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Catheter nerve analgesia

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https://www.readbyqxmd.com/read/28497931/is-outpatient-continuous-regional-analgesia-more-effective-and-equally-safe-than-single-shot-peripheral-nerve-blocks-after-ambulatory-orthopedic-surgery-a-systematic-review-of-randomized-double-blinded-placebo-controlled-trials
#1
Andrea Saporito, Luciano Anselmi, Evelina Sturini, Alain Borgeat, José A Aguirre
BACKGROUND: Continuous regional analgesia is an established technique for effective postoperative pain treatment, particularly after orthopedic surgical procedures. Even if it has been increasingly applied to the outpatient setting as well, many anesthesiologists are still reluctant to discharge patients with a perineural catheter in place. Aim of this review was to clarify the evidences about safety and effectiveness of outpatient continuous peripheral nerve blocks. METHODS: A systematic review of all prospective, randomized, double-blinded, placebo-controlled trials of the last 20 years on outpatient continuous peripheral nerve blocks after ambulatory orthopedic surgery was performed, using both PubMed and OVID databases were...
May 12, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28468607/does-local-infiltration-analgesia-reduce-peri-operative-inflammation-following-total-hip-arthroplasty-a-randomized-double-blind-study
#2
J Kuchálik, A Magnuson, E Tina, A Gupta
BACKGROUND: Postoperative inflammation following total hip arthroplasty (THA) can lead to delayed mobilization and return of hip function. Our primary aim was to assess whether local infiltration analgesia (LIA) during surgery can prevent postoperative inflammation. METHODS: This is a sub-analysis of data from a broader double-blind study where 56 patients received spinal anaesthesia for THA. Additionally, Group FNB (Femoral Nerve Block) received an ultrasound-guided femoral nerve block using 30 mL of ropivacaine 7...
May 3, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28371877/comprehensive-analysis-of-13-897-consecutive-regional-anesthetics-at-an-ambulatory-surgery-center
#3
Randall J Malchow, Rajnish K Gupta, Yaping Shi, Matthew S Shotwell, Lisa M Jaeger, Clifford Bowens
Objective.:  The authors investigated a wide range of perioperative outcome measures in the context of a robust regional anesthesia practice. Design.:  Comprehensive review of a prospectively collected six-year database. Setting.:  Freestanding, academic ambulatory surgery center. Subjects.:  There were 13,897 consecutive regional anesthetics in 10,338 patients. Methods.:  We investigated patient satisfaction, postoperative nausea and vomiting (PONV), postoperative pain, catheter analgesia, and complications...
March 24, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28348896/effect-of-arm-positioning-on-entrapment-of-infraclavicular-nerve-block-catheter
#4
Eric Kamenetsky, Rahul Reddy, Mark C Kendall, Antoun Nader, Jessica J Weeks
Continuous brachial plexus nerve block catheters are commonly inserted for postoperative analgesia after upper extremity surgery. Modifications of the insertion technique have been described to improve the safety of placing an infraclavicular brachial plexus catheter. Rarely, these catheters may become damaged or entrapped, complicating their removal. We describe a case of infraclavicular brachial plexus catheter entrapment related to differences in arm positioning during catheter placement and removal. Written authorization to obtain, use, and disclose information and images was obtained from the patient...
2017: Case Reports in Anesthesiology
https://www.readbyqxmd.com/read/28272290/a-double-blind-randomized-comparison-of-continuous-interscalene-supraclavicular-and-suprascapular-blocks-for-total-shoulder-arthroplasty
#5
David B Auyong, Stanley C Yuan, Daniel S Choi, Joshuel A Pahang, April E Slee, Neil A Hanson
BACKGROUND AND OBJECTIVES: Continuous brachial plexus blocks at the interscalene level are associated with known diaphragm dysfunction from phrenic nerve paresis. More distal blocks along the brachial plexus may provide postsurgical analgesia while potentially having less effect on diaphragm function. Continuous interscalene, continuous supraclavicular, and continuous suprascapular nerve blocks were evaluated for respiratory function and analgesia after total shoulder arthroplasty. METHODS: After ethics board approval, subjects presenting for total shoulder arthroplasty were planned for randomization in a 1:1:1 ratio of a continuous interscalene, supraclavicular, or suprascapular block...
May 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28271332/exparel-peripheral-catheter-use-in-the-ambulatory-setting-and-use-of-peripheral-catheters-postoperatively-in-the-home-setting
#6
REVIEW
Adam L Bromberg, Jeremy A Dennis, Karina Gritsenko
PURPOSE OF REVIEW: With the increasing number of ambulatory surgeries being performed, regional anesthesia has become an increasingly popular anesthetic modality, and many choices exist to provide efficient, effective quality perioperative analgesia. In this paper, we will review the various regional anesthesia options in addition to the advantages and disadvantages of each. Lastly, we will discuss liposomal bupivicaine, a long acting local anesthetic, and its future role in the anesthesiologist's armamentarium...
March 2017: Current Pain and Headache Reports
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
#7
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
#8
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
#9
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
#10
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...
May 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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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