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Catheter nerve analgesia

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https://www.readbyqxmd.com/read/28183576/the-benefits-of-ultrasound-guided-continuous-sensory-nerve-blockade-in-the-setting-of-burn-injury-a-case-report-of-bilateral-continuous-superficial-peroneal-nerve-blockade-in-a-patient-with-severe-sleep-apnea
#1
Vladislav Shick, Evan E Lebovitz, Emerson Conrad
The management of pain after burn injuries is a clinical challenge magnified in patients with significant comorbidities. Presently, burn pain is treated via a wide variety of modalities, including systemic pharmacotherapy and regional analgesia. Although the latter can provide effective pain control in patients with burn injuries, it is relatively underused. Furthermore, the development of ultrasound guidance has allowed for novel approaches and sparing of motor nerve blockade with preference toward sensory-specific analgesia that has not been possible previously...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28151818/the-effect-of-fixation-technique-on-continuous-interscalene-nerve-block-catheter-success-a-randomized-double-blind-trial
#2
David B Auyong, David Asher Cantor, Cynthia Green, Neil A Hanson
BACKGROUND: Continuous peripheral nerve blocks offer advantages over single-injection blocks, including extended analgesia and reduction in opioid consumption. These benefits require that the perineural catheter remain intact for the duration of the planned local anesthetic infusion. Mechanical displacement of catheters, leaking, and consequent failure are known complications. The aim of this study was to evaluate continuous perineural catheter tip-to-nerve apposition in vivo over 48 hours comparing 2 different simple fixation strategies...
March 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28149550/management-of-acute-postoperative-pain-with-continuous-intercostal-nerve-block-after-single-port-video-assisted-thoracoscopic-anatomic-resection
#3
Ming-Ju Hsieh, Kuo-Cheng Wang, Hung-Pin Liu, Diego Gonzalez-Rivas, Ching-Yang Wu, Yun-Hen Liu, Yi-Cheng Wu, Yin-Kai Chao, Ching-Feng Wu
BACKGROUND: Effective postoperative pain control for thoracic surgery is very important, not only because it reduces pulmonary complications but also because it accelerates the pace of recovery. Moreover, it increases patients' satisfaction with the surgery. In this study, we present a simple approach involving the safe placement of intercostal catheter (ICC) after single port video-assisted thoracoscopic surgery (VATS) anatomic resection and we evaluate postoperative analgesic function with and without it...
December 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28118226/intraoperative-placement-of-pectoral-nerve-block-catheters-description-of-a-novel-technique-and-review-of-the-literature
#4
Katharine M Hinchcliff, Jared R Hylton, Hakan Orbay, Michael S Wong
Regional and neuraxial anesthesia for pain management after breast surgery is not widely used despite data showing improved postoperative pain control and patient satisfaction scores. We report a case of a 61-year-old woman who underwent bilateral mastectomies, and received postoperative analgesia via pectoral nerves 1 and 2 nerve blocks. This case highlights a previously undescribed technique of prolonged postoperative pain control by intraoperative placement of pectoral nerves 1 and 2 regional anesthesia catheters under direct visualization...
January 23, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28033159/effect-of-perineural-dexamethasone-on-the-duration-of-single-injection-saphenous-nerve-block-for-analgesia-after-major-ankle-surgery-a-randomized-controlled-study
#5
Siska Bjørn, Frank Linde, Kristian K Nielsen, Jens Børglum, Rasmus Wulff Hauritz, Thomas Fichtner Bendtsen
BACKGROUND AND OBJECTIVES: Patients undergoing major elective ankle surgery often experience pain from the saphenous nerve territory persisting beyond the duration of a single-injection saphenous nerve block. We hypothesized that perineural dexamethasone as an adjuvant for the saphenous nerve block prolongs the duration of analgesia and postpones as well as reduces opioid-requiring pain. METHODS: Forty patients were included in this prospective, randomized, controlled study...
March 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/27924199/in-plane-three-step-needle-insertion-technique-for-ultrasound-guided-continuous-femoral-nerve-block-after-total-knee-arthroplasty-a-retrospective-review-of-488-cases
#6
Hyeon Ju Shin, Jung Sub Soh, Hyong Hwan Lim, Bumjoon Joo, Hye Won Lee, Hae Ja Lim
BACKGROUND: Continuous femoral nerve block (CFNB) improves postoperative analgesia after total knee arthroplasty (TKA). The aim of this study was to investigate the clinical efficacy and complications of our in-plane three-step needle insertion technique that was devised to reduce the risk of direct femoral nerve injury during CFNB in anesthetized patients. METHODS: This retrospective study included 488 patients who had undergone TKA. Ultrasound (US)-guided CFNB was performed under general or spinal anesthesia using an in-plane, three-step needle insertion technique...
December 2016: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/27871587/peripheral-nerve-blocks-in-the-management-of-postoperative-pain-challenges-and-opportunities
#7
REVIEW
Girish Joshi, Kishor Gandhi, Nishant Shah, Jeff Gadsden, Shelby L Corman
Peripheral nerve blocks (PNBs) are increasingly used as a component of multimodal analgesia and may be administered as a single injection (sPNB) or continuous infusion via a perineural catheter (cPNB). We undertook a qualitative review focusing on sPNB and cPNB with regard to benefits, risks, and opportunities for optimizing patient care. Meta-analyses of randomized controlled trials have shown superior pain control and reductions in opioid consumption in patients receiving PNB compared with those receiving intravenous opioids in a variety of upper and lower extremity surgical procedures...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27870742/thoracic-paravertebral-nerve-blocks-in-pediatric-patients-safety-and-clinical-experience
#8
Tricia Vecchione, David Zurakowski, Karen Boretsky
Thoracic paravertebral nerve blocks (PVNBs) provide excellent analgesia for many surgeries. The primary aim was to estimate the complication rate, and secondary aims were to provide information on the potential clinical application of PVNBs. Data on 2390 PVNBs were collected. A total of 625 catheters were performed on 468 patients, and 1765 single-injection PVNBs were performed on 403 patients. There was 1 case of local anesthetic systemic toxicity for a major complication rate of 1 per 2390 PVNBs. The minor complication rate was 13...
December 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27847703/treatment-of-post-latissimus-dorsi-flap-breast-reconstruction-pain-with-continuous-paravertebral-nerve-blocks-a-retrospective-review
#9
Jonathan T Unkart, Jennifer A Padwal, Brian M Ilfeld, Anne M Wallace
OBJECTIVES: The addition of a perioperative continuous paravertebral nerve block (cPVB) to a single-injection thoracic paravertebral nerve block (tPVB) has demonstrated improved analgesia in breast surgery. However, its use following isolated post-mastectomy reconstruction using a latissimus dorsi flap (LDF) has not previously been examined. METHODS: We performed a retrospective review of patients who underwent salvage breast reconstruction with a unilateral LDF by a single surgeon...
October 2016: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/27749354/continuous-peripheral-nerve-blocks-an-update-of-the-published-evidence-and-comparison-with-novel-alternative-analgesic-modalities
#10
Brian M Ilfeld
A continuous peripheral nerve block (CPNB) consists of a percutaneously inserted catheter with its tip adjacent to a target nerve/plexus through which local anesthetic may be administered, providing a prolonged block that may be titrated to the desired effect. In the decades after its first report in 1946, a plethora of data relating to CPNB was published, much of which was examined in a 2011 Anesthesia & Analgesia article. The current update is an evidence-based review of the CPNB literature published in the interim...
January 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27749351/optimizing-pain-and-rehabilitation-after-knee-arthroplasty-a-two-center-randomized-trial
#11
Stephen Choi, Turlough O'Hare, Jeffrey Gollish, James E Paul, Hans Kreder, Kevin E Thorpe, Joel D Katz, Muhammad Mamdani, Peter Moisiuk, Colin J McCartney
BACKGROUND: This randomized trial compared (1) continuous femoral nerve block (cFNB), (2) single femoral nerve block (sFNB), and (3) local infiltration analgesia (LIA) with respect to analgesic and functional outcomes after primary tricompartmental knee arthroplasty (TKA). METHODS: One hundred twenty patients undergoing primary tricompartmental knee arthroplasty were randomly assigned to 1 of 3 interventions for postoperative analgesia: (1) cFNB-preoperative bolus of ropivacaine 0...
November 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27745867/intercostal-nerve-cryoablation-versus-thoracic-epidural-catheters-for-postoperative-analgesia-following-pectus-excavatum-repair-preliminary-outcomes-in-twenty-six-cryoablation-patients
#12
MULTICENTER STUDY
Benjamin A Keller, Sandra K Kabagambe, James C Becker, Y Julia Chen, Laura F Goodman, Julianna M Clark-Wronski, Kenneth Furukawa, Rebecca A Stark, Amy L Rahm, Shinjiro Hirose, Gary W Raff
BACKGROUND: Multimodal pain management strategies are used for analgesia following pectus excavatum repair. However, the optimal regimen has not been identified. We describe our early experience with intercostal cryoablation for pain management in children undergoing the Nuss procedure and compare early cryoablation outcomes to our prior outcomes using thoracic epidural analgesia. METHODS: A multi-institutional, retrospective review of fifty-two patients undergoing Nuss bar placement with either intercostal cryoablation (n=26) or thoracic epidural analgesia (n=26) from March 2013 to January 2016 was conducted...
December 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27734492/a-randomised-controlled-trial-comparing-two-popliteal-nerve-catheter-tip-positions-for-postoperative-analgesia-after-day-case-hallux-valgus-repair
#13
A L Ambrosoli, L Guzzetti, M Chiaranda, S Cuffari, M Gemma, G Cappelleri
We compared the effect of two different positions of a sciatic nerve catheter within the popliteal fossa on local anaesthetic consumption and postoperative analgesia in patients undergoing day-case hallux valgus repair. Eighty-four patients were randomly allocated to receive a sciatic nerve catheter either between the tibial and peroneal components (sciatic group) or medial to the tibial nerve (tibial group). The primary endpoint was postoperative local anaesthetic consumption, while secondary endpoints were pain scores, number of occasions where sleep was disturbed by pain and incidence of insensate limb and foot drop at 24 h and 48 h postoperatively...
November 2016: Anaesthesia
https://www.readbyqxmd.com/read/27703632/a-comparison-of-strength-for-two-continuous-peripheral-nerve-block-catheter-dressings
#14
Lindsay Borg, Steven K Howard, T Edward Kim, Lauren Steffel, Cynthia Shum, Edward R Mariano
BACKGROUND: Despite the benefits of continuous peripheral nerve blocks, catheter dislodgment remains a major problem, especially in the ambulatory setting. However, catheter dressing techniques to prevent such dislodgment have not been studied rigorously. We designed this simulation study to test the strength of two commercially available catheter dressings. METHODS: Using a cadaver model, we randomly assigned 20 trials to one of two dressing techniques applied to the lateral thigh: 1) clear adhesive dressing alone, or 2) clear adhesive dressing with an anchoring device...
October 2016: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/27673545/systematic-review-of-liposomal-bupivacaine-exparel-for-postoperative-analgesia
#15
Krishna S Vyas, Sibi Rajendran, Shane D Morrison, Afaaf Shakir, Samir Mardini, Valerie Lemaine, Maurice Y Nahabedian, Stephen B Baker, Brian D Rinker, Henry C Vasconez
BACKGROUND: Management of postoperative pain often requires multimodal approaches. Suboptimal dosages of current therapies can leave patients experiencing periods of insufficient analgesia, often requiring rescue therapy. With absence of a validated and standardized approach to pain management, further refinement of treatment protocols and targeted therapeutics is needed. Liposomal bupivacaine (Exparel) is a longer acting form of traditional bupivacaine that delivers the drug by means of a multivesicular liposomal system...
October 2016: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/27631270/a-prospective-randomized-and-controlled-study-of-interscalene-brachial-plexus-block-for-arthroscopic-shoulder-surgery-a-comparison-of-c5-and-conventional-approach-a-consort-compliant-article
#16
RANDOMIZED CONTROLLED TRIAL
Hyun-Jung Shin, Hyo-Seok Na, Ah-Young Oh, Jung-Won Hwang, Byung-Gun Kim, Hee-Pyoung Park, Young-Tae Jeon, Seong-Won Min, Jung-Hee Ryu
BACKGROUND: The shoulder area is mainly innervated with the C5 and C6 nerve roots, and interscalene brachial plexus block (ISB) is widely used for postoperative analgesia after shoulder surgery. However, it is associated with adverse effects, such as numbness and weakness in the blocked arm due to an unwanted block of the lower brachial plexus (C7-T1). We hypothesized that the C5 approach during ISB would provide postoperative analgesia while minimizing adverse events after arthroscopic shoulder surgery...
September 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27603376/femoral-nerve-block-for-patient-undergoing-total-knee-arthroplasty-prospective-randomized-double-blinded-study-evaluating-analgesic-effect-of-perineural-fentanyl-additive-to-local-anesthetics
#17
RANDOMIZED CONTROLLED TRIAL
Bong Ha Heo, Hyeon Jung Lee, Hyung Gon Lee, Man Young Kim, Keun Suk Park, Jeong Il Choi, Myung Ha Yoon, Woong Mo Kim
BACKGROUND: The existence of peripheral opioid receptors and its effectiveness in peripheral nerve block remain controversial. The aim of this prospective, randomized, double-blinded study was to examine the analgesic effects of adding fentanyl to ropivacaine for continuous femoral nerve block (CFNB) using patient-controlled analgesia after total knee arthroplasty (TKA). METHODS: The patients were divided into 2 groups, each with n = 40 in ropivacaine (R) group and n = 42 in R with fentanyl (R + F) group...
September 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27597428/comparison-of-lumbar-epidurals-and-lumbar-plexus-nerve-blocks-for-analgesia-following-primary-total-hip-arthroplasty-a-retrospective-analysis
#18
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
https://www.readbyqxmd.com/read/27513969/bilateral-continuous-suprascapular-nerve-blocks-for-bilateral-shoulder-hemiarthroplasty
#19
James M Flaherty, David B Auyong, Neil A Hanson
We report a novel case of a patient undergoing a bilateral shoulder hemiarthroplasty for chronic bilateral shoulder dislocations with proximal humeral fractures. Bilateral selective suprascapular nerve catheters were placed preoperatively with the intent to provide continuous local anesthetic-based analgesia while sparing diaphragmatic function. Postoperative respiratory mechanics were relatively spared while numerical rating scale pain scores were suggestive of analgesic benefit.
September 15, 2016: A & A Case Reports
https://www.readbyqxmd.com/read/27510834/a-review-of-anesthetic-techniques-and-outcomes-following-minimally-invasive-repair-of-pectus-excavatum-nuss-procedure
#20
Geoff Frawley, Jacinta Frawley, Joe Crameri
BACKGROUND: Pectus excavatum (PE) is the most common congenital chest wall deformity, occurring in 1 : 1000 children with a male to female ratio of 4 : 1. Several procedures have been described to manage this deformity, including cartilage resection with sternal osteotomy (the Ravitch procedure) and a minimally invasive repair technique (the Nuss procedure). While initially described as a nonthoracoscopic technique, the current surgical approach of the Royal Childrens Hospital involves thoracoscopic assistance...
November 2016: Paediatric Anaesthesia
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