Pain physician
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Randomized Controlled Trial
Hemidiaphragmatic Paresis Following Interscalene Brachial Plexus Block With 2-Point Injection Technique.
An interscalene brachial plexus block is a commonly conducted nerve block for anesthesia and analgesia in shoulder surgery. Due to its proximity to the targeted nerve, the phrenic nerve, which innervates the diaphragm, is typically inadvertently blocked by ventral spread of the local anesthetic. Although hemidiaphragmatic paresis is tolerable in healthy patients, it would be an irreversible risk to patients with compromised lung reserve. ⋯ Reducing the local anesthetic volume by selective injection and observing the spread pattern resulted in a decreased incidence of hemidiaphragmatic paresis and preserved handgrip strength after interscalene block.
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Randomized Controlled Trial
Quadratus Lumborum Block Spares Postoperative Opioid Usage but Does Not appear to Prevent the Development of Chronic Pain After Gastrointestinal Surgery.
Regional anesthesia has been used to reduce acute postsurgical pain and to prevent chronic pain. The best technique, however, remains controversial. ⋯ Ultrasound-guided QLB provided superior short-term analgesia and reduced oxycodone consumption and the incidence of PONV after gastrointestinal surgery. However, the incidence of chronic pain was not significantly affected by this anesthetic technique.
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Randomized Controlled Trial
The Effect of Erector Spinae Plane Blockade on Prevention of Postherpetic Neuralgia in Elderly Patients: A Randomized Double-blind Placebo-controlled Trial.
Postherpetic neuralgia (PHN) is the most common chronic complication following the onset of herpes zoster (HZ). Both the incidence of HZ and the proportion of patients with HZ who develop PHN rise with age. Ultrasound-guided erector spinae plane blockade (ESPB) has been reported to relieve neuropathic pain and PHN in elderly patients, but no randomized controlled trials have been conducted regarding the effect of ESPB on elderly patients with HZ in the acute or subacute phases. ⋯ For elderly patients suffering acute or subacute HZ, ESPB reduces the incidence of PHN at 12 weeks after treatment; it also decreases the occurrence of neuropathic pain, sleep disturbance, and anxiety/depression.
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Randomized Controlled Trial
Comparative Study Between Dexmedetomidine and Fentanyl as an Adjuvant to Intraarticular Bupivacaine for Postoperative Analgesia after Knee Arthroscopy.
Intraarticular bupivacaine produces sufficient analgesia after arthroscopic knee surgery, but its analgesic duration is short. There is a need to search for an adjuvant with a longer duration of analgesia. ⋯ Fifty µg of fentanyl as an adjuvant to intraarticular bupivacaine produces effective and safe analgesia after knee arthroscopy as 100 µg of dexmedetomidine and has a longer analgesia duration in the first postoperative 24 hours.
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Randomized Controlled Trial
The Effect of Medial Branch Block on Postoperative Residual Pain Relieve After Percutaneous Kyphoplasty: A Randomized Controlled Trial With 12-Month Follow-up.
Percutaneous kyphoplasty (PKP) is a minimally invasive technique, and effective treatment, for an osteoporotic vertebral compression fracture (OVCF). Residual back pain is the most common complication of PKP. Medial branch block (MBB) is a treatment option for painful OVCF, it can break the vicious cycle to release short- or long-term pain. ⋯ MBB can effectively relieve back pain and reduce the incidence of residual back pain in OVCF patients after PKP surgery. Besides, it can also significantly improve postoperative physical function and patients' satisfaction with treatment.