Articles: nerve-block.
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Review Meta Analysis
Thoracolumbar interfascial plane block in spinal surgery: A systematic review with meta-analysis.
As the thoracolumbar interfascial plane (TLIP) block may be a promising alternative in spinal surgery, there is a need for timely meta-analysis of this method's effectiveness in different medical outcomes. ⋯ The TLIP block reduces postoperative pain intensity, opioid consumption, side effects, and requests for rescue analgesia after spinal surgery more than the no-block alternative.
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Erector spinae plane (ESP) block is a regional anesthesia technique that blocks both somatic and visceral nerve fibers. Despite its high analgesic potential, its mechanism of action is not yet fully understood. The ultrasound-guided ESP block, which can be easily performed, makes important contributions to the control of intraoperative pain in pediatric patients undergoing abdominal surgery. The follow-up of pain in the intraoperative period is usually done by evaluating the changes in hemodynamic parameters. Due to physiological differences in pediatric patients, it is more difficult to do this with only hemodynamic changes than in adult patients. Aim: The NOL® (Nociception Level) monitor calculates the nociception/pain score by evaluating many parameters through a proprietary algorithm. Our primary aim was to demonstrate the effectiveness of ESP block with an advanced pain monitor in this patient group; our secondary aim was to investigate the necessity of pain monitors in the pediatric patient group. ⋯ Considering the hemodynamic data, NOL values, postoperative pain scores, side effects, and complications, it was concluded that ESP block can be used safely in this patient group. Although the hemodynamic data and the NOL® index were compatible with each other after a nociceptive stimulus, the NOL index was less affected by other variables and gave the clinician clearer information about pain.
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Randomized Controlled Trial
Perineural and Systemic Dexamethasone and Ulnar Nerve Block Duration A Randomized, Blinded, Placebo-controlled Trial in Healthy Volunteers.
The authors hypothesized that both perineural and systemic dexamethasone as adjuncts to bupivacaine increase the duration of an ulnar nerve block compared with bupivacaine alone, and that systemic dexamethasone is noninferior to perineural dexamethasone. ⋯ Perineural dexamethasone as an adjunct to bupivacaine in healthy volunteers resulted in a greater duration of an ulnar nerve block when compared with placebo. Systemic dexamethasone resulted in a similar duration as placebo.