Articles: nerve-block.
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Randomized Controlled Trial
Combined proximal or distal nerve blocks for postoperative analgesia after total knee arthroplasty: a randomised controlled trial.
Many regional anaesthetic techniques have been proposed to manage pain after total knee arthroplasty, but the best approach is unclear. We compared opioid consumption in the first 48 h between two different regional anaesthesia strategies in patients undergoing total knee arthroplasty. ⋯ NCT04499716.
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Review Meta Analysis
Systematic review and meta-analysis of celiac plexus neurolysis for abdominal pain associated with unresectable pancreatic cancer.
Celiac plexus neurolysis (CPN) has been developed as adjunctive therapy to medical management (MM) of abdominal pain associated with unresectable pancreatic cancer. We aimed to conduct a systematic review and meta-analysis to obtain updated and more accurate evidence on the efficacy of additional types of CPN, including endoscopic ultrasound-guided CPN (EUS-CPN). ⋯ This updated meta-analysis of CPN demonstrates its efficacy for managing abdominal pain at 4 weeks. Although there are various limitations, when abdominal pain in patients with unresectable pancreatic cancer is poorly controlled with MM alone, CPN should be an option even if the duration of effect is short-lived, taking into account the absence of serious adverse events.
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Minerva anestesiologica · Sep 2022
A French nationwide survey on the practice of regional anaesthesia for breast cancer surgery.
The aim of this study was to assess the impact of recent recommendations concerning regional anesthesia for breast cancer surgery, a nationwide practice survey was carried out. ⋯ These encouraging results do not dispense with the need to improve anesthetic practices both in quantity and quality. Such improvement in the anatomic fit to the procedure and in the timing of blocks will also have to be considered.
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Reg Anesth Pain Med · Sep 2022
Cryoanalgesia for shoulder pain: a motor-sparing approach to rotator cuff disease.
Rotator cuff disease is a common cause of musculoskeletal pain and disability, and the management can be challenging. Joint denervation emerges as a new technique, but the literature on shoulder neural ablation procedure is largely limited to pulsed radiofrequency due to the concern of motor impairment. We described a novel motor-sparing approach of cryoablation for the management of shoulder pain based on the recent literature on the innervation of shoulder. ⋯ Based on the current understanding of the glenohumeral joint articular branches and their relationship to the bony landmark, targeting the articular branches only was feasible and led to good outcomes. Further large prospective cohort study is needed.
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Minerva anestesiologica · Sep 2022
Clinical TrialIdentification of the popliteal sciatic nerve through the above-knee lateral approach provides superior echogenicity and ultrasound visibility: a patient volunteer trial.
Distinguishing light-echoed nerves from surrounding structures is challenging but may be important in nerve block administration. We evaluated the effect of patient characteristics on the echogenicity or visibility of the popliteal sciatic nerve (PSN). ⋯ The ultrasound-guided above-knee lateral approach for PSN block improved the PSN identification success rate, ensured a more superficial nerve location, and provided a clearer image.