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Fascial block

Duncan Lee Hamilton, Baskar P Manickam, Matthew A J Wilson, Eiman Abdel Meguid
No abstract text is available yet for this article.
January 11, 2019: Regional Anesthesia and Pain Medicine
J C Galán Gutiérrez, B Tobera Noval, F J Sáenz Abós, M González Rodríguez, L A Fernández Meré, L A Sopena Zubiria
The addition of ultrasound to locoregional anaesthesia in the last few years has led to the description of various fascial thoracic blocks with analgesic purposes: PECS 1 and 2 block, serratus plane block, serratus intercostal fascial block, blockade in the plane of the thoracic transverse muscle..., which have been added to other well-known nerve blocks, such as thoracic paravertebral block or intercostal block. In this sense, locoregional anaesthesia has been universally recommended in patients with severe respiratory processes in order to avoid ventilatory support and subsequent weaning that considerably increases postoperative morbidity and mortality rates...
November 29, 2018: Revista Española de Anestesiología y Reanimación
Alexander J C Mittnacht
No abstract text is available yet for this article.
September 20, 2018: Journal of Cardiothoracic and Vascular Anesthesia
Duncan L Hamilton, Baskar P Manickam
No abstract text is available yet for this article.
November 2018: Regional Anesthesia and Pain Medicine
Brajesh Kaushal, Sandeep Chauhan, Kulbhushan Saini, Debesh Bhoi, Akshay K Bisoi, Tsering Sangdup, Maroof Ahmad Khan
OBJECTIVE: The aim of this study was to compare the relative efficacy of ultrasound-guided serratus anterior plane block (SAPB), pectoral nerves (Pecs) II block, and intercostal nerve block (ICNB) for the management of post-thoracotomy pain in pediatric cardiac surgery. DESIGN: A prospective, randomized, single-blind, comparative study. SETTING: Single-institution tertiary referral cardiac center. PARTICIPANTS: The study comprised 108 children with congenital heart disease requiring surgery through a thoracotomy...
August 31, 2018: Journal of Cardiothoracic and Vascular Anesthesia
Joan Melendez-Munoz, Meirav Braverman, Anna Rosamilia, Natharnia Young, Alison Leitch, Joseph K-S Lee
INTRODUCTION: Single incision slings (SIS) were introduced in an attempt to decrease the complications associated with retropubic and transobturator slings. The TVT Abbrevo is a modification of the TVT-O with a reduced length and less immediate postoperative pain. The Miniarc SIS has been shown to be equivalent to outside-in transobturator sling, Monarc at 12 month follow-up. OBJECTIVE: To evaluate objective and subjective outcomes of MiniArc SIS and TVT Abbrevo midurethral sling (MUS) in women with stress urinary incontinence...
November 2018: European Journal of Obstetrics, Gynecology, and Reproductive Biology
D Brenner, P Mahon, G Iohom, M Cronin, C O'Flynn, G Shorten
BACKGROUND: Fascial layers of the neurovascular sheath containing the brachial plexus influence distribution of local anaesthetic, hence increasing the risk of block failure when performing infraclavicular brachial plexus block (ICB). METHODS: Ultrasound-guided infraclavicular brachial plexus block was performed on cadavers using a single injection technique with dye (20-30 ml). After injection, we carried out consecutive dissection of the neurovascular bundle to study dye injectate spread and identify the presence of fascial layers...
October 2018: British Journal of Anaesthesia
Ki Jinn Chin, Sanjib Das Adhikary, Mauricio Forero
No abstract text is available yet for this article.
October 2018: Regional Anesthesia and Pain Medicine
Hesham Elsharkawy, Robert Maniker, Robert Bolash, Prathima Kalasbail, Richard L Drake, Nabil Elkassabany
BACKGROUND AND OBJECTIVES: Fascial plane blocks are rapidly emerging to provide safe, feasible alternatives to epidural analgesia for thoracic and abdominal pain. We define a new option for chest wall and upper abdominal analgesia, termed the rhomboid intercostal and subserratus plane (RISS) block. The RISS tissue plane extends deep to the erector spinae muscle medially and deep to the serratus anterior muscle laterally. We describe a 2-part proof-of-concept study to validate the RISS block, including a cadaveric study to evaluate injectate spread and a retrospective case series to assess dermatomal coverage and analgesic efficacy...
October 2018: Regional Anesthesia and Pain Medicine
S Kendir, Bilge İpek Torun, T Akkaya, A Comert, E Tuccar, I Tekdemir
PURPOSE: The aim of this study is to re-define the anatomical structures which are important for blocking the sciatic nerve and the nerves within the adductor canal which innervate the knee joint through the same injection site. We also aimed to investigate the spread of the anesthetic toward the areas in which the mentioned nerves lie on cadavers. METHODS: This study was performed on 16 lower extremities of formaldehyde-embalmed eight adult cadavers. The anatomy of adductor canal, courses of the nerves within the canal and the relationships of the saphenous, medial femoral cutaneous, medial retinacular, posterior branch of the obturator and sciatic nerves with each other and with the fascial compartments were investigated...
November 2018: Surgical and Radiologic Anatomy: SRA
H-M Yang, Y J Choi, H-J Kwon, J O, T H Cho, S H Kim
Although different injection locations for retrolaminar and erector spinae plane blocks have been described, the two procedures have a similar anatomical basis. In this cadaveric study we compared anatomical spread of dye in the thoracic region following these two procedures. Following randomisation, 10 retrolaminar blocks and 10 erector spinae plane blocks were performed on the left or right sides of 10 unembalmed cadavers. For each block, 20 ml of dye solution was injected at the T5 level. The back regions were dissected and the involvement of the thoracic spinal nerve was also investigated...
October 2018: Anaesthesia
Landon T Burns, Drew A Beasley, Mark A Stevens, Donald E Crabtree, Gregory R Mehaffey
Providing analgesia for patients with anterior rib and sternum fracture has been addressed from various types of modalities. Regional anesthesia via epidurals or peripheral nerve blocks, opiates, and other forms of multimodal pain regimens have been used. However, in the polytraumatic injury patient, positioning for an epidural may be problematic, and a predominantly opiate-based treatment plan may compromise respiratory status. In this case series, we describe the pectointercostal fascial block as another tool to treat patients with anterior rib and sternal fracture with polytraumatic injuries...
December 15, 2018: A&A practice
Jin-Soo Kim, Justin Sangwook Ko, Seunguk Bang, Hyungtae Kim, Sook Young Lee
Cervical plexus blocks (CPBs) have been used in various head and neck surgeries to provide adequate anesthesia and/or analgesia; however, the block is performed in a narrow space in the region of the neck that contains many sensitive structures, multiple fascial layers, and complicated innervation. Since the intermediate CPB was introduced in addition to superficial and deep CPBs in 2004, there has been some confusion regarding the nomenclature and definition of CPBs, particularly the intermediate CPB. Additionally, as the role of ultrasound in the head and neck region has expanded, CPBs can be performed more safely and accurately under ultrasound guidance...
August 2018: Korean Journal of Anesthesiology
Faraj W Abdallah, Tulin Cil, David MacLean, Caveh Madjdpour, Jaime Escallon, John Semple, Richard Brull
BACKGROUND AND OBJECTIVES: Serratus fascial plane block can reduce pain following breast surgery, but the question of whether to inject the local anesthetic superficial or deep to the serratus muscle has not been answered. This cohort study compares the analgesic benefits of superficial versus deep serratus plane blocks in ambulatory breast cancer surgery patients at Women's College Hospital between February 2014 and December 2016. We tested the joint hypothesis that deep serratus block is noninferior to superficial serratus block for postoperative in-hospital (pre-discharge) opioid consumption and pain severity...
July 2018: Regional Anesthesia and Pain Medicine
Malavika Prabhu, Mark A Clapp, Emily McQuaid-Hanson, Samsiya Ona, Taylor OʼDonnell, Kaitlyn James, Brian T Bateman, Blair J Wylie, William H Barth
OBJECTIVE: To evaluate whether a liposomal bupivacaine incisional block decreases postoperative pain and represents an opioid-minimizing strategy after scheduled cesarean delivery. METHODS: In a single-blind, randomized controlled trial among opioid-naive women undergoing cesarean delivery, liposomal bupivacaine or placebo was infiltrated into the fascia and skin at the surgical site, before fascial closure. Using an 11-point numeric rating scale, the primary outcome was pain score with movement at 48 hours postoperatively...
July 2018: Obstetrics and Gynecology
E Piraccini, G Biondi, H Byrne, M Calli, D Bellantonio, G Musetti, S Maitan
INTRODUCTION: Pectoral Nerves Block (PECS) and Serratus Plane Block (SPB) have been used to treat persistent post-surgical pain after breast and thoracic surgery; however, they cannot block the internal mammary region, so a residual pain may occur in that region. Parasternal block (PSB) and Thoracic Transversus Plane Block (TTP) anaesthetize the anterior branches of T2-6 intercostal nerves thus they can provide analgesia to the internal mammary region. METHODS: We describe a 60-year-old man suffering from right post-thoracotomy pain syndrome with residual pain located in the internal mammary region after a successful treatment with PECS and SPB...
October 2018: European Journal of Pain: EJP
Rakesh Garg, Swati Bhan, Saurabh Vig
Surgical resection of the primary tumour with axillary dissection is one of the main modalities of breast cancer treatment. Regional blocks have been considered as one of the modalities for effective perioperative pain control. With the advent of ultrasound, newer interventions such as fascial plane blocks have been reported for perioperative analgesia in breast surgeries. Our aim is to review the literature for fascial plane blocks for analgesia in breast surgeries. The research question for initiating the review was 'What are the reported newer regional anaesthesia techniques (fascial plane blocks) for female patients undergoing breast surgery and their analgesic efficacy?...
April 2018: Indian Journal of Anaesthesia
Susan E Smith, Susan E Hamblin, Oscar D Guillamondegui, Oliver L Gunter, Bradley M Dennis
BACKGROUND: Neuromuscular blocking agents (NMBA) have been associated with decreased time to fascial closure following damage control laparotomy (DCL). Changes in resuscitation over the last decade bring this practice into question. METHODS: A retrospective cohort study of adults who underwent DCL between 2009 and 2015 was conducted at an ACS-verified level 1 trauma center. The study group (NMBA+) received continuous NMBA within 24 h of DCL. Data collected included demographics, resuscitative fluids, mortality, and complications...
September 2018: American Journal of Surgery
John P Miller, Martin J Carney, Soobin Lim, John T Lindsey
BACKGROUND: Color Doppler ultrasound (CDUS) has not been routinely used in plastic and reconstructive surgery. Barriers to use have included large, cumbersome equipment, low-definition images, cost, and availability. In addition, programs in plastic surgery have not included training with ultrasound (US); thus, many current-day practitioners are unfamiliar with and reluctant to use this technology. Nevertheless, recent studies have demonstrated the utility of US in surgical planning. With the miniaturization, clearer imaging, and decreased costs of the latest US technology, previous barriers to use have largely been eliminated...
June 2018: Annals of Plastic Surgery
Seshadri Ramkiran, Mathews Jacob, Manish Honwad, Desiraju Vivekanand, Mathangi Krishnakumar, Seema Patrikar
Background: Pain associated with laparoscopic cholecystectomy is most severe during the first 24 h and the port sites are the most painful. Recent multimodal approaches target incisional pain instead of visceral pain which has led to the emergence of abdominal fascial plane blocks. This study embraces a novel combination of two independently effective fascial plane blocks, namely rectus sheath block and subcostal transversus abdominis plane (TAP) block to alleviate postoperative pain...
January 2018: Anesthesia, Essays and Researches
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