Articles: nerve-block.
-
Acta Anaesthesiol Scand · Nov 2024
ReviewPrimary outcomes and anticipated effect sizes in randomised clinical trials assessing adjuncts to peripheral nerve blocks: A scoping review.
Prolonging effects of adjuncts to local anaesthetics in peripheral nerve blocks have been demonstrated in randomised clinical trials. The chosen primary outcome and anticipated effect size have major impact on the clinical relevance of results in these trials. This scoping review aims to provide an overview of frequently used outcomes and anticipated effect sizes in randomised trials on peripheral nerve block adjuncts. ⋯ The reported outcomes and associated anticipated effect sizes can be used in future trials on adjuncts for peripheral nerve blocks to increase methodological homogeneity.
-
Acute postoperative pain is one of the most common challenges faced by patients who undergo surgery. Multimodal analgesia has been recommended in recent years to effectively control this condition. Nerve blocks are an important part of multimodal analgesia; a single peripheral nerve block is widely used in clinical practice. To prolong the analgesic duration of a single nerve block, adjuvants with different mechanisms, dosages, or administration routes are added to local anesthetics; however, it is not clear which adjuvant or combination is better. ⋯ Adjuvants with diverse mechanisms of action can variably extend the duration of local anesthetic effects. When utilizing adjuvants in conjunction with local anesthetics, perineural dexmedetomidine (1 mu-g/kg) or intravenous dexamethasone (10 mg) may be preferable, considering their efficacy and side effects. Current research suggests that the combination of perineural dexmedetomidine (1 mu-g/kg) and intravenous dexamethasone (10 mg) is more effective than either dexmedetomidine or dexamethasone alone.
-
Ultrasound-guided nerve blocks serve as a valuable component of multimodal pain management for acutely injured patients in the emergency department and offer a potentially more efficient alternative to time-consuming procedural sedation.
-
Int J Obstet Anesth · Nov 2024
Randomized Controlled Trial Comparative StudyComparison of erector spinae plane and transversus abdominis plane block for postoperative analgesia after caesarean delivery under spinal anaesthesia: A randomised controlled trial.
Truncal blocks contribute to multimodal analgesia that enhances early recovery after caesarean delivery. The transversus abdominis plane (TAP) block is an established technique that offers somatic abdominal wall analgesia. The erector spinae plane (ESP) block is a fascial plane technique that may offer additional visceral analgesic effects. This study hypothesized that ESP block would offer superior analgesic efficacy to TAP block in women undergoing caesarean delivery under spinal anaesthesia. ⋯ This study found similar postoperative opioid use and analgesic efficacy between ESP and TAP block after caesarean delivery performed under spinal anaesthesia.
-
J. Cardiothorac. Vasc. Anesth. · Nov 2024
Randomized Controlled Trial Comparative StudyEffect of Bilateral Erector Spinae Plane Block versus Fentanyl Infusion on Postoperative Recovery in Cardiac Surgeries via Median Sternotomy: A Randomized Controlled Trial.
To assess the effect of ultrasound-guided bilateral erector spinae plane block (ESPB) on the time to extubation in patients who had undergone cardiac surgery through a midline sternotomy. ⋯ Among adult patients undergoing cardiac surgery through a midline sternotomy, the extubation time was halved in patients who received single-shot bilateral ESPB compared to patients who received fentanyl infusion.