Articles: nerve-block.
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Reg Anesth Pain Med · Jul 2023
Ultrasound-guided flexor sheath block as a valid alternative to blind techniques for finger pain treatment: the horseshoe sign.
The flexor sheath digital block allows effective analgesia and anesthesia for finger pain control. To date, only blind techniques are described in the literature in patients with finger fractures, supposedly due to the superficial position of the structures used as landmarks. We describe an ultrasound-guided technique with a definite endpoint to achieve this block. To our knowledge, this is the first clinical application of this procedure. ⋯ The ultrasound-guided flexor digital sheath block is a valid alternative to the blind technique, allowing direct visualization and, thereby, confirming transthecal injection of the local anesthetic. The continuously increasing availability of ultrasound machines in emergency departments and operating theaters may encourage the spread of this technique.
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Reg Anesth Pain Med · Jul 2023
Case ReportsGenicular nerve and fracture site chemical neurolysis for distal femoral fracture: a case report.
Distal femur fractures account for approximately 3%-6% of all femoral fractures. Non-operative management may be an attractive option for the elderly with significant perioperative mortality risk. Adequate pain control is a major barrier to non-operative fracture management. Chemical neurolysis has been described for analgesic management of proximal hip fractures, however no description of interventional management of distal femur fracture exists in literature. We describe a case of phenol chemical neurolysis of genicular nerves in addition to injection at the site of fracture to provide effective analgesia for distal femur fracture. ⋯ We report the successful use of phenol neurolysis of genicular nerves and the fracture site in an elderly patient with a conservatively managed distal femur fracture. These interventions resulted in improved analgesia and achieved prolonged duration of effect.
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Anesthetic spread of ultrasound-guided paraspinal blocks is still unknown. ⋯ Compared with ESPB, ITPB yielded increased stability in lateral and anterior chest wall block with improved anterior and intercostal spread, but reduced cephalocaudal spread.
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Randomized Controlled Trial
Comparative outcome of lidocaine versus bupivacaine for cervical medial branch block (CMBB) in chronic cervical facet arthropathy: a randomized double-blind study.
This study evaluated the effect of prolonged concordant response and functional clinical improvement between lidocaine and bupivacaine for cervical medial branch block (CMBB) in chronic cervical facet syndrome. ⋯ CMBB using lidocaine or bupivacaine provided clinical benefits in prolonged analgesic effect and improving neck functions for chronic cervical facet syndrome. Lidocaine illustrated better performance and could be considered a local anesthetic of choice regarding the prolonged concordance response.