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Alicia J Mangram, Olakunle F Oguntodu, Alexandra K Hollingworth, Laura Prokuski, Arleen Steinstra, Mary Collins, Joseph F Sucher, Francis Ali-Osman, James K Dzandu
BACKGROUND: Hip fractures due to falls cause significant morbidity and mortality among geriatric patients. A significant unmet need is an optimal pain management strategy. Consequently, patients are treated with standard analgesic care (SAC) regimens, which deliver high narcotic doses. However, narcotics are associated with delirium as well as gastrointestinal and respiratory failure risks. The purpose of this pilot study was to determine the safety and effectiveness of ultrasound-guided continuous compartmental fascia iliaca block (CFIB) in patients 60 years or older with hip fractures in comparison with SAC alone...
December 2015: Journal of Trauma and Acute Care Surgery
Mark D Baker, John P Gullett
Pediatric acute femur fractures are a relatively common major orthopedic injury seen in emergency departments. Providing adequate and safe analgesia is essential while patients await definitive management of these fractures. Opioid medications are typically used to treat fracture-associated pain but have well-known adverse effects including respiratory and central nervous system depression, pruritus, nausea, and allergic reactions. Dose titration of opioids in pediatric patients may be difficult and requires frequent nursing and physician reassessments...
December 2015: Pediatric Emergency Care
Thomas Heflin, Terry Ahern, Andrew Herring
No abstract text is available yet for this article.
September 2015: American Journal of Emergency Medicine
Oron Frenkel, Otto Liebmann, Jason W Fischer
OBJECTIVES: Ultrasound-guided forearm nerve blocks have been shown to safely reduce pain for emergency procedures in the adult emergency department (ED). Although ultrasonography is widely used for forearm nerve blocks in the adult ED and in the pediatric operating room, no study to date has examined its use in the pediatric emergency setting. METHODS: We conducted a prospective nonblinded descriptive study of ultrasound-guided ulnar, median, and radial nerve blocks in a convenience sample of pediatric patients with hand injuries requiring procedural intervention who presented to a freestanding pediatric ED...
April 2015: Pediatric Emergency Care
Sacha Duchicela, Anthoney Lim
Successful injury management is often dependent upon optimal pain control. Many injuries do not require procedural sedation or systemic analgesia, and emergency clinicians have used peripheral nerve blocks for several decades for these injuries. Nerve blocks deliver anesthetic to the nerve that corresponds to the sensory innervation of the area where the wound or injury is located. In the pediatric setting, some nerve block modalities require modification to the approach and techniques commonly used in adult patients due to the age and weight of the child, the ability of the patient to cooperate, and the ability of the emergency clinician to observe pain response...
October 2013: Pediatric Emergency Medicine Practice
Ghada Mohammad Nabih Bashandy, Abeer Hassan Hamed Elkholy
BACKGROUND: Many multimodal analgesia techniques have been tried to provide adequate analgesia for midline incisions extending above and below the umbilicus aiming at limiting the perioperative use of morphine thus limiting side effects. Ultrasound (US) guidance made the anesthesiologist reconsider old techniques for wider clinical use. The rectus sheath block (RSB) is a useful technique under-utilized in the adult population. OBJECTIVES: Our study examined the efficacy of a preemptive single-injection rectus sheath block in providing better early postoperative pain scores compared to general anesthesia alone...
August 2014: Anesthesiology and Pain Medicine
Alyssa L Turner, Michelle D Stevenson, Keith P Cross
OBJECTIVE: The objective of this study was to compare the duration of analgesia, need for analgesic medications, and pain-related nursing interventions in patients who did and did not receive ultrasound-guided femoral nerve blocks for femur fracture pain. METHODS: This is a retrospective, preimplementation and postimplementation cohort study. An emergency department log of patients receiving femoral nerve blocks for femur fracture pain was compared with a similar cohort of patients with femur fractures who did not receive nerve blocks...
April 2014: Pediatric Emergency Care
C Baldi, S Bettinelli, P Grossi, A Fausto, F Sardanelli, F Cavalloro, M Allegri, A Braschi
Although regional anaesthesia has become safer, there are an increasing number of articles regarding complications of regional blocks. During the last few years, many authors have suggested the use of ultrasound to minimize the appearance of complications. This review was performed, through a Medline research, to evaluate articles concerning ultrasound and locoregional anaesthesia published until April 2005. A total of 39 articles were reviewed. Technical procedures, the use of ultrasound guidance in epidural anesthesia, the application of this technique for peripheral nerve blocks, and its indications in pregnancy and in pediatric patients were considered...
November 2007: Minerva Anestesiologica
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