Plastic and reconstructive surgery
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Plast. Reconstr. Surg. · Dec 2010
Review Comparative StudyDo not use epinephrine in digital blocks: myth or truth? Part II. A retrospective review of 1111 cases.
Epinephrine in digital blocks has been condemned by traditional medical theory. The authors provide a retrospective review of 1111 cases involving digital block anesthesia with epinephrine in conjunction with an extensive literature review. ⋯ After reviewing 1111 cases, there were no complications associated with the use of epinephrine in digital blocks. The authors suggest that correct application of epinephrine in digital blocks is appropriate, and defend its use.
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Plast. Reconstr. Surg. · Dec 2010
Neurovascular compression of the greater occipital nerve: implications for migraine headaches.
Surgical release of the greater occipital nerve has been demonstrated to be clinically effective in eliminating or reducing chronic migraine symptoms. However, migraine symptoms in some patients continue after this procedure. It was theorized that a different relationship between the greater occipital nerve and occipital artery may exist in these patients that may be contributing to these outcomes. A cadaveric investigation was performed in an effort to further delineate the occipital artery-greater occipital nerve relationship. ⋯ The greater occipital nerve and occipital artery have an anatomical intersection 54 percent of the time. There are two morphologic types of relationships between the structures: a single intersection point and a helical intertwining. Vascular pulsation may cause irritation of the nerve and is a possible explanation for migraine headaches that have the occipital region as a trigger point. Future imaging studies and clinical investigation is necessary to further examine the link between anatomy and clinical presentation.
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Plast. Reconstr. Surg. · Dec 2010
In vivo electrical conductivity across critical nerve gaps using poly(3,4-ethylenedioxythiophene)-coated neural interfaces.
Bionic limbs require sensitive, durable, and physiologically relevant bidirectional control interfaces. Modern central nervous system interfacing is high risk, low fidelity, and failure prone. Peripheral nervous system interfaces will mitigate this risk and increase fidelity by greatly simplifying signal interpretation and delivery. This study evaluates in vivo relevance of a hybrid peripheral nervous system interface consisting of biological acellular muscle scaffolds made electrically conductive using poly(3,4-ethylenedioxythiophene). ⋯ Nonmetallic, biosynthetic acellular muscle-poly(3,4-ethylenedioxythiophene) peripheral nervous system interfaces both sense and stimulate physiologically relevant efferent and afferent action potentials in vivo. This demonstrates their relevance not only as a nerve-electronic coupling device capable of reaching the long-sought goal of closed-loop neural control of a prosthetic limb, but also in a multitude of other bioelectrical applications.