European journal of anaesthesiology
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Review Meta Analysis
Combination of dexamethasone and local anaesthetic solution in peripheral nerve blocks: A meta-analysis of randomised controlled trials.
Dexamethasone doubled the duration of postoperative analgesia after brachial plexus block, as well as speeding onset and reducing PONV.
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Randomized Controlled Trial
Quadratus lumborum block for postoperative pain after caesarean section: A randomised controlled trial.
Quadratus lumborum block may improve analgesia and reduce morphine use after Caesarean section.
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Randomized Controlled Trial Comparative Study
Ropivacaine 0.375 vs. 0.75% with prilocaine for intermediate cervical plexus block for carotid endarterectomy: A randomised trial.
Carotid endarterectomy is widely performed under regional anaesthesia. Ultrasound guidance is increasingly used in many regional anaesthetic procedures to improve safety and efficacy, and because it can reduce the amount of local anaesthetic required. Despite this, an ideal approach and dosing regimen for cervical plexus block remain elusive. ⋯ An ultrasound-guided intermediate block provides adequate anaesthesia for carotid thrombendarterectomy with a little need for supplementary local anaesthetic. Use of 0.375% ropivacaine provided similarly effective analgesia as 0.75%, but resulted in significantly lower plasma concentrations.
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Clinical Trial
The Shamrock lumbar plexus block: A dose-finding study.
The Shamrock technique is a new method for ultrasound-guided lumbar plexus blockade. Data on the optimal local anaesthetic dose are not available. ⋯ A volume of 20.4 ml ropivacaine 0.5% provided a successful Shamrock lumbar plexus block in 50% of the patients. A volume of 36.0 ml would be successful in 95% of the patients.
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Observational Study
Influence of arm position on ultrasound visibility of the axillary brachial plexus.
Contemporary axillary brachial plexus block is performed by separate injections targeting radial, median, ulnar and musculocutaneous nerve. These nerves are arranged around the axillary artery, making ultrasound visualisation sometimes challenging. In particular, the radial nerve can be difficult to localise deep to the artery. ⋯ The visibility of the radial nerve was not improved by varying positions of the arm. S180°/E0° provided the best overall visibility and accessibility of nerves.