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Postoperative nerve blocks

Yu Takeda, Shigeo Fukunishi, Shoji Nishio, Shinichi Yoshiya, Kazuma Hashimoto, Yuka Simura
BACKGROUND: Postoperative pain is a significant concern of patients before surgery. Multimodal pain management is an effective method of pain control after major orthopedic surgery. Acetaminophen is the most commonly used analgesic for the management of pain. It was hypothesized that 1000 mg of intravenous acetaminophen (IA) dosed every 6 hours would significantly reduce the postoperative pain score at rest and the opioid consumption volume in patients who would undergo total hip arthroplasty (THA) when compared to a control group...
February 25, 2019: Journal of Arthroplasty
Miao-Pei Su, Peng-Ju Huang, Kuang-Yi Tseng, Ya-Chun Shen, Po-Nien Chen, Kuang-I Cheng
Adequate postoperative analgesia after hallux valgus (HV) correction surgery improves early mobilization and decreases hospital stay. Peripheral nerve block and peri-incisional local anesthetic (LA) infiltration are both widely used for pain management in orthopedic surgeries. The aim of this study was to compare the analgesic effects between the ankle block and peri-incisional infiltration technique in patients undergoing HV correction surgery. Ninety patients scheduled for hallux valgus correction surgery were randomly allocated into three groups...
March 2019: Kaohsiung Journal of Medical Sciences
Güldeniz Argun, Göze Çayırlı, Güray Toğral, Murat Arıkan, Süheyla Ünver
OBJECTIVES: This study aims to evaluate the efficacy of ultrasound (US)-guided peripheral nerve blocks in postoperative analgesia after pediatric orthopedic tumor surgery. PATIENTS AND METHODS: This retrospective study included 108 children (64 boys, 44 girls, mean age 10.23 years; range, 2 to 18 years) who were performed orthopedic tumor surgery under general anesthesia. The children were divided into two groups as those who were performed nerve block for postoperative pain control (group 1, n=54) and those who were performed intravenous analgesic (group 2, n=54)...
April 2019: Joint Diseases & related Surgery
Boohwi Hong, ChaeSeong Lim, Hyemin Kang, Hongsik Eom, Yeojung Kim, Hyun Jin Cho, Woosik Han, Sunyeul Lee, Woosuk Chung, Yoon-Hee Kim
BACKGROUND: The addition of the adjuvant dexmedetomidine to a nerve block improves the quality of the block and reduces perioperative opioid consumption. The aim of this study was to assess the effect of dexmedetomidine as an adjuvant for the thoracic paravertebral block (TPVB) in postoperative pain control after video-assisted thoracoscopic surgery (VATS). METHODS: Sixty-six males, aged 15⁻40 years, with spontaneous pneumothorax scheduled for VATS wedge resection were enrolled...
March 12, 2019: Journal of Clinical Medicine
Herman Sehmbi, Marjorie Johnson, Shalini Dhir
BACKGROUNDS AND OBJECTIVES: The anterior approach to the subomohyoid suprascapular (SOS) nerve is a new, technically easy and reliable regional anesthesia technique for postoperative shoulder analgesia. However, due to its proximity, the injectate may spread to the brachial plexus and phrenic nerve. The goal of this anatomic study with dye injection in the subomohyoid space and subsequent cadaver dissection was to establish the likely spread of local anesthesia and the extent of brachial plexus and phrenic nerve involvement resulting from ultrasound-guided SOS nerve block...
March 13, 2019: Regional Anesthesia and Pain Medicine
Peng Guo, Zeng-Jun Xu, Chang-En Hu, Yue-Ying Zheng, Dan-Feng Xu
BACKGROUND: Empty sella syndrome is a condition in which the pituitary gland shrinks or flattens. Patients with empty sella syndrome often present with headache, hypertension, obesity, visual disturbances, cerebrospinal fluid (CSF) rhinorrhoea, or endocrine dysfunction. Herein, we report a rare case of empty sella syndrome discovered after the patient experienced postoperative hypotension and respiratory failure. CASE SUMMARY: A 60-year-old man was admitted for further workup of left shoulder pain...
March 6, 2019: World Journal of Clinical Cases
Nicholas S Cormier, Michael J Stein, Tinghua Zhang, Haemi Lee, Jing Zhang
Background: Epidural nerve blocks (EA) have been widely used in abdominal and thoracic surgery as an adjunct to general anesthesia (GA). The role for EA in microsurgical free flap breast reconstruction remains unclear with concerns regarding its impact on flap survival and operating room efficiency. The purpose of this study was to examine the effectiveness of epidural blocks in patients undergoing deep inferior epigastric perforator (DIEP) flap breast reconstruction. Methods: A retrospective analysis of patients undergoing DIEP breast reconstruction under GA alone was compared with those receiving EA/GA...
January 2019: Plastic and Reconstructive Surgery. Global Open
Ahmet Murat Yayik, Sevim Cesur, Figen Ozturk, Ali Ahiskalioglu, Ayse Nur Ay, Erkan Cem Celik, Nuh Cagrı Karaavci
BACKGROUND: Spinal surgery is a procedure that causes intense and severe pain in the postoperative period. Erector spinae plane (ESP) block can target the dorsal-ventral rami of thoracolumbar nerves but its effect on lumbar surgery is unclear. The aim of this study was to investigate the effect of the ESP block on postoperative opioid consumption and pain scores in patients undergoing spinal surgery. METHODS: Sixty patients undergoing open lumbar decompression surgery, were randomized two groups...
March 7, 2019: World Neurosurgery
Başak Altıparmak, Melike Korkmaz Toker, Ali Ihsan Uysal, Yağmur Kuşçu, Semra Gümüş Demirbilek
STUDY OBJECTIVE: Laparoscopic cholecystectomy (LC) is a frequently applied minimally invasive surgery. Intraoperative access is provided with small keyhole entries on the abdominal wall. However, LC causes moderate to severe postoperative pain. The subcostal approach of TAP block was described by Hebbard et al. for postoperative analgesia especially for upper abdominal surgeries. Ultrasound-guided erector spinae plane (US-ESP) block is a novel technique targeting ventral rami, dorsal rami and rami communicantes of the spinal nerves...
March 6, 2019: Journal of Clinical Anesthesia
Joanne Guay, Sandra Kopp
BACKGROUND: General anaesthesia combined with epidural analgesia may have a beneficial effect on clinical outcomes. However, use of epidural analgesia for cardiac surgery is controversial due to a theoretical increased risk of epidural haematoma associated with systemic heparinization. This review was published in 2013, and it was updated in 2019. OBJECTIVES: To determine the impact of perioperative epidural analgesia in adults undergoing cardiac surgery, with or without cardiopulmonary bypass, on perioperative mortality and cardiac, pulmonary, or neurological morbidity...
March 1, 2019: Cochrane Database of Systematic Reviews
Joanne Guay, Santhanam Suresh, Sandra Kopp
BACKGROUND: The use of ultrasound guidance for regional anaesthesia has become popular over the past two decades. However, it is not recognized by all experts as an essential tool, perhaps because it is unclear whether ultrasound reduces the risk of severe neurological complications, and the cost of an ultrasound machine (USD 22,000) is substantially higher than the cost of other tools. This review was published in 2016 and updated in 2019. OBJECTIVES: To determine whether ultrasound guidance offers any clinical advantage when neuraxial and peripheral nerve blocks are performed in children in terms of decreasing failure rate or the rate of complications...
February 27, 2019: Cochrane Database of Systematic Reviews
N M Elkassabany, L F Cai, I Badiola, B Kase, J Liu, C Hughes, C L Israelite, C L Nelson
AIMS: Adductor canal block (ACB) has emerged as an alternative to femoral nerve block (FNB) for analgesia after total knee arthroplasty (TKA). The optimal duration of maintenance of the ACB is still questionable. The purpose of this study was to compare the analgesic benefits and physiotherapy (PT) outcomes of single-shot ACB to two different regimens of infusion of the continuous ACB, 24-hour and 48-hour infusion. PATIENTS AND METHODS: This was a prospective, randomized, unblinded study...
March 2019: Bone & Joint Journal
Rodney A Gabriel, Matthew W Swisher, Jacklynn F Sztain, Timothy J Furnish, Brian M Ilfeld, Engy T Said
There are various important implications associated with poorly controlled postoperative pain in the adult surgical patient - this includes cardiopulmonary complications, opioid-related side effects, unplanned hospital admissions, prolonged hospital stay, and the subsequent development of chronic pain or opioid addiction. With the ongoing national opioid crisis, it is imperative that perioperative providers implement pathways for surgical patients that reduce opioid requirements and pain-related complications...
February 27, 2019: Expert Opinion on Pharmacotherapy
Kris Vermeylen, Matthias Desmet, Ine Leunen, Filiep Soetens, Arne Neyrinck, Dirk Carens, Ben Caerts, Patrick Seynaeve, Admir Hadzic, Marc Van de Velde
BACKGROUND AND OBJECTIVES: Lumbar plexus block has been used to provide postoperative analgesia after lower limb surgery. The fascia iliaca compartment block (FICB) has been proposed as an anterior approach of the lumbar plexus targeting the femoral, obturator and lateral femoral cutaneous nerve. However, both radiological and clinical evidence demonstrated that an infra-inguinal approach to the fascia iliaca compartment does not reliably block the three target nerves.We hypothesized that a supra-inguinal approach of the fascia iliaca compartment results in a more consistent block of the three target nerves than an infra-inguinal approach...
February 22, 2019: Regional Anesthesia and Pain Medicine
Jean-Christophe Clement, Guillaume Besch, Marc Puyraveau, Tommy Grelet, David Ferreira, Lucie Vettoretti, Sébastien Pili-Floury, Emmanuel Samain, Francis Berthier
BACKGROUND AND OBJECTIVES: The effect of intravenous dexamethasone on the duration of axillary plexus block performed using ropivacaine is not described. The aim of this study is to assess the effect of intravenous dexamethasone on the duration of axillary plexus block analgesia after distal upper arm surgery. METHODS: In this prospective, randomized, placebo-controlled, double-blinded trial, consenting patients scheduled for hand or forearm surgery under ultrasound-guided axillary plexus block performed using 0...
March 2019: Regional Anesthesia and Pain Medicine
Qiang Zhu, Li Li, Zhaoyun Yang, Jinmei Shen, Rong Zhu, Yu Wen, Wenwu Cai, Lei Liu
BACKGROUND: Quadratus lumborum (QL) block is increasingly being used as a new abdominal nerve block technique. In some studies of mid and lower abdominal and hip analgesia, continuous QL block achieved favorable outcomes as an alternative to continuous intravenous analgesia with opioids. However, the use of continuous QL block for upper abdominal pain is less well characterized. This study aimed to investigate the effects of continuous anterior QL block (CQLB) on postoperative pain and recovery in patients undergoing open liver resection...
February 18, 2019: BMC Anesthesiology
Dhritiman Chakrabarti, Sriganesh Kamath, K R Madhusudan Reddy, Deepti B Srinivas, Nitin Manohar, Dheeraj Masapu
Background and Aims: The study was conceived to elucidate the effects of dexmedetomidine as an anesthetic adjunct to propofol (total intravenous anesthesia) on anesthetic dose reduction and anesthesia recovery parameters in cerebello-pontine angle (CPA) surgeries. Material and Methods: This prospective randomized study was conducted on 49 patients (25 with dexmedetomidine, 24 without). After standardized anesthetic induction, anesthesia was maintained using propofol (via target controlled infusion, titrated to maintain BIS between 40 and 60), fentanyl (0...
October 2018: Journal of Anaesthesiology, Clinical Pharmacology
Yugal Karkhur, Ramneek Mahajan, Abhimanyu Kakralia, Amol Prabhakar Pandey, Mukul Chandra Kapoor
Background: Patients undergoing total knee arthroplasty suffer from moderate-to-severe postoperative pain resulting in immobility-related complications and prolonged hospitalization. Femoral nerve block is associated with reduction in the quadriceps strength and increasing incidence of falls. Adductor canal block has been shown to be as effective as femoral nerve block without causing quadriceps weakness. Objectives: To compare outcomes of studies comparing adductor canal block and femoral nerve block in patients undergoing primary total knee arthroplasty...
October 2018: Journal of Anaesthesiology, Clinical Pharmacology
Y Deng, Y Li, Y Yao, D D Feng, M Xu
OBJECTIVE: To compare the effects of ultrasound-guided interscalene brachial plexus block and C5-6 nerve root block for analgesia after shoulder arthroscopy. METHODS: In the study, 40 patients of ASA I-II were selected for elective general anesthesia to repair the shoulder ligament rupture in Peking University Third Hospital, who were randomly divided into two groups, respectively for the intermuscular brachial plexus block group (group I) and C5-6 nerve root block group (group C), n=20...
February 18, 2019: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
Brian M Ilfeld, John J Finneran, Rodney A Gabriel, Engy T Said, Patrick L Nguyen, Wendy B Abramson, Bahareh Khatibi, Jacklynn F Sztain, Matthew W Swisher, Pia Jaeger, Dana C Covey, Matthew J Meunier, Eric R Hentzen, Catherine M Robertson
BACKGROUND AND OBJECTIVES: Percutaneous peripheral nerve stimulation (PNS) is an analgesic modality involving the insertion of a lead through an introducing needle followed by the delivery of electric current. This modality has been reported to treat chronic pain as well as postoperative pain following knee and foot surgery. However, it remains unknown if this analgesic technique may be used in ambulatory patients following upper extremity surgery. The purpose of this proof-of-concept study was to investigate various lead implantation locations and evaluate the feasibility of using percutaneous brachial plexus PNS to treat surgical pain following ambulatory rotator cuff repair in the immediate postoperative period...
February 15, 2019: Regional Anesthesia and Pain Medicine
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