Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Mar 2022
Randomized Controlled TrialPreoperative pericapsular nerve group (PENG) block for total hip arthroplasty: a randomized, placebo-controlled trial.
We hypothesized that the addition of a preoperative pericapsular nerve group (PENG) block to intra-articular local anesthetic injection would improve analgesia after total hip arthroplasty. ⋯ The addition of a preoperative PENG block to intra-articular injections of local anesthetic provides a limited benefit to postoperative analgesia in the recovery room with no discernible benefits thereafter.
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Reg Anesth Pain Med · Mar 2022
Review Meta AnalysisEfficacy of topical cannabinoids in the management of pain: a systematic review and meta-analysis of animal studies.
Cannabinoids are emerging as an alternative pain management option, preliminarily supported by preclinical and clinical studies. Unwanted side effects from oral or inhaled cannabinoids remain, however, a major barrier to widespread use. Peripherally acting cannabinoids (eg, topically applied) may circumvent these side effects while providing localized pain management. ⋯ Preclinical animal studies provided low-quality evidence for peripherally administered cannabinoids to provide regional, antinociceptive effects. The scarcity of high-quality human studies underscores the need to translate preclinical evidence into well-controlled human trials.
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Reg Anesth Pain Med · Mar 2022
Meta AnalysisEvaluation of language analysis to summarize the literature: a comparison to traditional meta-analysis in primary hip and knee surgery.
Sentiment analysis, by evaluating written wording and its context, is a growing tool used in computer science that can determine the level of support expressed in a body of text using artificial intelligence methodologies. The application of sentiment analysis to biomedical literature is a growing field and offers the potential to rapidly and economically explore large amounts of published research and characterize treatment efficacy. ⋯ Sentiment analysis applied to the medical literature can rapidly evaluate large collections of published data and generate an impression of overall findings that are aligned with the findings of a traditional meta-analysis.
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Reg Anesth Pain Med · Mar 2022
Randomized Controlled TrialComparison of contralateral oblique view with the lateral view for fluoroscopic-guided cervical epidural steroid injection: a randomized clinical trial.
Cervical epidural steroid injection is associated with rare but potentially catastrophic complications. The contralateral oblique (CLO) view may be a safe and feasible alternative to the lateral (LAT) view for fluoroscopic-guided cervical epidural steroid injection. However, evidence for the clinical usefulness of the CLO view for cervical epidural steroid injection is lacking. We assessed the clinical usefulness of the CLO view for cervical epidural steroid injection in managing cervical herniated intervertebral discs. ⋯ The CLO view may be recommended for fluoroscopic-guided cervical epidural steroid injection, considering its better clinical usefulness over the LAT view.
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Reg Anesth Pain Med · Mar 2022
Effect of superior trunk block on diaphragm function and respiratory parameters after shoulder surgery.
The interscalene brachial plexus block has been used effectively for intraoperative and postoperative analgesia in patients undergoing shoulder surgery, but it is associated with high rates of diaphragmatic dysfunction. Performing the block more distally, at the level of the superior trunk, may reduce the incidence of phrenic nerve palsy. We hypothesized that superior trunk block would result in diaphragmatic paralysis rate of less than 20%. ⋯ Although injection of local anesthetic at the superior trunk level is associated with less diaphragmatic paralysis compared with traditional interscalene block, a significant portion of patients will continue to have ultrasonographic and clinical evidence of diaphragmatic weakness or paralysis.