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Nerve Localisation in Diabetic Neuropathy

2014-08-27 03:18:26 | BioPortfolio

Summary

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.

Study Design

Observational Model: Case Control, Time Perspective: Prospective

Conditions

Diabetic Neuropathy

Intervention

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

Location

Toronto Western Hospital, University Health Network
Toronto
Ontario
Canada
M5T 2S8

Status

Not yet recruiting

Source

University Health Network, Toronto

Results (where available)

View Results

Links

Published on BioPortfolio: 2014-08-27T03:18:26-0400

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Medical and Biotech [MESH] Definitions

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.

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