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Fascial block

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https://www.readbyqxmd.com/read/30085936/pectointercostal-fascial-block-catheters-for-thoracic-injuries-a-case-series
#1
Landon T Burns, Drew A Beasley, Mark A Stevens, Donald E Crabtree, Gregory R Mehaffey
Providing analgesia for patients with anterior rib and sternum fracture has been addressed from various types of modalities. Regional anesthesia via epidurals or peripheral nerve blocks, opiates, and other forms of multimodal pain regimens have been used. However, in the polytraumatic injury patient, positioning for an epidural may be problematic, and a predominantly opiate-based treatment plan may compromise respiratory status. In this case series, we describe the pectointercostal fascial block as another tool to treat patients with anterior rib and sternal fracture with polytraumatic injuries...
August 6, 2018: A&A practice
https://www.readbyqxmd.com/read/29969890/cervical-plexus-block
#2
Jin-Soo Kim, Justin Sangwook Ko, Seunguk Bang, Hyungtae Kim, Sook Young Lee
Cervical plexus block (CPB) has been used in various head and neck surgeries to provide adequate anesthesia and/or analgesia. However, it is performed in narrow space of neck area containing many sensitive structures, multiple fascial layers, and complicated nerve innervation. Since intermediate CPB was introduced in addition to superficial and deep CPBs in 2004, there has been some confusion in nomenclature and definition of CPB, particularly the intermediate CPB. Additionally, as the role of ultrasound in the head and neck region has expanded, CPB can be performed more safely and accurately under ultrasound guidance...
July 4, 2018: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/29932431/too-deep-or-not-too-deep-a-propensity-matched-comparison-of-the-analgesic-effects-of-a-superficial-versus-deep-serratus-fascial-plane-block-for-ambulatory-breast-cancer-surgery
#3
Faraj W Abdallah, Tulin Cil, David MacLean, Caveh Madjdpour, Jaime Escallon, John Semple, Richard Brull
BACKGROUND AND OBJECTIVES: Serratus fascial plane block can reduce pain following breast surgery, but the question of whether to inject the local anesthetic superficial or deep to the serratus muscle has not been answered. This cohort study compares the analgesic benefits of superficial versus deep serratus plane blocks in ambulatory breast cancer surgery patients at Women's College Hospital between February 2014 and December 2016. We tested the joint hypothesis that deep serratus block is noninferior to superficial serratus block for postoperative in-hospital (pre-discharge) opioid consumption and pain severity...
July 2018: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29889750/liposomal-bupivacaine-block-at-the-time-of-cesarean-delivery-to-decrease-postoperative-pain-a-randomized-controlled-trial
#4
Malavika Prabhu, Mark A Clapp, Emily McQuaid-Hanson, Samsiya Ona, Taylor OʼDonnell, Kaitlyn James, Brian T Bateman, Blair J Wylie, William H Barth
OBJECTIVE: To evaluate whether a liposomal bupivacaine incisional block decreases postoperative pain and represents an opioid-minimizing strategy after scheduled cesarean delivery. METHODS: In a single-blind, randomized controlled trial among opioid-naive women undergoing cesarean delivery, liposomal bupivacaine or placebo was infiltrated into the fascia and skin at the surgical site, before fascial closure. Using an 11-point numeric rating scale, the primary outcome was pain score with movement at 48 hours postoperatively...
July 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29770535/ultrasound-guided-transversus-thoracic-plane-block-parasternal-block-and-fascial-planes-hydrodissection-for-internal-mammary-post-thoracotomy-pain-syndrome
#5
E Piraccini, G Biondi, H Byrne, M Calli, D Bellantonio, G Musetti, S Maitan
INTRODUCTION: Pectoral Nerves Block (PECS) and Serratus Plane Block (SPB) have been used to treat persistent post-surgical pain after breast and thoracic surgery; however, they cannot block the internal mammary region, so a residual pain may occur in that region. Parasternal block (PSB) and Thoracic Transversus Plane Block (TTP) anaesthetize the anterior branches of T2-6 intercostal nerves thus they can provide analgesia to the internal mammary region. METHODS: We describe a 60-year-old man suffering from right post-thoracotomy pain syndrome with residual pain located in the internal mammary region after a successful treatment with PECS and SPB...
May 16, 2018: European Journal of Pain: EJP
https://www.readbyqxmd.com/read/29720750/newer-regional-analgesia-interventions-fascial-plane-blocks-for-breast-surgeries-review-of-literature
#6
REVIEW
Rakesh Garg, Swati Bhan, Saurabh Vig
Surgical resection of the primary tumour with axillary dissection is one of the main modalities of breast cancer treatment. Regional blocks have been considered as one of the modalities for effective perioperative pain control. With the advent of ultrasound, newer interventions such as fascial plane blocks have been reported for perioperative analgesia in breast surgeries. Our aim is to review the literature for fascial plane blocks for analgesia in breast surgeries. The research question for initiating the review was 'What are the reported newer regional anaesthesia techniques (fascial plane blocks) for female patients undergoing breast surgery and their analgesic efficacy?...
April 2018: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/29685615/effectiveness-and-safety-of-continuous-neuromuscular-blockade-in-trauma-patients-with-an-open-abdomen-a-follow-up-study
#7
Susan E Smith, Susan E Hamblin, Oscar D Guillamondegui, Oliver L Gunter, Bradley M Dennis
BACKGROUND: Neuromuscular blocking agents (NMBA) have been associated with decreased time to fascial closure following damage control laparotomy (DCL). Changes in resuscitation over the last decade bring this practice into question. METHODS: A retrospective cohort study of adults who underwent DCL between 2009 and 2015 was conducted at an ACS-verified level 1 trauma center. The study group (NMBA+) received continuous NMBA within 24 h of DCL. Data collected included demographics, resuscitative fluids, mortality, and complications...
April 18, 2018: American Journal of Surgery
https://www.readbyqxmd.com/read/29668508/ultrasound-and-plastic-surgery-clinical-applications-of-the-newest-technology
#8
John P Miller, Martin J Carney, Soobin Lim, John T Lindsey
BACKGROUND: Color Doppler ultrasound (CDUS) has not been routinely used in plastic and reconstructive surgery. Barriers to use have included large, cumbersome equipment, low-definition images, cost, and availability. In addition, programs in plastic surgery have not included training with ultrasound (US); thus, many current-day practitioners are unfamiliar with and reluctant to use this technology. Nevertheless, recent studies have demonstrated the utility of US in surgical planning. With the miniaturization, clearer imaging, and decreased costs of the latest US technology, previous barriers to use have largely been eliminated...
June 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29628547/ultrasound-guided-combined-fascial-plane-blocks-as-an-intervention-for-pain-management-after-laparoscopic-cholecystectomy-a-randomized-control-study
#9
Seshadri Ramkiran, Mathews Jacob, Manish Honwad, Desiraju Vivekanand, Mathangi Krishnakumar, Seema Patrikar
Background: Pain associated with laparoscopic cholecystectomy is most severe during the first 24 h and the port sites are the most painful. Recent multimodal approaches target incisional pain instead of visceral pain which has led to the emergence of abdominal fascial plane blocks. This study embraces a novel combination of two independently effective fascial plane blocks, namely rectus sheath block and subcostal transversus abdominis plane (TAP) block to alleviate postoperative pain...
January 2018: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29589417/blocking-around-the-transversalis-fascia-behind-the-scene
#10
Francesco Vasques, Carla Stecco, Raffaele Mitri, Raffaele DE Caro, Pierfrancesco Fusco, Astrid U Behr
BACKGROUND: The transversalis fascia plane and the quadratus lomborum blocks target the branches of T12-L1 nerves and provide analgesia in patients undergoing surgery involving the corresponding dermatomes. The transversalis fascia is believed to contribute to determine the spread of local anesthetic in such blocks. Nonetheless, the anatomy of this fascia and its possible role in these blocks still have to be precisely defined. METHODS: We conducted a series of 10 dissections and full-thickness specimens were obtained from one side for the microscopic analysis...
March 27, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29561295/interfascial-plane-blocks-back-to-basics
#11
Hesham Elsharkawy, Amit Pawa, Edward R Mariano
Ultrasound-guided interfascial plane blocks are a recent development in modern regional anesthesia research and practice and represent a new route of transmission for local anesthetic to various anatomic locations, but much more research is warranted. Before becoming overtaken with enthusiasm for these new techniques, a deeper understanding of fascial tissue anatomy and structure, as well as precise targets for needle placement, is required. Many factors may influence the ultimate spread and quality of resulting interfascial plane blocks, and these must be understood in order to best integrate these techniques into contemporary perioperative pain management protocols...
May 2018: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29503165/factors-predicting-health-related-quality-of-life-following-necrotizing-fasciitis
#12
J P Gawaziuk, R Strazar, N Cristall, S Logsetty
BACKGROUND: Necrotizing fasciitis (NF) is a debilitating soft tissue infection that results in disfiguring scars and often amputations. While mortality rates have improved, long-term outcomes in survivors of NF are poorly understood. OBJECTIVES: The objective of this study is to analyze the impact of NF on survivors' health-related quality of life (HRQoL) influenced by age, sex, comorbidities, %TBSA, and confidence with appearance. METHODS: We surveyed 56 adult patients with NF treated at either of two regional referral centers in Manitoba, Canada, between January 1, 2004, and December 31, 2014...
June 2018: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/29226148/transition-from-deep-regional-blocks-toward-deep-nerve-hydrodissection-in-the-upper-body-and-torso-method-description-and-results-from-a-retrospective-chart-review-of-the-analgesic-effect-of-5-dextrose-water-as-the-primary-hydrodissection-injectate-to-enhance
#13
Stanley K H Lam, Kenneth Dean Reeves, An-Lin Cheng
Deep nerve hydrodissection uses fluid injection under pressure to purposely separate nerves from areas of suspected fascial compression, which are increasingly viewed as potential perpetuating factors in recalcitrant neuropathic pain/complex regional pain. The usage of 5% dextrose water (D5W) as a primary injectate for hydrodissection, with or without low dose anesthetic, could limit anesthetic-related toxicity. An analgesic effect of 5% dextrose water (D5W) upon perineural injection in patients with chronic neuropathic pain has recently been described...
2017: BioMed Research International
https://www.readbyqxmd.com/read/29046933/-regional-anesthesia-are-the-standards-changing
#14
REVIEW
T Volk, C Kubulus
Regional anesthesia has undergone many changes over the years and the increasing use of ultrasound has certainly played an important role in this. Apart from individual case reports in the literature of very different blocking options, some new procedures seem to have become established and can be broadly applied. Among these are blockades, by which ultrasound-guided injection of local anesthetics is carried out in fascial or muscular layers rather than around target nerves (e.g. cervical plexus blocks and truncal blocks)...
December 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/29016551/pectoral-fascial-pecs-i-and-ii-blocks-as-rescue-analgesia-in-a-patient-undergoing-minimally-invasive-cardiac-surgery
#15
Suraj Yalamuri, Rebecca Y Klinger, W Michael Bullock, Donald D Glower, Brandi A Bottiger, Jeffrey C Gadsden
INTRODUCTION: Patients undergoing minimally invasive cardiac surgery have the potential for significant pain from the thoracotomy site. We report the successful use of pectoral nerve block types I and II (Pecs I and II) as rescue analgesia in a patient undergoing minimally invasive mitral valve repair. CASE REPORT: In this case, a 78-year-old man, with no history of chronic pain, underwent mitral valve repair via right anterior thoracotomy for severe mitral regurgitation...
November 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28969327/influence-of-deep-neuromuscular-block-on-the-surgeon%C3%A5-assessment-of-surgical-conditions-during-laparotomy-a-randomized-controlled-double-blinded-trial-with-rocuronium-and-sugammadex
#16
M V Madsen, S Scheppan, E Mørk, P Kissmeyer, J Rosenberg, M R Gätke
Background: During laparotomy, surgeons may experience difficult surgical conditions if the patient's abdominal wall or diaphragm is tense. Deep neuromuscular block (NMB), defined as a post-tetanic-count (PTC) between 0-1, paralyses the abdominal wall muscles and the diaphragm. We hypothesized that deep NMB (PTC 0-1) would improve subjective ratings of surgical conditions during upper laparotomy as compared with standard NMB. Methods: This was a double blinded, randomized study...
September 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28867151/-axillary-local-anesthetic-spread-after-the-thoracic-interfacial-ultrasound-block-a-cadaveric-and-radiological-evaluation
#17
Patricia Alfaro de la Torre, Jerry Wayne Jones, Servando López Álvarez, Paula Diéguez Garcia, Francisco Javier Garcia de Miguel, Eva Maria Monzon Rubio, Federico Carol Boeris, Monir Kabiri Sacramento, Osmany Duany, Mario Fajardo Pérez, Borja de la Quintana Gordon
BACKGROUND: Oral opioid analgesics have been used for management of peri- and postoperative analgesia in patients undergoing axillary dissection. The axillary region is a difficult zone to block and does not have a specific regional anesthesia technique published that offers its adequate blockade. METHODS: After institutional review board approval, anatomic and radiological studies were conducted to determine the deposition and spread of methylene blue and local anesthetic injected respectively into the axilla via the thoracic inter-fascial plane...
November 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28832894/ultrasound-guided-regional-blockade-for-lipoma-excision-a-new-approach-to-an-old-technique
#18
RANDOMIZED CONTROLLED TRIAL
T F Tammam, G A Kamhawy
BACKGROUND: Local anesthesia for lipoma excision can be feasible with anesthetic injection in the fascial plane between the lipoma and the surrounding soft tissues under real-time ultrasonography [ultrasound- guided lipoma plane (ULP) block]. The advantage of targeting a single anesthetic injection plane under ultrasound guidance may allow for technically easier block placement and long-term analgesic effects. METHODS: Forty-eight patients were randomly assigned to receive ULP block, group A (n = 24) or traditional block, group B (n = 24)...
November 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28643890/anatomical-evaluation-of-the-thoracolumbar-nerves-related-to-the-transversus-abdominis-plane-block-technique-in-the-dog
#19
F E Castañeda-Herrera, E F Buriticá-Gaviria, D F Echeverry-Bonilla
Transversus abdominis plane (TAP) is a fascial plane containing the thoracolumbar nerve branches that innervate the abdominal wall. Limited information is available on the anatomical organization of these nerve branches in the dog, which is of great importance for the success of the TAP block anaesthetic technique. The aim of this study was to describe the origin and conformation of thoracolumbar nerves running through the TAP in 20 hemi-abdominal walls of 10 adult mongrel dog cadavers with an average body weight of 12...
August 2017: Anatomia, Histologia, Embryologia
https://www.readbyqxmd.com/read/28439439/fascial-plane-blocks-in-regional-anaesthesia-and-new-approaches
#20
Yavuz Gürkan, Alparslan Kuş
No abstract text is available yet for this article.
April 2017: Turkish Journal of Anaesthesiology and Reanimation
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