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Ultrasound guided pain

Lena F Carstensen, Morten Jenstrup, Jørgen Lund, Jørgen Tranum-Jensen
BACKGROUND AND OBJECTIVES: The popularization of ultrasound-guided nerve blocks in cosmetic and reconstructive breast surgery calls for better anatomical understanding of chest wall innervation. When inserting subpectoral implants, pain from pocket dissection, stretching of muscle, and release of costal attachments may be relieved by blocking the pectoral nerves in the interpectoral (IP) space.We describe the variable anatomy of the pectoral nerves in the IP space in order to define the area to be covered for sufficient blockade, based on cadaver dissections...
August 8, 2018: Regional Anesthesia and Pain Medicine
Aysha Hasan, Autumn D Nanassy, Gregory Disilvio, Teerin Meckmongkol, L Grier Arthur, Pravin A Taneja
The sickle cell patient population continues to provide challenges in pain control. Current therapies include narcotic usage with adjuvant therapies such as anti-inflammatories and nonpharmacological interventions. Poor pain management in the sickle cell patient population, especially postoperatively, can lead to hypoventilation, escalating opioid requirements, poor recovery, and longer hospital stays. This case report addresses a novel addition of ultrasound-guided paravertebral and rectus sheath blocks postinduction of general anesthesia and before surgical incision to assist with the intravenous postoperative pain management regimen after laparoscopic cholecystectomy in a 10-year-old boy with sickle cell disease...
August 7, 2018: A&A practice
Shaofeng Pu, Jie Chen, Xing Gu, Yongming Xu, Junzhen Wu, Yingying Lv, Dongping Du
BACKGROUND: The stellate ganglion block (SGB) can lead to vasodilation of the head and neck. However, controversy remains concerning the changes in extracerebral blood flow. The objective of this study is to assess the effects of SGB on the blood flow to the neck. METHODS: A randomized controlled crossover trial with 38 participants will be conducted. Participants who have primary headaches will be assigned to either group A or B. Patients in group A will receive SGB with 6 ml 1% lidocaine, and after a one-week washout period, they will undergo the second SGB with 6 ml normal saline...
August 7, 2018: Trials
Debesh Bhoi, Purnima Narasimhan, Ranjitha Nethaji, Praveen Talawar
To avoid the safety issues related to thoracic paravertebral blocks, we performed midpoint transverse process to pleura blocks in 3 patients before general anesthesia for modified radical mastectomies. The midpoint transverse process to pleura blocks served as the major component of multimodal analgesia. With ultrasound guidance, 7 mL of a mixture of 0.75% ropivacaine and 2% lidocaine with epinephrine were deposited at T2, T4, and T6 levels. We noted decreased sensation to cold and pinprick from T2 to T8 dermatome level with sparing of axilla and infraclavicular areas...
August 6, 2018: A&A practice
Akihiro Matsumi, Kazuyuki Matsumoto, Hiroyuki Okada
Endoscopic ultrasound-guided drainage and endoscopic necrosectomy (EN) has become an effective procedure for peripancreatic fluid collection (PFC). [1-3]. However, the rate of procedure related complications is 33-36% [4-5]. Bleeding is one of the major complications, and endoscopic hemostasis is difficult in most cases. A 77-year-old man was admitted for fever and abdominal pain. Computed tomography showed a large amount of ascites around the liver. This article is protected by copyright. All rights reserved...
August 7, 2018: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
Young Hak Roh, Seok Woo Hong, Hyun Sik Gong, Goo Hyun Baek
A total of 154 patients with De Quervain tendinopathy were randomized into a blind injection group or an ultrasound-guided injection group to compare effectiveness and complications of steroid injection. The visual analogue scale score for pain, Finkelstein test result, and Disability of the Arm, Shoulder, and Hand (DASH) score were assessed at 12 and 24 weeks follow-up. At 12 weeks, the DASH scores were significantly better in the ultrasound-guided group, but the mean difference was less than the minimum clinically important difference...
August 4, 2018: Journal of Hand Surgery, European Volume
Matthew J Zdilla, Michelle L Russell, Aaron W Koons
BACKGROUND: Infraorbital nerve blocks are often performed for the management of postoperative pain associated with cleft lip correction. Infraorbital nerve block procedures depend on the identification of the infraorbital foramen; however, there is little information regarding the infraorbital foramen location in the pediatric population. AIMS: The aim of this study was to identify the location of the infraorbital foramen in the pediatric population relative to a midpoint between the nasospinale and jugale...
August 5, 2018: Paediatric Anaesthesia
Indu Suseela, Krishnadas Anandan, Arun Aravind, Suvarna Kaniyil
Background and Aims: Many patients experience moderate-to-severe pain after laparoscopic cholecystectomy. We aimed to compare the efficacy of ultrasound-guided bilateral subcostal transversus abdominis plane (TAP) block with port-site infiltration for post-operative analgesia after laparoscopic cholecystectomy. Methods: Patients undergoing elective laparoscopic cholecystectomy under general anaesthesia were divided into two groups of 40 each to receive ultrasound-guided bilateral subcostal TAP block (T) with 0...
July 2018: Indian Journal of Anaesthesia
Cosy Wing Ching Cheung, Alice Wong Wai Yee, Pui Shan Chan, Sotirios H Saravelos, Jacqueline Pui Wah Chung, Lai Ping Cheung, Grace Wing Shan Kong, Tin-Chiu Li
RESEARCH QUESTION: Does music therapy help in reducing pain and anxiety in women undergoing transvaginal ultrasound-guided oocyte retrieval (TUGOR)? DESIGN: In this randomized controlled open label study, 209 participants were recruited and randomized into three groups (music group, n = 70; headphone group, n = 70; control group, n = 69). Patients' psychological status was assessed using the visual analogue scale of pain (VAS-P), satisfaction of pain control, state-trait anxiety inventory (STAI), Beck depression inventory (BDI), and general health questionnaire (GHQ)...
August 2018: Reproductive Biomedicine Online
Xue-Qing Yang, Hai-Yan Zhu, Xian Wang, Huai-Bing Zhao, Wei Zhang, Min Xiao, Li-Jing Zhang
RATIONALE: Spontaneous coronary artery dissection is a highly unusual cause of acute coronary disease. It is a result of a hematoma formation within the outer third of the tunica media,with subsequent expansion leading to compression of the true lumen and resultant myocardial ischemia. PATIENT CONCERNS: We present a case of a middle-aged woman presenting with chest pain with acute anterior myocardial infarction, who did not reveal any of the cardiovascular risk factors...
August 2018: Medicine (Baltimore)
Mark D Unger, Naveen S Murthy, Rahul Kanwar, Kasey A Strand, Timothy P Maus, Andreas S Beutler
INTRODUCTION: Osteoarthritis (OA) is the most common form of arthritis. Medical and surgical treatments have yet to substantially diminish the global health and economic burden of OA. Due to recent advances in clinical imaging, including magnetic resonance imaging (MRI), a correlation has been established between structural joint damage and OA-related pain and disability. Existing preclinical animal models of OA are useful tools but each suffers specific roadblocks when translating structural MRI data to humans...
2018: PloS One
Ravi Shergill, Hema Nalini Choudur
Lateral epicondylitis is a painful condition related to the myotendinous origin of the extensor muscles at the lateral epicondyle of the humerus. Primary treatment typically involves the use of rest, non-steroidal anti-inflammatory drugs (NSAIDs), and physiotherapy. However, in refractory cases where conventional therapy is ineffective, ultrasound-guided injection therapies have become a growing form of treatment. These include needle tenotomy, autologous whole blood injection (AWB), platelet-rich plasma (PRP) injection and steroid injection...
August 3, 2018: Journal of Clinical Rheumatology: Practical Reports on Rheumatic & Musculoskeletal Diseases
Priti J Bhatt, Elliot M Greenberg, Brian D Suh
A 71-year-old woman with a 10-month history of atraumatic low back pain was referred to physical therapy after an insidious exacerbation of symptoms. Red flags raised suspicions for spinal compression fracture, necessitating the physical therapist to contact her physician and recommend imaging. Radiographs and magnetic resonance imaging were ordered, the latter of which showed an acute fracture at T10, with lesions at T9 and in the liver suggesting metastasis. Following bone scintigraphy and an ultrasound-guided biopsy of a liver lesion, she was diagnosed with metastatic breast cancer...
July 2018: Journal of Orthopaedic and Sports Physical Therapy
Masoud Pezeshki Rad, Bita Abbasi, Negar Morovatdar, Masoomeh Sadeghi, Khaled Hashemi
PURPOSE: Effective pain control during and after percutaneous core needle liver biopsy is important with regard to ethical considerations and patient comfort. In this randomized double-blind study, we compared post-biopsy pain in the patients undergoing liver core-needle biopsy using either subcostal or intercostal approaches. METHODS: All patients referred for ultrasound-guided CNLB between July 2017 and January 2018 to our interventional radiology department were randomized into two groups...
July 31, 2018: Abdominal Radiology
Fernando Ruiz Santiago, Nicolás Prados Olleta, Pablo Tomás Muñoz, Luis Guzmán Álvarez, Alberto Martínez Martínez
OBJECTIVE: The aim of this work is to compare the effectiveness of blind and ultrasound-guided injection for Morton's neuroma (MN) to determine which is more appropriate as the initial procedure in conservative treatment. METHODS: This is an evaluator-blinded randomised trial. Of the 56 included patients, 27 were assigned to the blind group (A) and 29 to the ultrasound-guided group (B). Injection includes 1 ml of 2% mepivacaine and 40 mg of triamcinolone in each web space with MN...
July 31, 2018: European Radiology
John George, Shyan Ch'ng Li, Zulkarnain Jaafar, Mohamad Shariff A Hamid
Objective: To evaluate the efficacy of dextrose prolotherapy injection for focal supraspinatus rotator cuff tendinosis via outcomes such as functional score, range of movement, and real-time ultrasound parameters. Materials and Methods: 12 adult patients with focal supraspinatus tendinosis recruited after they had less than 30% improvement in functional (DASH) scores after one month of physiotherapy following initial presentation. Seven patients had 0.5-1.0 ml of prolotherapy injection (12...
2018: Scientifica
Arif Ahmed, Divesh Arora
Introduction: The knee arthroplasty is the best option for patients with advanced osteoarthritis who have failed all other conservative options, but regrettably many patients fail to undergo surgery due to co-morbidities or other reasons. So, new alternative modes are always in demand for these patients. Methods: The ultrasound-guided radiofrequency ablation (RFA) of all the genicular nerves of knee joint was done in patients with grade III and IV osteoarthritis of knee joint, with severe pain (numerical rating scale (NRS) > 7) who had failed conservative management and intra-articular injections after a positive genicular nerve block with local anaesthetics...
August 2018: British Journal of Pain
Fabrizio Dal Moro, Luca Aiello, Paola Pavarin, Fabio Zattoni
Several works stress the importance of ultrasound-guided transversus abdominis plane block (TAPb) for post-operative analgesia and its versatility in all types of abdominal surgery, thanks to laparotomy and laparoscopy. The aim of this study was to evaluate the impact of TAPb on intra- and post-operative analgesia in the first 24 h after robot-assisted radical prostatectomy (RARP). TAPb is a new local anesthetic technique which provides analgesia after abdominal surgery. It involves injection of local anesthetic into the plane between the transversus abdominis and the internal oblique muscles...
July 28, 2018: Journal of Robotic Surgery
Siva N Krishna, Sandeep Chauhan, Debesh Bhoi, Brajesh Kaushal, Suruchi Hasija, Tsering Sangdup, Akshay K Bisoi
OBJECTIVES: To examine the analgesic efficacy of bilateral erector spinae plane (ESP) block compared with conventional treatment for pain after cardiac surgery in adult patients. DESIGN: A prospective, randomized, controlled, single-blinded study. SETTING: Single-center tertiary teaching hospital. PARTICIPANTS: One hundred and six adult patients undergoing elective cardiac surgery with cardiopulmonary bypass. INTERVENTIONS: Patients were randomized into 2 groups...
June 4, 2018: Journal of Cardiothoracic and Vascular Anesthesia
Stephen C Haskins, Richelle Kruisselbrink, Jan Boublik, Christopher L Wu, Anahi Perlas
This article in our series on point-of-care ultrasound (US) for the regional anesthesiologist and pain management specialist describes the emerging role of gastric ultrasonography. Although gastric US is a relatively new point-of-care US application in the perioperative setting, its relevance for the regional anesthesiologist and pain specialist is significant as our clinical practice often involves providing deep sedation without a secured airway. Given that pulmonary aspiration is a well-known cause of perioperative morbidity and mortality, the ability to evaluate for NPO (nil per os) status and risk stratify patients scheduled for anesthesia is a powerful skill set...
July 27, 2018: Regional Anesthesia and Pain Medicine
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