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Regional anesthesia, ultrasound, pain, postoperative pain

Alecia L S Stein, Dorothea Baumgard, Isis Del Rio, Jacqueline L Tutiven
PURPOSE OF REVIEW: The purpose of this review is to summarize the latest advances in pediatric regional anesthesia with special emphasis on its role in the ambulatory surgical setting. RECENT FINDINGS: Undertreated pain in children following ambulatory surgery is not a rare occurrence and it is associated with increased morbidity and significant psychosocial harm. Use of regional anesthesia as part of the anesthetic approach in the ambulatory setting is safe when performed on children under general anesthesia and inclusion of certain adjuncts improves block outcomes...
February 2017: Current Pain and Headache Reports
Luciano Frassanito, Sara Pitoni, Gianluigi Gonnella, Sergio Alfieri, Miryam Del Vicario, Stefano Catarci, Gaetano Draisci
BACKGROUND: The transversus abdominis plane (TAP) block is a regional anesthesia technique that effectively reduces the pain intensity and use of analgesia in abdominal surgery. The aim of this study was to determine the utility of the ultrasound-guided TAP block in improving the efficacy of the ultrasound-guided ilioinguinal/iliohypogastric nerve (IIN/IHN) block for intraoperative anesthesia and postoperative pain control in day-case inguinal hernia repair (IHR). METHODS: We conducted a descriptive study of patients undergoing elective primary unilateral open IHR...
February 2017: Korean Journal of Anesthesiology
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
E Nohuz, B El Drayi, A Triki, K Grossmannova, B Boudier, K Koffi, M Albaut, C Dualé
Used in clinical practice as part of a multimodal analgesic regimen, the transversus abdominis plane block (TAP block) is a relative novel procedure in which local anaesthetic agents are injected into the anatomic neurofascial space between the internal oblique and the transversus abdominis muscle. It allows a significantly prolonged duration of analgesia during the early postoperative stage in abdominal surgery. This regional anesthesia technique provides analgesia to the skin, muscles of the anterior abdominal wall and parietal peritoneum in order to decrease the incision-related pain...
December 2016: Gynécologie, Obstétrique & Fertilité
Dragan Marinković, Jovana M Simin, Biljana Drasković, Ivana M Kvrgić, Marina Pandurov
INTRODUCTION: Ultrasound guided lower limb peripheral nerve blocks are efficient for perioperative pain treatment in children. The aim was to see if lower limb peripheral nerve blocks reduced the amount of propofol and opioid analgesics used intraoperatively, as well as the level of pain and consumption of systemic analgesics postoperatively. MATERIAL AND METHODS: A randomized, prospective clinical trial was carried out. It included 60 children between 11 and 18 years of age scheduled for elective knee arthroscopy...
January 2016: Medicinski Pregled
Sung Hye Byun, Jonghoon Lee, Jong Hae Kim
BACKGROUND: Patients on antiplatelet therapy following percutaneous coronary intervention can become coagulopathic due to infection. Performing regional anesthesia for bilateral surgery in such cases is challenging. We report a case of successful combined inguinal femoral and subgluteal sciatic nerve blocks (CFSNBs) for simultaneous bilateral below-knee amputations in a coagulopathic patient on antiplatelet therapy. METHODS: A 70-year-old male patient presented with pain in both feet due to diabetic foot syndrome...
July 2016: Medicine (Baltimore)
Andrijan Kartalov, Nikola Jankulovski, Biljana Kuzmanovska, Milka Zdravkovska, Mirjana Shosholcheva, Tatjana Spirovska, Aleksandra Panovska Petrusheva, Marija Tolevska, Marija Srceva, Vesna Durnev, Gjorgji Jota, Redzep Selmani, Atanas Sivevski
BACKGROUND: The transverses abdominals plane block (TAP) is a regional anesthesia technique that provided analgesia to the parietal peritoneum, skin and muscles of the anterior abdominal wall. The aim of this randomized double-blind study was to evaluate postoperative analgesia on patients undergoing open inguinal hernia repair under general anesthesia (GA), (GA + TAP) block preformed with ropivacaine and (GA + TAP-D) block preformed with ropivacaine and 4 mg dexamethasone. METHODS: 90 (ASA I-II) adult patients for unilateral open inguinal hernia repair were included in this study...
2015: Prilozi (Makedonska Akademija Na Naukite i Umetnostite. Oddelenie za Medicinski Nauki)
Michele Curatolo
PURPOSE OF REVIEW: The study focuses on neural blocks with local anesthetics in postoperative and chronic pain. It is prompted by the recent publication of several systematic reviews and guidelines. RECENT FINDINGS: For postoperative pain, the current evidence supports infusions of local anesthetics at the surgical site, continuous peripheral nerve blocks, and neuraxial analgesia for major thoracic and abdominal procedures. Ultrasound guidance can improve the performance of the blocks and different patient outcomes, although the incidence of peripheral nerve damage is not decreased...
October 2016: Current Opinion in Anaesthesiology
Gökhan Temiz, Hakan Şirinoğlu, Hakan Demirel, Nebil Yeşiloğlu, Murat Sarıcı, Gaye Taylan Filinte
BACKGROUND: Glomus tumor is a common lesion of the subungual area of the hand fingers. However, glomus tumors located outside the hand region are rare and the diagnosis is often difficult due to their low incidence and lack of distinct clinical features in the physical examination. The presented article contains five cases of extradigital glomus tumors with a short review of the literature. PATIENTS AND METHODS: Five cases of extradigital glomus tumor were included in the study...
January 2016: Indian Journal of Dermatology
Lihua Yang, Yucan Xu, Zhongyu Wang, Wei Zhang
The aim of this study was to evaluate the safety and efficacy of ultrasound-guided ilioinguinal/iliohypogastric nerve block (IINB) in pediatric patients undergoing same-day inguinal region surgery. Ninety patients aged 4-6 years, ASA levels I-II, were randomly divided into three groups: U, T, or C (n = 30 each). After basic anesthesia, patients in group U underwent ultrasound-guided IINB, those in group T underwent traditional Schulte-Steinberg IINB, and those in group C (controls) received intravenous anesthesia (ketamine-propofol) only...
December 2015: Indian Journal of Surgery
Loreto Lollo, Sanjay Bhananker, Agnes Stogicza
BACKGROUND: Guidelines warn of increased risks of injury when placing regional nerve blocks in the anesthetized adult but complications occurred in patients that received neither sedation nor local anesthetic. This restriction of nerve block administration places vulnerable categories of patients at risk of severe opioid induced side effects. Patient and operative technical factors can preclude use of preoperative regional anesthesia. The purpose of this study was to assess complications following sciatic popliteal and femoral or saphenous nerve blockade administered to anesthetized adult patients following foot and ankle surgery...
October 2015: International Journal of Critical Illness and Injury Science
Pierfrancesco Fusco, Vincenza Cofini, Emiliano Petrucci, Paolo Scimia, Giuseppe Paladini, Astrid U Behr, Fabio Gobbi, Tullio Pozone, Giorgio Danelli, Mauro Di Marco, Roberto Vicentini, Stefano Necozione, Franco Marinangeli
Inguinal herniorrhaphy is a common surgical procedure. The aim of this investigation was to determine whether unilateral paravertebral block could provide better control of postoperative pain syndrome compared with unilateral subarachnoid block (SAB). A randomized controlled study was conducted using 50 patients with unilateral inguinal hernias. The patients were randomized to receive either paravertebral block (S group) or SAB (C group). Paravertebral block was performed by injecting a total of 20 mL of 0...
May 2016: Pain
Hossam A Elshamaa
BACKGROUND: Shoulder surgeries are known to cause moderate to severe pain. Many techniques have been used successfully to minimize that stress response including interscalene block. Ultrasound guided techniques are becoming widely spread and commonly used for regional anesthesia. The objective of the present randomized controlled study is to compare the ultrasound guidance with nerve stimulation for interscalene brachial plexus block (IBPB) regarding the effect on stress response. PATIENTS AND METHODS: 50 patients, American Society of Anesthesiologists physical status I, II, and III, undergoing shoulder surgery were enrolled in the current study...
October 2015: Saudi Journal of Anaesthesia
Caroline D Fosnot, Lee A Fleisher, John Keogh
PURPOSE OF REVIEW: The purpose of this review is to discuss current practices and changes in the field of ambulatory anesthesia, in both hospital and ambulatory surgery center settings. New trends in ambulatory settings are discussed and a review of the most current and comprehensive guidelines for the care of ambulatory patients with comorbid conditions such as postoperative nausea and vomiting (PONV), obstructive sleep apnea and diabetes mellitus are reviewed. Future direction and challenges to the field are highlighted...
December 2015: Current Opinion in Anaesthesiology
Alexandre Takeda, Leonardo Henrique Cunha Ferraro, André Hosoi Rezende, Eduardo Jun Sadatsune, Luiz Fernando Dos Reis Falcão, Maria Angela Tardelli
INTRODUCTION: The use of ultrasound in regional anesthesia allows reducing the dose of local anesthetic used for peripheral nerve block. The present study was performed to determine the minimum effective concentration (MEC90) of bupivacaine for axillary brachial plexus block (ABPB). METHODS: Patients undergoing hand surgery were recruited. To estimate the MEC90, a sequential up-down biased coin method of allocation was used. The bupivacaine dose was 5mL for each nerve (radial, ulnar, median, and musculocutaneous)...
May 2015: Revista Brasileira de Anestesiologia
Chandra H Lloyd, Arjun K Srinath, Ryan D Muchow, Henry J Iwinski, Vishwas R Talwalkar, Janet L Walker, Christopher Montgomery, Todd Milbrandt
BACKGROUND: Peripheral nerve blocks (PNBs) have the potential to reduce postoperative pain. The use of ultrasound (US) to guide PNBs may be more beneficial than nerve stimulation (NS); however, very few studies have studied this technique in children. The objective of this study was to compare postoperative pain control in pediatric patients who had general anesthesia (GA) alone compared with those who had PNB performed by NS, or PNB with both NS and US guidance. Our hypothesis was that compared with NS, the US-guided PNB would result in reduced postoperative pain and opioid use, and that both PNB conditions would have improved outcomes compared with GA...
October 2016: Journal of Pediatric Orthopedics
Alexandre Takeda, Leonardo Henrique Cunha Ferraro, André Hosoi Rezende, Eduardo Jun Sadatsune, Luiz Fernando dos Reis Falcão, Maria Angela Tardelli
INTRODUCTION: The use of ultrasound in regional anesthesia allows reducing the dose of local anesthetic used for peripheral nerve block. The present study was performed to determine the minimum effective concentration (MEC90) of bupivacaine for axillary brachial plexus block. METHODS: Patients undergoing hand surgery were recruited. To estimate the MEC90, a sequential up-down biased coin method of allocation was used. The bupivacaine dose was 5 mL for each nerve (radial, ulnar, median, and musculocutaneous)...
May 2015: Brazilian Journal of Anesthesiology
Jens Döffert, Thorsten Steinfeldt
Regional anaesthesia has significant advantages compared to general anaesthesia with an opiate-based postoperative analgesia in injuries of the upper extremity. Severe pain may be considered a risk factor for the development of chronic postoperative pain syndromes in adults and children. Depending on the anticipated postoperative pain level, a catheter procedure should be used. Fractures of the upper extremity are common and may also be associated with seemingly minor injuries with a high postoperative pain level...
April 2015: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
Smaranjit Chatterjee, Jayanta Bain, Somita Christopher, Tirupati Venkata Swamy Gopal, Kalidindi Prasad Raju, Piyush Mathur
AIM: The number of patients with end-stage renal disease (ESRD) has shown a consistent rise in India in recent years. Continuous ambulatory peritoneal dialysis (CAPD) remains one of the safe and effective forms of treatment. In this study, we have tried to assess the effectiveness of field block technique for analgesia during catheter placement surgery until 24 h postoperatively, also, if it can obviate the need for general anesthesia in these high-risk patients. MATERIALS AND METHODS: We studied 52 ESRD patients from 2010 to 2012 who were posted for CAPD catheterization in the Department of Urology, Care Hospital, Hyderabad, India...
April 2015: Saudi Journal of Anaesthesia
Brian Schloss, David Martin, Jennifer Tripi, Kevin Klingele, Joseph D Tobias
BACKGROUND: There continues to be a significant focus on the value of regional and neuraxial anesthesia techniques for adjunctive use when combined with general anesthesia. The reported advantages include decreased patient opiate exposure, decreased medication-related adverse effects, decreased postanesthesia recovery room time and hospital stay, and increased patient satisfaction. MATERIALS AND METHODS: The authors present a case-controlled series evaluating the use of a single caudal epidural injection prior to incision as an adjunct to general anesthesia for the open repair of slipped capital femoral epiphysis...
April 2015: Saudi Journal of Anaesthesia
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