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https://www.readbyqxmd.com/read/27913981/the-challenges-of-anaesthesia-and-pain-relief-in-hip-fracture-care
#1
Rachel Cowan, Jun Hao Lim, Terence Ong, Ashok Kumar, Opinder Sahota
The care of the older person with hip fracture is complicated by their comorbid condition, limited physiological reserve, cognitive impairment and frailty. Two aspects of hip fracture management that have received considerable attention are how best to manage the pain associated with it and the ideal mode of anaesthesia. Existing literature has reported on the suboptimal treatment of pain in this orthogeriatric cohort. With recent advancements in medical care, a number of options have emerged as alternatives to conservative systemic analgesia...
December 3, 2016: Drugs & Aging
https://www.readbyqxmd.com/read/27904260/sonographic-identification-of-peripheral-nerves-in-the-forearm
#2
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/27901275/peripheral-nerve-blocks-for-the-treatment-of-headache-in-older-adults-a-retrospective-study
#3
Jacob R Hascalovici, Matthew S Robbins
OBJECTIVE: The objective of this study is to provide demographical and clinical descriptions of patients age 65 years old and older who were treated with peripheral nerve blocks (PNBs) at our institution and evaluate the safety and efficacy of this treatment. BACKGROUND: Headache disorders are common, disabling chronic neurological diseases that often persist with advancing age. Geriatric headache management poses unique therapeutic challenges because of considerations of comorbidity, drug interactions, and adverse effects...
November 30, 2016: Headache
https://www.readbyqxmd.com/read/27871587/peripheral-nerve-blocks-in-the-management-of-postoperative-pain-challenges-and-opportunities
#4
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/27871508/perineural-catheter-infection-a-systematic-review-of-the-literature
#5
REVIEW
Davide Nicolotti, Enrico Iotti, Guido Fanelli, Christian Compagnone
Perineural catheter infection is a rare but potentially dramatic complication of continuous peripheral nerve block. Different risk factors have been identified and the incidence of infection is increased in trauma victims, intensive care unit patients, immunodeficient individuals, and diabetic patients. Also, postoperative hyperglycemia, the absence of antibiotic prophylaxis, and catheter lasting more than 48 hours seem to be associated with a greater risk of infection. Skin disinfection and a strict aseptic technique during catheter placement are fundamental...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27860187/autophagy-activated-by-tuberin-mtor-p70s6k-suppression-is-a-protective-mechanism-against-local-anaesthetics-neurotoxicity
#6
Jingwei Xiong, Qiuyue Kong, Leyang Dai, He Ma, Xiaofei Cao, Li Liu, Zhengnian Ding
The local anaesthetics (LAs) are widely used for peripheral nerve blocks, epidural anaesthesia, spinal anaesthesia and pain management. However, exposure to LAs for long duration or at high dosage can provoke potential neuronal damages. Autophagy is an intracellular bulk degradation process for proteins and organelles. However, both the effects of LAs on autophagy in neuronal cells and the effects of autophagy on LAs neurotoxicity are not clear. To answer these questions, both lipid LAs (procaine and tetracaine) and amide LAs (bupivacaine, lidocaine and ropivacaine) were administrated to human neuroblastoma SH-SY5Y cells...
November 15, 2016: Journal of Cellular and Molecular Medicine
https://www.readbyqxmd.com/read/27792212/postoperative-analgesia-for-elective-total-knee-arthroplasty-under-subarachnoid-anesthesia-with-opioids-comparison-between-epidural-femoral-block-and-adductor-canal-block-techniques-with-and-without-perineural-adjuvants-a-prospective-randomized-clinical-trial
#7
José R Ortiz-Gómez, Marta Perepérez-Candel, José M Vázquez-Torres, José M Rodriguez-Del Río, Berta Torrón-Abad, Inocencia Fornet-Ruiz, Francisco J Palacio-Abizanda
BACKGROUND: Optimal control of acute postoperative pain and prevention of chronic persistent pain in total knee arthroplasty (TKA) remain a challenge. The main hypothesis was that nerve blocks improve postoperative analgesia especially if perineural adjuvants are added. METHODS: Immediate postoperative pain (24 h) was evaluated every hour in 639 patients using a verbal rating 11-point scale for patient self-reporting of pain (VRS-11). All patients received subarachnoid anesthesia and were randomly allocated in 8 groups: control group, epidural (EA) and single shots femoral (FNB) or adductor canal blocks (ACB), both with and without adjuvants: dexamethasone (+Dexa) or dexmedetomidine (+Dexm)...
October 28, 2016: Minerva Anestesiologica
https://www.readbyqxmd.com/read/27792047/does-dexmedetomidine-have-a-perineural-mechanism-of-action-when-used-as-an-adjuvant-to-ropivacaine-a-paired-blinded-randomized-trial-in-healthy-volunteers
#8
Jakob H Andersen, Ulrik Grevstad, Hanna Siegel, Jørgen B Dahl, Ole Mathiesen, Pia Jæger
BACKGROUND: Dexmedetomidine used as an adjuvant to local anesthetics may prolong the duration of peripheral nerve blocks. Whether this is mediated by a perineural or systemic mechanism remains unknown. The authors hypothesized that dexmedetomidine has a peripheral mechanism of action. METHODS: The authors conducted a randomized, paired, triple-blind trial in healthy volunteers. All received bilateral saphenous nerve blocks with 20 ml ropivacaine, 0.5%, plus 1 ml dexmedetomidine, 100 µg/ml, in one thigh and 20 ml ropivacaine 0...
October 28, 2016: Anesthesiology
https://www.readbyqxmd.com/read/27753708/perioperative-nerve-injury-after-peripheral-nerve-block-in-patients-with-previous-systemic-chemotherapy
#9
Arnoley S Abcejo, Hans P Sviggum, Michelle L Mauermann, James R Hebl, Carlos B Mantilla, Andrew C Hanson, Yi Lin, Adam K Jacob
BACKGROUND AND OBJECTIVES: There are multiple risk factors for developing perioperative nerve injury (PNI). Perioperative nerve injury after peripheral nerve blockade (PNB) is rare. Exposure to systemic chemotherapy may cause peripheral neuropathy, but its role as a risk factor for PNI after PNB is unknown. The objective of this retrospective study was to determine the incidence of PNI in patients undergoing PNB as part of extremity surgery after prior exposure to systemic chemotherapy...
November 2016: Regional Anesthesia 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...
October 3, 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27748255/ultrasound-guided-peripheral-nerve-blocks-are-useful-for-resections-of-malignant-skin-tumours-on-the-leg
#11
Kenji Yokota, Takaaki Matsumoto, Yoshie Murakami, Kaori Ando, Masashi Akiyama
No abstract text is available yet for this article.
October 17, 2016: European Journal of Dermatology: EJD
https://www.readbyqxmd.com/read/27746528/lower-limb-surgeries-under-combined-femoral-and-sciatic-nerve-block
#12
Lipsy Bansal, Joginder Pal Attri, Pawan Verma
INTRODUCTION: Peripheral nerve blocks are gaining popularity for many infraumblical surgeries with the development of new techniques such as ultrasound and peripheral nerve stimulator. It provides stable hemodynamic, better, and prolonged postoperative analgesia. This study was carried out to see the effectiveness of combined femoral and sciatic nerve block with ropivacaine alone and by adding fentanyl. MATERIALS AND METHODS: The study was carried out on 100 patients scheduled for lower limb surgeries and were randomly divided into two groups of 50 each...
September 2016: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/27746524/evaluation-of-clonidine-as-an-adjuvant-to-bupivacaine-in-wound-infiltration-for-providing-postoperative-analgesia-after-abdominal-hysterectomy
#13
Venkatesh Selvaraj
BACKGROUND: Clonidine is an effective adjuvant to local anesthetics in peripheral nerve blocks. We studied the effect of clonidine as an adjuvant in wound infiltration for postoperative analgesia. AIM: To evaluate the role of clonidine as an adjuvant to bupivacaine in wound infiltration in terms of quality and duration of postoperative analgesia in patients undergoing total abdominal hysterectomy. SETTINGS AND STUDY DESIGN: Prospective, randomized, double-blinded study...
September 2016: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/27731894/patterns-of-use-of-peripheral-nerve-blocks-and-trigger-point-injections-for-pediatric-headache-results-of-a-survey-of-the-american-headache-society-pediatric-and-adolescent-section
#14
Christina L Szperka, Amy A Gelfand, Andrew D Hershey
OBJECTIVE: To describe current patterns of use of nerve blocks and trigger point injections for treatment of pediatric headache. BACKGROUND: Peripheral nerve blocks are often used to treat headaches in adults and children, but the available studies and practice data from adult headache specialists have shown wide variability in diagnostic indications, sites injected, and medication(s) used. The purpose of this study was to describe current practice patterns in the use of nerve blocks and trigger point injections for pediatric headache disorders...
November 2016: Headache
https://www.readbyqxmd.com/read/27723392/continuous-peripheral-nerve-blocks-for-postoperative-pain
#15
Mohammed Haque, Gary Yap
No abstract text is available yet for this article.
October 2016: British Journal of Hospital Medicine
https://www.readbyqxmd.com/read/27703632/a-comparison-of-strength-for-two-continuous-peripheral-nerve-block-catheter-dressings
#16
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/27687357/regional-anesthesia-practice-in-china-a-survey
#17
Jeffrey Huang, Huan Gao
STUDY OBJECTIVE: Neuraxial anesthesia has been widely used in China. Recently, Chinese anesthesiologists have applied nerve stimulator and ultrasound guidance for peripheral nerve blocks. Nationwide surveys about regional anesthesia practices in China are lacking. We surveyed Chinese anesthesiologists about regional anesthesia techniques, preference, drug selections, complications, and treatments. DESIGN: A survey was sent to all anesthesiologist members by WeChat...
November 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27685346/the-optimal-analgesic-block-for-total-knee-arthroplasty
#18
Thomas Fichtner Bendtsen, Bernhard Moriggl, Vincent Chan, Jens Børglum
Peripheral nerve block for total knee arthroplasty is ideally motor sparing while providing effective postoperative analgesia. To achieve these goals, one must understand surgical dissection techniques, distribution of nociceptive generators, sensory innervation of the knee, and nerve topography in the thigh.
September 28, 2016: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/27685345/ultrasound-guided-percutaneous-peripheral-nerve-stimulation-for-postoperative-analgesia-could-neurostimulation-replace-continuous-peripheral-nerve-blocks
#19
Brian M Ilfeld, Stuart A Grant
No abstract text is available yet for this article.
September 28, 2016: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/27676687/proposed-medicare-physician-payment-schedule-for-2017-impact-on-interventional-pain-management-practices
#20
Laxmaiah Manchikanti, Alan D Kaye, Joshua A Hirsch
The Centers for Medicare and Medicaid Services (CMS) released the proposed 2017 Medicare physician fee schedule on July 7, 2016, addressing Medicare payments for physicians providing services either in an office or facility setting, which also includes payments for office expenses and quality provisions for physicians. This proposed rule occurs in the context of numerous policy changes, most notably related to the Medicare Access & CHIP Reauthorization Act of 2015 (MACRA) and its Merit-Based Incentive Payment System (MIPS)...
September 2016: Pain Physician
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