Articles: nerve-block.
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Case Reports
Ultrasound-guided spinal accessory nerve block for intractable trapezius pain: A case series.
Myofascial pain affects about 10% of the United States population, often involves the trapezius muscle, and can be difficult to manage using conventional analgesic medications in the Emergency Department (ED). The use of ultrasound-guided nerve blocks performed by emergency physicians is well-documented, but this is the first report describing the technique and effectiveness of an ultrasound-guided spinal accessory nerve block for acutely treating trapezius myofascial pain in the ED setting. In this case series of three patients with intractable trapezius pain, the ultrasound-guided spinal accessory nerve block proved feasible and offered substantial therapeutic benefit.
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Practice Guideline
Regional anaesthesia in patients on antithrombotic drugs: Joint ESAIC/ESRA guidelines.
Bleeding is a potential complication after neuraxial and peripheral nerve blocks. The risk is increased in patients on antiplatelet and anticoagulant drugs. This joint guideline from the European Society of Anaesthesiology and Intensive Care and the European Society of Regional Anaesthesia aims to provide an evidence-based set of recommendations and suggestions on how to reduce the risk of antithrombotic drug-induced haematoma formation related to the practice of regional anaesthesia and analgesia. ⋯ In patients taking antiplatelet or anticoagulant medications, practitioners must consider the bleeding risk both before and after nerve blockade and during insertion or removal of a catheter. Healthcare teams managing such patients must be aware of the risk and be competent in detecting and managing any possible haematomas.
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Patients undergoing spine surgery may experience substantial postoperative pain. The aim of this systematic review is to examine the clinical efficacy of a newly introduced regional anesthetic block, the erector spinae plane block (ESPB), for adults undergoing posterior spine surgeries. ⋯ Current evidence is insufficient to support the widespread use of ESPB for spine surgery. More studies are warranted to confirm or refute its role in clinical practice.
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Journal of anesthesia · Feb 2022
Injectate spread in ultrasound-guided inferior alveolar nerve block: a cadaveric study.
Ultrasound-guided inferior alveolar nerve block (UGIANB) is a mandibular analgesic procedure in which local anesthetic is injected into the pterygomandibular space (PMS). Several studies have reported the clinical efficacy of UGIANB for mandibular surgeries; however, its effective range has never been investigated. We performed a cadaveric study to investigate the success rate of UGIANB injections and to determine whether injected dye could stain the mandibular nerve (MN) trunk and its branches. ⋯ UGIANB can administer anesthetic into the PMS with high accuracy. UGIANB injections reached the IAN, LN, and BNs, but did not reach the MN or ATNs located outside the PMS. The findings of this cadaveric study indicate that UGIANB can provide sufficient analgesia for mandibular surgeries.