Regional anesthesia and pain medicine
-
Reg Anesth Pain Med · Oct 2021
Randomized Controlled TrialRandomized comparison between pericapsular nerve group (PENG) block and suprainguinal fascia iliaca block for total hip arthroplasty.
This randomized trial compared ultrasound-guided pericapsular nerve group block and suprainguinal fascia iliaca block in patients undergoing primary total hip arthroplasty. We selected the postoperative incidence of quadriceps motor block (defined as paresis or paralysis of knee extension) at 6 hours as the primary outcome. We hypothesized that, compared with suprainguinal fascia iliaca block, pericapsular nerve group block would decrease its occurrence from 70% to 20%. ⋯ For primary total hip arthroplasty, pericapsular nerve group block results in better preservation of motor function than suprainguinal fascia iliaca block. Additional investigation is required to elucidate the optimal local anesthetic volume for motor-sparing pericapsular nerve group block and to compare the latter with alternate motor-sparing strategies such as periarticular local anesthetic infiltration.
-
Reg Anesth Pain Med · Oct 2021
Randomized Controlled TrialUltrasound-guided genicular nerve blocks following total knee arthroplasty: a randomized, double-blind, placebo-controlled trial.
Local anesthetic blockade of the genicular nerves, known targets of radiofrequency ablative techniques for knee pain, has not previously been studied in a randomized controlled trial evaluating acute pain after knee arthroplasty. We hypothesized that genicular nerve blockade added to an existing block regimen in total knee arthroplasty would result in a reduction in 24 hours opioid consumption. ⋯ Genicular nerve blockade was associated with a reduction in opioid consumption at 24 hours in primary total knee arthroplasty patients.
-
Reg Anesth Pain Med · Oct 2021
ReviewNarrative review of neuraxial potassium chloride administration errors: clinical features, human factors, and prevention measures.
Administration of the wrong drug via the epidural or intrathecal route can cause devastating consequences. Because of the commonality of potassium replacement therapy coupled to its potential neurotoxic profile, we suspected that injuries related to this drug error would be present in the literature. ⋯ KCl administration via epidural or intrathecal route has been reported to cause catastrophic consequences.
-
Reg Anesth Pain Med · Oct 2021
Non-Fellowship regional anesthesia training and assessment: an international Delphi study on a consensus curriculum.
While there are several published recommendations and guidelines for trainees undertaking subspecialty Fellowships in regional anesthesia, a similar document describing a core regional anesthesia curriculum for non-fellowship trainees is less well defined. We aimed to produce an international consensus for the training and teaching of regional anesthesia that is applicable for the majority of worldwide anesthesiologists. ⋯ This international consensus study provides specific information for designing a non-fellowship regional anesthesia curriculum. Implementation of a standardized curriculum has benefits for patient care through improving quality of training and quality of nerve blocks.