquee®. Abdom Radiol (NY) 2022; 47:2632-9. [PMID: 34181039 DOI: 10.1007/s00261-021-03187-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 06/15/2021] [Accepted: 06/16/2021] [Indexed: 01/18/2023]
Abstract
PURPOSE To compare clinical efficacy, subjective radiologist preference, and complication rates for two different core biopsy needles, the Achieve® and Marquee®. METHODS Retrospective review included consecutive patients who underwent 18 gauge non-targeted core liver biopsy, 30 with Achieve® (Merit Medical) and 30 with Marquee® (BD Bard) Pathologist (blinded to needle type) reviewed specimen total length, maximum width, and portal triad count. Sixteen radiologists subjectively rated (1 to 5(best)) each needle for cocking, firing, recoil, chamber exposure, handling, and overall. A medical records search of all (targeted and non-targeted) core liver biopsies 1/1/17-9/30/2020 compared rates of major (requiring transfusion and/or embolization) and minor (self-limited bleeding) hemorrhagic complications. Comparison between needle types was performed using t-test. RESULTS For Achieve® and Marquee® needles, the respective mean (SD) for total length(mm) was 29.7(7.0) and 31.9(4.6), p = 0.1; max width(mm) was 0.78(0.1) and 0.85(0.1), p < 0.01; and number of portal triads was 15.3(5.3) and 17.3(5.3), p = 0.2. Radiologists subjectively preferred the Marquee® for several measures including cocking, chamber exposure, and overall (p < 0.02 for each), while the needles were rated similarly for firing, recoil, and handling. Review of 800 cases showed no difference in major (1.0% Achieve®, 1.9% Marquee®, p = 0.5) or minor (1.5% Achieve®, 0.5% Marquee®, p = 0.3) rates of hemorrhagic complications. CONCLUSION Liver biopsy specimens were significantly wider with Marquee® compared to Achieve®. Radiologists preferred the Marquee® for multiple tactile measures, while the major complication rate was not significantly different. While both needles have a similar side-notch design, the Marquee® needle demonstrates better sample quality and higher user preference, without compromising safety.
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Ben Khadra S, Hacking SM, Carpentier B, Singh K, Wang L, Yakirevich E, Wang Y. Mass-forming ductal carcinoma in situ: An ultrasonographic and histopathologic correlation study. Pathol Res Pract 2022; 237:154035. [PMID: 35878531 DOI: 10.1016/j.prp.2022.154035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 07/19/2022] [Indexed: 10/17/2022]
Abstract
Ultrasound (US) guided core needle biopsy (CNB) for mass lesions resulting in a diagnosis of ductal carcinoma in situ (DCIS) is often considered radiologically discordant and generates surgical planning difficulty. One hundred cases of US-guided CNB for mass lesions diagnosed as DCIS were collected from 2013 to 2021. Histological features were reviewed and correlated with radiology and surgical excision findings. Thirty (30%) were high-grade (HG), and seventy (70%) were low- to intermediate-grade. Seventy-one (71%) cases had a histological correlate of a mass-forming lesion, including 26 (26%) were associated with benign mass-forming lesions (category 1) such as papilloma, complex sclerosing lesion/radial scar, fibroadenoma, sclerosing adenosis, and ruptured cyst; 23 (23%) were HG with solid pattern, comedo necrosis, and stromal desmoplasia (category 2); and 22 (22%) had predominantly papillary architecture (category 3). Twenty-nine (29%) were discordant with no histologic correlate of a mass lesion (category 4). Follow-up excisions were available in 79 cases. Invasive carcinoma was identified in 14 cases (18%), of which 8 were from the radiologically discordant category (35%), 3 (17%) associated with HG DCIS with desmoplasia, 2 (10%) associated with benign mass lesion and 1(5%) was predominantly papillary architecture. US-guided CNB for mass-forming lesions with a DCIS diagnosis on CNB can be grouped into four categories. Radiology-pathology correlation is essential. This categorization emphasized rad-path correlation and had a clear difference in upgrade rate on follow-up excision. Rad-path discordant biopsy cases were more likely to be associated with a missed invasive carcinoma (p < 0.05).
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Affiliation(s)
- Shaza Ben Khadra
- Department of Pathology and Laboratory Medicine, Rhode Island Hospital, Warren Alpert Medical School of Brown University, Providence, RI, USA; Department of Pathology and Laboratory Medicine, Women and Infant Hospital, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Sean M Hacking
- Department of Pathology and Laboratory Medicine, Rhode Island Hospital, Warren Alpert Medical School of Brown University, Providence, RI, USA; Department of Pathology and Laboratory Medicine, Women and Infant Hospital, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Bianca Carpentier
- Department of Diagnostic Radiology, Rhode Island Hospital and Alpert Medical School of Brown University, Providence, RI, USA; Department of Pathology and Laboratory Medicine, Women and Infant Hospital, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Kamaljeet Singh
- Department of Pathology and Laboratory Medicine, Rhode Island Hospital, Warren Alpert Medical School of Brown University, Providence, RI, USA; Department of Pathology and Laboratory Medicine, Women and Infant Hospital, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Lijuan Wang
- Department of Pathology and Laboratory Medicine, Rhode Island Hospital, Warren Alpert Medical School of Brown University, Providence, RI, USA; Department of Pathology and Laboratory Medicine, Women and Infant Hospital, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Evgeny Yakirevich
- Department of Pathology and Laboratory Medicine, Rhode Island Hospital, Warren Alpert Medical School of Brown University, Providence, RI, USA; Department of Pathology and Laboratory Medicine, Women and Infant Hospital, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Yihong Wang
- Department of Pathology and Laboratory Medicine, Rhode Island Hospital, Warren Alpert Medical School of Brown University, Providence, RI, USA; Department of Pathology and Laboratory Medicine, Women and Infant Hospital, Warren Alpert Medical School of Brown University, Providence, RI, USA.
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Zhang L, Qiu Y, Zhao W, Wang X. Ultrasound-guided lumbar sympathetic ganglion block: A visual teaching method. Asian J Surg 2022; 45:2382-2383. [PMID: 35788327 DOI: 10.1016/j.asjsur.2022.05.172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 05/13/2022] [Indexed: 11/02/2022] Open
Affiliation(s)
- Liang Zhang
- Department of Anesthesiology, The Second Affiliated Hospital of Inner Mongolia Medical University, Hohhot, Inner Mongolia 010030, China
| | - Yi Qiu
- Department of Anesthesiology, The Second Affiliated Hospital of Inner Mongolia Medical University, Hohhot, Inner Mongolia 010030, China.
| | - Wenxing Zhao
- Department of pain treatment, Xuanwu Hospital, Capital Medical University, Beijing, 100054, China
| | - Xiaodong Wang
- Department of Anesthesiology, The Second Affiliated Hospital of Inner Mongolia Medical University, Hohhot, Inner Mongolia 010030, China
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Abdelrazik AN, Ibrahim IT, Farghaly AE, Mohamed SR. Ultrasound-guided Erector Spinae Muscle Block Versus Ultrasound-guided Caudal Block in Pediatric Patients Undergoing Lower Abdominal Surgeries. Pain Physician 2022; 25:E571-E580. [PMID: 35793181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
BACKGROUND The erector spinae plane block is a new regional anesthetic technique that is gaining popularity in pediatric medicine. OBJECTIVES This study aimed to evaluate the safety and efficacy of ultrasound-guided erector spinae block and compare its analgesic effect with that of the ultrasound-guided caudal block in pediatric patients. STUDY DESIGN Prospective, randomized, double-blind, controlled study. SETTING Department of Anesthesia and Intensive Care, faculty of medicine, Minia University, Egypt. METHODS Sixty-three children scheduled for unilateral lower abdominal surgeries, under general anesthesia were randomly allocated into 3 parallel equal groups: Group I (erector spinae block [ESB] group) received ultrasound-guided an erector spinae muscle block in a dose of 0.4 mg/kg of 0.25% bupivacaine between the 10th transverse process and the erector spinae muscles. Group II (caudal block [CB] group) received an ultrasound-guided caudal block in a dose of 2.5 mg/kg of 0.25% bupivacaine. The last group, Group III (control [C] group), did not receive any regional block. Our primary outcome was to evaluate the quality of postoperative analgesia using the Face, Legs, Activity, Cry, Consolability (FLACC) Pain Scale; secondary outcomes were to assess the time to first analgesic request, total analgesic requests during the first 24 hours, and the occurrence of any side effects. RESULTS The early postoperative FLACC score was less in the ESB group than the CB group; both were lower than the control group. The erector spinae block had a longer duration of analgesia than the caudal block as the median (interquartile range [IQR]) ``of the duration of analgesia in the ESB group was 8 (8-12) hours while it was 6 (6-8) hours in group the CB group; both groups had a longer duration of analgesia compared to the C group 0.25 (0.17-4) hours. The total amount of analgesia was less in the ESB group than the CB group. The number of patients who needed rescue intravenous fentanyl analgesia was 14 patients in the C group while no patient needed intravenous fentanyl in the ESB and CB groups. LIMITATIONS Sensory evaluation of the patients was not done since the 2 blocks were done under general anesthesia but did not affect the outcome. CONCLUSIONS Ultrasound-guided erector spinae block was safe and effective in pediatric patients undergoing unilateral lower abdominal surgery as it provided a longer duration of analgesia and less analgesic requirement than caudal block and fewer side effects.
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Affiliation(s)
- Amr Nady Abdelrazik
- Lecturer in Anesthesia and Intensive Care, Faculty of Medicine, Minya University, Egypt
| | | | - Arwa Essam Farghaly
- Resident in Anesthesia and Intensive Care, Faculty of Medicine, Minya University, Egypt
| | - Shadwa Rabea Mohamed
- Lecturer in Anesthesia and Intensive Care , Faculty of Medicine, Minia University, Egypt
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Lieu D. FNA 2.0: Value of cytopathologist-performed ultrasound-guided core-needle biopsy. Semin Diagn Pathol 2022; 39:426-435. [PMID: 35752516 DOI: 10.1053/j.semdp.2022.06.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Revised: 01/29/2022] [Accepted: 06/09/2022] [Indexed: 11/11/2022]
Abstract
In the late 20th century, pathologist-performed palpation-guided fine-needle aspiration (PG-FNA) of superficial masses was popularized in the United States. It brought pathologists out of the laboratory to see patients and the hope of decreasing the need for surgical biopsy for diagnostic purposes. This first iteration of minimally invasive tissue sampling could be informally called FNA 1.0. FNA 1.0 had shortcomings, such as detection of invasion in breast cancer, precise subtyping of lymphomas, aspiration of fibrous lesions, and diagnosis of sarcomas. The early 21st century brought new hope. Ultrasound-guidance became commonly used to guide FNA of both palpable and non-palpable masses. Ultrasound-guided core-needle biopsy was available to complement FNA in select cases. Flow cytometry, immunohistochemistry, fluorescent in-situ hybridization, and genomic studies could be done on cell block and core biopsy specimens. These advances in minimally invasive tissue diagnosis could be informally called FNA 2.0. In particular, pathologist-performed ultrasound-guided core-needle biopsy can overcome many of the criticisms and shortcomings of FNA. As pathologists were once leaders in palpation-guided fine-needle aspiration, they now have the opportunity to add pathologist-performed ultrasound-guided core-needle biopsy to their skill set and emerge once again as leaders in minimally invasive tissue diagnosis. This will bring pathology to the next level.
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Affiliation(s)
- David Lieu
- University of California, Los Angeles/Fine Needle Aspiration Medical Group, 320 S. Garfield Ave. # 278, Alhambra, CA 91801 United States.
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Lynn TJ, Monaco SE. Adding the "US" in FNA: Pearls for starting a pathologist-performed ultrasound-guided fine needle aspiration service (USG FNA). Semin Diagn Pathol 2022; 39:410-420. [PMID: 35718580 DOI: 10.1053/j.semdp.2022.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 01/29/2022] [Accepted: 06/09/2022] [Indexed: 11/11/2022]
Abstract
Ultrasound-guided fine needle aspiration (USG-FNA) biopsies have traditionally been performed in the radiology department, with radiologists performing the procurement with or without on-site cytotechnologists or pathologists to provide adequacy or diagnostic evaluation of the specimen. However, more recently, these image-guided biopsies have been performed by endocrinologists and now cytopathologists. Starting an USG-FNA service is a big task that requires consideration of multiple factors, including training, certification, privileges, equipment, documentation, information technology (IT) issues, and the overall business plan or financial component. In this review, the issues confronted when bringing on an USG-FNA service are discussed in detail in an effort to highlight the issues and challenges that many cytopathology laboratories are facing when implementing this new service.
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Affiliation(s)
- Terrance J Lynn
- Geisinger Medical Center, 100N. Academy Ave, Danville, PA 17822 United States
| | - Sara E Monaco
- Geisinger Medical Center, 100N. Academy Ave, Danville, PA 17822 United States.
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Wang Y, Agyekum EA, Chen J, Du J, Ren Y, Zhang Q, Wang X, Xie L, Qian X. Fabrication of SEBS Block Copolymer-Based Ultrasound Phantom Containing Mimic Tumors for Ultrasound-Guided Needle Biopsy Training. Ultrasound Med Biol 2022; 48:1143-1150. [PMID: 35341620 DOI: 10.1016/j.ultrasmedbio.2022.02.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 02/08/2022] [Accepted: 02/20/2022] [Indexed: 06/14/2023]
Abstract
The creation of various phantoms is important in medical education, especially for intern physicians who need to practice their skills. Ultrasound phantoms are particularly useful for training in ultrasound-guided needle biopsy. SEBS, or poly(styrene-ethylene-butylene-styrene), is a thermoplastic elastomer that can be used with mineral oil to make ultrasound phantoms and a tumor-like structure. SEBS block copolymer-based phantoms are inexpensive, non-toxic and shelf-stable, and are easy to modulate. Most importantly, such ultrasound phantoms have acoustic and mechanical properties similar to those of human soft tissues. The quality of ultrasound images of phantoms and mimic tumors is excellent and can be maintained even after several biopsy needle punctures, making them excellent ultrasound phantoms for physician practice as needed.
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Affiliation(s)
- Yuguo Wang
- Department of Ultrasound, Nanjing Lishui District Hospital of Traditional Chinese Medicine, Nanjing, Jiangsu, China; Department of Ultrasound, Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Enock Adjei Agyekum
- Department of Ultrasound, Jiangsu University Affiliated People's Hospital, Zhenjiang, China; School of Medicine, Jiangsu University, Zhenjiang, Jiangsu, China
| | - Jing Chen
- QingPu Branch of Zhongshan Hospital Affiliated to Fudan University, Shanghai, China
| | - Jing Du
- Department of Ultrasound, Nanjing Lishui District Hospital of Traditional Chinese Medicine, Nanjing, Jiangsu, China
| | - Yongzhen Ren
- Department of Ultrasound, Jiangsu University Affiliated People's Hospital, Zhenjiang, China; School of Medicine, Jiangsu University, Zhenjiang, Jiangsu, China
| | - Qing Zhang
- Department of Ultrasound, Jiangsu University Affiliated People's Hospital, Zhenjiang, China
| | - Xian Wang
- Department of Ultrasound, Jiangsu University Affiliated People's Hospital, Zhenjiang, China
| | - Lijun Xie
- Department of Ultrasound, Zhenjiang First People's Hospital Branch, Zhenjiang, Jiangsu, China
| | - Xiaoqin Qian
- Department of Ultrasound, Jiangsu University Affiliated People's Hospital, Zhenjiang, China.
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Osman A, Ahmad AH, Shamsudin NS, Baherin MF, Fong CP. A novel in-plane technique ultrasound-guided pericardiocentesis via subcostal approach. Ultrasound J 2022; 14:20. [PMID: 35596893 PMCID: PMC9124248 DOI: 10.1186/s13089-022-00271-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 05/01/2022] [Indexed: 11/24/2022] Open
Abstract
Background Cardiac tamponade occurs when fluid or blood, fills the pericardial space, and causes hemodynamic compromise due to compression of the heart. It is a potentially life-threatening condition, that requires rapid recognition and immediate treatment. Formerly, blind or surgical techniques were used, and it is associated with complications. Medical technology development has enabled us to perform the procedure safely, with the assistance of ultrasound devices. This article will highlight the novel use of an in-plane subcostal technique, as a safe option for pericardiocentesis in cardiac tamponade. Case presentation A 50-year-old man presented to the emergency department (ED) with shortness of breath and shock. He was intubated for respiratory distress. His bedside echocardiography showed cardiac tamponade. Ultrasound-guided pericardiocentesis was carried out using an in-plane technique, at the subcostal region, with a high-frequency linear ultrasound transducer. This particular method provided full visualization of needle trajectory throughout the procedure. It was successfully completed with no complications and patient’s hemodynamic status improved post-procedure. He was successfully discharged on day 13. Conclusions The in-plane subcostal pericardiocentesis is a safe, and simple approach that can be performed in the ED for patients with cardiac tamponade. We recommend this new in-plane method, with high-frequency linear transducer at the subcostal area as an alternative when cardiac window for other approaches cannot be visualized. Supplementary Information The online version contains supplementary material available at 10.1186/s13089-022-00271-9.
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Affiliation(s)
- Adi Osman
- Consultant Emergency Physician & ED Critical Care, Resuscitation & Emergency Critical Care Unit (RECCU), Trauma & Emergency Department, Hospital Raja Permaisuri Bainun, Ipoh, Perak, Malaysia.
| | - Azma Haryaty Ahmad
- Consultant Emergency Physician & ED Critical Care, Resuscitation & Emergency Critical Care Unit (RECCU), Trauma & Emergency Department, Hospital Raja Permaisuri Bainun, Ipoh, Perak, Malaysia.
| | - Nurul Shaliza Shamsudin
- Emergency Physician, Trauma & Emergency Department, Hospital Raja Permaisuri Bainun, Ipoh, Perak, Malaysia
| | - Muhammad Faiz Baherin
- Emergency Physician, Trauma & Emergency Department, Hospital Raja Permaisuri Bainun, Ipoh, Perak, Malaysia
| | - Chan Pei Fong
- Consultant Emergency Physician & ED Critical Care, Resuscitation & Emergency Critical Care Unit (RECCU), Trauma & Emergency Department, Hospital Raja Permaisuri Bainun, Ipoh, Perak, Malaysia
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Zhang L, Li X, Yao J, Wulan N. Ultrasound-guided stellate ganglion block: A visual teaching method. Asian J Surg 2022; 45:1596-1597. [PMID: 35361549 DOI: 10.1016/j.asjsur.2022.03.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 03/10/2022] [Indexed: 11/02/2022] Open
Affiliation(s)
- Liang Zhang
- Department of Anesthesiology, The Second Affiliated Hospital of Inner Mongolia Medical University, Hohhot, Inner Mongolia, 010030, China
| | - Xiaoyan Li
- Department of Anesthesiology, The Second Affiliated Hospital of Inner Mongolia Medical University, Hohhot, Inner Mongolia, 010030, China.
| | - Jinhui Yao
- Department of Anesthesiology, The Second Affiliated Hospital of Inner Mongolia Medical University, Hohhot, Inner Mongolia, 010030, China
| | - Nari Wulan
- Department of Anesthesiology, The Second Affiliated Hospital of Inner Mongolia Medical University, Hohhot, Inner Mongolia, 010030, China
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Jiang YP, Zhang S, Lin RH. Uncommon complication of nasoenteral feeding tube: A case report. World J Clin Cases 2022; 10:1598-1601. [PMID: 35211598 PMCID: PMC8855256 DOI: 10.12998/wjcc.v10.i5.1598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 10/19/2021] [Accepted: 01/10/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The jejunal nutrition tube has increasingly been used in clinical practice, and the results in frequent complications.
CASE SUMMARY We present the case of a 74-year-old male patient who had been admitted to the intensive care unit for aspiration pneumonia and respiratory failure. When confirming the position of the jejunal tube by X-ray, we found that the feeding tube had been placed into the chest. The complications was a disaster, though the misplacement of jejunal feeding tube are uncommon.
CONCLUSION We introduced a way of ultrasound-guided jejunum feeding tube placement to avert the disaster, which was convenient and economical.
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Affiliation(s)
- Yong-Po Jiang
- Department of Critical care medicine, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Taizhou 317000, Zhejiang Province, China
| | - Sheng Zhang
- Department of Critical care medicine, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Taizhou 317000, Zhejiang Province, China
| | - Rong-Hai Lin
- Department of Critical care medicine, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Taizhou 317000, Zhejiang Province, China
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Zeng Z, Chen CX. Ultrasound-guided needle release plus corticosteroid injection of superficial radial nerve: A case report. World J Clin Cases 2022; 10:1320-1325. [PMID: 35211565 PMCID: PMC8855185 DOI: 10.12998/wjcc.v10.i4.1320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 11/07/2021] [Accepted: 12/23/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The radial nerve (RN) splits into two main branches at the elbow: The superficial branch of RN (SBRN) and the deep branch of RN. The SBRN can be easily damaged in acute trauma due to its superficial feature.
CASE SUMMARY A 55-year-old male patient injured his right wrist 10 mo ago. Debridement, suturing and bandaging were performed in the emergency room. Six months after the scar had healed, he felt numbness and tingling in the dorsal surface of the thumb of the right hand. So the surgery of resection and SBRN anastomosis were performed. The pathological findings showed it as traumatic neuroma. Four months after surgery, the patient felt numbness and tingling in the right dorsal surface of the thumb again. The tenderness was marked in the operated area. Ultrasound indicated that the SBRN was adhered to the surrounding tissue. The patient refused further surgical treatment and underwent ultrasound-guided needle release plus corticosteroid injection of the SBRN. Four weeks later, the tenderness in the surgical area was reduced by 70%, the numbness in the dorsal surface of the thumb of the right hand was reduced by 40% and the nerve swelling evaluated by ultrasound was reduced. Four months passed, he did not feel any numbness or tingling sensation of his right wrist. This is the first report of ultrasound-guided needle release plus corticosteroid injection of the SBRN.
CONCLUSION Ultrasound can evaluate the condition of the RN, and the relationship with surrounding tissues. Ultrasound-guided needle release plus corticosteroid injection is an effective and safe treatment for SBRN adhesion.
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Affiliation(s)
- Zeng Zeng
- Department of Ultrasound, Zhejiang Provincial People's Hospital, Hangzhou 310000, Zhejiang Province, China
| | - Cong-Xian Chen
- Department of Ultrasound, Zhejiang Provincial People's Hospital, Hangzhou 310000, Zhejiang Province, China
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Li W, Li H, Wang H, Wang S. Ultrasound-guided preoperative localization of radial nerve in the treatment of extra-articular distal humeral shaft fractures. BMC Musculoskelet Disord 2022; 23:1. [PMID: 34980067 PMCID: PMC8725401 DOI: 10.1186/s12891-021-04954-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 12/08/2021] [Indexed: 01/13/2023] Open
Abstract
Background The aim of this study was to discuss the treatment of extra-articular distal humeral shaft fractures using ultrasound-guided preoperative localization of radial nerve. Methods Between May 2010 and December 2019, 56 patients with extra-articular distal humeral shaft fractures were retrospectively reviewed. Twenty eight patients were received examination by using preoperative localization of radial nerve guided by ultrasound-guided preoperative localization (group A) and 28 control patients without ultrasound-guided (group B). All patients were treated surgically for distal humeral shaft fractures by posterior approach techniques. Operative time, radial nerve exposure time, intraoperative bleeding volume, union time and iatrogenic radial nerve palsy rate were compared between the two groups. Elbow function was also evaluated using the Mayo Elbow Performance Score (MEPS). Results A significant difference was observed between the two groups, Operative time (113.25 min vs 135.86 min) (P < 0.001), radial nerve exposure time (20.82 min vs 32.53 min) (P < 0.001), intraoperative bleeding volume (246.80 ml vs 335.52 ml) (P < 0.001). However, iatrogenic radial nerve palsy rate (3.6% vs 7.1%) (P = 0.129), the fracture union time (13.52 months vs 12.96 months) (P = 0.796) and the MEPS score (87.56 vs 86.38) (P = 0.594) were no significantly different in both groups. Conclusions The study demonstrates that ultrasound-guided preoperative localization is an effective approach in the treatment of extra-articular distal humeral shaft fracture by revealing radial nerve, which may help reduce the operative time, radial nerve exposure time and the intraoperative bleeding volume.
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Affiliation(s)
- Weifeng Li
- Department of Orthopaedic Surgery, Baoding No 1 Central Hospital, No. 320, Changcheng Street, Baoding, 071000, Hebei, People's Republic of China
| | - Hui Li
- Department of Orthopaedic Surgery, Baoding No 1 Central Hospital, No. 320, Changcheng Street, Baoding, 071000, Hebei, People's Republic of China
| | - Haiying Wang
- Department of Orthopaedic Surgery, Baoding No 1 Central Hospital, No. 320, Changcheng Street, Baoding, 071000, Hebei, People's Republic of China
| | - Shunyi Wang
- Department of Orthopaedic Surgery, Baoding No 1 Central Hospital, No. 320, Changcheng Street, Baoding, 071000, Hebei, People's Republic of China.
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Xue J, Teng D, Wang H. Efficacy and safety of ultrasound-guided radiofrequency ablation for papillary thyroid microcarcinoma: a systematic review and meta-analysis. Int J Hyperthermia 2022; 39:1300-1309. [PMID: 36195326 DOI: 10.1080/02656736.2022.2129101] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 09/12/2022] [Accepted: 09/21/2022] [Indexed: 10/10/2022] Open
Abstract
BACKGROUND We comprehensively evaluate the efficacy and safety of US-guided radiofrequency ablation (RFA) in the treatment of papillary thyroid microcarcinoma (PTMC) via a systematic review and meta-analysis. METHODS We searched the PubMed, Embase and Cochrane Library databases for studies published during the time between the establishment of the database through October 2021. We included a 10 non-randomized controlled trial (non-RCT) that reported the application of US-guided RFA in PTMC. The sample size of patients totaled 1279. We evaluated the ablation efficacy by analyzing the volume reduction rate (VRR), complete disappearance rate (CDR) and recurrence rate of PTMC treated by RFA. We analyzed all data using STATA version 15.1 (Stata Corporation, College Station, TX). RESULTS Our pooled results proved RFA treatment significantly reduces the volume of tumors (Weighted Mean Difference [WMD] = -103.20, 95% CI: -111.93 - -94.48, p = 0.000). We also found the VRR at 12 months after RFA was 93.27% (95% CI: 84.68-101.86), and the CDR at 12 months after RFA was 64% (95% CI: 39-89%). Additionally, pooled results showed the incidence of mPTC residue in ablation area, newly discovered mPTC and lymph node metastases after RFA treatment were respectively 0.3% (95% CI: -0.1-0.7%), 2.5% (95% CI: 1.1-3.9%) and 1.0% (95% CI: 0.2-1.9%), and the incidence of complications after RFA treatment was 1.8% (95% CI: 0.7-3.2%). CONCLUSIONS US-guided RFA is effective and safe for treating PTMC. It could be an excellent alternative to the existing treatment options.
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Affiliation(s)
- JiaNan Xue
- Department of Ultrasound, China-Japan Union Hospital, Jilin University, Changchun, PR China
| | - DengKe Teng
- Department of Ultrasound, China-Japan Union Hospital, Jilin University, Changchun, PR China
| | - Hui Wang
- Department of Ultrasound, China-Japan Union Hospital, Jilin University, Changchun, PR China
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Hernández-Chávez E, Alfaro-Hurtado M, Sánchez-López CE, Badallo-Rivas GA, Gómez-Navarro G, Castillo-de León YA. Ultrasound-guided percutaneous liver biopsy in children. Five-year experience at a tertiary care center. Rev Gastroenterol Mex (Engl Ed) 2021; 87:170-175. [PMID: 34794922 DOI: 10.1016/j.rgmxen.2021.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 01/14/2021] [Indexed: 11/17/2022]
Abstract
INTRODUCTION AND AIMS Percutaneous liver biopsy with histopathologic analysis is a valuable tool for the diagnosis, prognosis, and treatment evaluation of liver diseases. Its ultrasound-guided performance is useful, making the procedure safer and reducing the risk for complications and hospital stay. Our aim was to describe the indications, histopathologic study, and complications associated with the performance of ultrasound-guided percutaneous liver biopsy in pediatric patients. MATERIAL AND METHODS The study included 102 ultrasound-guided percutaneous liver biopsies performed on patients <16 years of age, within the time frame of January 2014 and December 2019. The information was obtained from electronic files and histopathologic studies and the data were analyzed through descriptive statistics. RESULTS A total of 102 procedures were carried out on 99 patients. Mean patient age was 72 months and 58.8% of the patients were female. Over 65% of the indications for liver biopsy included autoimmune hepatitis (23.5%), elevated liver enzymes (21.5%), and chronic liver disease (20.5%). Four patients presented with immediate complications (3.9%), three of which were major (2.9%), concurring with that reported in the international literature. CONCLUSIONS Our study corroborates the importance of ultrasound-guided liver biopsy in the diagnosis and follow-up of pediatric patients. The procedure also had a low complication rate of only 3.9%.
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Affiliation(s)
- E Hernández-Chávez
- Servicio de Gastroenterología y Nutrición Pediátrica, UMAE Hospital de Pediatría, Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social, Guadalajara, Jalisco, Mexico.
| | - M Alfaro-Hurtado
- Servicio de Gastroenterología y Nutrición Pediátrica, UMAE Hospital de Pediatría, Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social, Guadalajara, Jalisco, Mexico
| | - C E Sánchez-López
- Servicio de Gastroenterología y Nutrición Pediátrica, UMAE Hospital de Pediatría, Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social, Guadalajara, Jalisco, Mexico
| | - G A Badallo-Rivas
- Servicio de Imagenología, UMAE Hospital de Pediatría, Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social, Guadalajara, Jalisco, Mexico
| | - G Gómez-Navarro
- Servicio de Gastroenterología y Nutrición Pediátrica, UMAE Hospital de Pediatría, Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social, Guadalajara, Jalisco, Mexico
| | - Y A Castillo-de León
- Servicio de Gastroenterología y Nutrición Pediátrica, UMAE Hospital de Pediatría, Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social, Guadalajara, Jalisco, Mexico
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Ji X, Wei M, Wang L, Li J, Gao D, Geng C. Application of ultrasound-guided placement of markers for locating axillary lymph nodes of breast cancer. Gland Surg 2021; 10:3067-3074. [PMID: 34926222 PMCID: PMC8637064 DOI: 10.21037/gs-21-598] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 10/29/2021] [Indexed: 01/02/2023]
Abstract
BACKGROUND With the continuous improvement of pathological complete response (pCR) rate after neoadjuvant therapy (NAT), it is necessary to locate the tumor bed and axillary lymph nodes (ALNs) for subsequent surgery. Therefore, breast tissue markers emerge. This study aims to evaluate the feasibility and accuracy of ultrasound (US)-guided placement of markers for locating ALNs of breast cancer. METHODS A total of 285 patients who received US-guided placement of markers for locating ALNs in our hospital were selected. Among these patients, 87 patients were in the early breast cancer (EBC) group with negative ALNs and 198 ones were in the NAT group with positive ALNs. Data including the basic information of patients, position and size of ALN, process of US-guided marker placement, placement success rate, complications, detection rate of marker by imaging, and shift rate were recorded. RESULTS All patients were successfully undergone US-guided marker placement. And the average operation time was 2 minutes with no adverse reactions. All the patients underwent surgery successfully. US, computer tomography (CT) and magnetic resonance imaging (MRI) were used to detect the marker. The detection rate of markers by US and CT/MRI were 100% (87/87) in EBC group, and 98.5% (195/198) and 100% (198/198) by US and CT/MRI, respectively, in NAT group. The postoperative marker shift rate was 2.1% (6/285), including 3.4% (3/87) marker shift rate in EBC group and 1.5% (3/198) in NAT group, with no statistically significant difference between them. CONCLUSIONS US-guided marker placement in ALNs of breast cancer is simple and safe, with firm positioning and low shift rate, which is convenient for clinical promotion.
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Affiliation(s)
- Xiaohui Ji
- Department of Ultrasound, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Mengying Wei
- Department of Ultrasound, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Liuyuan Wang
- Department of Breast Surgery, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Juanjuan Li
- Department of Ultrasound, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Dongxia Gao
- Department of Ultrasound, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Cuizhi Geng
- Department of Breast Surgery, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
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Chung JPW, Law TSM, Mak JSM, Liu RCY, Sahota DS, Li TC. Hyoscine butylbromide in pain reduction associated with ultrasound-guided manual vacuum aspiration: a randomized placebo-controlled trial. Reprod Biomed Online 2021; 44:295-303. [PMID: 34949538 DOI: 10.1016/j.rbmo.2021.10.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 09/20/2021] [Accepted: 10/15/2021] [Indexed: 11/16/2022]
Abstract
RESEARCH QUESTION What is the effect of adding an anti-spasmodic drug to an existing ultrasound-guided manual vacuum aspiration (USG-MVA) protocol to alleviate immediate post-procedure abdominal cramping pain in women treated for early pregnancy loss? DESIGN Double-blind, placebo-controlled, randomized controlled trial conducted between February 2018 and January 2020. Participants were assigned to receive a 1-ml intravenous injection containing 20-mg hyoscine butylbromide (HBB) (n=55) or saline (n =56) as a control immediately before USG-MVA. Primary outcome was reduced abdominal pain after adding a 20-mg dose of HBB to the current pain control regimen. Secondary outcomes were vaginal pain, complications and side-effects, women's pre- and post-procedure psychological state, physiological stress (saliva alpha-amylase) and procedure pain control satisfaction. Two-way mixed ANOVA was used to evaluate the main effects and interactions. RESULTS VAS abdominal pain scores in the HBB group were 16% lower immediately after and 21% lower 2 h after surgery (not statistically significant). Two-way ANOVA indicated that time (F[1108] = 83.41, P < 0.001) was the only significant main effect for reduced abdominal pain after the procedure and vaginal pain score (F[1108] = 180.1, P < 0.0001) but not drug received. No adverse events were reported. No significant difference was found for psychological state, physiological stress and procedure pain control satisfaction between the two groups. CONCLUSIONS Anti-spasmodic drugs can help to reduce abdominal cramping pain associated with USG-MVA; HBB produced an insignificant decrease in abdominal pain score. Further studies with longer acting or larger doses of anti-spasmodic drugs are warranted.
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Affiliation(s)
- Jacqueline Pui Wah Chung
- Department of Obstetrics and Gynecology, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories Hong Kong SAR, China.
| | - Tracy Sze Man Law
- Department of Obstetrics and Gynecology, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories Hong Kong SAR, China
| | - Jennifer Sze Man Mak
- Department of Obstetrics and Gynecology, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories Hong Kong SAR, China
| | - Rebecca Chui Yiu Liu
- Department of Obstetrics and Gynecology, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories Hong Kong SAR, China
| | - Daljit Singh Sahota
- Department of Obstetrics and Gynecology, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories Hong Kong SAR, China
| | - Tin Chiu Li
- Department of Obstetrics and Gynecology, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories Hong Kong SAR, China
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Wang Y, Wang S, Luan S, Yu S, Zheng Y, Ma C, Wu S. Accuracy and Feasibility of Ultrasound-Guided Intra-articular Injection of the Rat Hip Joint. Ultrasound Med Biol 2021; 47:2936-2940. [PMID: 34266679 DOI: 10.1016/j.ultrasmedbio.2021.06.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 05/18/2021] [Accepted: 06/07/2021] [Indexed: 06/13/2023]
Abstract
Intra-articular injection is frequently used as an effective diagnostic and treatment tool for hip joint diseases. However, the underlying treatment mechanism remains unclear because of a lack of experimental animal models. A challenge facing researchers is how to accurately and consistently perform injections involving animal hip joints. The purpose of this study, then, was to establish an ultrasound (US)-guided intra-articular (IA) injection technique using rat hip joints and to evaluate its accuracy and feasibility versus a fluoroscopy (FL)-guided technique. For this study, 20 US-guided and 20 FL-guided IA injections were administered to separate groups of Sprague-Dawley rats. For each procedure, 50 μL of iohexol was injected into the hip joint using a 25G needle. The US-guided injections were performed using a linear probe, and the FL-guided IA injections were performed using C-arm X-ray fluoroscopy. All injections were verified by computed tomography imaging. The number of successful injections and needle repositions per injection, as well as operating times, were recorded, and the rats were observed for complications for 10 d after the injections. Statistical analysis was used to compare US-guided and FL-guided techniques with significance set at p < 0.05. The success rate was markedly higher for the US-guided interventions (90%) than for the FL-guided interventions (75%) (p<0.05). The intervention time was shorter in the US-guided group (95.95 ± 8.376 s) than in the FL-guided group (110.70 ± 20.236 s) (p < 0.05), and the median number of needles repositioned per injection in the US-guided group (1.20 ± 0.41) was notably less than that in the FL-guided group (1.60 ± 0.68) (p < 0.05). A puncture site hematoma was noted in two rat hips (10%) the day after injection in the FL-guided group. Overall, the study indicated that ultrasound-guided intra-articular injection of the hip is a feasible, accurate and safe method for use in rats. This makes it a promising tool for diagnosing coxofemoral pain, producing hip osteoarthritis animal models and administering intra-articular medication.
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Affiliation(s)
- Yanxue Wang
- Department of Rehabilitation, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Shaoling Wang
- Department of Rehabilitation, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Shuo Luan
- Department of Rehabilitation, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Shaojun Yu
- Department of Rehabilitation, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Yaochao Zheng
- Department of Rehabilitation, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Chao Ma
- Department of Rehabilitation, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Shaoling Wu
- Department of Rehabilitation, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China.
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50
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Zhan L, Zhang YJ, Wang JX. Combined fascia iliaca compartment block and monitored anesthesia care for geriatric patients with hip fracture: Two case reports. World J Clin Cases 2021; 9:8268-8273. [PMID: 34621890 PMCID: PMC8462197 DOI: 10.12998/wjcc.v9.i27.8268] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Revised: 07/06/2021] [Accepted: 07/27/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Major hip surgery usually requires neuraxial or general anesthesia with tracheal intubation and may be supplemented with a nerve block to provide intraoperative and postoperative pain relief.
CASE SUMMARY This report established that hip surgical procedures can be performed with a fascia iliaca compartment block (FICB) and monitored anesthesia care (MAC) while avoiding neuraxial or general anesthesia. This was a preliminary experience with two geriatric patients with hip fracture, American Society of Anesthesiologists status III, and with many comorbidities. Neither patient could be operated on within 48 h after admission. Both general anesthesia and neuraxial anesthesia were high-risk procedures and had contraindications. Hence, we chose nerve block combined with a small amount of sedation. Intraoperative analgesia was provided by single-injection ultrasound-guided FICB. Light intravenous sedation was added. Surgical exposure was satisfactory, and neither patient complained of any symptoms during the procedure.
CONCLUSION This report showed that hip surgery for geriatric patients can be performed with FICB and MAC, although complications and contraindications are common. The anesthetic program was accompanied by stable respiratory and circulatory system responses and satisfactory analgesia while avoiding the adverse effects and problems associated with either neuraxial or general anesthesia.
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Affiliation(s)
- Li Zhan
- Department of Anesthesiology, Lu’an Affiliated Hospital of Anhui Medical University, Anhui Medical University, Lu’an 237005, Anhui Province, China
| | - Yu-Jie Zhang
- Department of Anesthesiology, Lu’an Affiliated Hospital of Anhui Medical University, Anhui Medical University, Lu’an 237005, Anhui Province, China
| | - Jing-Xian Wang
- Department of Anesthesiology, Lu’an Affiliated Hospital of Anhui Medical University, Anhui Medical University, Lu’an 237005, Anhui Province, China
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