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Regional anesthesia analgesia

Ashutosh Sahu, Rajnish Kumar, Mumtaz Hussain, Ajit Gupta, K H Raghwendra
BACKGROUND: Regional anesthesia using paravertebral block has been suggested as an ideal adjunct to general anesthesia for modified radical mastectomy. Paravertebral block is an effective management of peri-operative pain for Modified radical mastectomy, however, there are no established guidelines regarding what is the most suitable strategy when varying drugs and dosages between different groups. AIM: To evaluate the effectiveness of paravertebral block comparing the most frequently employed drugs in this procedure (bupivacaine vs ropivacaine)...
September 2016: Anesthesia, Essays and Researches
Madhavi Unmesh Santpur, Govind Marutrao Kahalekar, Nowreen Saraf, Aparna Losari
BACKGROUND: Regional anesthesia is the preferred technique for most of lower abdominal and lower limb surgeries. For decades, lignocaine had been the local anesthetic of choice for spinal anesthesia. Recent studies show that intravenous clonidine and dexmedetomidine can prolong the duration of the spinal anesthesia. Dexmedetomidine is a more suitable adjuvant compared to clonidine due to its more selective α2A receptor agonist activity. AIM: The study was undertaken to evaluate the effects of intravenous administration of dexmedetomidine on spinal anesthesia with 0...
September 2016: Anesthesia, Essays and Researches
Misty A Edmondson
Local, regional, and spinal anesthesias are safe, effective, often more desirable procedures for ruminants than general anesthesia. Many procedures can be performed safely and humanely in ruminants using a combination of physical restraint, mild sedation, and local, regional, or spinal anesthesia. This article focuses on the use of local anesthetics for providing anesthesia for dehorning, procedures of the nose and eye, laparotomy, reproductive procedures, teat repair, and procedures on the distal limb. Local, regional, and spinal anesthesia techniques are safe effective methods for providing anesthesia for common surgical procedures and analgesia for painful conditions in cattle and small ruminants...
November 2016: Veterinary Clinics of North America. Food Animal Practice
Rikard Ambrus, Rune B Strandby, Niels H Secher, Kim Rünitz, Morten B S Svendsen, Lonnie G Petersen, Michael P Achiam, Lars B Svendsen
BACKGROUND: Thoracic epidural analgesia (TEA) is used for pain relief during and after abdominal surgery, but the effect of TEA on the splanchnic microcirculation remains debated. We evaluated whether TEA affects splanchnic microcirculation in the pig. METHODS: Splanchnic microcirculation was assessed in nine pigs prior to and 15 and 30 min after induction of TEA. Regional blood flow was assessed by neutron activated microspheres and changes in microcirculation by laser speckle contrast imaging (LSCI)...
October 6, 2016: BMC Anesthesiology
Marcus Hards, Arisa Harada, Isobel Neville, Sheelagh Harwell, Mahwash Babar, Abdulsatar Ravalia, Giles Davies
STUDY OBJECTIVES: To determine the effectiveness of serratus plane block performed under direct vision on postoperative pain after mastectomy. DESIGN: We performed a retrospective study of elective breast surgery patients undergoing mastectomy over 6 months. We collected data on the outcomes for the pain score and use of analgesia in recovery, the use of analgesia and antiemetics overnight, and the pain score and mobilization status of the patient 1 day after the operation...
November 2016: Journal of Clinical Anesthesia
Katherine H Dobie, Yaping Shi, Matthew S Shotwell, Warren S Sandberg
STUDY OBJECTIVE: Regional anesthesia and analgesia for shoulder surgery is most commonly performed via interscalene nerve block. We developed an ultrasound-guided technique that specifically targets the C5 nerve root proximal to the traditional interscalene block and assessed its efficacy for shoulder analgesia. DESIGN: Prospective case series. SETTING: Vanderbilt Bone and Joint Surgery Center. PATIENTS: Patients undergoing shoulder arthroscopy at an ambulatory surgery center...
November 2016: Journal of Clinical Anesthesia
Stephen King, Elizabeth S Roberts, Jonathan N King
BACKGROUND: Few pharmaceuticals are registered in cats for the management of post-operative pain and inflammation. The objective of this study was to assess the field efficacy and safety of an injectable formulation of the nonsteroidal anti-inflammatory drug robenacoxib in cats undergoing surgery. The study was a multi-center, prospective, randomized, masked, parallel-group, placebo-controlled clinical trial. A total of 349 cats were enrolled and underwent surgery comprising forelimb onychectomy, as an example of orthopedic surgery, plus either ovariohysterectomy or castration...
September 29, 2016: BMC Veterinary Research
Jeremy D Deer, Amod Sawardekar, Santhanam Suresh
PURPOSE OF REVIEW: The objective of this review is to provide an overview of recent developments in pediatric regional anesthesia and elucidate outcomes as it relates to patient safety and overall satisfaction. RECENT FINDINGS: Since the inception of the Pediatric Regional Anesthesia Network database, the acquisition of data has enabled the pediatric anesthesiologist to extrapolate results and translate them into useful outcomes. Despite the growing trend to provide regional anesthesia in the pediatric population, there continues to be a paucity of available research studies to evaluate outcomes of various regional nerve blocks...
September 28, 2016: Current Opinion in Anaesthesiology
Juan P Cata, Mariana Chavez-MacGregor, Vicente Valero, Walter Black, Daliah M Black, Farzin Goravanchi, Ifey C Ifeanyi, Mike Hernandez, Andrea Rodriguez-Restrepo, Vijaya Gottumukkala
BACKGROUND AND OBJECTIVES: The impact of regional anesthesia on breast cancer recurrence is controversial. We tested the hypothesis that the use of paravertebral block (PVB) analgesia during breast cancer surgery prolongs the recurrence-free survival (RFS) and overall survival (OS) of women with breast cancer. METHODS: Seven hundred ninety-two women with nonmetastatic breast cancer were included in this retrospective study. Patients were divided based on the administration of PVB analgesia for mastectomy surgeries...
September 28, 2016: Regional Anesthesia and Pain Medicine
J Singer, A Jank, S Amara, P D H Stepan, U Kaisers, C Hoehne
Background: Peripartum anesthesia may consist of parenteral opioids and/or regional analgesia. There is only limited data in the literature comparing both methods in daily obstetric practice. This observational study investigated the opioids pethidine and meptazinol as well as regional analgesics with regard to their administration, efficacy, side effects and subjective maternal satisfaction with therapy. The rates of secondary regional analgesia administration after administration of the respective opioid served as a means of evaluating treatment...
September 2016: Geburtshilfe und Frauenheilkunde
Yeon-Dong Kim, Seon-Jeong Park, Junho Shim, Hyungtae Kim
The recently introduced pectoral nerve (Pecs) block is a simple alterative to the conventional thoracic paravertebral block or epidural block for breast surgery. It produces excellent analgesia and can be used to provide balanced anesthesia and as a rescue block in cases where performing a neuraxial blockade is not possible. In the thoracic region, a neuraxial blockade is often used to manage zoster-associated pain. However, this can be challenging for physicians due to the increased risk of hemodynamic instability in the upper thoracic level, and comorbid and contraindicated medical conditions such as coagulopathy...
September 20, 2016: Journal of Anesthesia
Marita Windpassinger, Olga Plattner, Jana Gemeiner, Kornelia Böhler, Robert Luntzer, Walter Klimscha, Dongsheng Yang, Edward J Mascha, Daniel I Sessler
BACKGROUND: The intravenous anesthetic propofol is a gamma-aminobutyric acid A receptor agonist. Propofol promotes analgesia by depressing nociceptive transmission in peripheral neurons, antagonizing N-methyl-D-aspartate receptors, and activating gamma-aminobutyric acid A receptors in dorsal root ganglion receptor cells. Nevertheless, it remains unclear whether intraoperative propofol causes clinically meaningful postoperative analgesia. We therefore tested the hypothesis that patients anesthetized with sevoflurane require a greater quantity of postoperative opioids (from the end of surgery until the next postoperative morning) than those anesthetized with propofol...
November 2016: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
Ali Akbar Jafarian, Farnad Imani, Reza Salehi, Farid Najd Mazaher, Fatemeh Moini
BACKGROUND: Intravenous Regional Anesthesia (IVRA) is a well-known technique for producing analgesia during surgical procedures in the extremities. However, the rapid onset of pain following the deflation of a double-cuff tourniquet during IVRA is a serious disadvantage, leading patient suffering. OBJECTIVES: The aim of this study was to evaluate the clinical effectiveness of a pneumatic arm tourniquet applied 2 cm above the double-cuff tourniquet in controlling the pain that occurs after its deflation...
June 2016: Anesthesiology and Pain Medicine
Archana Tripathi, Khushboo Sharma, Mukesh Somvanshi, Rajib Lochan Samal
BACKGROUND AND AIMS: Various additives are mixed with local anesthetic agents to increase the quality of block in regional anesthesia. We compared clonidine and dexmedetomidine as an adjunct to bupivacaine in supraclavicular brachial plexus block with respect to the onset and duration of sensory and motor block and duration of analgesia. MATERIAL AND METHODS: Sixty American Society of Anesthesiologists Grades I and II patients scheduled for various orthopedic surgeries of the upper limb under supraclavicular brachial plexus block were divided into two equal groups in a randomized, double-blind manner...
July 2016: Journal of Anaesthesiology, Clinical Pharmacology
Mercedes Fernández Gacio, Ana Maria Agrelo Lousame, Susana Pereira, Clara Castro, Juliana Santos
BACKGROUND: Several locoregional techniques have been described for the management of acute and chronic pain after breast surgery. The optimal technique should be easy to perform, reproducible, with little discomfort to the patient, little complications, allowing good control of acute pain and a decreased incidence of chronic pain, namely intercostobrachial neuralgia for being the most frequent entity. OBJECTIVES: The aim of this study was to evaluate the paravertebral block with preoperative single needle prick for major breast surgery and assess initially the control of postoperative nausea and vomiting (PONV) and acute pain in the first 24h and secondly the incidence of neuropathic pain in the intercostobrachial nerve region six months after surgery...
September 2016: Brazilian Journal of Anesthesiology
R Kamal Kanthan
AIM: (1) To assess the feasibility, safety, and effectiveness of superficial cervical plexus (SCP) block in oral and maxillofacial surgical (OMFS) practice as an alternative to general anesthesia in selective cases. (2) To assess any associated complication specifically related to the procedure. SUBJECTS AND METHODS: The total number of patients was 10, out of which 6 were male and 4 were female patients. Six patients had incision and drainage of perimandibular space infections, two patients had Level Ib cervical lymph node biopsies, one patient had enucleation of cyst in the body of mandible, one patient had open reduction and internal fixation isolated angle fracture...
January 2016: Annals of Maxillofacial Surgery
Khoa N Nguyen, Heather S Byrd, Jonathan M Tan
AIM: Caudal epidural anesthesia has been shown to reduce stress response and shorten the time to extubation in children after cardiac surgery. Combined with general anesthesia, regional anesthesia has been proven to be safe and efficacious in the pediatric population. It is not known, however, whether the use of caudal anesthesia actually reduces postoperative pain scores and decreases postoperative opioid use. METHODS: We retrospectively analyzed the charts of 199 children who underwent repair for atrial septal defect (ASD), ventricular septal defect (VSD), and Tetralogy of Fallot (TOF) at a major academic children's hospital between 2010 and 2013...
November 2016: Paediatric Anaesthesia
Rajesh Kumar Singh, J P Chaturvedi, H S Agrawal, Nitesh Agrawal
BACKGROUND: Aging causes progressive deterioration of all the organ systems. Physiological changes of aging and co-morbidities make regional anesthesia a preferred technique for this age group. Regional anesthesia with risk of hypotension and its consequences is fraught with dangers. Peripheral nerve blocks (PNBs) are much safer and give much superior post-op analgesia. The present study was undertaken to perform major lower limb orthopedic surgeries PNBs in geriatric settings. METHODS: A feasibility study was undertaken in patients above age of 60 years admitted for lower limb surgeries to undertake these surgeries under para-vertebral blocks for a period of one year from Mar 2011 to Feb 2012...
July 2016: Medical Journal, Armed Forces India
Samuel Grodofsky
This review includes a summary of contemporary theories of pain processing and advocates a multimodal analgesia approach for providing perioperative care. A summary of various medication classes and anesthetic techniques is provided that highlights evidence emerging from neurosurgical literature. This summary covers opioid management, acetaminophen, nonsteroidal antiinflammatories, ketamine, lidocaine, dexmedetomidine, corticosteroids, gabapentin, and regional anesthesia for neurosurgery. At present, there is not enough investigation into these areas to describe best practices for treating or preventing chronic pain in neurosurgery; but providers can identify a wider range of options available to personalize perioperative care strategies...
September 2016: Anesthesiology Clinics
Susan C Modesitt, Bethany M Sarosiek, Elisa R Trowbridge, Dana L Redick, Puja M Shah, Robert H Thiele, Mohamed Tiouririne, Traci L Hedrick
OBJECTIVE: To examine implementing an enhanced recovery after surgery (ERAS) protocol for women undergoing major gynecologic surgery at an academic institution and compare surgical outcomes before and after implementation. METHODS: Two ERAS protocols were developed: a full pathway using regional anesthesia for open procedures and a light pathway without regional anesthesia for vaginal and minimally invasive procedures. Enhanced recovery after surgery pathways included extensive preoperative counseling, carbohydrate loading and oral fluids before surgery, multimodal analgesia with avoidance of intravenous opioids, intraoperative goal-directed fluid resuscitation, and immediate postoperative feeding and ambulation...
September 2016: Obstetrics and Gynecology
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