Ultrasound-guided lumbar plexus block (LPB) performed with the Shamrock approach has received much interest since the technique was first described in 2013. The technique is believed to be faster and easier to perform and possibly safer in regards to potential complications compared with other LPBs. In order to outline some favorable characteristics of the Shamrock LPB, we performed an exhaustive search of the current literature; even though it is rather limited. We have related the evidence to our own clinical experience about the block execution. We present a narrative review of the alleged superiority of the ultrasound-guided Shamrock LPB. Our aim was to assess some of the characteristics that we believe differentiate the Shamrock technique from other ultrasound-guided LPB techniques. We present graphical directions about how to carry out the Shamrock block, and we present novel magnetic resonance images illustrating the injectate spread around the lumbar plexus within the intrapsoas compartment after Shamrock guided injection of contrast enhanced local anesthetic. The Shamrock approach is easier, faster and better to visualise the LPB compared to other LPB techniques. The needle trajectory and needle tip location just lateral to the lumbar plexus probably reduces the risk of adverse effects and complications. Ultrasound guided lumbar plexus blockade is an expert technique. The Shamrock technique improves but does not eliminate all the challenges of ultrasound-guided LPB technique.
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http://dx.doi.org/10.23736/S0375-9393.17.11783-9 | DOI Listing |
Bioelectromagnetics
January 2025
Department of Electrical Engineering and ITEMS, University of Southern California, Los Angeles, California, USA.
As the clinical applicability of peripheral nerve stimulation (PNS) expands, the need for PNS-specific safety criteria becomes pressing. This study addresses this need, utilizing a novel machine learning and computational bio-electromagnetics modeling platform to establish a safety criterion that captures the effects of fields and currents induced on axons. Our approach is comprised of three steps: experimentation, model creation, and predictive simulation.
View Article and Find Full Text PDFJ Orthop Surg Res
January 2025
Operation Room, Hunan University of Medicine General Hospital, No. 144, Jinxi South Road, Huaihua City, Hunan Province, 418000, China.
Objective: The surgical team in this study examined the efficacy of a modified reverse sural neurocutaneous flap repair in treating soft tissue defects of the ankle and foot caused by accidents.
Methods: This study enrolled 89 patients treated for soft tissue defects of the ankle or foot between January 2007 and December 2023. The patients were divided into two groups: 44 patients underwent a modified reverse sural neurocutaneous flap repair, while 45 received traditional treatment.
Iowa Orthop J
January 2025
Department of Orthopedics, Lifeline Multispecialty Hospital, Adoor, India.
Tarsal tunnel syndrome (TTS) refers to compression of the posterior tibial nerve as it traverses the tarsal tunnel in the ankle. First described by Keck and Lam in 1962, TTS is an underdiagnosed cause of heel pain and foot dysfunction. The tarsal tunnel contains the tibial nerve, posterior tibial artery, and tendons of the tibialis posterior, flexor digitorum longus, and flexor hallucis longus muscles.
View Article and Find Full Text PDFMedicine (Baltimore)
November 2024
Department of Anesthesiology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China.
Background: Postoperative delirium (POD) is an acute brain dysfunction that mainly occurs in elderly patients after surgery. Postoperative pain is an important factor in the occurrence of POD, and effective pain management can reduce the risk of POD. Our study aims is to investigate the effect of ultrasound-guided femoral nerve block (FNB) on postoperative pain and the occurrence of POD after knee arthroplasty, and whether its mechanism is related to oxidative stress, inflammatory factors.
View Article and Find Full Text PDFJ Am Acad Orthop Surg Glob Res Rev
January 2025
From the Department of Anatomy, School of Medicine, Marmara University, Basibuyuk Yolu, Maltepe, Istanbul, Turkey (Dr. Ismailoglu, Dr. Sehirli, and Dr. Ayingen); the Department of Anatomy, School of Medicine, Acibadem Mehmet Ali Aydinlar University, Atasehir, Istanbul, Turkey (Dr. Bayramoglu and Dr. Savasan); and the Department of Orthopedic Surgery, Faculty of Medicine, Acibadem Mehmet Ali Aydinlar University, Atasehir, Istanbul, Turkey (Dr. Kocaoglu).
Purpose: The surgical approach for midfoot injuries classically requires dual dorsal incision and identification of the neurovascular structures that are susceptible to injury during the surgery. The aim of this study was to map the topographic anatomy of the dorsum of the foot along with tarsal joints for the dorsal approach of midfoot surgery that would facilitate the surgery and minimize the risk of neurovascular injuries for surgeons who specially focus on foot and ankle injuries.
Methods: The dorsum of the foot was evaluated in 12 feet injected with latex containing a red colorant to visualize the arterial vessels.
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