Purpose: Penile Nerve Block is the most popular Nerve Block for the circumcision in pediatric patients. This study aimed to compare the analgesic efficiency of penile Nerve Block and the pudendal Nerve Block on postoperative pain and additional analgesic requirements in children undergoing circumcision. Material and Methods: This prospective randomized double-blind study enrolled 85 children, aged 1 to10 years, undergoing circumcision. The patients were randomly divided into two groups either receiving dorsal penile Block group (PNB-Group) or pudendal Nerve Block (PDB-Group). In the PNB-Group, 0. 3 ml/kg 0. 25 % bupivacaine was used; and, in the PDB-Group, 0. 3 ml/kg bupivacaine was applied with Nerve stimulator at a concentration of 0. 25 %. In the postoperative period, the modified CHEOPS pain scale scoring and additional analgesic demand were evaluated at the 5th and 30th minutes and at the 1st and 2nd hours. The subsequent pain evaluations were made by the parents at home, at the postoperative 6th, 12th, 18th and 24th hours. Results: Seven patients were excluded from the study, and seventy eight patients were evaluated for analysis. Patients in PDB-Group had significantly lower postoperative pain intensity and lower mCHEOPS scores (3. 83 ± 0. 98) when compared to the PNB-Group (6. 47 ± 0. 91) (P <. 01) at all measurement times and none of patients in PDB-Group had additional analgesic requirements up to 24 hours. Patients in the PNB-Group had significantly more analgesic requirements at all measurements times except at the 1st, 2nd, 24th hours. 3. 8%, 30. 8%, 46. 2% and 59% of the patients in the PNB group needed additional analgesia respectively at 5th, 6th, 12th and 18th hours. Conclusion: Pudendal Nerve Block provided additional analgesic free period and had better analgesic efficiency compared to the penile Nerve Block lasting until 24 hours after operation.

Introduction & Objective: Schwannoma, a benign tumor of Nerve sheath origin, is commonly found in the head and neck, as well as flexor surfaces of the extremities.It can rarely occur in the breast and stomach with only a few cases being reported. Case Reports: The cases are: 1) a 57-year- old man with breast mass, 2) a 58 - year -old man with gastrointestinal complaints who were finally diagnosed as Peripheral Nerve schwannomas.Conclusion: Clinical suspicion and histopathological confirmation are the keys to schwannomas diagnosis. Surgical excision is the treatment of choice for such patients.

Background: While there are multiple guidelines for the management of bleeding complications and hematoma if being treated with antithrombotic and anticoagulant drugs, these risks are not yet stratified for procedures with regional anesthesia. Materials and Methods: This study was an umbrella review of systematic studies and meta-analysis based on PRISMA guidelines in databases of Scopus, PubMed, Medline, Cochrane Library, and Web of Science databases. Due to heterogeneity in evaluated outcomes and methods of studies, only the qualitative evidence synthesis was performed. AMSTAR checklist was used to assess the risk of bias in included systematic reviews. Results: After an extensive search of relevant studies, 971 primary cases were identified. Following a thorough screening process, 5 systematic reviews were selected. The evidence suggests that head and neck punctures generally do not result in bleeding complications, except for rare cases of hematoma associated with Infraclavicular brachial plexus Block. A deep cervical plexus Block is not recommended. Interscalene Blocks have varying findings, with some studies reporting hematoma incidence and spinal injury, while others consider them low risk. Supraclavicular brachial plexus Block might be associated with hemothorax and infraclavicular Blocks are not favored by reviews. Axillary brachial plexus Blocks have a minor incidence of hematoma. Abdomen Blocks, TAP Blocks, ilioinguinal Blocks, and rectus sheath Blocks carry a higher risk of hematoma. Pectoral Nerve (PECS) Blocks have a relatively high risk, while paravertebral and intercostal Blocks are considered high risk, but further research is needed regarding paravertebral Blocks. Conclusion: The available evidence from systematic reviews and studies suggests varying levels of risk for different Blocks and procedures that should be considered before decision-making.

Background: Chronic pelvic/groin pain (CP/GP) is a debilitating condition with various treatment options, including Nerve Blocks. This study aimed to compare the effectiveness of ilioinguinal/iliohypogastric (II/IH) Nerve Block and the combination of genitofemoral (GF) and II/IH Nerve Block in patients with CP/GP.Methods: This retrospective quasi-experimental (longitudinal) study was conducted at Labbafinejad Hospital (Shahid Beheshti University of Medical Science, Tehran, Iran) and assessed the medical records of 54 patients with CP/GP. Patients alternately received interventions from an experienced pain specialist. Twenty-six patients received the II/IH plus GFN Block, and 28 patients received the II/IH Nerve Block alone. Visual analog scale (VAS) scores (before and 1, 2, and 3 months after intervention) available in medical records were extracted for all patients.Results: In the first (P=0.019), second (P=0.015), and third month (P=0.021) following the intervention, patients in the G+I group consistently reported significantly lower pain severity compared to patients in the I group. Patients with pain from surgical causes demonstrated significantly better treatment response than those with idiopathic causes in the second (P=0.014, 0.021) and third months (P=0.015, 0.026) post-intervention in the G+I group compared to the I group.Conclusion: Both II/IH Nerve Block and II/IH Nerve Block plus GFN Block are effective in treating CP/GP. However, patients who received II/IH Nerve Block plus GFN Block demonstrated a better treatment response than those who received II/IH Nerve Block alone. Additionally, it is worth noting that patients with pain from surgical causes reported lower pain intensity compared to patients with idiopathic causes in both treatment groups.

Peripheral Nerve injuries (PNI) can lead to lifetime loss of function and disfigurement. Different methods such as conventional allograft procedures and using of biological tubes have problems for damaged Peripheral Nerves reconstruction. Designed scaffolds with natural and synthetic materials are now widely used in the reconstruction of damaged tissues. Utilization of absorbable and non-absorbable synthetic and natural polymers with unique characteristics can be an appropriate solution to repair damaged Nerve tissues.Polymeric nanofibrous scaffolds with properties similar to neural structure can be more effective in the reconstruction process. Better cell adhesion and migration, more guiding of axons and structural features such as porosity provide clearer role of nanofibers for the restoration of neural tissues. In this paper, basic concepts of Peripheral Nerve injury, types of artificial and natural guides and the methods to improve the performance of tubes like orientation, nanotechnology applications for Nerve reconstruction, fiber and nanofibers, electrospinning methods and their application in the Peripheral Nerve reconstruction have been reviewed.