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Ultrasound nerve block and pain management

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https://www.readbyqxmd.com/read/27904260/sonographic-identification-of-peripheral-nerves-in-the-forearm
#1
Saundra A Jackson, Charlotte Derr, Anthony De Lucia, Marvin Harris, Zuheily Closser, Branko Miladinovic, Rahul Mhaskar, Theresa Jorgensen, Lori Green
BACKGROUND: With the growing utilization of ultrasonography in emergency medicine combined with the concern over adequate pain management in the emergency department (ED), ultrasound guidance for peripheral nerve blockade in ED is an area of increasing interest. The medical literature has multiple reports supporting the use of ultrasound guidance in peripheral nerve blocks. However, to perform a peripheral nerve block, one must first be able to reliably identify the specific nerve before the procedure...
October 2016: Journal of Emergencies, Trauma, and Shock
https://www.readbyqxmd.com/read/27842565/regional-anesthesia-for-painful-injuries-after-disasters-rapid-study-protocol-for-a-randomized-controlled-trial
#2
Adam C Levine, Carrie Teicher, Adam R Aluisio, Tess Wiskel, Pola Valles, Miguel Trelles, Justin Glavis-Bloom, Rebecca F Grais
BACKGROUND: Lower extremity trauma during earthquakes accounts for the largest burden of disaster-related injuries. Insufficient pain management is common in resource-limited disaster settings, and regional anesthesia (RA) may reduce pain in injured patients beyond current standards of care. To date, no controlled trials have been conducted to evaluate the use of RA for pain management in a disaster setting. METHODS/DESIGN: The Regional Anesthesia for Painful Injuries after Disasters (RAPID) study aims to evaluate whether regional anesthesia (RA), either with or without ultrasound (US) guidance, can reduce pain from earthquake-related lower limb injuries in a disaster setting...
November 14, 2016: Trials
https://www.readbyqxmd.com/read/27822391/ultrasound-guided-genicular-nerve-thermal-radiofrequency-ablation-for-chronic-knee-pain
#3
Joshua Wong, Nicholas Bremer, Paul D Weyker, Christopher A J Webb
Osteoarthritis (OA) of the knee is one of the most common joint diseases affecting adults in the United States. For elderly patients with multiple medical comorbidities who do not wish to undergo total knee arthroplasty (TKA), lifestyle modification, pharmacologic management, and injections are the mainstay of therapy. Previously, pain management interventions were limited to intra-articular joint injections and viscosupplementation with hyaluronic acid. Fluoroscopic-guided techniques for radiofrequency ablation (RFA) of the genicular nerves have been previously described and a recent cadaveric study suggests that ultrasound-guided genicular nerve blocks can be performed accurately...
2016: Case Reports in Anesthesiology
https://www.readbyqxmd.com/read/27676665/efficacy-and-safety-of-ketamine-added-to-local-anesthetic-in-modified-pectoral-block-for-management-of-postoperative-pain-in-patients-undergoing-modified-radical-mastectomy
#4
Ahmed H Othman, Ahmad M Abd El-Rahman, Fatma El Sherif
BACKGROUND: Breast surgery is an exceedingly common procedure with an increased incidence of acute and chronic pain. Pectoral nerve block is a novel peripheral nerve block alternative to neuro-axial and paravertebral blocks for ambulatory breast surgeries. OBJECTIVES: This study aims to compare the analgesic efficacy and safety of modified Pecs block with ketamine plus bupivacaine versus bupivacaine in patients undergoing breast cancer surgery. STUDY DESIGN: A randomized, double-blind, prospective study...
September 2016: Pain Physician
https://www.readbyqxmd.com/read/27650294/clinical-usefulness-of-pectoral-nerve-block-for-the-management-of-zoster-associated-pain-case-reports-and-technical-description
#5
Yeon-Dong Kim, Seon-Jeong Park, Junho Shim, Hyungtae Kim
The recently introduced pectoral nerve (Pecs) block is a simple alterative to the conventional thoracic paravertebral block or epidural block for breast surgery. It produces excellent analgesia and can be used to provide balanced anesthesia and as a rescue block in cases where performing a neuraxial blockade is not possible. In the thoracic region, a neuraxial blockade is often used to manage zoster-associated pain. However, this can be challenging for physicians due to the increased risk of hemodynamic instability in the upper thoracic level, and comorbid and contraindicated medical conditions such as coagulopathy...
September 20, 2016: Journal of Anesthesia
https://www.readbyqxmd.com/read/27630930/analgesic-efficacy-of-ultrasound-guided-ficb-in-patients-with-hip-fracture
#6
Devender Kumar, Sarla Hooda, Shashi Kiran, Jyoti Devi
INTRODUCTION: Hip fractures are often encountered in the elderly and present special problems to the anaesthesiologist. Fascia iliaca compartment block is another technique with the intent to block all the three nerves like 3-in-1 nerve block. AIM: To evaluate the analgesic efficacy of ultrasound guided fascia iliaca compartment block to facilitate positioning of patients with hip fracture for spinal anaesthesia. MATERIALS AND METHODS: This prospective study was conducted in 50 patients aged between 40-80 years, belonging to American Society of Anesthesiologists (ASA) physical status I-III undergoing surgery for hip fracture...
July 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/27607407/ultrasound-guided-temporomandibular-joint-injection-for-chronic-posthemimandibulectomy-jaw-pain
#7
Arunangshu Chakraborty, Taniya Datta, Dayananda Lingegowda, Rakhi Khemka
Temporomandibular joint (TMJ) pain can be difficult to diagnose and treat. We describe a patient with left jaw pain after right hemimandibulectomy. The patient was initially managed conservatively, which failed to reduce pain. He was then administered inferior alveolar nerve block and TMJ injection with steroid and local anesthetic. These injections provided temporary pain relief that lasted approximately 1 month and the pain recurred. Computed tomography scan showed lateral displacement of left mandibular condyle...
September 7, 2016: A & A Case Reports
https://www.readbyqxmd.com/read/27587333/ultrasound-guided-serratus-plane-block-for-treatment-of-postmastectomy-pain-syndromes-in-breast-cancer-patients-a-case-series
#8
Jennifer A Zocca, Grant H Chen, Vinay G Puttanniah, Joseph C Hung, Amitabh Gulati
Postmastectomy pain syndrome is common after surgical treatment for breast cancer and may be challenging to manage. Currently, there are a wide variety of approaches to treat this type of pain, including medications, physical therapy, and interventional procedures. However, because of the complexity of innervation of the breast, the serratus plane block may better target the web of nerves innervating the anterior chest wall including the breast. We present a case series of 8 patients who were successfully treated with serratus plane block for pain after treatment for breast cancer...
September 2, 2016: Pain Practice: the Official Journal of World Institute of Pain
https://www.readbyqxmd.com/read/27555210/interventional-and-multimodal-pain-rehabilitation-in-a-child-with-meralgia-paresthetica
#9
Andrew D Franklin, G Bennett Cierny, Twila R Luckett
Meralgia paresthetica is a chronic pain syndrome that is extremely rare in the pediatric population. It is manifested by hypesthesia or pain in the distribution of the lateral femoral cutaneous nerve (LFCN) and is typically caused by entrapment as the nerve passes deep to the inguinal ligament. This sensory mononeuropathy is rare in children and diagnosis is typically delayed, often leading to prolonged functional impairment and unnecessary medical testing. A 9-year-old girl presented to the pain clinic with a 6-week history of right anterolateral thigh pain first noticed after a nontraumatic cheerleading practice...
September 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27498527/efficiency-of-ultrasound-guided-lower-limb-peripheral-nerve-blocks-in-perioperative-pain-management-for-knee-arthroscopy-in-children-a-randomized-study
#10
RANDOMIZED CONTROLLED TRIAL
Dragan Marinković, Jovana M Simin, Biljana Drasković, Ivana M Kvrgić, Marina Pandurov
INTRODUCTION: Ultrasound guided lower limb peripheral nerve blocks are efficient for perioperative pain treatment in children. The aim was to see if lower limb peripheral nerve blocks reduced the amount of propofol and opioid analgesics used intraoperatively, as well as the level of pain and consumption of systemic analgesics postoperatively. MATERIAL AND METHODS: A randomized, prospective clinical trial was carried out. It included 60 children between 11 and 18 years of age scheduled for elective knee arthroscopy...
January 2016: Medicinski Pregled
https://www.readbyqxmd.com/read/27442683/ultrasound-guided-bilateral-combined-inguinal-femoral-and-subgluteal-sciatic-nerve-blocks-for-simultaneous-bilateral-below-knee-amputations-due-to-bilateral-diabetic-foot-gangrene-unresponsive-to-peripheral-arterial-angioplasty-and-bypass-surgery-in-a-coagulopathic
#11
Sung Hye Byun, Jonghoon Lee, Jong Hae Kim
BACKGROUND: Patients on antiplatelet therapy following percutaneous coronary intervention can become coagulopathic due to infection. Performing regional anesthesia for bilateral surgery in such cases is challenging. We report a case of successful combined inguinal femoral and subgluteal sciatic nerve blocks (CFSNBs) for simultaneous bilateral below-knee amputations in a coagulopathic patient on antiplatelet therapy. METHODS: A 70-year-old male patient presented with pain in both feet due to diabetic foot syndrome...
July 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27389118/ultrasound-guided-genicular-nerve-pulsed-radiofrequency-treatment-for-painful-knee-osteoarthritis-a-preliminary-report
#12
Serdar Kesikburun, Evren Yaşar, Ayça Uran, Emre Adigüzel, Bilge Yilmaz
BACKGROUND: Genicular nerve ablation with radiofrequency (RF) has recently emerged as a promising treatment in the management of osteoarthritis related knee pain. To date, genicular nerve injections have been performed under fluoroscopic guidance. OBJECTIVE: To evaluate the effect of ultrasound-guided genicular nerve pulsed RF treatment on chronic knee pain and function in patients with knee osteoarthritis. STUDY DESIGN: Single-arm prospective study...
July 2016: Pain Physician
https://www.readbyqxmd.com/read/27382811/combined-block-of-the-femoral-and-lateral-femoral-cutaneous-nerves-under-ultrasound-for-post-operative-analgesia-in-patients-undergoing-hip-surgery-a-double-blind-randomized-trial
#13
RANDOMIZED CONTROLLED TRIAL
Maroun Badwi Ghabach, Jamil Marwan Elmawieh, May Semaan Matta, May Rady Helou
BACKGROUND: Inadequate pain management of post-operative pain of patients undergoing hip surgery can result in morbidity and mortality complications. Anatomically, pain resulted from the incision site innervation (Lateral femoral cutaneous nerve) and the hip joint innervation mainly the femoral nerve. Adding femoral nerve blockade to the multimodal regimen for postoperative pain control after hip surgery has been described. METHODS: all 31 patients included in the study received preoperatively combined FN and LFCN block with Normal Saline 0, 9% (group I) or bupivacaine 0...
February 2016: Middle East Journal of Anesthesiology
https://www.readbyqxmd.com/read/27363208/stellate-ganglion-blockade-techniques-and-modalities
#14
A Ghai, T Kaushik, R Wadhera, S Wadhera
Stellate ganglion block (SGB) is utilized in the diagnosis and management of various vascular disorders and sympathetically mediated pain in upper extremity, head and neck. The stellate ganglion lies medial to the scalene muscles, lateral to longus coli muscle, esophagus, trachea and recurrent laryngeal nerve, anterior to C7 transverse process and prevertebral fascia, superior to the subclavian artery and posterior to vertebral vessels. Consequently, inadvertent placement of the needle tip into these soft tissues and vessels occur with blind technique...
2016: Acta Anaesthesiologica Belgica
https://www.readbyqxmd.com/read/27311148/intrathecal-spread-of-injectate-following-an-ultrasound-guided-selective-c5-nerve-root-injection-in-a-human-cadaver-model
#15
Christian R Falyar, Caroline Abercrombie, Robert Becker, Chuck Biddle
Ultrasound-guided selective C5 nerve root blocks have been described in several case reports as a safe and effective means to anesthetize the distal clavicle while maintaining innervation of the upper extremity and preserving diaphragmatic function. In this study, cadavers were injected with 5 mL of 0.5% methylene blue dye under ultrasound guidance to investigate possible proximal and distal spread of injectate along the brachial plexus, if any. Following the injections, the specimens were dissected and examined to determine the distribution of dye and the structures affected...
April 2016: AANA Journal
https://www.readbyqxmd.com/read/27228533/ultrasound-guided-phrenic-nerve-block-for-intractable-hiccups-following-placement-of-esophageal-stent-for-esophageal-squamous-cell-carcinoma
#16
David Arsanious, Spiro Khoury, Edgar Martinez, Ali Nawras, Gregory Filatoff, Hossam Ajabnoor, Umar Darr, Joseph Atallah
UNLABELLED: Hiccups are actions consisting of sudden contractions of the diaphragm and intercostals followed by a sudden inspiration and transient closure of the vocal cords. They are generally short lived and benign; however, in extreme and rare cases, such as esophageal carcinoma, they can become persistent or intractable, up to and involving significant pain, dramatically impacting the patient's quality of life. This case involves a 60-year-old man with a known history of squamous cell carcinoma of the esophagus...
May 2016: Pain Physician
https://www.readbyqxmd.com/read/27222157/combined-fluoroscopic-and-ultrasound-guided-cervical-nerve-root-injections
#17
Christopher Wakeling, Antony Bateman, Andrew Hatrick, Srinivasa Chatakondu
PURPOSE: To assess the technical feasibility, safety and initial clinical efficacy of a combined ultrasound and fluoroscopy imaging approach to cervical nerve root blocks. Fluoroscopic guided cervical transforaminal and selective nerve root injections are often used in the investigation or treatment of radicular symptoms, although rare but serious complications including death have been reported. We report a combined technique developed to increase safety of selective nerve root injections, including the safety and early efficacy of this novel technique in our initial patient cohort...
May 24, 2016: International Orthopaedics
https://www.readbyqxmd.com/read/27179044/echo-guided-differential-popliteal-block-in-an-obese-patient-with-intractable-painful-leg-ulcer-for-early-discharge-in-day-surgery
#18
Maddalena Zampi, Carmine Iacovazzo, Tommaso Pagano, Pasquale Buonanno, Mariella Carlomagno, Flavia Cianciulli, Giuseppe Servillo
Pain management is extremely important in day surgery, and it is one of the limiting factors for this type of procedures. Locoregional anesthesia is strongly recommended for day surgery; nevertheless, it could be very difficult to localize nerve position especially in obese patients. Furthermore, a complete nerve blockade could result in a delayed discharge. We present a case of analgesic ultrasound-guided block of tibial and common peroneal nerves in the popliteal fossa without any motor function involvement in an obese patient undergoing debridement of an infected lower limb ulcer; all previous attempts of surgical debridement in day surgery with topical anesthetics had failed because of discomfort due to pain...
June 2016: International Journal of Lower Extremity Wounds
https://www.readbyqxmd.com/read/27137511/regional-anesthesia-in-pain-management
#19
Michele Curatolo
PURPOSE OF REVIEW: The study focuses on neural blocks with local anesthetics in postoperative and chronic pain. It is prompted by the recent publication of several systematic reviews and guidelines. RECENT FINDINGS: For postoperative pain, the current evidence supports infusions of local anesthetics at the surgical site, continuous peripheral nerve blocks, and neuraxial analgesia for major thoracic and abdominal procedures. Ultrasound guidance can improve the performance of the blocks and different patient outcomes, although the incidence of peripheral nerve damage is not decreased...
October 2016: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/27091235/does-waiting-after-peri-prostatic-nerve-block-reduce-pain-during-transrectal-ultrasound-guided-prostate-biopsy-a-randomized-controlled-trial
#20
Jason Du, James Johnston, Rodney Studd
BACKGROUND: To determine if a short, clinically sufficient and manageable time delay after peri-prostatic nerve block (PNB) reduces pain during transrectal ultrasound (TRUS)-guided prostate biopsy. METHODS: This was a prospective, randomized controlled trial. All patients who underwent TRUS-guided prostate biopsy between February and June 2014 were randomized into waiting or control groups. All biopsies were performed by senior registrars with the same PNB technique...
April 18, 2016: ANZ Journal of Surgery
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