Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Nov 2023
Rate of occurrence of respiratory complications in patients who undergo shoulder arthroplasty with a continuous interscalene brachial plexus block and associated risk factors.
Continuous interscalene nerve block techniques are an effective form of targeted non-opioid postoperative analgesia for shoulder arthroplasty patients. One of the limiting risks, however, is potential phrenic nerve blockade with resulting hemidiaphragmatic paresis and respiratory compromise. While studies have focused on block-related technical aspects to limit the incidence of phrenic nerve palsy, little is known about other factors associated with increased risk of clinical respiratory complications in this population. ⋯ Patient-related factors that can be measured preoperatively are associated with increased likelihood of respiratory complications after elective shoulder arthroplasty with CISB.
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Reg Anesth Pain Med · Nov 2023
Cadaveric study investigating the femoral nerve-sparing volume for pericapsular nerve group (PENG) block.
This cadaveric study investigated the maximum effective volume of dye in 90% of cases (MEV90) required to stain the iliac bone between the anterior inferior iliac spine (AIIS) and the iliopubic eminence (IPE) while sparing the femoral nerve during the performance of pericapsular nerve group (PENG) block. ⋯ For PENG block, the MEV90 of methylene blue required to spare the femoral nerve in a cadaveric model is 13.2 mL. Further studies are required to correlate this finding with the MEV90 of local anesthetic in live subjects.
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Reg Anesth Pain Med · Nov 2023
Randomized Controlled TrialPericapsular nerve group (PENG) block for early pain management of elderly patients with hip fracture: a single-center double-blind randomized controlled trial.
The pericapsular nerve group block (PENG) is a novel technique that blocks the articular branches of the hip joint. This study aimed to compare its effectiveness to a sham block in elderly patients with hip fractures. ⋯ PENG block provided effective analgesia for acute traumatic pain following hip fracture. Further studies are required to validate the superiority of PENG blocks over other regional techniques.