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Lumbar Plexus Block

Luiz Eduardo Imbelloni, Geraldo Borges de Morais Filho
BACKGROUND: The fast-track concept refers to all phases of perioperative care: Preoperative, intraoperative, and postoperative strategies. Although most research has focused on adherence to medication, adherence also encompasses numerous health-related behaviors. The aim of this prospective study was to determine the attitudes and awareness among health professionals involved in the treatment of elderly patients with fractures of the femur and the results of 400 patients. METHODS: The postoperative protocol acceleration was presented to various hospital departments through four seminars...
September 2016: Anesthesia, Essays and Researches
S D Adhikary, K El-Boghdadly, Z Nasralah, N Sarwani, A M Nixon, K J Chin
We performed bilateral transmuscular quadratus lumborum blocks in six cadavers using iodinated contrast and methylene blue. Computed tomography imaging was performed in four cadavers and anatomical dissection was completed in five. This demonstrated spread to the lumbar paravertebral space in 63% of specimens, laterally to the transversus abdominis muscle in 50% and caudally to the anterior superior iliac spine in 63% of specimens. There was no radiographic evidence of spread to the thoracic paravertebral space...
October 12, 2016: Anaesthesia
Yad R Yadav, Vijay S Parihar, Mina Todorov, Yatin Kher, Ishwar D Chaurasia, Sonjjay Pande, Hemant Namdev
Hydrocephalus is one of the commonest complications of tuberculous meningitis (TBM). It can be purely obstructive, purely communicating, or due to combinations of obstruction in addition to defective absorption of cerebrospinal fluid (CSF). Endoscopic third ventriculostomy (ETV) as an alternative to shunt procedures is an established treatment for obstructive hydrocephalus in TBM. ETV in TBM hydrocephalus can be technically very difficult, especially in acute stage of disease due to inflamed, thick, and opaque third ventricle floor...
October 2016: Asian Journal of Neurosurgery
Sylvia H Wilson, Bethany J Wolf, Abdalrahman A Algendy, Clark Sealy, Harry A Demos, Julie R McSwain
BACKGROUND: Total hip arthroplasty (THA) is associated with significant postoperative pain. Both lumbar epidurals and lumbar plexus nerve blocks have been described for postoperative pain control, but it is unclear if one technique is more beneficial. METHODS: Using electronic medical records, a randomly selected, cohort of 58 patients with lumbar epidurals were compared with 58 patients with lumbar plexus nerve blocks following primary THA. The primary end point was 48-hour postoperative opiate consumption...
August 10, 2016: Journal of Arthroplasty
Rajesh Kumar Singh, J P Chaturvedi, H S Agrawal, Nitesh Agrawal
BACKGROUND: Aging causes progressive deterioration of all the organ systems. Physiological changes of aging and co-morbidities make regional anesthesia a preferred technique for this age group. Regional anesthesia with risk of hypotension and its consequences is fraught with dangers. Peripheral nerve blocks (PNBs) are much safer and give much superior post-op analgesia. The present study was undertaken to perform major lower limb orthopedic surgeries PNBs in geriatric settings. METHODS: A feasibility study was undertaken in patients above age of 60 years admitted for lower limb surgeries to undertake these surgeries under para-vertebral blocks for a period of one year from Mar 2011 to Feb 2012...
July 2016: Medical Journal, Armed Forces India
Hai Chuan Yu, Mohammed Al-Shehri, Kelly D Johnston, Ryan Endersby, Leyla Baghirzada
PURPOSE: Hip arthroscopy is a minimally invasive surgical procedure indicated for the treatment of specific hip disorders. In this narrative review, we aim to examine the key components in providing anesthesia for this procedure. SOURCE: MEDLINE(®), PubMed, and EMBASE™ databases were searched for peer-reviewed articles discussing the anesthetic management of patients undergoing hip arthroscopy. PRINCIPAL FINDINGS: The primary anesthetic regimen used for hip arthroscopy should balance patient factors, preferences of the surgeon, and the demands of the procedure itself...
November 2016: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
K H Thybo, O Mathiesen, J B Dahl, H Schmidt, D Hägi-Pedersen
BACKGROUND: Peripheral regional nerve blocks are commonly used for pain management after lower extremity surgery, but motor blockade can be a significant concern. The lateral femoral cutaneous nerve (LFCN) is a purely sensory nerve from the lumbar plexus. We hypothesised that an LFCN block would reduce movement-related pain after total hip arthroplasty (THA) in patients with moderate-to-severe pain. METHODS: Sixty patients with visual analogue scale (VAS) score > 40 mm during 30-degree active flexion of the hip on either the first or second postoperative day after THA were included in this prospective, randomised, blinded, placebo-controlled trial...
October 2016: Acta Anaesthesiologica Scandinavica
Enrique A Goytizolo, Ottokar Stundner, Sandra Hurtado Rúa, Dorothy Marcello, Valeria Buschiazzo, Ansara M Vaz, Stavros G Memtsoudis
BACKGROUND: While it is assumed that neuraxial analgesia and pain management may beneficially influence perioperative hemodynamics, few studies provided data quantifying such effects and none have assessed the potential contribution of the addition of a nerve block. QUESTIONS/PURPOSES: This clinical trial compared the visual analog scale (VAS) scores and measurement of arterial tone using augmentation index of patients who received combined spinal-epidural (CSE) only to patients who received both CSE and lumbar plexus block...
July 2016: HSS Journal: the Musculoskeletal Journal of Hospital for Special Surgery
Andrea Tognù, Veronica Cauli, Nicola de Simone, Lucia Aurini, Marco Manfrini, Stefano Bonarelli
This case report details the feasibility of a continuous lumbar plexus block obtained with a paramedian transverse scan of the lumbar paravertebral region, using a catheter-over-needle system, as a main postoperative orthopedic analgesia, in a 14-month-old patient undergoing surgical treatment of a localized Ewing family tumor of the right proximal femur. After surgery, the patient remained in the intensive care unit for 3 days; pain was assessed regularly using the Children's and Infants' Postoperative Pain Scale, and comfort was monitored...
July 2016: Regional Anesthesia and Pain Medicine
Medhat M Messeha
BACKGROUND: Lumbar plexus block, combined with a sciatic nerve block, is an effective locoregional anesthetic technique for analgesia and anesthesia of the lower extremity. The aim of this study was to compare the clinical results outcome of the adductor canal block versus the psoas compartment block combined with sciatic nerve block using real time ultrasound guidance in patients undergoing elective laparoscopic knee surgeries. PATIENTS AND METHODS: Ninety patients who were undergoing elective laparoscopic knee surgeries were randomly allocated to receive a sciatic nerve block in addition to lumbar plexus block using either an adductor canal block (ACB) or a posterior psoas compartment approach (PCB) using 25 ml of bupivacine 0...
May 2016: Anesthesia, Essays and Researches
Jui-An Lin
No abstract text is available yet for this article.
October 2016: European Journal of Anaesthesiology
Diana Chieira, Luis Conceição, Edgar Semedo, Valentina Almeida
Osler-Weber-Rendu syndrome, or hereditary haemorrhagic telangiectasia (HHT), is an autosomal dominant vascular dysplasia characterised by mucocutaneous telangiectases and arteriovenous malformations (AVMs). Diagnosis is clinical and treatment is supportive. The authors demonstrate a safe anaesthetic approach for a patient with HHT. A 53-year-old woman with a left trochanteric fracture was scheduled for urgent orthopaedic surgery. She was diagnosed as having HHT and presented with recurrent epistaxis, telangiectases and gastrointestinal AVMs...
2016: BMJ Case Reports
Nina Mænchen, Mette Dam, Axel R Sauter, Kyrre Ullensvang, Thomas F Bendtsen, Luis Romundstad, Jens Børglum
No abstract text is available yet for this article.
October 2016: European Journal of Anaesthesiology
Yavuz Gürkan, Can Aksu, Alparslan Kuş, Kamil Toker, Mine Solak
Lumbar plexus block has been shown to be effective for providing postoperative analgesia after major hip surgeries in children. The goal of the study was to evaluate the feasibility of ultrasound guidance during lumbar plexus block in children undergoing hip surgery for congenital hip dislocation. After obtaining local institutional ethical committee approval and parental informed consent, ASA I or II, 1-6 years old children undergoing hip surgery were included into the study. Lumbar plexus block was performed after general anaesthesia using ultrasound guided Shamrock Method...
March 31, 2016: Journal of Clinical Monitoring and Computing
Jeffrey Kay, Darren de Sa, Muzammil Memon, Nicole Simunovic, James Paul, Olufemi R Ayeni
PURPOSE: This systematic review examined the efficacy of perioperative nerve blocks for pain control after hip arthroscopy. METHODS: The databases Embase, PubMed, and Medline were searched on June 2, 2015, for English-language studies that reported on the use of perioperative nerve blocks for hip arthroscopy. The studies were systematically screened and data abstracted in duplicate. RESULTS: Nine eligible studies were included in this review (2 case reports, 2 case series, 3 non-randomized comparative studies, and 2 randomized controlled trials)...
April 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
Donghua Liu, Jianzhong Ma, Zongwang Zhang, Ailan Yu, Xueli Chen, Cuicui Feng, Weifu Lei
The aim of the study was to investigate current situation of postoperative pain management in medical institutions in Shandong Province.A questionnaire was developed on the basis of guidelines of acute pain and pain quality assessment scale. The questionnaire was used to obtain information regarding the nature and scale of the medical institution, structure of pain management organization, implementation of pain assessment, and analgesic techniques and processes used in clinical practice. A multistage stratified and cluster sampling method was employed to investigate the current situation of postoperative pain management in 168 medical institutions in Shandong Province...
February 2016: Medicine (Baltimore)
Young Eun Moon, Jung Hyun Choi, Hue Jung Park, Ji Hye Park, Ji Hyun Kim
Neuropathic pain includes postherpetic neuralgia (PHN), painful diabetic neuropathy (PDN), and trigeminal neuralgia, and so on. Although various drugs have been tried to treat neuropathic pain, the effectiveness of the drugs sometimes may be limited for chronic intractable neuropathic pain, especially when they cannot be used at an adequate dose, due to undesirable severe side effects and the underlying disease itself. Botulinum toxin type A (BoNT-A) has been known for its analgesic effect in various pain conditions...
January 2016: Toxins
Erin Bruce, Adam O Spencer, Mehmet Sait Albayram
PURPOSE: The sum of the volumes of brain tissue, cerebrospinal fluid (CSF), and intracranial blood remain constant. This tenet of the Monroe-Kellie hypothesis is most often considered in the setting of intracranial hypertension, but it can also be applied in the setting of CSF volume depletion. We used this hypothesis to explain a case of failed caudal block in a patient with an iatrogenic CSF leak. CLINICAL FEATURES: A one-month-old baby (3 kg) born at 35 weeks' gestation presented for right inguinal hernia repair...
May 2016: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
Chun-Guang Wang, Yan-Ling Ding, Ai-Ping Han, Chang-Qing Hu, Shi Hao, Fang-Fang Zhang, Yong-Wang Li, Hu Liu, Zhe Han, De-Li Guo, Zhi-Qiang Zhang
The ischemia necrosis of limb frequently requires surgery of amputation. Lumbar plexus and sciatic nerve block is an ideal intra-operative anesthetic and post-operative antalgic technique for patients of amputation, especially for high-risk patients who have severe cardio-cerebrovascular diseases. However, the duration of analgesia of peripheral nerve block is hardly sufficient to avoid the postoperative pain and the usage of opioids. In this case, a 79-year-old man, with multiple cerebral infarcts, congestive heart failure, atrial flutter and syncope, was treated with an above knee amputation because of ischemia necrosis of his left lower limb...
2015: International Journal of Clinical and Experimental Medicine
Matthew L Brown, Thorsten M Seyler, John Allen, Johannes F Plate, Daryl S Henshaw, Jason E Lang
INTRODUCTION: Unicondylar knee arthroplasty (UKA) offers decreased morbidity, faster recovery, better functional outcomes, and equivalent survivorship compared to TKA for certain patients. To fully capture these benefits, regional anesthesia techniques must facilitate rather than compromise patients ability for early postoperative mobilization and safe discharge following UKA. The purpose of this study was to determine whether the predominantly sensory adductor canal blockade (ACB) shortens hospital stay after medial UKA (mUKA)...
July 2015: Bulletin of the Hospital for Joint Diseases
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