Articles: nerve-block.
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Eur J Trauma Emerg Surg · Aug 2022
Observational StudyThe impact of loco-regional anaesthesia on postoperative opioid use in elderly hip fracture patients: an observational study.
Hip fractures are a common health problem among the elderly with an increasing incidence. They are associated with high mortality and morbidity. Optimal pain management remains challenging and inadequate pain control is known for negatively affecting outcomes. Loco-regional anaesthetics (LRA) have been proven to benefit pain management and to lower the risks of opioid use and -related side effects. We aimed to evaluate the use and efficacy of different LRA in elderly hip fracture patients. ⋯ This article shows that LRA in the form of FNB and CFNC causes a significant decrease in postoperative opioid consumption. Differences between single-shot FNB or CFNC were minimal. There were no significant differences in clinical outcomes such as HLOS, delirium, 30-day and 90-day mortality and postoperative falls. We suggest that use of LRA should be incorporated in the perioperative treatment of elderly patients with a hip fracture. For future research, we recommend evaluating the number of postoperative complications and mortality.
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Case Reports
Retrolaminar Continuous Nerve Block Catheter for Multiple Rib Fractures: A Case Report.
Rib fractures carry high morbidity and mortality due to pain-related complications, such as hypoventilation, atelectasis, and pneumonia. Ultrasound-guided regional anesthesia is a common treatment for pain associated with rib fractures. ⋯ In these instances, it is advantageous to have a tactile or landmark-based approach to treating rib fracture pain. We present a case of a continuous retrolaminar nerve block catheter placed without ultrasound guidance in a 67-year-old man with oxygen-dependent chronic obstructive pulmonary disease and a prior intrathecal pump, who presents with multiple unilateral rib fractures.
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Greater trochanteric pain syndrome is a common cause of lateral hip pain. Corticosteroid injections are commonly utilized as nonsurgical interventions; however, they are not effective for all patients. This technical case report describes a method for treating greater trochanteric pain syndrome by utilizing cooled radiofrequency ablation. ⋯ Cooled radiofrequency ablation of the trochanteric branch of the nervus femoralis is a potential treatment for greater trochanteric pain syndrome. This procedure provides a potential steroid-sparing interventional treatment based on reproducible fluoroscopic landmarks.