Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Feb 2023
Randomized Controlled TrialComparison of labor analgesia efficacy between single-orifice and multiorifice wire-reinforced catheters during programmed intermittent epidural boluses: a randomized controlled clinical trial.
We compared analgesic outcomes between single-orifice and multiorifice wire-reinforced catheters under 480 mL/hour delivery rate with programmed intermittent epidural bolus administration. ⋯ Single-orifice catheters used for programmed intermittent epidural bolus at 480 mL/hour for epidural labor analgesia had improved analgesic efficacy than multiorifice catheters.
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Reg Anesth Pain Med · Jan 2023
Randomized Controlled TrialAnterior quadratus lumborum block does not reduce postoperative opioid consumption following laparoscopic hemicolectomy: a randomized, double-blind, controlled trial in an ERAS setting.
An opioid-sparing postoperative analgesic regimen following laparoscopic hemicolectomy is optimal to promote minimal postoperative pain, early mobilization, and improved quality of recovery. Various regional anesthesia techniques have been tested to improve postoperative pain management after laparoscopic hemicolectomy. In this study, we aimed to assess the effect of administering a preoperative bilateral ultrasound-guided anterior quadratus lumborum nerve block on postoperative opioid consumption after laparoscopic colon cancer surgery. ⋯ The administration of a preoperative bilateral anterior quadratus lumborum nerve block as part of a multimodal analgesic regimen for laparoscopic hemicolectomy did not significantly reduce opioid consumption 24 hours postsurgery. Trial registration number NCT03570541.
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Reg Anesth Pain Med · Jan 2023
Randomized Controlled TrialComparing bupivacaine alone to liposomal bupivacaine plus bupivacaine in interscalene blocks for total shoulder arthroplasty: a randomized, non-inferiority trial.
Interscalene brachial plexus blocks are a commonly performed procedure to reduce pain following total shoulder arthroplasty. Liposomal bupivacaine has been purported to prolong the duration of brachial plexus blocks for up to 72 hours; however, there has been controversy surrounding the analgesic benefits of this drug. Our hypothesis was that an interscalene block performed with bupivacaine alone would be non-inferior to a combination of liposomal bupivacaine and bupivacaine with respect to opioid consumption following total shoulder arthroplasty. ⋯ Interscalene brachial plexus blocks performed with bupivacaine alone did not demonstrate non-inferiority compared to a mixture of liposomal bupivacaine plus bupivacaine with regards to 72-hour cumulative opioid consumption following total shoulder arthroplasty. However, the difference between groups did not appear to be clinically meaningful.
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Reg Anesth Pain Med · Dec 2022
Randomized Controlled TrialEfficacy of ultrasound-guided single-injection erector spinae plane block for thoracoscopic wedge resection: a prospective randomized control trial.
Despite advances in minimally invasive thoracic surgery, patients remain at risk of adverse pulmonary events with suboptimal postoperative analgesia. Novel methods of regional analgesia are warranted. Our objective was to prospectively evaluate the impact of ultrasound-guided single-injection erector spinae plane (ESP) block with ropivacaine compared with placebo control on standard of care postoperative recovery in subjects undergoing video-assisted thoracoscopic surgery (VATS) wedge resection. ⋯ Following VATS wedge resection, the addition of an ESP block with ropivacaine to standard multimodal analgesia is unlikely to add meaningful clinical value.
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Reg Anesth Pain Med · Dec 2022
Randomized Controlled TrialNerve stimulation guided bilateral pudendal nerve block versus landmark-based caudal block for hypospadias repair in young children: a prospective, randomized, pragmatic trial.
Caudal block is frequently performed to provide analgesia for hypospadias repair. Literature suggests that pudendal block provides prolonged postoperative analgesia as compared with caudal block in children between 2 and 5 years. We compared the efficacy of pudendal and caudal blocks in children less than 2 years. ⋯ In children less than 2 years, both blocks provide comparable intraoperative and postoperative pain relief in the first 24 hours after hypospadias surgery.