Articles: analgesia.
-
Paediatric anaesthesia · Jul 2020
Continuous Chloroprocaine Paravertebral Infusions for Postoperative Analgesia in Infants and Very Young Children.
Infants having regional anesthesia (RA) haveincreased risk for local anesthetic systemic toxicityand, following epidural bupivacaine infusions, can have high plasma bupivacaine concentrations.1 Limited evidence supports the effective use of 2-chloroprocaine in infant epidural infusions2,3 but reports of peripheral nerve blocks with 2-chloroprocaine are sparse. Paravertebral nerve blocks (PVNBs) are alternatives to epidural analgesia for thoracic and abdominal surgeries with limited reports on 2-chloroprocaine PVNB in infants. We provide a retrospective review of our experience using 1.5% 2-chloroprocaine PVNB infusionsin infants.
-
Caesarean delivery is the most commonly performed inpatient surgical procedure globally. Pain after caesarean delivery is moderate to severe if not adequately treated, and is a primary anaesthetic concern for patients. Transversus abdominis plane and quadratus lumborum blocks are fascial plane blocks that have the potential to improve analgesia following caesarean delivery. ⋯ Similar results were found for resting and active pain scores at 4-6 h, 8-12 h, 24 h and 36 h, although quadratus lumborum block was associated with lower pain scores at 36 h when compared with transversus abdominis plane block (very low-quality evidence). However, transversus abdominis plane block was associated with a reduced incidence of postoperative nausea and vomiting (moderate-quality evidence) and sedation when compared with inactive control following intrathecal morphine administration (low-quality evidence). There are insufficient data to draw definitive conclusions, but transversus abdominis plane and quadratus lumborum block appear to be superior to control in the absence of intrathecal morphine, but provide limited additional benefit over inactive control when intrathecal morphine is also used.
-
Remimazolam is a newly developed benzodiazepine as an alternative of conventional sedatives in the procedure of anesthesia. For the purpose of evaluating the efficacy and safety of remimazolam sedation during an endoscopy, we will perform a systematic review and meta-analysis of randomized controlled trials that compared remimazolam with midazolam and/or placebo. ⋯ CRD42020170745.