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More than 50% of diabetic patients suffer from neuropathy, potentially making them more susceptible to further nerve injury following regional anesthesia. Key to regional anesthesia is localizing the block needle close enough to the nerve to achieve successful blockade but not so close as to injure the nerve. Nerve stimulation is the gold standard technique for nerve localization. However, this technique can fail in diabetic patients. Another endpoint for nerve localization is elicitation of paresthesia with needle-nerve contact (MEP) but more than half of the diabetic patients with neuropathy suffer from paresthesia, making it unreliable. With the use of ultrasound as a more definitive endpoint of nerve localization, the traditional techniques can be evaluated in diabetic patients with neuropathy. This study will compare, in patients undergoing surgery involving ankle blockade, nerve localization techniques and nerve characteristics in diabetic patients to those in healthy patients.
Observational Model: Case Control, Time Perspective: Prospective
Nerve Localization in Diabetics Having Foot Surgery under Ultrasound-Guided Ankle Blockade, Nerve Localization in Non-Diabetic Patients Having Foot Surgery Under Ultrasound-Guided Nerve Blockade
Toronto Western Hospital, University Health Network
Not yet recruiting
University Health Network, Toronto
Published on BioPortfolio: 2014-08-27T03:18:26-0400
Hypothesis: When performed under ultrasound guidance, there is improvement in the sensory and motor blockade obtained with stimulating popliteal catheters versus those placed without nerve...
Sciatic nerve blocks are frequently used for anesthesia or analgesia for surgery of the lower legs. Currently, if ultrasound is used to find the sciatic nerve, the leg must be raised to l...
Sciatic nerve block is used routinely in ankle and foot surgery. It is applied often by a posterior approach at the popliteal fossa, near where the nerve divides into the common peroneal ...
Ropivacaine 0.5% and 0.5% in levobupivacaïne are used in regional anesthesia for major surgery of the foot. The literature does not highlight a significant difference in terms of onset of...
The purpose of this study was to investigate the preemptive effect of ultrasound guided popliteal scistic nerve block on postoperative acute pain in patients with bilateral hallux valgus. ...
The risk of lower extremity amputations (LEAs) in diabetics is 20 times higher than in non-diabetics. Clinical practice guidelines recommend that all diabetics should receive an annual foot examinatio...
We propose a novel framework for enhancement and localization of steeply inserted hand-held needles under in-plane 2D ultrasound guidance.
Epidural steroid injection for low back and leg pain has been shown to result in a positive clinical outcome. Lumbosacral selective nerve root block (SNRB) via a transforaminal approach is commonly pe...
Sensory feedback from the foot dorsum during walking has only been studied globally by whole nerve stimulation. Stimulating the main nerve innervating the dorsal surface produces a functional stumble ...
Limited regeneration after nerve injury often leads to delayed or incomplete reinnervation and consequently insufficient muscle function. Following nerve surgery, application of low-intensity ultrasou...
Entrapment of the distal branches of the posterior TIBIAL NERVE (which divides into the medial plantar, lateral plantar, and calcanial nerves) in the tarsal tunnel, which lies posterior to the internal malleolus and beneath the retinaculum of the flexor muscles of the foot. Symptoms include ankle pain radiating into the foot which tends to be aggravated by walking. Examination may reveal Tinel's sign (radiating pain following nerve percussion) over the tibial nerve at the ankle, weakness and atrophy of the small foot muscles, or loss of sensation in the foot. (From Foot Ankle 1990;11(1):47-52)
The lateral of the two terminal branches of the sciatic nerve. The peroneal (or fibular) nerve provides motor and sensory innervation to parts of the leg and foot.
The medial terminal branch of the sciatic nerve. The tibial nerve fibers originate in lumbar and sacral spinal segments (L4 to S2). They supply motor and sensory innervation to parts of the calf and foot.
A branch of the tibial nerve which supplies sensory innervation to parts of the lower leg and foot.
A nerve inflammation in the foot caused by chronic compression of the plantar nerve between the METATARSAL BONES.
Diabetes is a lifelong condition that causes a person's blood sugar level to become too high. The two main types of diabetes are: type 1 diabetes type 2 diabetes In the UK, diabetes affects approximately 2.9 million people. There are a...
Anesthesia is the loss of feeling or sensation in all or part of the body. It may result from damage to nerves or can be induced by an anesthetist (a medical professional) using anesthetics such as thiopental or propofol or sevoflurane during a surgical ...
An anesthesiologist (US English) or anaesthetist (British English) is a physician trained in anesthesia and perioperative medicine. Anesthesiologists are physicians who provide medical care to patients in a wide variety of (usually acute) situations. ...