Current opinion in anaesthesiology
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New block techniques are being constantly developed or old techniques modified to improve outcomes after surgery. This review discusses the reasons why new block techniques need to be developed to match the needs of contemporary anesthetic practice. ⋯ Future studies need to be undertaken to further refine these techniques and produce evidence of support for analgesic efficacy, safety, and reliability.
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Curr Opin Anaesthesiol · Oct 2018
ReviewRecent developments in ultrasound imaging for neuraxial blockade.
Recent research has shed further light on the place of ultrasound imaging in neuraxial blockade in routine clinical practice, its use in thoracic epidurals, and real-time ultrasound-guided techniques. ⋯ Ultrasound imaging of the spine is a valuable technique that, while not indicated for routine use, should be part of the skillset of any practitioner that regularly performs lumbar and thoracic neuraxial blockade.
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Curr Opin Anaesthesiol · Oct 2018
ReviewIs epidural analgesia still a viable option for enhanced recovery after abdominal surgery.
Although thoracic epidural analgesia (TEA) is considered often as gold standard in multimodal analgesia with regard to major abdominal surgery, there is an ongoing debate if it is still a viable option for enhanced recovery because of its potential severe complications. ⋯ TEA provides superior pain control with a handful of important advantages if used sensibly and with caution. Because of associated risks for severe neurological complications, clear contraindications should be ruled out. Special attention needs be paid to potential hypotension in the setting of epidural analgesia. If these key points are considered, a TEA still represents a viable option for enhanced recovery after major abdominal surgery.