Articles: nerve-block.
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Ear pain is mediated by cranial nerves V, IX, and X, as well as branches of C2 and C3, including the occipital nerve. Occipital neuralgia may play a role in the development or worsening of tinnitus and otalgia. The authors reviewed and report 33 cases of ultrasound-guided occipital nerve blocks in patients with tinnitus and otalgia, with postprocedure follow-up intervals of up to 2 years. We found that greater occipital nerve blocks may be a valuable treatment method for these patients.
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Randomized Controlled Trial
Day-One Pain Reductions after Hip and Knee Replacement when Buprenorphine-Clonidine-Dexamethasone is added to Bupivacaine Nerve/Plexus Blocks: A Randomized Clinical Trial.
To compare pain outcome reports of patients undergoing hip or knee replacement who received single-injection nerve/plexus blocks with plain bupivacaine (BPV) with those of patients who received injections of buprenorphine-clonidine-dexamethasone (BCD) admixed with BPV. ⋯ Preoperative BPV-BCD blocks in the L2-L4 and L4-S3 nerve distributions for hip and knee replacements led to less pain on postoperative day one and increased knee and hip range of motion, compared with plain BPV blocks.
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Randomized Controlled Trial
Effect of general anesthesia with thoracic paravertebral block on postoperative delirium in elderly patients undergoing thoracoscopic lobectomy: a randomized-controlled trial.
Postoperative delirium (POD) is characterized by acute brain dysfunction, especially in elderly patients. Postoperative pain is an important factor in the development of delirium, and effective pain management can reduce the risk of POD. Thoracic paravertebral block (TPVB) can effectively relieve postoperative pain and inhibit the perioperative stress and inflammatory response. We investigated whether the combination of TPVB with general anesthesia reduced the occurrence of POD following thoracoscopic lobectomy. ⋯ Thoracic paravertebral block analgesia is associated with lower incidence of postoperative delirium, probably due to its anti-neuroinflammatory effects. Furthermore, as a component of multimodal analgesia, TPVB provides not only superior analgesic but also opioid-sparing effects.
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Lumpectomy is important for preventing malignant changes in benign tumors and diagnosing malignant tumors. Intercostal nerve blocks (ICNBs) are useful for breast lumpectomy as either the primary anesthetic or as an adjuvant anesthetic procedure. To our knowledge, no studies have evaluated the association between Horner syndrome and ICNB. ⋯ Horner's syndrome, intercostal nerve block, breast lumpectomy, enhanced recovery.