Articles: nerve-block.
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Case Reports
Successful Ultrasound-Guided Erector Spinae Plane Block for Herpes Zoster in the Emergency Department: A Case Report.
The varicella zoster virus, which lies dormant in the dorsal root ganglion, can be reactivated as herpes zoster in times of acute stress or immunosuppression. The herpes zoster lesions can be very painful, both at the time of eruption and after healing, as postherpetic neuralgia. During the acute outbreak time period, many patients visit the emergency department (ED) for pain control, often requiring opioids. ⋯ Here, we demonstrate two cases for which an erector spinae plane (ESP) nerve block with ropivicaine was used as an alternative to opioids, resulting in immediate and safe analgesia in the ED. Both patients had lesions across the back that were significantly impairing their daily lives; one with distribution in the thoracic region, one in the lumbar region. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: ESP blocks can offer quick, easy, and effective analgesia in the ED and can be used in place of parenteral or oral analgesia. It also can be used to reduce opioid prescriptions issued from the ED. Further studies can be done to confirm the efficacy of ESP blocks against opioids through prospective trials.
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Journal of anesthesia · Apr 2021
Dermatomal coverage of single-injection ultrasound-guided parasagittal approach to anterior quadratus lumborum block at the lateral supra-arcuate ligament.
The subcostal quadratus lumborum (QL) block is used in postoperative analgesia for abdominal surgery. However, only a small portion of local anesthetic can spread into the thoracic paravertebral space from the injection site via the lateral arcuate ligament, due to the barrier action of the ligament. In this study, we determined the effectiveness of a new ultrasound-guided parasagittal approach to anterior QL block at the lateral supra-arcuate ligament. ⋯ Four patients (16.7%) developed quadriceps weakness after the blocks. The parasagittal technique provides a new choice for postoperative analgesia of abdominal surgery with rapid onset and reliable dermatomal coverage. Trial registration: Chinese Clinical Trial Registry: ChiCTR2000029211.