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https://www.readbyqxmd.com/read/28720187/experiences-with-regional-anesthesia-for-analgesia-during-prolonged-aeromedical-evacuation
#1
Jeffrey M Carness, Melissa A Wilson, Mark J Lenart, Danny E Smith, Susan F Dukes
INTRODUCTION: There is much debate regarding the appropriate analgesic management of patients undergoing medical evacuation following combat trauma. Our primary objective was to review the utility of regional anesthetic techniques in patients undergoing aeromedical evacuation following surgical limb amputation as treatment for combat trauma. METHODS: This study was conducted as an observational retrospective cohort whereby acutely injured amputee patients were identified via the U...
August 1, 2017: Aerospace Medicine and Human Performance
https://www.readbyqxmd.com/read/28719457/regional-anesthesia-in-diabetic-peripheral-neuropathy
#2
Werner Ten Hoope, Marjolein Looije, Philipp Lirk
PURPOSE OF REVIEW: The aim of this review is to summarize recent relevant literature regarding regional anesthesia in the diabetic neuropathic patient and formulate recommendations for clinical practice. RECENT FINDINGS: Diabetic neuropathic nerves, but not nerves of diabetic patients per se, exhibit complex functional changes. As a result, they seem more sensitive to local anesthetics, and are more difficult to stimulate. When catheters are used postoperatively, diabetes is an independent risk factor for infection...
July 15, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28700368/regional-anesthesia-and-analgesia-in-cancer-care-is-it-time-to-break-the-bad-news
#3
Mir W Sekandarzad, André A J van Zundert, Chris W Doornebal, Markus W Hollmann
PURPOSE OF REVIEW: There is ongoing controversy regarding the tumor-protective effects of regional anesthesia in patients undergoing cancer surgery. Evidence of up-to-date systematic reviews will be presented alongside recent updates on the effects of opioids and local anesthetics. RECENT FINDINGS: In recent years, the literature regarding the effects of regional anesthesia techniques on cancer recurrence has raised many unanswered questions. Ongoing randomized controlled trials may not be able to shed light on the controversial discussion regarding the tumor protective effects of regional anesthesia because the expected effect size and event rate in those studies may be overstated...
July 11, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28696947/regional-blocks-carried-out-during-general-anesthesia-or-deep-sedation-myths-and-facts
#4
Peter Marhofer
PURPOSE OF REVIEW: More patients will accept regional blocks if these are performed during sedation or general anesthesia. This review discusses regional anesthesia in sedated or anesthetized patients. RECENT FINDINGS: As complications of regional blocks are rare, regional anesthesia can be considered aswell-tolerated. Awake patients will notice only a minority of needle-to-nerve contacts, that renders the notion of a 'live monitor' obsolete. Using high-resolution ultrasound, the needle can be advanced to an extraepineural position for injection, thus strictly avoiding needle-to-nerve contact or intraepineural injection of local anesthetic...
July 10, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28692439/lipid-emulsion-in-local-anesthetic-toxicity
#5
Martyn Harvey, Grant Cave
PURPOSE OF REVIEW: Enthusiasm for regional anesthesia has been driven by multimodal benefits to patient outcomes. Despite widespread awareness and improved techniques (including the increasing use of ultrasound guidance for block placement), intravascular sequestration and the attendant risk of local anesthetic systemic toxicity (LAST) remains. Intravenous lipid emulsion (ILE) for the treatment of LAST has been endorsed by anesthetic regulatory societies on the basis of animal study and human case report data...
July 7, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28686756/local-anesthetics-in-cosmetic-dermatology
#6
Peter W Hashim, John K Nia, Mark Taliercio, Gary Goldenberg
Local anesthetics play an important role in cosmetic dermatology. Techniques using topical and regional anesthesia provide numerous pain management options for laser and injection treatments. In this article, we review strategies to maximize patient comfort during cosmetic interventions.
June 2017: Cutis; Cutaneous Medicine for the Practitioner
https://www.readbyqxmd.com/read/28663624/the-effect-of-preemptive-ankle-block-using-ropivacaine-and-dexamethasone-on-postoperative-analgesia-in-foot-surgery
#7
Ashraf Elsayed Alzeftawy, Nabil Aly Elsheikh
BACKGROUND: Peripheral nerve blocks have become an increasingly popular form of anesthesia. Preemptive analgesia reduces central sensitization, postoperative pain, and analgesic consumption. Different additive has been used to prolong regional blockade and improve postoperative analgesia. AIM: This study was conducted to evaluate whether preemptive ankle block using combination of ropivacaine and dexamethasone would succeed in improving the postoperative analgesia after foot surgery in patients receiving general anesthesia...
April 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28663617/comparison-between-epidural-ropivacaine-versus-ropivacaine-with-clonidine-in-patients-undergoing-abdominal-hysterectomy-a-randomized-study
#8
Keshav Govind Rao, Shilpi Misra, Aparna Shukla
CONTEXT: Regional anesthesia has emerged as one of the preferred and convenient modes for intra- and post-operative management owing to its advantage of not interfering with the metabolic functions, better tolerability, and decrease in reflex activity. In recent years, ropivacaine has increasingly replaced bupivacaine as a preferred local anesthetic because of its similar analgesic properties, lesser motor blockade, and decreased propensity of cardiotoxicity. Neuraxial adjuvant such as clonidine used in epidural anesthesia offers advantage by augmenting the local anesthetic effect and reducing the anesthetic and analgesic requirement...
April 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28663615/randomized-controlled-trial-for-evaluating-the-analgesic-effect-of-nalbuphine-as-an-adjuvant-to-bupivacaine-in-supraclavicular-block-under-ultrasound-guidance
#9
Nazia Nazir, Shruti Jain
INTRODUCTION: Benefits of regional anesthesia can be prolonged by adding adjuvants to local anesthetics. This study was designed to test the efficacy of adding nalbuphine to bupivacaine in supraclavicular brachial plexus blockade using ultrasound (US) guidance. METHODOLOGY: This was a prospective, randomized, double-blind study involving sixty patients of either sex undergoing elective orthopedic procedures of upper limb. In control Group C (n = 30), 30 mL of 0...
April 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28654558/the-efficacy-of-ultrasound-guided-type-ii-pectoral-nerve-blocks-in-perioperative-pain-management-for-immediate-reconstruction-after-modified-radical-mastectomy-a-prospective-randomized-study
#10
Kaiyuan Wang, Xiaobei Zhang, Tingting Zhang, Hui Yue, Shan Sun, Hongwei Zhao, Peng Zhou
OBJECTIVES: The pectoral nerves (Pecs) II block is a technique that places local anesthetic between the thoracic muscles to block the axillary and breast regions. This study aimed to compare the quality of perioperative analgesia and side effects of the Pecs II block under general anesthesia versus general anesthesia alone in immediate unilateral breast reconstruction with an implant and latissimus dorsi (LD) flap after modified radical mastectomy. METHODS: Sixty-four patients scheduled for immediate breast reconstruction after modified radical mastectomy were randomly allocated into the Pecs II block under general anesthesia group (Group P, n=32) or the general anesthesia alone group (Group G, n=32)...
June 16, 2017: Clinical Journal of Pain
https://www.readbyqxmd.com/read/28641966/no-clinical-difference-comparing-general-regional-and-combination-anesthesia-in-hip-arthroplasty-a-multicenter-cohort-study-regarding-perioperative-pain-management-and-patient-satisfaction
#11
Felix Greimel, Guenther Maderbacher, Florian Zeman, Joachim Grifka, Winfried Meissner, Achim Benditz
BACKGROUND: Steadily increasing numbers of hip arthroplasties are reported in the past years. Different types of anesthetic methods for surgery itself as well as pain management programs have been established. It is one of the main goals to reduce postoperative pain levels and guarantee better and faster mobilization in the postoperative period. The present study aims to compare the use of general and regional spinal anesthesia and their combination regarding perioperative pain management and patient satisfaction...
May 26, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28631539/regional-nerve-blocks-for-equine-dentistry
#12
Molly K Rice
Regional nerve blocks are necessary to facilitate equine oral surgery in the standing sedated patient. Step-by-step instruction on how to perform common regional nerve blocks are discussed, including infraorbital, maxillary, middle mental, and inferior alveolar nerve blocks. Regional nerve blocks are critical when performing dental procedures in the standing horse.(1) The infraorbital and maxillary nerve blocks provide anesthesia of the infraorbital nerve, which is a branch of the maxillary nerve. Both nerve blocks provide adequate anesthesia for all maxillary dental procedures...
June 2017: Journal of Veterinary Dentistry
https://www.readbyqxmd.com/read/28623471/the-effect-of-intravenous-lidocaine-infusion-on-bispectral-index-during-major-abdominal-surgery
#13
Patrick Bazin, James Padley, Matthew Ho, Jennifer Stevens, Erez Ben-Menachem
Intraoperative lidocaine infusion has become widely accepted as an adjunct to general anesthesia where its use has been associated with opioid-sparing and enhanced recovery. The aims of this study were to determine whether or not intravenous (IV) lidocaine infusion (a) has an anesthetic sparing effect during major colorectal procedures and (b) if it also affects level of hypnosis as measured by bispectral index (BIS). Twenty-five patients undergoing laparotomy for resection of colorectal tumours were randomized to receive either IV lidocaine (1...
June 16, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28619696/postoperative-pain-management-in-spanish-hospitals-a-cohort-study-using-the-pain-out-registry
#14
Mauricio Polanco-García, Jaume García-Lopez, Neus Fàbregas, Windfried Meissner, Margarita M Puig
Pain after surgery remains a problem worldwide, though there is no published data on postoperative outcomes in Spain. We evaluated 2922 patients in the first day after surgery in thirteen tertiary care Spanish Hospitals, using the PAIN-OUT questionnaire. Aims were to: assess postoperative outcomes, and anesthetic/analgesic management in orthopedics (ORT) and general (GEN) surgery patients; explore the influence of the analgesic therapy on outcomes and opioid requirements; evaluate and compare outcomes and analgesic management by surgical procedure...
June 12, 2017: Journal of Pain: Official Journal of the American Pain Society
https://www.readbyqxmd.com/read/28617723/effect-of-uterine-fundal-pressure-on-maternal-intraocular-pressure-in-cesarean-delivery-comparison-of-regional-and-general-anesthesia
#15
Aysun Kurtay, Esra Ozayar, Handan Gulec, Gokhan Yildiz, Esra Turkyilmaz, Zennure Yildiz, Eyup Horasanli
PURPOSE: To evaluate the intraocular pressure (IOP) changes accompanying fundal pressure during a cesarean-section procedure under both regional and general anesthesia. METHODS: In total, 60 women scheduled for elective cesarean section, none of them diagnosed with ocular problems, were enrolled in the study. Patients underwent cesarean section under either general (group G, n=30) or regional anesthesia (group S, n=30) according to their choice. IOP was measured with a Tono-Pen before (T1) and after (T2) application of anesthesia, during fundal pressure (T3), and after the birth of the baby (T4)...
June 14, 2017: Journal of Glaucoma
https://www.readbyqxmd.com/read/28611929/epidural-anesthesia-for-cesarean-section-in-a-pregnant-woman-with-marfan-syndrome-and-dural-ectasia
#16
Franco Pepe, Mariagrazia Stracquadanio, Francesco De Luca, Agata Privitera, Elisabetta Sanalitro, Puccio Scarpinati
Marfan syndrome (MFS) is a genetic disorder of connective tissue, characterized by variable clinical features and multisystem complications. The anesthetic management during delivery is debated. Regional anesthesia has been used with success during cesarean delivery, but in some MFS patients there is a probability of erratic and inadequate spread of intrathecal local anesthetics as a result of dural ectasia. In these cases, epidural anesthesia may be a particularly useful technique during cesarean delivery because it allows an adequate spread and action of local anesthetic with a controlled onset of anesthesia, analgesia, and sympathetic block and a low risk of perioperative complications...
2017: Case Reports in Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28610706/ultrasound-guided-bilateral-rectus-sheath-block-vs-conventional-local-analgesia-in-single-port-laparoscopic-appendectomy-for-children-with-nonperforated-appendicitis
#17
Caroline Maloney, Michelle Kallis, Ibrahim Abd El-Shafy, Aaron M Lipskar, John Hagen, Michelle Kars
INTRODUCTION: Despite its minimally invasive approach, laparoscopic surgery can cause considerable pain. Regional analgesic techniques such as the rectus sheath block (RSB) offer improved pain management following elective umbilical hernia repair in the pediatric population. This effect has not been examined in laparoscopic single-incision surgery in children. We sought to compare the efficacy of bilateral ultrasound-guided RSB versus local anesthetic infiltration (LAI) in providing postoperative pain relief in pediatric single-incision transumbilical laparoscopic assisted appendectomy (TULA) with same-day discharge...
June 2, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28607342/continuous-regional-anesthesia-a-review-of-perioperative-outcome-benefits
#18
Dario Bugada, Daniela Ghisi, Edward R Mariano
Routine use of regional anesthesia for patients having surgery is supported by general safety and proven effectiveness as a targeted modality in the prevention and treatment of acute pain. Recently, perioperative physicians have become much more interested in improving long-term outcomes after surgery rather than focusing on the well-established short-term benefits of regional anesthesia. This interest has raised important questions regarding the potential influence of regional anesthesia on morbidity and mortality, persistent pain and cancer prognosis...
June 12, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28598921/virtual-reality-as-an-adjunctive-nonpharmacological-sedative-during-orthopedic-surgery-under-regional-anesthesia-a-pilot-and-feasibility-study
#19
Peter Y Chan, Simon Scharf
This pilot study assessed the feasibility and potential for any possible sedation sparing effect of immersive virtual reality (IVR) therapy on patients undergoing joint replacement surgery under regional anesthesia. Nine participants were given IVR, regional anesthetic, and sedation. Ten received conventional care. Mean propofol usage was 155 ± 45 mg/h in the conventional care group and 63 ± 21 mg/h in the IVR group (P = .088, mean difference -91.6 mg/h, 95% confidence interval -200 to 16.87 mg/h). There was no significant difference in postoperative satisfaction between the 2 groups...
June 7, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28598918/falls-from-the-o-r-or-procedure-table
#20
Richard C Prielipp, Julia L Weinkauf, Thomas M Esser, Brian J Thomas, Mark A Warner
Patient safety secured by constant vigilance remains a primary responsibility of every anesthesia professional. Although significant attention has been focused on patient falls occurring before and after surgery, a potentially catastrophic complication is when patients fall off an operating room or procedure table during anesthesia care. Because such events are (fortunately) uncommon, and because very little information is published in our literature, we queried 2 independent closed claims databases (the American Society of Anesthesiologists Closed Claims Project and the secure records of a private, anesthesia specialty-specific liability insurer) for information...
June 8, 2017: Anesthesia and Analgesia
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