Saudi journal of anaesthesia
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Case Reports
Combined PENG and LFCN blocks for postoperative analgesia in hip surgery-A case report.
Total hip arthroplasty (THA) is considered an extremely painful procedure. Postoperative analgesic technique especially in an elderly with significant comorbidities is even more challenging. Pericapsular nerve group (PENG) block is a novel technique that has been described recently as an effective analgesic method for hip surgery. We report a case of a successful PENG and lateral femoral cutaneous nerve blocks for postoperative analgesia in THA.
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Infraclavicular approach is a common technique of brachial plexus block. The main difficulty of ultrasound guided technique is in needle visualization due to deep location of the cords. Hebbard et al described a retroclavicular approach wherein the needle was inserted posteriorly to the clavicle. ⋯ Retroclavicular approach is a feasible option of infraclavicular brachial plexus block in Indian Subpopulation in terms of needle visibility and block success rate.
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Rapid sequence induction and intubation (RSII) with application of "Cricoid pressure" and avoidance of "facemask ventilation" (FMV) is believed to minimize the risk of pulmonary aspiration of gastric contents during general anesthesia. However, some patients may be at risk of developing hypoxemia and may benefit from FMV during RSII. The purpose of this study was to assess the effectiveness of "cricoid pressure" in preventing gastric insufflation during FMV using gastric ultrasonography. ⋯ Cricoid pressure is effective in preventing gastric insufflation during FMV at P aw less than 20 cmH2O. Observation of comet tail artifacts in gastric antrum along with measurement of change in antral CSA on ultrasound examination is a feasible and reliable method to detect gastric insufflation.
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Thoracotomy needs adequate powerful postoperative analgesia. This study aims to compare the safety and efficacy of ultrasound (US)-guided serratus anterior plane block (SAPB) and thoracic paravertebral block (TPVB) for perioperative analgesia in cancer patients having lung lobectomy. ⋯ Preemptive TPVB and SAPB provide comparable levels of adequate analgesia for the first 24 h after thoracotomy. TPVB provided better analgesia after 12 h. The two procedures reduce intraoperative fentanyl and postoperative morphine consumption.