Articles: nerve-block.
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Acute pain management in the emergency department (ED) is a challenging task, more so in pain due to malignancy. Opioids have life-threatening side effects in ED patients, along with the risk of dependency. Erector spinae plane block (ESPB) is a recently described plane block technique with ease of performance and minimal side effects, making it suitable for emergency settings. ⋯ A 62-year-old male patient recently diagnosed with cholangiocarcinoma presented to the ED with severe right upper abdominal pain. There was no pain relief with high doses of analgesics. ESPB was administered at T7 vertebrae level. The patient's Defense and Veteran Pain Rating Scale score reduced from 8/10 pre-procedure to 3/10 within 15 min, and 2/10 1 h after the procedure. He reported that he had an uninterrupted pain-free sleep after 4 days. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: ESPB is a novel regional analgesia that may help in management of uncontrolled severe pain not relieved with analgesics in patients with cholangiocarcinoma in the ED.
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Reg Anesth Pain Med · Mar 2022
Randomized Controlled TrialPreoperative pericapsular nerve group (PENG) block for total hip arthroplasty: a randomized, placebo-controlled trial.
We hypothesized that the addition of a preoperative pericapsular nerve group (PENG) block to intra-articular local anesthetic injection would improve analgesia after total hip arthroplasty. ⋯ The addition of a preoperative PENG block to intra-articular injections of local anesthetic provides a limited benefit to postoperative analgesia in the recovery room with no discernible benefits thereafter.