Articles: nerve-block.
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The development of truncal and fascial plane blocks has created novel opportunities to apply regional analgesic techniques to patients undergoing spine surgery. This review will summarize recent literature devoted to evaluating candidate blocks for spine surgery, including erector spinae plane block, thoracolumbar interfascial plane block, midpoint transverse process to pleura block, and transversus abdominis plane block. Procedure-specific effects of blocks on patient and healthcare system outcomes will be presented and gaps in care and knowledge will be highlighted. ⋯ Our understanding of the risks, benefits, and value of truncal and fascial plane blocks for spine surgery cohorts is evolving. Although the results derived from this body of literature are encouraging, further research is required before the widespread adoption of specified blocks into spine care can be recommended.
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Curr Opin Anaesthesiol · Oct 2022
ReviewClinical care pathways for ambulatory total shoulder arthroplasty.
Total shoulder arthroplasty (TSA) is growing in popularity and is increasingly done on an ambulatory basis. This review examines recent developments in anesthesia and analgesia for ambulatory shoulder surgery. Pathway components are discussed and a sample pathway is described. ⋯ Anesthesiologists should lead the way to create and implement pathways for ambulatory total shoulder arthroplasty, incorporating appropriate patient selection, patient education, long-lasting nerve blockade, and multimodal analgesia.
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Finger and toe injuries are a common reason for presentation to the emergency department. In order to properly care for these injuries, it is valuable for emergency medicine clinicians to be aware of the different approaches to anesthetize the digit. ⋯ There are a number of options at the disposal of the emergency medicine clinician for anesthesia of the finger and toe. This article summarizes the key techniques, variations on these techniques, advantages, and disadvantages for each approach.
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Pediatric umbilical hernia repair could cause considerable postoperative discomfort. This study aimed to compare the analgesia between rectus sheath block and local anesthetic infiltration in child pediatric umbilical hernia repair. ⋯ Rectus sheath block and local anesthetic are effective methods for analgesia in pediatric umbilical hernia repair.
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Emergency clinicians utilize local anesthetics for a variety of procedures in the emergency department (ED) setting. Local anesthetic systemic toxicity (LAST) is a potentially deadly complication. ⋯ This focused review provides an update for the emergency clinician to manage patients with LAST.