The Experts below are selected from a list of 360 Experts worldwide ranked by ideXlab platform
Hongling Zhou - One of the best experts on this subject based on the ideXlab platform.
-
a randomized controlled trial evaluating the hemodynamic impact of ultrasound guided Great Auricular Nerve block in middle ear microsurgery
BMC Anesthesiology, 2020Co-Authors: Jinsheng Liu, Hongling Zhou, Kezhi Yuan, Guyan WangAbstract:The peri-operative effectiveness of ultrasound-guided Great Auricular Nerve block (GANB) in patients, especially in adult patients undergoing middle ear microsurgery remains unclear. We hypothesized that ultrasound-guided GANB would decrease the hemodynamic responsiveness to incision and opioid consumption in middle ear microsurgery as well as the post-operative analgesia requirement. Sixty patients undergoing middle ear microsurgery were randomized into two equal groups to receive either a GANB with 2 ml of 0.25% ropivacaine under ultrasound guidance (GANB group) or to receive a blank control intervention (without any performed injection) before general anesthesia inductions. The primary outcomes were hemodynamic changes of MAP (mean artery pressure) and HR (heart rate) to skin incision. The secondary endpoints were to determine the consumptions of propofol and remifentanil during the operation and the incidence of remedial analgesia 48 h post-operation to maintain VAS ≤ 3. The MAP post incision in GANB group was significantly lower than that in control group (GANB group 93.83 ± 11.72 mmHg vs. control group 100.87 ± 12.65 mmHg, P = 0.029). The increases for MAP and HR post incision were also lower in GANB group (∆MAP GANB group 11.90 ± 8.32 mmHg vs. control group 19.83 ± 10.37 mmHg, P = 0.002; ∆HR GANB group 3.67 ± 5.30 beat min− 1 vs. control group 8.23 ± 8.56 beat min− 1, P = 0.016). Remifentanil consumption was significantly decreased in GANB group (GANB group 401.55 ± 100.51 μg h− 1 vs. control group 697.34 ± 215.45 μg h− 1, P = 0.000). The incidence of remedial analgesia post-operation in GANB group (5/30) was significantly lower than that in control group (20/30, P = 0.000). Ultrasound-guided GANB decreases the hemodynamic responsiveness to incision and remifentanil consumption in middle ear microsurgery as well as the post-operative analgesia requirement. This trial was retrospectively registered at http://www.chictr.org.cn with the registration number of ChiCTR1800014333 on 6 January, 2018.
-
efficacy of ultrasound guided Great Auricular Nerve block combined with general anesthesia for middle ear microsurgery in adult patients
Chinese Journal of Anesthesiology, 2018Co-Authors: Jinsheng Liu, Hongling Zhou, Chuxiong Pan, Xuegong Niu, Kezhi YuanAbstract:Objective To evaluate the efficacy of ultrasound-guided Great Auricular Nerve (GAN) block combined with general anesthesia for middle ear microsurgery in adult patients. Methods Sixty-four adult patients of both sexes, aged 18-60 yr, of American Society of Anesthesiologists physical statusⅠ or Ⅱ, scheduled for elective middle ear microsurgery, were assigned into 2 groups (n=32 each) using a random number table: GAN block combined with general anesthesia group (group GANB+ G) and general anesthesia group (group G). Patients received GAN block with 0.25% ropivacaine 2 ml using ultrasound-guided in-plane technique before anesthesia induction in group GANB+ G.Anesthesia induction and maintenance protocols (IV infusion of propofol and target-controlled infusion of remifentanil) were similar in two groups.Analgesia was performed with sufentanil, flurbiprofen axetil or parecoxib sodium after operation to maintain visual analog scale score <4 within 48 h after operation.The infusion duration and consumption of propofol and remifentanil, requirement for postoperative analgesia and occurrence of postoperative nausea and vomiting were recorded. Results Compared with group G, the consumption of remifentanil was significantly reduced, and the requirement for postoperative analgesia and incidence of postoperative nausea and vomiting were decreased in group GANB+ G (P<0.05 or 0.01). Conclusion Ultrasound-guided GAN block combined with general anesthesia provides better analgesic efficacy in the the perioperative period in adult patients undergoing middle ear microsurgery. Key words: Ear, middle; Ultrasonography; Nerve block
-
efficacy of ultrasound guided Great Auricular Nerve block with different concentrations of ropivacaine for postoperative analgesia in patients undergoing tympanic and mastoid surgery
Chinese Journal of Anesthesiology, 2017Co-Authors: Hongling ZhouAbstract:Objective To evaluate the efficacy of ultrasound-guided Great Auricular Nerve block with different concentrations of ropivacaine for postoperative analgesia in patients undergoing tympanic and mastoid surgery. Methods Ninety American Society of Anesthesiologists physical status Ⅰor Ⅱ patients of both sexes, aged 18-60 yr, with body mass index of 19-25 kg/m2, undergoing elective tympanic and mastoid surgery under general anesthesia, were divided into 3 groups(n=30 each)using a random number table: control group(group C), 0.25% ropivacaine group(group R1)and 0.50% ropivacaine group(group R2). In R1 and R2 groups, Great Auricular Nerve block was performed under ultrasound guidance before anesthesia induction, 0.25% and 0.50% ropivacaine 2 ml were injected, respectively, 10 min later the block in the area innervated by Great Auricular Nerve was evaluated using the method of acupuncture in comparison with the contralateral area.After successful block was confirmed, the patients were ventilated using the laryngeal mask airway under general anesthesia.Flurbiprofen axetil was given as rescue analgesic, sufentanil was used when the efficacy was not satisfactory, and visual analog scale score was maintained less than or equal to 3 points.The number of patients requiring rescue analgesic was recorded within 48 h after surgery. Results The Great Auricular Nerve was successfully blocked in 60 patients of R1and R2groups.Compared with group C, the requirement for rescue analgesic was significantly decreased within 48 h after surgery in R1 and R2 groups(P 0.05). Conclusion Ultrasound-guided Great Auricular Nerve block with 0.25% ropivacaine provides better efficacy for postoperative analgesia in the patients undergoing tympanic and mastoid surgery. Key words: Amides; Ultrasonography; Nerve block; Ear diseases; Analgesia
Ravi C Nayar - One of the best experts on this subject based on the ideXlab platform.
-
the x pointer a forgotten anatomical relationship of spinal accessory Nerve and Great Auricular Nerve
Surgical Oncology-oxford, 2021Co-Authors: Vishal Rao, Anand Subash, Piyush Sinha, Sataksi Chatterjee, Ravi C NayarAbstract:Abstract Introduction The preservation of the spinal accessory Nerve cannot be overlooked in neck dissection. Injury to the Nerve results in shoulder dysfunction and other related morbidities. In this article, we describe a unique constant relationship between spinal accessory Nerve and Great Auricular Nerve, at the junction of the anterior and posterior triangles of the neck, eponymously labelled the X- pointer. Methodology This was an observational study conducted at a tertiary care cancer centre that runs a comprehensive surgical training program. A 100 cases of modified radical neck dissection performed for oral cavity squamous cell carcinoma from January 2017 to January 2019 in were included. The relationship was analyzed in 100 cases of neck dissection for its constancy. Result In all the 100 cases, the X-pointer was demonstrated as a constant anatomical relationship between the spinal accessory Nerve and Great Auricular Nerve. The crossing over of the Nerve on the undersurface of the sternocleidomastoid muscle is constant and independent of the patient's body proportions. Conclusions The relationship between the spinal accessory Nerve and Great Auricular Nerve remains constant irrespective of the technique of neck dissection and body habitus of the patient. In our view, this relationship can be used as an additional confirmatory landmark to prevent inadvertent injury to the spinal accessory Nerve.
Saeyoung Kim - One of the best experts on this subject based on the ideXlab platform.
-
treatment of Great Auricular neuralgia with real time ultrasound guided Great Auricular Nerve block a case report and review of the literature
Medicine, 2017Co-Authors: Younghoon Jeon, Saeyoung KimAbstract:Rationale The Great Auricular Nerve can be damaged by the neck surgery, tumor, and long-time pressure on the neck. But, Great Auricular neuralgia is very rare condition. It was managed by several medication and landmark-based Great Auricular Nerve block with poor prognosis. Patient concerns A 25-year-old man presented with a pain in the left lateral neck and auricle. Diagnosis He was diagnosed with Great Auricular neuralgia. Interventions His pain was not reduced by medication. Therefore, the Great Auricular Nerve block with local anesthetics and steroid was performed under ultrasound guidance. Outcomes Ultrasound guided Great Auricular Nerve block alleviated Great Auricular neuralgia. Lessons This medication-resistant Great Auricular neuralgia was treated by the ultrasound guided Great Auricular Nerve block with local anesthetic agent and steroid. Therefore, Great Auricular Nerve block can be a good treatment option of medication resistant Great Auricular neuralgia.
Vishal Rao - One of the best experts on this subject based on the ideXlab platform.
-
the x pointer a forgotten anatomical relationship of spinal accessory Nerve and Great Auricular Nerve
Surgical Oncology-oxford, 2021Co-Authors: Vishal Rao, Anand Subash, Piyush Sinha, Sataksi Chatterjee, Ravi C NayarAbstract:Abstract Introduction The preservation of the spinal accessory Nerve cannot be overlooked in neck dissection. Injury to the Nerve results in shoulder dysfunction and other related morbidities. In this article, we describe a unique constant relationship between spinal accessory Nerve and Great Auricular Nerve, at the junction of the anterior and posterior triangles of the neck, eponymously labelled the X- pointer. Methodology This was an observational study conducted at a tertiary care cancer centre that runs a comprehensive surgical training program. A 100 cases of modified radical neck dissection performed for oral cavity squamous cell carcinoma from January 2017 to January 2019 in were included. The relationship was analyzed in 100 cases of neck dissection for its constancy. Result In all the 100 cases, the X-pointer was demonstrated as a constant anatomical relationship between the spinal accessory Nerve and Great Auricular Nerve. The crossing over of the Nerve on the undersurface of the sternocleidomastoid muscle is constant and independent of the patient's body proportions. Conclusions The relationship between the spinal accessory Nerve and Great Auricular Nerve remains constant irrespective of the technique of neck dissection and body habitus of the patient. In our view, this relationship can be used as an additional confirmatory landmark to prevent inadvertent injury to the spinal accessory Nerve.
Kezhi Yuan - One of the best experts on this subject based on the ideXlab platform.
-
a randomized controlled trial evaluating the hemodynamic impact of ultrasound guided Great Auricular Nerve block in middle ear microsurgery
BMC Anesthesiology, 2020Co-Authors: Jinsheng Liu, Hongling Zhou, Kezhi Yuan, Guyan WangAbstract:The peri-operative effectiveness of ultrasound-guided Great Auricular Nerve block (GANB) in patients, especially in adult patients undergoing middle ear microsurgery remains unclear. We hypothesized that ultrasound-guided GANB would decrease the hemodynamic responsiveness to incision and opioid consumption in middle ear microsurgery as well as the post-operative analgesia requirement. Sixty patients undergoing middle ear microsurgery were randomized into two equal groups to receive either a GANB with 2 ml of 0.25% ropivacaine under ultrasound guidance (GANB group) or to receive a blank control intervention (without any performed injection) before general anesthesia inductions. The primary outcomes were hemodynamic changes of MAP (mean artery pressure) and HR (heart rate) to skin incision. The secondary endpoints were to determine the consumptions of propofol and remifentanil during the operation and the incidence of remedial analgesia 48 h post-operation to maintain VAS ≤ 3. The MAP post incision in GANB group was significantly lower than that in control group (GANB group 93.83 ± 11.72 mmHg vs. control group 100.87 ± 12.65 mmHg, P = 0.029). The increases for MAP and HR post incision were also lower in GANB group (∆MAP GANB group 11.90 ± 8.32 mmHg vs. control group 19.83 ± 10.37 mmHg, P = 0.002; ∆HR GANB group 3.67 ± 5.30 beat min− 1 vs. control group 8.23 ± 8.56 beat min− 1, P = 0.016). Remifentanil consumption was significantly decreased in GANB group (GANB group 401.55 ± 100.51 μg h− 1 vs. control group 697.34 ± 215.45 μg h− 1, P = 0.000). The incidence of remedial analgesia post-operation in GANB group (5/30) was significantly lower than that in control group (20/30, P = 0.000). Ultrasound-guided GANB decreases the hemodynamic responsiveness to incision and remifentanil consumption in middle ear microsurgery as well as the post-operative analgesia requirement. This trial was retrospectively registered at http://www.chictr.org.cn with the registration number of ChiCTR1800014333 on 6 January, 2018.
-
efficacy of ultrasound guided Great Auricular Nerve block combined with general anesthesia for middle ear microsurgery in adult patients
Chinese Journal of Anesthesiology, 2018Co-Authors: Jinsheng Liu, Hongling Zhou, Chuxiong Pan, Xuegong Niu, Kezhi YuanAbstract:Objective To evaluate the efficacy of ultrasound-guided Great Auricular Nerve (GAN) block combined with general anesthesia for middle ear microsurgery in adult patients. Methods Sixty-four adult patients of both sexes, aged 18-60 yr, of American Society of Anesthesiologists physical statusⅠ or Ⅱ, scheduled for elective middle ear microsurgery, were assigned into 2 groups (n=32 each) using a random number table: GAN block combined with general anesthesia group (group GANB+ G) and general anesthesia group (group G). Patients received GAN block with 0.25% ropivacaine 2 ml using ultrasound-guided in-plane technique before anesthesia induction in group GANB+ G.Anesthesia induction and maintenance protocols (IV infusion of propofol and target-controlled infusion of remifentanil) were similar in two groups.Analgesia was performed with sufentanil, flurbiprofen axetil or parecoxib sodium after operation to maintain visual analog scale score <4 within 48 h after operation.The infusion duration and consumption of propofol and remifentanil, requirement for postoperative analgesia and occurrence of postoperative nausea and vomiting were recorded. Results Compared with group G, the consumption of remifentanil was significantly reduced, and the requirement for postoperative analgesia and incidence of postoperative nausea and vomiting were decreased in group GANB+ G (P<0.05 or 0.01). Conclusion Ultrasound-guided GAN block combined with general anesthesia provides better analgesic efficacy in the the perioperative period in adult patients undergoing middle ear microsurgery. Key words: Ear, middle; Ultrasonography; Nerve block
