Articles: nerve-block.
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Reg Anesth Pain Med · Jun 2022
Randomized Controlled TrialOptimal location for continuous catheter analgesia among the femoral triangle, proximal, or distal adductor canal after total knee arthroplasty: a randomized double-blind controlled trial.
Pain management after total knee arthroplasty is essential to improve early mobilization, rehabilitation, and recovery. Continuous adductor canal (AC) block provides postoperative analgesia while preserving quadriceps strength. However, there have been inconsistencies regarding the optimal location for continuous catheter block. We compared continuous femoral triangle, proximal AC, and distal AC blocks for postoperative analgesia after total knee arthroplasty. ⋯ Continuous femoral triangle, proximal AC, and distal AC blocks in the setting of periarticular local anesthetic infiltration provide comparable postoperative analgesia after total knee arthroplasty.
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Journal of anesthesia · Jun 2022
Randomized Controlled TrialComparison of three obturator nerve block techniques for injectate spread into the obturator canal: a randomized controlled trial.
The obturator nerve branches into the obturator canal; therefore, local anesthetic spread into the obturator canal predicts the success of the obturator nerve block (ONB). We compared three ONB techniques for the spread of local anesthetic mixed with contrast medium into the obturator canal. ⋯ Local anesthetic spread into the obturator canal using the UMA was superior to that using the PA and IA. Both branches of the obturator nerve could be blocked using the UMA.
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Anesthesia and analgesia · Jun 2022
Randomized Controlled TrialEffect of Lidocaine 2% Versus Bupivacaine 0.5% and 1 Versus 2 Dual Separate Injections on Onset and Duration of Ultrasound-Guided Wrist Blocks: A Blinded 2 × 2 Factorial Randomized Clinical Trial.
Local anesthetics are often selected or mixed to accomplish faster onset of anesthesia. However, with ultrasound guidance, local anesthetics are delivered with greater precision, which may shorten the onset time with all classes of local anesthetics. In this study, we compared onset time and duration of ultrasound-guided wrist blocks with a fast onset versus a longer lasting local anesthetic administered via single or dual (spatially separate) injections at the level of the midforearm. ⋯ No significant effect was found for onset time between lidocaine 2% and bupivacaine 0.5% used in ultrasound-guided wrist blocks. Dual injections did not shorten onset time. Since mean nerve block duration was longer with bupivacaine 0.5%, our results suggest that the selection of local anesthetic for the median and ulnar nerves at the level of the midforearm should be based on the desired duration of the block and not on its speed of onset.
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Reg Anesth Pain Med · Jun 2022
Exploring the utility of assistive artificial intelligence for ultrasound scanning in regional anesthesia.
Ultrasound-guided regional anesthesia (UGRA) involves the acquisition and interpretation of ultrasound images to delineate sonoanatomy. This study explores the utility of a novel artificial intelligence (AI) device designed to assist in this task (ScanNav Anatomy Peripheral Nerve Block; ScanNav), which applies a color overlay on real-time ultrasound to highlight key anatomical structures. ⋯ ScanNav shows potential to support non-experts in training and clinical practice, and experts in teaching UGRA. Such technology may aid the uptake and generalizability of UGRA.