Articles: nerve-block.
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Chemical neurolysis of the genicular nerves is a treatment option for intractable non-cancer knee pain. This scoping review synthesizes the available literature on the effectiveness, adverse events, and procedural techniques of chemical neurolysis of genicular nerves for the management of knee pain. ⋯ Open Science Framework (https://osf.io/jg8wh).
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Curr Pain Headache Rep · Jan 2025
ReviewRhomboid Intercostal and Subserratus Plane Block for Acute Pain Management after Abdominal Surgeries: A Narrative Review.
The rhomboid intercostal and subserratus plane (RISS) block is an effective, safer alternative for managing postoperative acute pain following abdominal surgeries. The RISS block offers several advantages over traditional approaches, including reduced incidence of puncture-related complications, lower rates of systemic opioid consumption, and more consistent analgesic coverage of lower thoracic dermatomes. ⋯ Future directions include clinical trials to validate efficacy across diverse patient populations, comparative studies with other regional blocks, and evaluations of long-term outcomes. Expanding our understanding of RISS block application may help advance multimodal pain management protocols, underscoring potential to improve recovery, reduce opioid dependency, and elevate patient quality of life in postoperative settings.
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Curr Pain Headache Rep · Jan 2025
ReviewEfficacy of Transversus Thoracic Plane Block for Pain Management in Cardiac Surgeries.
Effective pain management in cardiac surgery presents as a continuous challenge related to the intensity of postoperative pain and reliance on opioid therapy. The dependance of opioid-based therapies is concerning, as these therapies carry risk future addiction and potential severe side effects. The transversus thoracic plane block (TTPB) has emerged as a promising regional anesthesia technique that blocks the anterior branches of the intercostal nerves in the chest wall, potentially providing improved analgesia for cardiac surgery patients. The present investigation evaluates the efficacy of TTPB in reducing opioid consumption, decreasing postoperative pain scores, and enhancing recovery outcomes in patients undergoing cardiac surgeries. ⋯ Despite these promising results, challenges in technique standardization and limited long-term data are still obstacles that prevent widespread adoption. Achieving consistent TTPB efficacy requires technical precision in ultrasound guidance, and there is little research on its effectiveness across diverse populations, such as pediatric and high-risk cardiac patients. Addressing these gaps through multi-center, long-term studies could help establish TTPB as a prominent pain management strategy in cardiac surgery to minimize opioid dependence and enhance patient comfort and recovery.
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Rib fractures are frequently diagnosed and treated in the emergency department (ED). Thoracic trauma has serious morbidity and mortality, particularly in older adults, with complications including pulmonary contusions, hemorrhage, pneumonia, or death. Bedside ED-performed ultrasound-guided anesthesia is gaining in popularity, and early and adequate pain control has shown improved patient outcomes with rare complications. ⋯ Thoracic nerve blocks (e.g., ESP, SANB, ICNB) can be performed safely by appropriately trained emergency physicians, provide excellent anesthesia for rib fractures and thoracic trauma, and should be strongly considered for improved patient-centered outcomes. Furthermore, performing regional nerve blocks in the emergency department can reduce complications including adverse effects from opioids or other delirium-inducing medications.
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Acta Anaesthesiol Scand · Jan 2025
Review Meta AnalysisAnterior quadratus lumborum blocks for postoperative pain treatment following intra-abdominal surgery: A systematic review with meta-analyses and trial sequential analyses.
The anterior quadratus lumborum (QL) block may be used for postoperative pain management for intra-abdominal surgeries, but the evidence is uncertain. We aimed to investigate the benefit and harm of the anterior QL block compared to placebo/no block for intra-abdominal surgery. ⋯ The anterior QL block may reduce cumulative 24-h opioid consumption. Reported serious adverse events were few and the anterior QL block may have little to no effect on the number of SAEs, but the evidence was very uncertain.