Pain physician
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Randomized Controlled Trial
Transforaminal Versus Interlaminar Approach of Full-Endoscopic Lumbar Discectomy Under Local Anesthesia for L5/S1 Disc Herniation: A Randomized Controlled Trial.
Local anesthesia is feasible for both transforaminal and interlaminar approaches in percutaneous endoscopic lumbar discectomy (PELD). However, the optimal approach for PELD has not yet been established at the L5/S1 segment under local anesthesia with 1% lidocaine. ⋯ Both TELD and IELD can provide good clinical outcomes for L5/S1 DH under local anesthesia with 1% lidocaine. TELD was superior to IELD in terms of surgical-related experience and complications.
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Randomized Controlled Trial
Radiofrequency Denervation on Lumbar Facet Joint Pain in the Elderly: A Randomized Controlled Prospective Trial.
Lumbar facet joint (LFJ) pain is the most common cause of low back pain in the elderly. Denervation of the medial branch of the spinal dorsal ramus can theoretically achieve long-term pain relief. Yet there is little evidence of high-level prospective randomized controlled research. ⋯ Radiofrequency denervation can effectively reduce LFJ pain and improve movement disorder. The effect is good until 6 months later.
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Randomized Controlled Trial
Comparison of Erector Spinae Plane Block at the Level of the Second Thoracic Vertebra With Suprascapular Nerve Block for Postoperative Analgesia in Arthroscopic Shoulder Surgery.
Appropriate postoperative pain management in shoulder surgeries is the mainstay of rehabilitation therapy and subsequent improved functional outcomes. However, adequate pain control either with opioids or interscalene brachial plexus block is often challenged by their side effects. In this context, this study compared the suprascapular nerve block (SSNB) to the newly emerging erector spinae plane block at the second thoracic vertebral level (high thoracic-ESPB) as an alternative pain therapy. ⋯ SSNB is not inferior to high thoracic-ESPB in the context of phrenic nerve sparing pain control for arthroscopic surgeries. Moreover, SSNB is a more established technique with more predicted sensory distributions and a lower risk of LA toxicity.
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Randomized Controlled Trial
Comparison of Intravascular Uptake and Technical Ease Between Anteroposterior and Oblique Views During Lumbar Medial Branch Block.
Inadvertent intravascular injection of local anesthetics can lead to false-negative results following lumbar medial branch block (MBB) performed to diagnose facet joint origin pain. A previous study demonstrated that the type of approach method could affect the incidence of intravascular injections and technical ease of the procedure. ⋯ The overall incidence rate of intravascular injection during lumbar MBB showed nearly 20% in both approach methods groups. The OB approach and left side MBBs were associated with a longer total procedure time and a higher radiation dose.
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Randomized Controlled Trial
Pediatric Postoperative Pain Control With Quadratus Lumborum Block and Dexamethasone in Two Routes With Bupivacaine: A Prospective Randomized Controlled Clinical Trial.
Ultrasound-guided Quadratus Lumborum block (QLB) is a regional analgesia approach that has been reported to provide effective post-operative pain relief for both abdominal and retroperitoneal surgery. Bupivacaine is the most often used and well documented local anesthetic medication in children. Dexamethasone is a systemic glucocorticoid that is often used to minimize postoperative nausea, vomiting, and pain to improve recovery quality after surgery. ⋯ Dexamethasone may be more effective when added to bupivacaine than when given systemically in analgesic effects without any impact on the other secondary pain-related outcomes. Dexamethasone as an adjuvant to bupivacaine has a marked hand on prolongation of the postoperative duration of analgesia, less request for rescue analgesia, and fewer side effects as compared to bupivacaine if used as a sole agent in QLB.