Articles: nerve-block.
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Pain following amputation is often poorly controlled despite the use of nerve blocks. We describe a novel pain management approach in a 56-year-old woman with episodes of poorly controlled pain following below-knee amputation despite a multimodal analgesic regimen with continuous sciatic nerve block. Effective analgesia was observed during those episodes when the nerve block catheter was briefly stimulated at low frequency using a nerve stimulator designed for regional anesthesia procedural guidance. This case report explains the utilization and rationale of this hybrid technique of combined peripheral nerve stimulation and locoregional analgesia via perineural nerve block catheters to augment analgesia.
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Currently, no meta-analysis exists elucidate the analgesic effect of adding IPACK block to our current multimodal analgesia regimen after total knee replacement (TKR). The purpose of this study is to systematically review the level I evidence in the literature to ascertain whether IPACK block can bring additional analgesic benefits to existing multimodal analgesia regimens. ⋯ The addition of an IPACK block to multimodal analgesia regiments does not reduce the postoperative opioid consumption nor improve functional performance. However, it may be an appropriate method to improve immediate analgesic effects after TKR.
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Randomized Controlled Trial
Obturator Nerve Blockade vs. Neuromuscular Blockade for the Prevention of Adductor Spasm in Patients Undergoing Transurethral Resection of Bladder Tumors: A Randomized Controlled Trial.
The obturator nerve runs along the posterolateral walls of the bladder and electrosurgical stimulation in this region can result in adductor spasm which can occur suddenly and unexpectedly with potentially catastrophic results. ⋯ Both techniques are safe and efficacious for preventing adductor spasm. Our data and experience suggest that the ONB is relatively easy to perform and should be considered in patients with posterolateral bladder tumors.
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Minerva anestesiologica · Jun 2021
Randomized Controlled TrialA randomized clinical trial comparing six techniques of postoperative analgesia for elective total hip arthroplasty under subarachnoid anesthesia with opioids.
Optimal control of acute postoperative pain and prevention of chronic persistent pain in total hip arthroplasty (THA) remain a challenge. The main hypothesis was that peripheral nerve blocks improve postoperative analgesia. ⋯ combined with a multimodal analgesic approach, infra-inguinal FICB and LFCNB did not improve immediate postoperative analgesia for THA in our hospital. Other options and longer-term studies should be more extensively investigated to determine the role of peripheral blocks in postoperative pain treatment protocols.