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jrgRegional Anesthesia

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23 papers 25 to 100 followers
By Jesse Guscott McMaster Family Practice Anesthesia program director. Medical educator, ER, Anesthesia Twitter:@GuscottJesse
Faraj W Abdallah, Daniel B Whelan, Vincent W Chan, Govindarajulu A Prasad, Ryan V Endersby, John Theodoropolous, Stephanie Oldfield, Justin Oh, Richard Brull
BACKGROUND: By targeting the distal branches of the femoral nerve in the mid-thigh, the adductor canal block (ACB) can preserve quadriceps muscle strength while providing analgesia similar to a conventional femoral nerve block (FNB) for inpatients undergoing major knee surgery. In this randomized, double-blind, noninferiority trial, the authors hypothesized that ACB provides postoperative analgesia that is at least as good as FNB while preserving quadriceps strength after outpatient anterior cruciate ligament reconstruction...
May 2016: Anesthesiology
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
Sumitra G Bakshi, Amol Mapari, T S Shylasree
BACKGROUND: Opioid-sparing pain management is important for Enhanced Recovery After Surgery. Rectus sheath (RS) blocks are emerging as a promising modality for pain relief following midline laparotomy; however, there are limited prospective clinical trials testing their efficacy. The purpose of this randomized-controlled trial is to assess the morphine-sparing effect of local anesthetic (LA) boluses through RS catheters following elective gynecological oncology surgery. METHOD: After patients' informed consent, bilateral RS catheters were placed intraoperatively in 74 females (American Society of Anesthesiologists physical status I-II) undergoing elective midline laparotomy under general anesthesia...
September 14, 2016: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
Ghada Mohammad Nabih Bashandy, Dina Nabil Abbas
BACKGROUND: The pectoral nerves (Pecs) block types I and II are novel techniques to block the pectoral, intercostobrachial, third to sixth intercostals, and the long thoracic nerves. They may provide good analgesia during and after breast surgery. Our study aimed to compare prospectively the quality of analgesia after modified radical mastectomy surgery using general anesthesia and Pecs blocks versus general anesthesia alone. METHODS: One hundred twenty adult female patients scheduled for elective unilateral modified radical mastectomy under general anesthesia were randomly allocated to receive either general anesthesia plus Pecs block (Pecs group, n = 60) or general anesthesia alone (control group, n = 60)...
January 2015: Regional Anesthesia and Pain Medicine
Yeon-Dong Kim, Seon-Jeong Park, Junho Shim, Hyungtae Kim
The recently introduced pectoral nerve (Pecs) block is a simple alterative to the conventional thoracic paravertebral block or epidural block for breast surgery. It produces excellent analgesia and can be used to provide balanced anesthesia and as a rescue block in cases where performing a neuraxial blockade is not possible. In the thoracic region, a neuraxial blockade is often used to manage zoster-associated pain. However, this can be challenging for physicians due to the increased risk of hemodynamic instability in the upper thoracic level, and comorbid and contraindicated medical conditions such as coagulopathy...
September 20, 2016: Journal of Anesthesia
Edward Durant, Brittany Dixon, Josh Luftig, Daniel Mantuani, Andrew Herring
No abstract text is available yet for this article.
January 2017: American Journal of Emergency Medicine
R Blanco, T Parras, J G McDonnell, A Prats-Galino
We present a novel ultrasound-guided regional anaesthetic technique that may achieve complete paraesthesia of the hemithorax. This technique may be a viable alternative to current regional anaesthetic techniques such as thoracic paravertebral and central neuraxial blockade, which can be technically more challenging and have a higher potential side-effect profile. We performed the serratus block at two different levels in the midaxillary line on four female volunteers. We recorded the degree of paraesthesia obtained and performed fat-suppression magnetic resonance imaging and three-dimensional reconstructions of the spread of local anaesthetic in the serratus plane...
November 2013: Anaesthesia
P H Rosenberg
No abstract text is available yet for this article.
September 2016: Acta Anaesthesiologica Scandinavica
Daniel Micheller, Matthew J Chapman, Michael Cover, Jonathan D Porath, Nik Theyyunni, Ross Kessler, Robert Huang
No abstract text is available yet for this article.
August 1, 2016: CJEM
Sarah Luckett-Gatopoulos, Brent Thoma, Ken Milne, Chris Bond
No abstract text is available yet for this article.
July 2016: CJEM
E Albrecht, O Guyen, A Jacot-Guillarmod, K R Kirkham
Many consider femoral nerve block the gold standard in pain management following knee arthroplasty. Local infiltration analgesia is an alternate approach that applies the concept of surgical wound infiltration with local anaesthetics. This meta-analysis aims to compare both analgesic treatments for analgesia and functional outcomes after total knee arthroplasty. This meta-analysis was performed according to the PRISMA statement guidelines. The primary outcomes were cumulative i.v. morphine consumption, pain scores at rest and on movement on postoperative day one (analogue scale,0-10)...
May 2016: British Journal of Anaesthesia
Aaron B Dahl, Joseph M Neal, Michael F Mulroy
No abstract text is available yet for this article.
August 2016: American Journal of Emergency Medicine
Eitan Dickman, Illya Pushkar, Antonios Likourezos, Knox Todd, Ula Hwang, Saadia Akhter, Sean Morrison
OBJECTIVES: To compare pain relief between patients with intracapsular and extracapsular hip fractures who received an ultrasound-guided femoral nerve block (USFNB). DESIGN: A multicenter, prospective, randomized, clinical trial. SETTING: The study was conducted in the emergency departments of 3 academic hospitals located in New York City. SUBJECTS: Patients aged ≥60 years presenting to the emergency department with hip fracture...
March 2016: American Journal of Emergency Medicine
Daryl S Henshaw, Jonathan Douglas Jaffe, Jon Wellington Reynolds, Sean Dobson, Gregory B Russell, Robert S Weller
BACKGROUND: Unicondylar knee arthroplasty (UKA) is a commonly performed procedure with significant expected postoperative pain. Peripheral nerve blocks are 1 analgesic option, but some approaches may decrease quadriceps motor strength and interfere with early ambulation. In this study, we compared the analgesia provided by an adductor canal block (ACB) and a psoas compartment block (PCB) after UKA. We hypothesized that the ACB would provide equivalent analgesia, defined as a difference of <2 points on the pain scale (0-10 numeric rating scale [NRS]), at rest and with movement 6 hours after block placement...
April 2016: Anesthesia and Analgesia
Joseph M Neal
UNLABELLED: In 2010, the American Society of Regional Anesthesia and Pain Medicine's evidence-based medicine assessment of ultrasound (US)-guided regional anesthesia (UGRA) analyzed the effect of this nerve localization technology on patient safety. That analysis focused on 4 important regional anesthesia complications: peripheral nerve injury, local anesthetic systemic toxicity (LAST), hemidiaphragmatic paresis (HDP), and pneumothorax. In the intervening 5 years, further research has allowed us to refine our original conclusions...
March 2016: Regional Anesthesia and Pain Medicine
Jinlei Li, Thomas Halaszynski
Incidence of hemorrhagic complications from neuraxial blockade is unknown, but classically cited as 1 in 150,000 epidurals and 1 in 220,000 spinals. However, recent literature and epidemiologic data suggest that for certain patient populations the frequency is higher (1 in 3,000). Due to safety concerns of bleeding risk, guidelines and recommendations have been designed to reduce patient morbidity/mortality during regional anesthesia. Data from evidence-based reviews, clinical series and case reports, collaborative experience of experts, and pharmacology used in developing consensus statements are unable to address all patient comorbidities and are not able to guarantee specific outcomes...
2015: Local and Regional Anesthesia
Jeffrey Gadsden, Sabry Ayad, Jeffrey J Gonzales, Jaideep Mehta, Jan Boublik, Jacob Hutchins
Transversus abdominis plane (TAP) infiltration is a regional anesthesia technique that has been demonstrated to be effective for management of postsurgical pain after abdominal surgery. There are several different clinical variations in the approaches used for achieving analgesia via TAP infiltration, and methods for identification of the TAP have evolved considerably since the landmark-guided technique was first described in 2001. There are many factors that impact the analgesic outcomes following TAP infiltration, and the various nuances of this technique have led to debate regarding procedural classification of TAP infiltration...
2015: Local and Regional Anesthesia
Brandon Ritcey, Paul Pageau, Michael Y Woo, Jeffrey J Perry
OBJECTIVES: Hip and femoral neck fractures are common in elderly patients, who are at an increased risk of complications if their pain is suboptimally managed. This systematic review seeks to determine if regional nerve blocks reduce pain, reduce the need for parenteral opiates, and reduce complications, compared to standard pain management with opiates, acetaminophen, or NSAIDs. DATA SOURCES: Systematic review of MEDLINE, EMBASE, CINAHL, and the Cochrane Central Register of Controlled Trials found 401 articles, of which nine were selected for inclusion...
January 2016: CJEM
Madison Riddell, Maria Ospina, Jayna M Holroyd-Leduc
OBJECTIVE: Hip fractures are a common source of acute pain amongst the frail elderly. One potential technique to adequately manage pain in this population is the femoral nerve block. The objective of this systematic review was to provide updated evidence for the use of femoral nerve blocks as a pain management technique for older hip fracture patients in the emergency department (ED). Data Sources Searches of Medline, EMBASE, and the Cochrane Central Register of Controlled Trials were conducted between December 2010 and May 2014...
July 2016: CJEM
Dong Li, Guo-Guang Ma
PURPOSE: Femoral nerve blocks (FNBs) provide effective analgesia after total knee arthroplasty, but have been associated with quadriceps weakness. Adductor canal block (ACB) is a promising alternative option that delivers a primarily sensory blockade. The aim of this study was to determine whether ACB provides superior quadriceps strength and similar pain control than FNB. METHODS: A systematic search of PubMed, the Cochrane Library, EMBASE and Web of Science was conducted without publication data or language restriction...
August 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
2016-01-12 23:02:10
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