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Postoperative nerve blocks

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https://www.readbyqxmd.com/read/30100852/anesthesiologist-preference-for-postoperative-analgesia-in-major-surgery-patients-with-obstructive-sleep-apnea
#1
Olumuyiwa A Bamgbade
Obstructive sleep apnea (OSA) is prevalent and presents perioperative challenges. There are guidelines regarding perioperative care of OSA, but analgesia management of OSA patients is inconsistent or inadequate. This is a study of the United Kingdom anesthesiologists' postoperative analgesia preferences for OSA patients. Overall, the 1st choice of main analgesia was continuous epidural local anesthetic (LA) without opioid, at 30% rate; P = 0.001. The 2nd choice was continuous epidural LA plus fentanyl, at 21% rate; P = 0...
July 2018: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/30096081/continuous-popliteal-sciatic-blocks-for-postoperative-analgesia-traditional-proximal-catheter-insertion-superficial-to-the-paraneural-sheath-versus-a-new-distal-insertion-site-deep-to-the-paraneural-sheath
#2
Jacklynn F Sztain, John J Finneran, Amanda M Monahan, Bahareh Khatibi, Patrick L Nguyen, Sarah J Madison, Richard H Bellars, Rodney A Gabriel, Sonya S Ahmed, Alexandra K Schwartz, William T Kent, Michael C Donohue, Jennifer A Padwal, Brian M Ilfeld
We tested the hypothesis that during a continuous popliteal-sciatic nerve block, postoperative analgesia is improved with the catheter insertion point "deep" to the paraneural sheath immediately distal to the bifurcation between the tibial and common peroneal branches, compared with the traditional approach "superficial" to the paraneural sheath proximal to the bifurcation. The needle tip location was determined to be accurately located with a fluid bolus visualized with ultrasound; however, catheters were subsequently inserted without a similar fluid injection and visualization protocol (visualized air injection was permitted and usually implemented, but not required per protocol)...
August 9, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/30095549/efficacy-and-safety-of-dexmedetomidine-in-peripheral-nerve-blocks-a-meta-analysis-and-trial-sequential-analysis
#3
Alexander Schnabel, Sylvia U Reichl, Stephanie Weibel, Peter Kranke, Peter K Zahn, Esther M Pogatzki-Zahn, Christine H Meyer-Frießem
BACKGROUND: The duration of analgesia provided by nerve blocks is limited if local anaesthetics are administered alone. Therefore, several additives, including dexmedetomidine (DEX), have been investigated in order to prolong postoperative analgesia following single-shot regional anaesthesia. OBJECTIVES: The aim of this meta-analysis was to assess the efficacy and safety of the addition of perineural DEX to local anaesthetics compared with local anaesthetics alone or local anaesthetics combined with systemic administration of DEX...
August 7, 2018: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/30095446/pain-control-in-a-pediatric-patient-with-sickle-cell-disease-using-regional-nerve-blocks-for-laparoscopic-cholecystectomy-a-case-report
#4
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
https://www.readbyqxmd.com/read/30092937/update-on-selective-regional-analgesia-for-hip-surgery-patients
#5
REVIEW
Dario Bugada, Valentina Bellini, Luca F Lorini, Edward R Mariano
In hip surgery, regional anesthesia offers benefits in pain management and recovery. There are a wide range of regional analgesic options; none have shown to be superior. Lumbar plexus block, femoral nerve block, and fascia iliaca block are the most supported by published literature. Other techniques, such as selective obturator and/or lateral femoral cutaneous nerve blocks, represent alternatives. Newer approaches, such as quadratus lumborum block and local infiltration analgesia, require rigorous studies...
September 2018: Anesthesiology Clinics
https://www.readbyqxmd.com/read/30092936/novel-methodologies-in-regional-anesthesia-for-knee-arthroplasty
#6
REVIEW
Rodney A Gabriel, Brian M Ilfeld
Maximizing analgesia is critical following joint arthroplasty because postoperative pain is a major barrier to adequate physical therapy. Continuous peripheral nerve blocks have been the mainstay for acute pain management in this population; however, this and similar techniques are limited by their duration of action. Cryoneurolysis and peripheral nerve stimulation are two methodologies used for decades to treat chronic pain. With the advent of portable ultrasound devices and percutaneous administration equipment, both procedures may now be suitable for treatment of acute pain...
September 2018: Anesthesiology Clinics
https://www.readbyqxmd.com/read/30079491/infraorbital-foramen-location-in-the-pediatric-population-a-guide-for-infraorbital-nerve-block
#7
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
https://www.readbyqxmd.com/read/30078859/erector-spinae-plane-block-in-abdominal-surgery-case-series
#8
Juan Carlos Luis-Navarro, María Seda-Guzmán, Cristina Luis-Moreno, Ki-Jinn Chin
The aim of this study is to report 11 cases of erector spinae plane (ESP) block used for unilateral or bilateral abdominal surgery, adding to the overall limited experience with abdominal ESP block. The procedures were carried out at a teaching hospital in 11 patients (eight males, three females, ages 36-80 years) requiring abdominal surgery, including laparoscopic surgery. Each patient required surgery under different physical circumstances and likely different conceptions of what constituted pain. Two of the eleven patients were administered the ESP block and did not require general anaesthesia...
July 2018: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/30075877/the-opioid-crisis-and-the-orthopedic-surgeon
#9
Nicholas A Trasolini, Braden M McKnight, Lawrence D Dorr
Opioid use and abuse has become a national crisis in the United States. Many opioid abusers become addicted through an initial course of legal, physician-prescribed medications. Consequently, there has been increased pressure on medical care providers to be better stewards of these medications. In orthopedic surgery and total joint arthroplasty, pain control after surgery is critical for restoring mobility and maintaining patient satisfaction in the early postoperative period. Before the opioid misuse epidemic, orthopedic surgeons were frequently influenced to "treat pain with pain medications...
July 11, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/30074492/extended-release-bupivacaine-formulations-for-postoperative-analgesia-an-update
#10
Angela Lucia Balocco, Pieter G E Van Zundert, Sophie S Gan, Tong J Gan, Admir Hadzic
PURPOSE OF REVIEW: New formulations of local anesthetics with sustained release and longer duration of action are being developed to improve patient outcomes following surgery. This review summarizes the efficacy and safety of the three most recently developed extended-release formulations of the local anesthetic, bupivacaine. RECENT FINDINGS: Bupivacaine liposome injectable suspension (EXPAREL) encapsulates bupivacaine in biodegradable liposomes. It is currently the only extended-release formulation of bupivacaine approved by the FDA for infiltration of the tissues during surgery and for interscalene nerve block analgesia following shoulder surgery...
July 31, 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/30066465/ultrasound-guided-adductor-canal-block-after-arthroscopic-anterior-cruciate-ligament-reconstruction-effect-of-adding-dexamethasone-to-bupivacaine-a-randomized-controlled-trial
#11
Waleed S Farrag
BACKGROUND: Dexamethasone improves the quality and duration of peripheral nerve block when used as an adjuvant to local anesthetic. We evaluated the effect of adding dexamethasone to bupivacaine on the duration of postoperative analgesia in patients undergoing knee arthroscopy using ultrasound guided adductor canal block. METHODS: The study was a randomized, double-blinded, trial. Sixty patients scheduled for arthroscopic anterior cruciate ligament reconstruction were randomly allocated into two groups to receive adductor canal block...
July 31, 2018: European Journal of Pain: EJP
https://www.readbyqxmd.com/read/30063033/postoperative-regional-analgesia-is-effective-in-preserving-perforin-expressing-lymphocytes-in-patients-after-total-knee-replacement
#12
Sandra Velcic Brumnjak, Ivan Rakovac, Dijana Papez Kinkela, Kresimir Bukal, Branko Sestan, Vera Tulic, Elisa Velcic Janjetic, Vlatka Sotosek Tokmadzic
BACKGROUND Pain and surgical stress cause a pro-inflammatory response followed by downregulation of the immune response, which can increase the incidence of postoperative complications, such as infections or prolonged wound healing. T lymphocytes and natural killer (NK) cells have cytotoxic potential and are crucial components of cellular immunity, which is important for maintenance of immune balance. The aim of this study was to analyze the effects of 3 types of postoperative analgesia on the preservation and cytotoxic potential of T lymphocytes, NK cells, and their subpopulations, as well as NKT cells, in patients after total knee replacement (TKR) to find the most effective analgesic technique for mitigating immune suppression...
July 31, 2018: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/30052231/efficacy-of-bilateral-pectoralis-nerve-block-for-ultrafast-tracking-and-postoperative-pain-management-in-cardiac-surgery
#13
Karthik Narendra Kumar, Ravikumar Nagashetty Kalyane, Naveen G Singh, P S Nagaraja, Madhu Krishna, Balaji Babu, R Varadaraju, N Sathish, N Manjunatha
Background: Good postoperative analgesia in cardiac surgical patients helps in early recovery and ambulation. An alternative to parenteral, paravertebral, and thoracic epidural analgesia can be pectoralis nerve (Pecs) block, which is novel, less invasive regional analgesic technique. Aims: We hypothesized that Pecs block would provide superior postoperative analgesia for patients undergoing cardiac surgery through midline sternotomy compared to parenteral analgesia...
July 2018: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/30051443/-operative-strategy-and-short-term-efficacy-of-recurrent-groin-hernia
#14
Xitao Wang, Gengwen Huang, Dingcheng Shen, Jiayan Lin, Caihong Ning, Xintong Cao, Liandong Ji, Yebin Lu, Wei Wei
OBJECTIVE: To explore the appropriate operative strategy in recurrent groin hernia repair. METHODS: Clinical and follow-up data of 82 patients with recurrent groin hernia undergoing operation at Department of Pancreatobiliary Surgery, Xiangya Hospital of Central South University from April 2010 to April 2017 were analyzed retrospectively. The operative approaches included laparoscopic transabdominal preperitoneal (TAPP) hernia repair, Lichtenstein repair and hybrid repair...
July 25, 2018: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/30037575/association-of-serratus-anterior-plane-block-for-minimally-invasive-direct-coronary-artery-bypass-surgery-with-higher-opioid-consumption-a-retrospective-observational-study
#15
Vanessa Moll, Carla Maffeo, Matthew Mitchell, Ceressa T Ward, Robert F Groff, Simon C Lee, Michael E Halkos, Craig S Jabaley, Vikas N O'Reilly-Shah
OBJECTIVE: The optimal regional technique for minimally invasive direct coronary artery bypass (MIDCAB) has yet to be determined. The aim of this study was to compare the efficacy of ultrasound-guided serratus anterior plane block (SAPB) with paravertebral block (PVB) and no block for controlling acute thoracotomy pain after robotic-assisted coronary artery bypass grafting (CABG). DESIGN: This is a retrospective study. Multiple variable regression analyses were performed...
April 26, 2018: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/30037342/effect-of-local-infiltration-analgesia-peripheral-nerve-blocks-general-and-spinal-anesthesia-on-early-functional-recovery-and-pain-control-in-unicompartmental-knee-arthroplasty
#16
M T Berninger, J Friederichs, W Leidinger, P Augat, V Bühren, C Fulghum, W Reng
BACKGROUND: The aim of the study was to analyze the effect of local infiltration analgesia (LIA), peripheral nerve blocks, general and spinal anesthesia on early functional recovery and pain control in primary unicompartmental knee arthroplasty (UKA). METHODS: Between January 2016 until August 2016, 134 patients underwent primary UKA and were subdivided into four groups according to their concomitant pain and anesthetic procedure with catheter-based techniques of femoral and sciatic nerve block (group GA&FNB, n = 38) or epidural catheter (group SP&EPI, n = 20) in combination with general anesthesia or spinal anesthesia, respectively, and LIA combined with general anesthesia (group GA&LIA, n = 46) or spinal anesthesia (group SP&LIA, n = 30)...
July 24, 2018: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/30035357/dorsal-penile-nerve-block-for-circumcision-in-pediatric-patients-a-prospective-observer-blinded-randomized-controlled-clinical-trial-for-the-comparison-of-ultrasound-guided-vs-landmark-technique
#17
An Teunkens, Marc Van de Velde, Kristien Vermeulen, Philippe Van Loon, Guy Bogaert, Steffen Fieuws, Steffen Rex
BACKGROUND AND AIMS: Circumcision is a frequently performed procedure in day case pediatric surgery. Dorsal penile nerve block has proven its effectiveness for the management of acute postoperative pain after circumcision. We investigated if the ultrasound-guided placement of a dorsal penile nerve block could reduce opioid requirement as compared to a landmark-based technique. METHODS: Three hundred and ten prepubertal children, aged between 52 weeks postconception and 11 years, were included in this prospective, observer-blinded, randomized controlled trial and received either a landmark- or an ultrasound-guided dorsal penile nerve block, using a caudal needle and injecting 0...
July 23, 2018: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/30024078/a-feasibility-study-of-percutaneous-peripheral-nerve-stimulation-for-the-treatment-of-postoperative-pain-following-total-knee-arthroplasty
#18
Brian M Ilfeld, Scott T Ball, Rodney A Gabriel, Jacklynn F Sztain, Amanda M Monahan, Wendy B Abramson, Bahareh Khatibi, Engy T Said, Jesal Parekh, Stuart A Grant, Amorn Wongsarnpigoon, Joseph W Boggs
INTRODUCTION: The objective of the present feasibility study was to investigate the use of a new treatment modality-percutaneous peripheral nerve stimulation (PNS)-in controlling the often severe and long-lasting pain following total knee arthroplasty (TKA). METHODS: For patients undergoing a primary, unilateral TKA, both femoral and sciatic open-coil percutaneous leads (SPR Therapeutics, Cleveland, OH) were placed up to seven days prior to surgery using ultrasound guidance...
July 19, 2018: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/30021587/effect-of-local-infiltration-analgesia-peripheral-nerve-blocks-general-and-spinal-anesthesia-on-early-functional-recovery-and-pain-control-in-total-knee-arthroplasty
#19
M T Berninger, J Friederichs, W Leidinger, P Augat, V Bühren, C Fulghum, W Reng
BACKGROUND: Postoperative pain control and enhanced mobilization, muscle strength and range of motion following total knee arthroplasty (TKA) are pivotal requisites to optimize rehabilitation and early recovery. The aim of the study was to analyze the effect of local infiltration analgesia (LIA), peripheral nerve blocks, general and spinal anesthesia on early functional recovery and pain control in primary total knee arthroplasty. METHODS: Between January 2016 until August 2016, 280 patients underwent primary TKA and were subdivided into four groups according to their concomitant pain and anesthetic procedure with catheter-based techniques of femoral and sciatic nerve block (group GA&FNB, n = 81) or epidural catheter (group SP&EPI, n = 51) in combination with general anesthesia or spinal anesthesia, respectively, and LIA combined with general anesthesia (group GA&LIA, n = 86) or spinal anesthesia (group SP&LIA, n = 61)...
July 18, 2018: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/30015059/general-laryngeal-mask-airway-anesthesia-with-lumbar-plexus-and-sciatic-block-provides-better-outcomes-than-general-anesthesia-and-endotracheal-intubation-in-elderly-patients-undergoing-hip-surgery
#20
Wei-Qiang Chen, Na Guo, Shan-Shan Wang, Ren Wang, Fei Huang, Shang-Rong Li
OBJECTIVE: To compare the perioperative outcomes and hemodynamic effects at induction of general laryngeal mask airway (LMA) anesthesia with lumbar plexus-sciatic nerve block (LPSB) and general anesthesia with endotracheal intubation (ET) in elderly patients undergoing hip surgery. METHODS: A total of 63 patients having open reduction internal fixation of an intertrochanteric fracture were randomly assigned to receive LMA anesthesia with LPSB or general anesthesia with ET...
September 2018: Archives of Gerontology and Geriatrics
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