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Postoperative nerve blocks

Julia Sicard, Shahnaz Klouche, Christel Conso, Nicolas Billot, Jean-Charles Auregan, Samuel Poulain, Florent Lespagnol, Nicolas Solignac, Thomas Bauer, Mathieu Ferrand, Philippe Hardy
BACKGROUND: The aim of this study was to compare the efficacy of local infiltration analgesia (LIA) and interscalene nerve block (ISB) for early postoperative pain control after total shoulder arthroplasty (TSA). The hypothesis was that LIA is not inferior to ISB. METHODS: A prospective, randomized controlled study was performed in 2014-2016. All patients who underwent TSA for shoulder osteoarthritis were included. Patients in the ISB group received a continuous infusion of 0...
December 10, 2018: Journal of Shoulder and Elbow Surgery
Zhigang Guo, Zhijia Wang, Kai Li, Chao Du, Xingli Zhao, Min Cheng, Yu Tian
Objectives: Patients with trigeminal neuralgia who are refractory to medical therapy may choose to undergo Gasserian ganglion percutaneous radiofrequency thermocoagulation. However, in cases where the foramen ovale is difficult to access due to various anatomical anomalies, the typical estimation of the facial entry point is suboptimal. Methods: Three-dimensional computed tomography reconstruction imaging performed before surgery revealed anatomical variations in each of the four adult patient cases that made it more difficult to successfully access the foramen ovale (FO) for percutaneous radiofrequency thermocoagulation...
December 7, 2018: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
Amarjeet Kumar, Chandni Sinha, Ajeet Kumar, Poonam Kumari, Sailesh Kumar Mukul
Background and Aims: Ultrasound (USG)-guided injection in pterygopalatine fossa is an indirect approach to block the trigeminal nerve. Trigeminal nerve block for maxillofacial surgeries may provide preemptive analgesia, reduce opioid consumption and opioid-related adverse effects. Methods: In this randomised, prospective double-blind study, 60 American Society of Anesthesiologists I/II patients, within the age group of 18-60 years scheduled for faciomaxillary surgery (fracture/pathological lesion of maxilla or mandible and cleft lip), were recruited...
November 2018: Indian Journal of Anaesthesia
Ilker Ince, Ozgur Ozmen, Mehmet Aksoy, Sumeyra Zeren, Ali Bilal Ulas, Yener Aydin
The erector spinae plane (ESP) block is a novel plane block first reported for thoracic analgesia. It affects the dorsal and ventral rami of the thoracic nerves. Owing to the ease of the technique and decreased risk of complication of the ESP block under ultrasound guidance, it can be a preferable procedure compared with other invasive techniques, such as neuraxial and nerve blocks. In this case report, we presented three patients who had thoracic surgery under general anesthesia. The ESP block and catheter placement was applied to the patients before operation...
October 2018: Eurasian Journal of Medicine
Mustafa Karahan
Pain management is crucial for a successful result after various knee surgeries. Opioids may be included in the postoperative pain management protocol but may be abused if not controlled. Following knee arthroscopy and related surgery, adolescent and young adult patients are commonly overprescribed opioids. The driving force behind opioid prescription should be explored in addition to reviewing and emphasizing perioperative interventions that can reduce postoperative opioid consumption, including wound injections and peripheral nerve blocks...
December 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
Zhen Tan, Pengde Kang, FuXing Pei, Bin Shen, ZongKe Zhou, Jing Yang
BACKGROUND: The aim of this study was to compare the analgesic effect on the lateral and overall knee and early rehabilitation between adductor canal block (ACB) and femoral nerve block (FNB) after total-knee arthroplasty. METHOD: Two hundred patients randomly participated in the study and were divided into the ACB group and FNB group in a randomized manner. All patients received standardized anesthesia and analgesia upon hospitalization. Outcome evaluations included visual analog scale (VAS) scores at rest and during activity, quadriceps strength, range of motion (ROM), total opioid consumption and complication occurrence, sleep interruptions caused by pain, postoperative nausea and vomiting (PONV), and postoperative length of stay (PLOS) before discharge in all groups...
November 2018: Medicine (Baltimore)
Cong Ning, Yuanyi Wang, Feng Xu, Wenjing Zhang, Wei Liu, Zhenshan Lv, Yadong Liu, Changfeng Fu
RATIONALE: The accurate and smooth establishment of a working cannula guarantees rapid and minimally invasive treatment effects using percutaneous endoscopic lumbar discectomy (PELD) for lumbar disc herniation (LDH). With anatomic variations such as a hyperplastic superior articular process (SAP), the conventional transforaminal approach cannot achieve an ideal result. PATIENT CONCERNS: A 48-year-old male patient suffered waist and left lower limb pain, with exacerbation of symptoms after exertion...
November 2018: Medicine (Baltimore)
A Ran Lee, Young Woo Cho, Jae Min Lee, Yong Joon Shin, Il Sang Han, Hyung Kwan Lee
RATIONALE: Although persistent postoperative hiccups can cause various problems (such as sleep disorders, depression, fatigue) for the patient, there has been little research on this topic. The purpose of this study is to determine the effectiveness of treating persistent postoperative hiccups with a stellate ganglion block (SGB), an injection of local anesthetic in the sympathetic nerve tissue of the neck. PATIENT CONCERNS AND DIAGNOSES: Three patients each developed persistent hiccups within 3 days of abdominal surgery, lasting for 3 to 6 days...
November 2018: Medicine (Baltimore)
J C Galán Gutiérrez, B Tobera Noval, F J Sáenz Abós, M González Rodríguez, L A Fernández Meré, L A Sopena Zubiria
The addition of ultrasound to locoregional anaesthesia in the last few years has led to the description of various fascial thoracic blocks with analgesic purposes: PECS 1 and 2 block, serratus plane block, serratus intercostal fascial block, blockade in the plane of the thoracic transverse muscle..., which have been added to other well-known nerve blocks, such as thoracic paravertebral block or intercostal block. In this sense, locoregional anaesthesia has been universally recommended in patients with severe respiratory processes in order to avoid ventilatory support and subsequent weaning that considerably increases postoperative morbidity and mortality rates...
November 29, 2018: Revista Española de Anestesiología y Reanimación
Alessandro De Cassai, Daniele Bonvicini, Michele Ruol, Christelle Correale, Maurizio Furnari
Breast innervation consists of intercostal nerves and brachial plexus. Here we propose a technique to execute breast surgery without general anesthesia using erector spinae plane (ESP) block and selective block of four nerves arising from brachial plexus and innervating breast and axilla (from now on SBP block. A 77-year-old male presented for breast cancer with indication to radical mastectomy and axillary clearance. He had a history of myocardial infarction resulting in postinfarction dilated cardiomyopathy with a severe reduction in ejection fraction...
November 27, 2018: Korean Journal of Anesthesiology
Zoher Naja, Saleh Kanawati, Ziad El Khatib, Fouad Ziade, Rakan Nasreddine, Ahmad Salah Naja
PURPOSE: The objective of the study was to compare three nerve stimulator-guided paravertebral injections versus five injections for elderly patients undergoing inguinal hernia repair in terms of the amount of intraoperative fentanyl and propofol consumption and conversion to general anesthesia. The secondary objective was postoperative pain. METHODS: A prospective, randomized, double-blind clinical trial was performed. 200 elderly patients undergoing unilateral herniorrhaphy were randomized into two groups...
November 16, 2018: Journal of Anesthesia
Kompal Jain, Vikky Jaiswal, Arun Puri
Erector spinae plane (ESP) block is an interfascial plane block where a local anaesthetic is injected in a plane preferably below the erector spinae muscle. It is supposed to work at the origin of spinal nerves based on cadaveric and contrast study. It has emerged as an effective and safe analgesic regional technique. It has a wide variety of applications ranging from control of acute postoperative pain to chronic pain. In this series, we report a series of six cases, which include postoperative pain management in breast, thoracic, and abdominal surgeries along with management of two chronic pain cases to illustrate the potential uses of continuous and single-shot ESP block...
October 2018: Indian Journal of Anaesthesia
Mona Ahmed Ammar, Mohamed Taeimah
Background: Thoracolumbar interfascial plane (TLIP) block involves injection of local anesthetics between multifidus and longissimus muscles at the 3rd lumbar vertebral level assuming that it can block the dorsal rami of thoracolumbar nerves. Objective: The objective of this study was to evaluate the analgesic effects gained after performing TLIP block (analogous to the transversus abdominis plane [TAP] block, but intended for the back) in patients undergoing lumbar discectomy...
October 2018: Saudi Journal of Anaesthesia
Rune Sort, Stig Brorson, Ismail Gögenur, Jesper K Nielsen, Ann M Møller
BACKGROUND: Peripheral nerve blocks (PNB) are increasingly used for anaesthesia and postoperative pain control in acute orthopaedic limb surgery but rebound pain upon cessation of PNBs may challenge the benefits on the pain profile. We aimed to explore the pain profile following acute ankle fracture surgery under PNB anaesthesia and investigate if rebound pain could pose a clinical problem. METHODS: Exploratory, observational study of adults scheduled for acute primary internal fixation of an ankle fracture under ultrasound-guided popliteal sciatic and saphenous ropivacaine block anaesthesia...
November 8, 2018: Acta Anaesthesiologica Scandinavica
Hongwei Fang, Jinyuan Zhang, Yu Yang, Le Ye, Xiangrui Wang
Background: Pudendal neuralgia is an intractable pain related to the pudendal nerve. The clinical effect and safety evaluation of pudendal neuralgia were investigated by pulse radiofrequency (PRF) treatment of pudendal nerve. Patients and methods: Eighty patients who were diagnosed with pudendal neuralgia were randomly divided into PRF group (PRF and pudendal nerve block [NB]) and NB group. After surgery, the patients were followed up to evaluate the visual analog scale (VAS) score and the Patient Health Questionnaire score on the postoperative day and at 2 weeks, 1 and 3 months...
2018: Journal of Pain Research
Korgün Ökmen, Burcu Metin Ökmen
OBJECTIVES: The aim of the study was to investigate the effect of ultrasound guided superficial cervical plexus (SCP) block versus greater auricular nerve (GAN) block for on postoperative tympanomastoid surgery analgesia. METHODS: In this prospective, randomized, single-blind study, a total of 50 patients aged between 25 and 70 years, those who were in the American Society of Anesthesiologists I-II class and underwent tympanomastoid surgery were included in the study...
October 2018: Aǧrı: Ağrı (Algoloji) Derneği'nin Yayın Organıdır, the Journal of the Turkish Society of Algology
Seha Ahn, Youngkyu Moon, Zeead M AlGhamdi, Sook Whan Sung
Background: We report our surgical technique for nonintubated uniportal video-assisted thoracoscopic surgery (VATS) pulmonary resection and early postoperative outcomes at a single center. Methods: Between January and July 2017, 40 consecutive patients underwent nonintubated uniportal VATS pulmonary resection. Multilevel intercostal nerve block was performed using local anesthesia in all patients, and an intrathoracic vagal blockade was performed in 35 patients (87...
October 2018: Korean Journal of Thoracic and Cardiovascular Surgery
Wirinaree Kampitak, Aree Tanavalee, Srihatach Ngarmukos, Chavarin Amarase
BACKGROUND: Peripheral nerve block and local infiltration analgesia (LIA) have an increasing role as part of multimodal analgesia for enhanced recovery after total knee arthroplasty (TKA). We hypothesized that the combination of obturator nerve block (ONB) and tibial nerve block (TNB) would reduce pain and opioid consumption more than ONB or TNB alone when combined with continuous adductor canal block and LIA. METHODS: Ninety patients were recruited into the study and received spinal anesthesia, LIA, and continuous adductor canal block...
October 13, 2018: Journal of Arthroplasty
Frances A Tepolt, Jennifer Bido, Stephanie Burgess, Lyle J Micheli, Mininder S Kocher
PURPOSE: The purpose of this study was to compare the number of opioids prescribed with the amount of pain medication required after knee arthroscopy and related surgery in adolescent and young adult patients to determine the effectiveness of current pain-control practices at a single institution. The secondary purpose was to determine what demographic or surgical factors are associated with increased opioid intake. METHODS: Adolescent and young adult patients who underwent knee arthroscopy and related surgery, including ligament reconstruction or tibial tubercle osteotomy, between May and August 2016 were provided pain-control logbooks in which they were asked to maintain a record of daily pain medication intake...
November 2, 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
Sophie C Payne, John B Furness, Martin J Stebbing
The gastrointestinal tract has extensive, surgically accessible nerve connections with the central nervous system. This provides the opportunity to exploit rapidly advancing methods of nerve stimulation to treat gastrointestinal disorders. Bioelectric neuromodulation technology has considerably advanced in the past decade, but sacral nerve stimulation for faecal incontinence currently remains the only neuromodulation protocol in general use for a gastrointestinal disorder. Treatment of other conditions, such as IBD, obesity, nausea and gastroparesis, has had variable success...
November 2, 2018: Nature Reviews. Gastroenterology & Hepatology
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