The Experts below are selected from a list of 285 Experts worldwide ranked by ideXlab platform

Amitabh Gulati - One of the best experts on this subject based on the ideXlab platform.

  • Thoracic cancer pain
    Essentials of Interventional Cancer Pain Management, 2018
    Co-Authors: Joseph C. Hung, Rajiv Shah, Amitabh Gulati
    Abstract:

    Malignant pain from within the thoracic cavity may originate from primary or metastatic neoplasms involving the lungs, heart, esophagus, and neural structures such as the brachial plexus and Intercostal Nerves, osseous structures, or lymph nodes. Systemic analgesic therapy including opioids has the potential to provide significant pain relief in this population. However, some patients may fail to achieve meaningful pain relief or suffer from unbearable medication- related adverse side effects. In this subset of patients, interventional pain management techniques targeting the Intercostal Nerves, thoracic nerve roots, and/or neuroaxis can offer additional palliation when more conventional methods of pain control have failed.

  • novel use of noninvasive high intensity focused ultrasonography for Intercostal nerve neurolysis in a swine model
    Regional Anesthesia and Pain Medicine, 2014
    Co-Authors: Amitabh Gulati, Jeffrey Loh, N Gutta, Paula C Ezell, Sebastien Monette, Joseph P Erinjeri, Majid Maybody, Stephen B Solomon
    Abstract:

    Background High-intensity focused ultrasound (HIFU) is a noninvasive thermal ablation technique. High-intensity focused ultrasound has been used in small-animal models to lesion neural tissue selectively. This study aimed to evaluate the efficacy of HIFU in a large-animal model for ablation of Nerves similar in size to human Nerves. Methods Twelve acute magnetic resonance–guided HIFU ablation lesions were created in Intercostal Nerves in a swine model. In a second pig, as a control, 4 radiofrequency ablation and 4 alcohol lesions were performed on Intercostal Nerves under ultrasound guidance. Preprocedural and postprocedural magnetic resonance imaging was then performed to evaluate radiologically the lesion size created by HIFU. Animals were euthanized 1 hour postprocedure, and necropsy was performed to collect tissue samples for histopathologic analysis. Results On gross and histological examination of the Intercostal nerve, acute HIFU nerve lesions showed evidence of well-demarcated, acute, focally extensive thermal necrosis. Four Intercostal Nerves ablated with HIFU were sent for histopathologic analysis, with 2 of 4 lesions showing pathologic damage to the Intercostal nerve. Similar results were shown with radiofrequency ablation technique, whereas the Intercostal Nerves appeared histologically intact with alcohol ablation. Conclusions High-intensity focused ultrasound may be used as a noninvasive neurolytic technique in swine. High-intensity focused ultrasound may have potential as a neuroablation technique for patients with chronic and cancer pain.

  • Ultrasound-Guided Intercostal Nerve Cryoablation
    Anesthesia and analgesia, 2006
    Co-Authors: Michael G. Byas-smith, Amitabh Gulati
    Abstract:

    Ultrasound technology has advanced regional anesthesia and pain management, by improving accuracy and reducing complication rates. We have successfully performed cryoablation of Intercostal Nerves with ultrasound guidance with no complications. Four patients with postthoracotomy pain syndrome had pain relief for at least 1 mo after selective cryoablation of Intercostal Nerves at the mid-axillary line. Visualizing the pleura during the procedure is the greatest benefit of using ultrasonography, especially in thin patients whose Intercostal groove to pleural distance may be

Li Mei-xia - One of the best experts on this subject based on the ideXlab platform.

  • Clinical study on cryonalgesia on Intercostal Nerves for post-thoracotomy pain
    Hainan Medical Journal, 2008
    Co-Authors: Li Mei-xia
    Abstract:

    Objective To investigate the effects of cryoanalgesia for post-thoractomy pain on the Intercostals Nerves. Methods Fifty-five patients suffering from thoracotomy were divided into two groups according to different analgesia: control group and cryoanalgesia group (trail group). Cryoanalgesia group(n=29): cryoanalgesia on Intercostal Nerves were freezed at -50℃ ～-70℃ for 90 seconds; Control group(n=26): Morphine given irregularly intra-muscularly. Severity of pain was graded by Visual Analogue Scale and pulmonary complication. Results There was significant difference between the trail group and the control group. The VSA score of the trail group and the control group was 1.31 and 7.36 (x2=27.44, P0.01) respectively, and the total effective rates were 100%, 34.6% respectively. The mean amount required of morphine in the two groups were 5.17mg and 18.6mg respectively (P0.01). Pulmonary complication in trail group after operation was lower than that in control group (3.4% vs 26.9%, P0.05). Conclusion Cryoanalgesia on post-thoracotomy pain is very effective and may improve the respiratory function after operation.

Carlos Avendaño - One of the best experts on this subject based on the ideXlab platform.

  • Anatomical and functional connectivity of the transected ulnar nerve after Intercostal neurotization in cats.
    Journal of neurosurgery, 1999
    Co-Authors: Alberto Isla, Bartolomé Bejarano, Carmen Morales, Concepción Pérez Conde, Carlos Avendaño
    Abstract:

    Object. Acute transfer of three Intercostal Nerves to the ulnar nerve was performed in cats for histological and clinical evaluation of a distal muscle reinnervation. Methods. Infraclavicular Intercostal-ulnar communications were created after dividing the motor branches of the upper Intercostal Nerves in 14 adult cats. Reinnervation of distal forelimb muscles in the ulnar territory was assessed by electromyographic (EMG) studies and motor function rating each month until 18 months postsurgery. In five of these treated animals, and in four controls, horseradish peroxidase (HRP) was applied to the ulnar or Intercostal Nerves to study the amount and distribution of retrograde motor neuron labeling in the spinal cord. Also, samples of reinnervated muscles and neurotized ulnar Nerves were processed to assess regeneration. Simple ulnar transection without reconstruction led to permanent atrophy of ulnar muscles, lack of recovery according to EMG or clinical studies, and disappearance of the ulnar motor neuron ...

Jiang Peng-fei - One of the best experts on this subject based on the ideXlab platform.

  • Comparison of the therapeutic effect of analgesic methods after thoracotomy
    Journal of Traumatic Surgery, 2005
    Co-Authors: Jiang Peng-fei
    Abstract:

    Objective To compare the effect of different analgesic methods after thoracotomy. Methods One hundred and twenty cases who received different analgesic methods after thoracotomy were randomly divided into groupⅠ(using analgesic),groupⅡ(administered through epidural catheter) and groupⅢ(freezing of Intercostal Nerves). The effect,postoperative complication and analgesic methods were compared among the three groups. Results The effect in groupⅢ was obviously superior to groupⅠ and groupⅡ(P0.05),and the compmication was decreased as compared to groupⅠ and groupⅡ(P0.05). Conclusion Freezing Intercostal Nerves is an effective and reliable way to prevent intense chest pain after thoracotomy.

Zhao Fan - One of the best experts on this subject based on the ideXlab platform.

  • Cryoanalgesia on Intercostal Nerves for Post-Thoracotomy Pain:A Clinical Report
    Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2006
    Co-Authors: Zhao Fan
    Abstract:

    Objective To investigate the effects of cryoanalgesia for post-thoracotomy pain on the Intercostal Nerves.Methods Two hundred and eight patients suffering from thoracotomy were divided into three groups,according to different analgesia received respectively.Cryoanalgesia group(n=80): cryoanalgesia on the Intercostal Nerves,Intercostals Nerves was freezed at-55℃ for 90 seconds;patient controlled analgesia by vein(PCA group,(n=)80): patient controlled analgesia was practiced intravenously,and control group(n=48): Dolantin given irregularly intra-muscularly and/or tramadol orally.Severity of pain was graded by visual analogue scale.Forced expiratory volume in one second(FEV_(1.0)) was measured and pulmonary complication after operation was compared.Results There was a statistically significant improvement in postoperative pain scores and an improvement in respiratory function tests for patients in cryoanalgesia group(χ~2=74.93,15.04,P0.05).FEV_(1.0) in cryoanalgesia group was significantly higher than that in control group(1.97±0.27L vs.1.39±0.14 L,P0.05).Pulmonary complication in cryoanalgesia group after operation was lower than that in control group(6.25% vs.31.25%,P0.05). Conclusion Cryoanalgesia on post-thoracotomy pain is very effective and may improve the respiratory function after operation.