Articles: nerve-block.
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Severe headache is a hallmark clinical feature of spontaneous subarachnoid hemorrhage (SAH), affecting nearly 90% of patients during index hospitalization, regardless of the SAH severity or presence of a culprit aneurysm. Up to 1 in 4 survivors of SAH experience chronic headaches, which may be severe and last for years. Data guiding the optimal management of post-SAH headache are lacking. Opioids, often in escalating doses, remain the guideline-recommended mainstay of acute therapy, but pain relief remains suboptimal. ⋯ PPF blockade might constitute a promising opioid-sparing therapeutic strategy for the management of post-SAH headache that merits further prospective controlled randomized studies.
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Patients undergoing bariatric surgery present unique analgesic challenges, including poorly controlled pain, increased prevalence of obstructive sleep apnea, and opioid-induced respiratory depression. The transversus abdominis plane (TAP) has been demonstrated to be a safe and effective component of multimodal analgesia for a variety of abdominal surgeries. ⋯ TAP block is an effective, safe modality that can be performed under anesthesia. It decreases pain, opioid use, and time to ambulation after bariatric surgeries and should be considered in multimodal analgesia for enhanced recovery in this high-risk surgical population.
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Randomized Controlled Trial Multicenter Study
Transforaminal Epidural Steroid Injection for Zoster-Related Pain: The Golden Period for the Best Outcome.
Zoster-related pain (ZRP) has many negative effects on a patient's quality of life. The transforaminal steroid injection (TFESI), which reduces neural inflammation and pain, has been advocated by pain physicians. Many reports demonstrated that early administration of TFESI showed better efficacy; however, the golden period during which TFESI is most effective remains unclear. ⋯ TFESI is more effective when administered within 12 weeks of onset of herpes zoster.
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Randomized Controlled Trial
Posteromedial quadratus lumborum block versus wound infiltration after caesarean section: A randomised, double-blind, controlled study.
Reducing pain and minimising the use of opioids after caesarean section are crucial to enhancing maternal recovery and promoting mother-newborn interaction. Various techniques have been implemented to improve analgesia. We compared the analgesic efficacy of posteromedial quadratus lumborum block with that of wound infiltration following elective caesarean section. ⋯ As a component of multimodal post-caesarean section analgesia, posteromedial quadratus lumborum block was associated with lower 24-h opioid consumption compared with wound infiltration.
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Randomized Controlled Trial Controlled Clinical Trial
Verification of Sphenopalatine Ganglion Block Success Using Transcranial Doppler in Management of Patients with Postdural.
Sphenopalatine ganglion block (SPGB) is traditionally advised in the management of head and neck pain. Since SPGB is a minimally invasive, repeatable, and simple technique, SPGB should be tried first in the management of postdural puncture headaches (PDPH). Verification of the block's success in diagnostic, prognostic, and therapeutic nerve blocks, is of paramount importance in pain management. ⋯ Performing SPGB without standardized equipment may limit the results of the current studyCONCLUSIONS: SPGB should be considered as a first treatment modality for PDPH. Moreover, the results indicate that TCD is a successful objective tool in assessing a transnasal sphenopalatine ganglion block.