Regional anesthesia and pain medicine
-
Reg Anesth Pain Med · Sep 2021
Association of body pain and chronic disease: evidence from a 7-year population-based study in China.
Evidence is limited on the risk impact of body pain on future chronic disease. The present study aimed to investigate the association between body pain and chronic diseases. ⋯ Body pain is associated with major disease and mortality. Future clinical research should be targeted to whether or not improved pain control can mitigate this population-level disease burden.
-
Reg Anesth Pain Med · Sep 2021
Randomized Controlled TrialCombination of femoral triangle block and infiltration between the popliteal artery and the capsule of the posterior knee (iPACK) versus local infiltration analgesia for analgesia after anterior cruciate ligament reconstruction: a randomized controlled triple-blinded trial.
Femoral triangle block and local infiltration analgesia are two effective analgesic techniques after anterior cruciate ligament reconstruction. Recently, the iPACK block (infiltration between the popliteal artery and the capsule of the posterior knee) has been described to relieve posterior knee pain. This randomized controlled triple-blinded trial tested the hypothesis that the combination of femoral triangle block and iPACK provides superior analgesia to local infiltration analgesia after anterior cruciate ligament reconstruction. ⋯ The combination of femoral triangle block and iPACK reduces intravenous morphine consumption during the first 24 hours after anterior cruciate ligament reconstruction, when compared with local infiltration analgesia, without effect on other pain-related, early, or late functional-related outcomes.
-
Reg Anesth Pain Med · Sep 2021
Randomized Controlled TrialIs preoperative genicular radiofrequency ablation effective for reducing pain following total knee arthroplasty? A pilot randomized clinical trial.
Although total knee arthroplasty (TKA) is an effective treatment for severe knee osteoarthritis (OA), a subset of patients experience significant postoperative pain and dissatisfaction. Several clinical trials support the analgesic benefits of genicular nerve radiofrequency ablation (GN-RFA) for non-operative knee OA, but only one prior trial has examined the effects of this intervention given preoperatively on postoperative outcomes following TKA, showing no analgesic benefit of cooled GN-RFA. The current study evaluated whether conventional thermal GN-RFA performed preoperatively resulted in significant improvements in pain and function following TKA. ⋯ Conventional GN-RFA of the superior lateral, superior medial, and inferior medial genicular nerves when performed prior to TKA did not provide clinically significant pain relief or improvement in functional status at 2 or 6 weeks postoperatively.
-
Reg Anesth Pain Med · Sep 2021
Cadaveric investigation of the minimum effective volume for ultrasound-guided suprainguinal fascia iliaca block.
This cadaveric dose-finding study investigated the minimum effective volume of dye in 90% of cases (MEV90), required to stain the femoral, lateral femoral cutaneous and obturator nerves for ultrasound-guided suprainguinal fascia iliaca block (SIFIB). ⋯ For ultrasound-guided SIFIB, the MEV90 of dye required to stain the femoral, lateral femoral cutaneous and obturator nerves is 62.5 mL. Further studies are required to correlate this finding with the MEV90 of local anesthetic in human subjects.
-
Reg Anesth Pain Med · Sep 2021
Ultrasound-guided regional anesthesia in the emergency department: an argument for multidisciplinary collaboration to increase access while maintaining quality and standards.
The practice of ultrasound-guided regional anesthesia (UGRA) by emergency medicine physicians in the emergency department (ED) is increasing. The need for effective alternatives to opioid analgesia in the acute care setting likely exceeds the current capacity of UGRA-trained anesthesia teams. ⋯ The sustained interest in UGRA shown by many emergency medicine physicians should be viewed open-mindedly by anesthesiologists. Failure to collaborate on local and national scales could lead to delays in the development and implementation of patient-centered, safe procedural care, and limit patient access to the benefits of regional anesthesia.