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Postoperative nerve blocks

Gavin M Hamilton, Reva Ramlogan, Anne Lui, Colin J L McCartney, Faraj Abdallah, Daniel I McIsaac
PURPOSE: Regional anesthesia may have immediate postoperative advantages compared with general anesthesia, but its impact on post-discharge outcomes is poorly described. Our objective was to measure the association between regional anesthesia and outcomes after ambulatory shoulder surgery. METHODS: We conducted a historical cohort study at The Ottawa Hospital. Adults ≥ 18 yr old having elective ambulatory shoulder surgery from January 1, 2011 to December 31, 2016 were included...
October 17, 2018: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
Darpan Bhargava, Rajkumar Ahirwal, Ganesh Koneru, Balaji R Srikanth, Sivakumar Beena
PURPOSE: To determine the quantity of dexamethasone plasma concentration achieved following intrapterygomandibular space injection of dexamethasone when co-administered with inferior alveolar nerve block correlating with the clinical effects in the postoperative phase. OBJECTIVE: A preliminary prospective study to evaluate the dexamethasone plasma concentration achieved following intrapterygomandibular space injection of dexamethasone with 2% lignocaine inferior alveolar nerve block to achieve hemi-mandibular anesthesia for minor oral surgical procedures and derive clinical correlations...
October 16, 2018: Oral and Maxillofacial Surgery
Rupavath Ramkumar, Suman Arora, Nidhi Bhatia, Sandeep Bansal
INTRODUCTION: Blindly administered bilateral (B/L) superior laryngeal nerve (SLN) blocks, have been used to decrease the perioperative stress response of endoscopic laryngosurgeries. Use of ultrasound (USG) for giving these blocks is more likely to be successful, with fewer complications. We evaluated the efficacy of USG guided B/L SLN block in decreasing perioperative cough, sore-throat and hoarseness of voice. MATERIAL AND METHODS: This study was conducted on forty patients undergoing endoscopic laryngosurgery under GA...
September 13, 2018: American Journal of Otolaryngology
Gaston Echaniz, Marcos De Miguel, Glenn Merritt, Plinio Sierra, Pranjal Bora, Nabamallika Borah, Christopher Ciarallo, Miriam de Nadal, Richard J Ing, Adrian Bosenberg
BACKGROUND: Cleft defects are common craniofacial malformations which require early surgical repair. These patients are at high risk of postoperative airway obstruction and respiratory failure. Cleft surgery may require high doses of opioids which may contribute to these complications. OBJECTIVES: To compare the effectiveness of proximal and distal approaches to blocking the maxillary nerve in patients undergoing cleft lip or cleft palate surgery. DESIGN: Randomised, controlled and double-blind study...
October 10, 2018: European Journal of Anaesthesiology
Kuang-Yi Tseng, Hung-Chen Wang, Lin-Li Chang, Kuang-I Cheng
Peripheral nerve blockade (PNB) is advantageous for patients undergoing surgery to decrease the perioperative opioid consumptions and enhance recovery after surgery.Inadvertent local anesthetic (LA) administration into nerve fiber intrafascicularly easily results in unrecognized nerve injury. Using nerve block guidance either by ultrasound, electrical nerve stimulator, or using pressure devices does not prevent nerve damage, even though most of the nerve injury is transiently. The incidence of neurologic symptoms or neuropathy is in the range of 0...
2018: Advances in Experimental Medicine and Biology
Carolina C Rennó, Juliana Z B Papini, Cintia Maria Saia Cereda, Elizabeth Martinez, Victor Angelo Montalli, Eneida de Paula, José Pedrazzoli Júnior, Silvana Aparecida Calafatti, Giovana Radomille Tofoli
BACKGROUND: Our research group has recently developed liposomes with ionic gradient and in a combined manner as donor and acceptor vesicles containing ropivacaine (RVC; at 2% or 0.75%). Looking for applications of such novel formulations for postoperative pain control, we evaluated the duration of anesthesia, pharmacokinetics, and tissue reaction evoked by these new RVC formulations. METHODS: The formulations used in this study were large multivesicular vesicle (LMVV) containing sodium acetate buffer at pH 5...
October 9, 2018: Anesthesia and Analgesia
Pengcheng Liu, Yingbo Wu, Zhiquan Liang, Yingjie Deng, Qingcai Meng
The aim of our current study is to compare efficiency of various interventions implemented for pain management after total hip arthroplasty (THA). PubMed and EMBASE were searched for randomized clinical trials (RCTs) reporting the pain scales for evaluate the efficacy of pain control after THA including at least one pair of direct control groups. Pain scale values and the associated 95% credible interval (CrI) were used to describe efficacy. Surface under the cumulative ranking curve (SUCRA) of each means of pain control was calculated to compare the relative ranking of different interventions...
October 9, 2018: Journal of Cellular Biochemistry
Leonardo Diniz Correa Pinto, Cláudia Helena Ribeiro da Silva, Pedro Marcos Silva E Gonçalves, Roberto José Valadares
BACKGROUND AND OBJECTIVES: Ultrasound-guided upper limb blocks may provide great benefits to patients with serious diseases. Patients with Steinert's disease have muscle weakness and risk of triggering myotomy or malignant hyperthermia due to the use of anesthetic agents and surgical stress. The objective of this report was to demonstrate a viable alternative for clavicle fracture surgery with upper trunk and supraclavicular nerve block, thus reducing the spread of local anesthetic to the phrenic nerve in a patient with muscular dystrophy...
October 6, 2018: Revista Brasileira de Anestesiologia
Fernanda Moreira Gomes Mehlmann, Leonardo Henrique Cunha Ferraro, Paulo César Castello Branco de Sousa, Graziella Prianti Cunha, Esthael Cristina Querido Avelar Bergamaschi, Alexandre Takeda
BACKGROUND: A patient's ability to move his/her fingers during hand surgery may be helpful to surgeons because it allows the effectiveness of the intervention evaluation and prediction of hand function in the postoperative period. The purpose of this case series is to demonstrate the efficacy of an ultrasound-guided peripheral nerve block technique to maintain the hand flexor and extensor muscles motor function and discuss the benefits of the technique for trigger finger surgery. CASE REPORT: Ten patients scheduled to undergo trigger finger surgery were selected...
October 6, 2018: Revista Brasileira de Anestesiologia
Erich M Gauger, Peter C Rhee
Posttraumatic elbow stiffness is common with the primary indication for contracture release being limited motion that affects functional activities which has not adequately improved after intensive therapy and rehabilitation. Preoperative evaluation focuses on the history of previous nonoperative and/or operative treatment, physical exam with particular attention paid to the status of the ulnar nerve, and imaging consisting of radiographs and computed tomography. There are multiple intrinsic and extrinsic causes of posttraumatic contracture...
October 8, 2018: Techniques in Hand & Upper Extremity Surgery
Brajesh Kaushal, Sandeep Chauhan, Kulbhushan Saini, Debesh Bhoi, Akshay K Bisoi, Tsering Sangdup, Maroof Ahmad Khan
OBJECTIVE: The aim of this study was to compare the relative efficacy of ultrasound-guided serratus anterior plane block (SAPB), pectoral nerves (Pecs) II block, and intercostal nerve block (ICNB) for the management of post-thoracotomy pain in pediatric cardiac surgery. DESIGN: A prospective, randomized, single-blind, comparative study. SETTING: Single-institution tertiary referral cardiac center. PARTICIPANTS: The study comprised 108 children with congenital heart disease requiring surgery through a thoracotomy...
August 31, 2018: Journal of Cardiothoracic and Vascular Anesthesia
Debbie Chi, Edward R Mariano, Stavros G Memtsoudis, Laurence C Baker, Eric C Sun
BACKGROUND: Total knee arthroplasty is a commonly performed procedure and an important contributor to national health care spending. Reducing the incidence of readmission could have important consequences for patient well-being and relevant financial implications. Whether regional anesthesia techniques are associated with decreased readmission rates and costs among privately insured patients remains unknown. METHODS: Using administrative claims data, we identified 138,362 privately insured patients 18-64 years of age who underwent total knee arthroplasty between 2002 and 2013...
October 3, 2018: Anesthesia and Analgesia
Takuma Wakasugi, Ritsuro Shirasaka
A 15-year-old male patient presented with difficulty extending his right thumb due to subluxation of the extensor pollicis longus (EPL) tendon. Physical examination showed that active motion of the thumb's metacarpophalangeal (MP) joint was 76° in flexion and -58° in extension. During active extension, the EPL tendon shifted onto the ulnar aspect of the MP joint, and the extensor pollicis brevis (EPB) tendon shifted onto the central dorsal course of the MP joint. After repositioning by adducting the thumb into the palm to extend the MP joint (dynamic tenodesis effect), active extension of the MP joint increased to -12°...
September 2018: Journal of Hand Surgery Asian-Pacific Volume
Takanobu Otsuka, Hideki Okamoto, Jun Mizutani, Hideyuki Goto, Isato Sekiya
Early active mobilization after hand surgery is extremely important for preventing scar tissue and adhesion. We examined four patients for whom continuous peripheral nerve blocks (CPNB) were used during and after hand surgery. This method was used for three median nerves and one ulnar nerve. A 2-cm incision was made at distal one-third of the forearm with local analgesia. The catheter tip was placed in the distal one-fourth of the forearm, and the hand surgery was begun. Early active mobilization and the self-rehabilitation exercise started immediately after the operation...
September 2018: Journal of Hand Surgery Asian-Pacific Volume
Yitong Jia, Yuesong Pan, Hao Ren, Nan Ji, Fang Luo
BACKGROUND: Trigeminal neuralgia (TN) is a neurological syndrome characterized by paroxysmal, lightning-like, severe pain in the facial area innervated by the trigeminal nerve. Patients who do not respond well to drug treatment can undergo a nerve block, a traditional conservative treatment. Pulsed radiofrequency (PRF) is a nondestructive pain intervention technique. However, its treatment effectiveness for TN has rarely been reported and remains controversial among scholars. A recent single-center preliminary clinical study showed that high-voltage PRF was significantly effective in the treatment of TN...
September 2018: Pain Physician
Wen-Sheng He, Zhuo Liu, Zhen-Yu Wu, Hai-Jun Sun, Xiao-Chun Yang, Xiu-Li Wang
BACKGROUND: Coracoid approach brachial plexus block (CABPB) is safe and effective for clinical anesthesia and analgesia. Dual stimulation can enhance the block effect of CABPB when using nerve stimulator. Dexmedetomidine is a highly selective α-adrenoceptor agonist and it can prolong the duration of anesthesia when it is added into local anesthetics. The aim of this study was to assess the effects of dexmedetomidine on the duration of anesthesia and the effective postoperative analgesia time when it was mixed with ropivacaine for CABPB under dual stimulation...
September 2018: Medicine (Baltimore)
Philip Wrotslavsky
Postoperative pain management for surgery in the lower extremities has historically been managed mechanically through the use of elevation, ice, compression and drains. Pharmacological management includes the use of nerve blocks and analgesics. Due to the current opioid crisis, new methods are being sought to reduce post-operative pain so that patients are at lower risk for opioid addiction. Postoperative edema control is vital to reduce tension on the incision, since increased incisional tension may cause an increase in pain at the surgical site...
October 1, 2018: Surgical Technology International
Robert P Runner, Stephanie A Boden, William S Godfrey, Ajay Premkumar, Heather Samady, Michael B Gottschalk, John W Xerogeanes
Background: Peripheral nerve blocks, particularly femoral nerve blocks (FNBs), are commonly performed for anterior cruciate ligament (ACL) reconstruction. However, associated quadriceps muscle weakness after FNBs is well described and may occur for up to 6 months postoperatively. The adductor canal block (ACB) has emerged as a viable alternative to the FNB, theoretically causing less quadriceps weakness during the immediate postoperative period, as it bypasses the majority of the motor fibers of the femoral nerve that branch off proximal to the adductor canal...
September 2018: Orthopaedic Journal of Sports Medicine
Richard Gnatzy, Jochen Fuchs, Manuela Siekmeyer, Anne Bettina Beeskow, Jan-Hendrik Gosemann, Martin Lacher
Circumcision is one of the most frequent procedures performed by pediatric surgeons. A dorsal penile nerve block (DPNB) is commonly used for perioperative analgesia. We report the case of a 16-year-old boy with ischemia of the glans who presented on the first postoperative day after circumcision under DPNB (0.25% bupivacaine) at an outside hospital. The patient underwent immediate angiography under sedation. An intra-arterial spasmolysis was performed with alprostadil and nitroglycerine and a sufficient perfusion of the glans penis was confirmed...
January 2018: European Journal of Pediatric Surgery Reports
Han Sun, Shuxiang Li, Kun Wang, Jian Zhou, Guofeng Wu, Sheng Fang, Xiaoliang Sun
Objective: Controversy still exists regarding the efficiency and safety of liposomal bupivacaine (LB) vs interscalene nerve block (INB) for pain management after total shoulder arthroplasty (TSA). The aim of the present meta-analysis was to perform a relatively credible and overall assessment to compare the efficiency and safety of LB-based infiltration vs INB for pain management after TSA. Methods: The PubMed, Cochrane Library, Web of Science, and EMBASE were systematically searched...
2018: Journal of Pain Research
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