Objective: To determine the relationship between various parameters of high-frequency biphasic stimulation (HFBS) and the recovery period of post-HFBS block of the pudendal nerve in cats.
Materials And Methods: A tripolar cuff electrode was implanted on the pudendal nerve to deliver HFBS in ten cats. Two hook electrodes were placed central or distal to the cuff electrode to stimulate the pudendal nerve and induce contractions of external urethral sphincter (EUS). A catheter was inserted toward the distal urethra to slowly perfuse the urethra and record the back-up pressure generated by EUS contractions. After determining the block threshold (T), HFBS (6 or 10 kHz) of different durations (1, 5, 10, 20, 30 min) and intensities (1T or 2T) was used to produce the post-HFBS block.
Results: HFBS at 10 kHz and 1T intensity must be applied for at least 30 min to induce post-HFBS block. However, 10 kHz HFBS at a higher intensity (2T) elicited post-HFBS block after stimulation of only 10 min; and 10 kHz HFBS at 2T for 30 min induced a longer-lasting (1-3 h) post-HFBS block that fully recovered with time. HFBS of 5-min duration at 6 kHz produced a longer period (20.4 ± 2.1 min, p < 0.05, N = 5 cats) of post-HFBS block than HFBS at 10 kHz (9.5 ± 2.1 min).
Conclusion: HFBS of longer duration, higher intensity, and lower frequency can produce longer-lasting reversible post-HFBS block. This study is important for developing new methods to block nerve conduction by HFBS.
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http://dx.doi.org/10.1111/ner.13060 | DOI Listing |
Urogynecology (Phila)
October 2024
From the Urology Institute, University Hospitals/ Cleveland Medical Center, Cleveland, OH.
Importance: Evidence regarding the effect of pudendal nerve blockade during vaginal surgery is conflicting. Previous studies compared pudendal nerve blockade to either normal saline placebo injection or no injection, demonstrating small or no difference in pain outcomes. Studies investigating nerve blocks at the time of vaginal surgery have not evaluated the effect of infiltration of the space around the pudendal nerve.
View Article and Find Full Text PDFArthroscopy
December 2024
Texas Tech University Health Sciences Center, Department of Orthopaedic Surgery & Rehabilitation, Lubbock TX 79430. Electronic address:
Traditionally, distraction of the hip joint during hip arthroscopy has been achieved with the use of a perineal post which acts as a counterforce. However, our knowledge of the potential complications related to the use of a perineal post continues to grow. While pudendal neurapraxia is the most common of these potential complications, the perineal post may also cause skin tears of the perineum, erectile dysfunction and, in rare cases, permanent pudendal nerve injury.
View Article and Find Full Text PDFInt Urogynecol J
November 2024
Department of Obstetrics and Gynecology and Urology, New York Medical College, Valhalla, NY, USA.
Introduction And Hypothesis: Pudendal neuralgia is chronic pelvic pain associated with the pudendal nerve. Unfortunately, the best treatment approach is unknown. Our objective was to systematically assess interventions for pudendal neuralgia for improvement in pain.
View Article and Find Full Text PDFCureus
November 2024
Department of Pediatrics and Neonatology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, IND.
Introduction: Caudal block is an effective regional anesthesia technique for perineal surgeries but is associated with various adverse effects. Recently, pudendal nerve block has emerged as a promising alternative for these procedures. This study assessed the effectiveness of a novel transperineal technique for ultrasound-guided pudendal nerve block and compares it with ultrasound-guided caudal block for perineal surgeries in pediatric patients.
View Article and Find Full Text PDFArthrosc Sports Med Rehabil
October 2024
Section of Young Adult Hip Surgery, Division of Sports Medicine, Department of Orthopedic Surgery, Rush Medical College of Rush University, Rush University Medical Center, Chicago, Illinois, U.S.A.
Purpose: To identify structures at risk during proximal adductor longus repair and to report observed distances between these structures and the adductor longus (AL) footprint.
Methods: Eight hemipelves from fresh cadaver whole-body specimens were dissected using a previously established surgical approach. The tendinous attachment of the AL was scored into the underlying bone and the footprint size was measured in millimeters.
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